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Assessment of the anti-microbial agent C31G as a spermicide: comparison with nonoxynol-9.

The broad-spectrum anti-microbial agent, C31G, containing an equimolar mixture of n-dodecyl-dimethylamine-N-oxide (C12-N-O) and N-(n-dodecyl), N-dimethyl-glycine (C12-betaine), was tested for spermicidal activity in comparison with the currently used spermicide, nonoxynol-9 (N-9). The rate of sperm cell permeabilization by the spermicides, as assayed with the fluorescent probe, TO-PRO-1, increased as the cube of the C31G concentration, while the rate increase was linear with N-9 concentration. At 0.04%, the rate of sperm cell permeabilization with both spermicides is at the limit of rapid measurement. C31G diffuses through cervical mucus at a more rapid rate than does N-9. C31G has long been known to aid wound healing and reduce inflammation, whereas N-9 has been reported to induce vaginal irritation. C31G would, thus, seem to have the spermicidal efficacy, the broad range of anti-microbial activity, and the lack of inflammatory activity that is sought in the ideal vaginal spermicide.

Adult↗

Correlates of oral contraceptive use in two New England communities: 1981-1993.

This study compared the sociodemographic and cardiovascular correlates of oral contraceptive users and nonusers between 1981 and 1993. We also sought to determine changes in the prevalence of oral contraceptive use among older premenopausal women. Using data from six biennial cross-sectional household surveys in a population-based sample of two New England communities, 5239 women between ages 18 and 45 years were identified. Women using oral contraceptives were 5 years younger and better educated than nonusers, and users more frequently reported a per capita income above the median for the survey population than nonusers. Users were more likely to report smoking and have a lower body mass index than nonusers. Little use of oral contraceptives was detected among women ages 40-45 years despite changes in FDA recommendations about their use and increasing evidence of their noncontraceptive benefits in healthy older nonsmoking women.

Adolescent↗

Oral contraceptives and risk of benign proliferative epithelial disorders of the breast.

In a case-control study conducted in Adelaide, South Australia, we investigated the hypothesis that use of oral contraceptives is associated with increased risk of benign proliferative epithelial disorders (BPED) of the breast, conditions strongly associated with increased risk of breast cancer and thought to have pre-malignant potential. The study was restricted to women with no prior history of breast biopsy, and involved 383 cases of biopsy-confirmed BPED, 192 controls whose biopsy did not show epithelial proliferation, and 383 unbiopsied community controls individually matched to cases by age and socio-economic grading of area of residence. When cases were compared with community controls, the adjusted odds ratio (OR) for the association between ever-use of oral contraceptives and risk of BPED was 1.1 (95% CI 0.7 to 1.7), while when cases were compared with biopsy controls, the adjusted OR was 0.9 (95% CI 0.5 to 1.5). There was little variation in risk of BPED with total duration of use of oral contraceptives, and with duration of use before first pregnancy, while current users had a statistically significant 60% reduction in risk, irrespective of the control group used for comparative purposes. Also, there was little variation in risk with years since first and last use of oral contraceptives, and there was no trend in the association between ever-use of oral contraceptives and risk of BPED by degree of cytological atypia.

Adult↗

Sexual behavior among university students in Nigera.

Sexual behavior patterns among Nigerian university students and factors influencing them were studied. While permarital cohabitation is common, a large percentage (48%) had their first coital experience between the ages of 22 and 27. Religion does not appear to have a strong inhibiting influence on premarital sex, although it does affect the frequency of changing partners. Contraceptives, although known to almost all the respondents, are not widely used. The use of contraceptives had little influence on premarital cohabitation. Oral-genital, male-male, and female-female sexual practices are very uncommon.

Adolescent↗

Oral contraceptives and pelvic inflammatory disease.

To study the association of the use of oral contraceptives and pelvic inflammatory disease (PID), we analyzed data from a large multicenter case-control study of contraceptive use and serious gynecologic disorders. The analysis included data from interviews of 648 women hospitalized with an initial episode of PID and 2,516 hospitalized control subjects. The risk of PID for women using oral contraceptives in the 3 months prior to interview was 0.5 (95% confidence limits, 0.4 to 0.6) relative to women using no contraceptive method during this period. This association was not explained by differences between case subjects and control subjects in demographic variables, level of sexual activity, or medical history. The protective effect of current oral contraceptive use against PID was restricted to women using oral contraceptives for more than 12 months; past use of oral contraceptives did not exert a protective effect against PID. Annually, an estimated 50,000 initial cases of PID are prevented by oral contraceptive use; 12,500 hospitalizations are also averted by oral contraceptive use. Consequently, protection against PID is one of the most important noncontraceptive benefits of oral contraception.

Adolescent↗

A randomized, double-blind study of two combined oral contraceptives containing the same progestogen, but different estrogens. World Health Organization Task Force on Oral Contraception.

The results are reported of a randomized, double-blind study of two daily oral contraceptives, both containing 3mg norethisterone acetate; one also contained 50 microgram ethinyl estradiol, while the other contained a mixture of micronized 4mg estradiol plus 2mg estriol. The trial was conducted to a common protocol at WHO Collaborating Centres for Clinical Research (CCCR's) in Bangkok, Bombay, Singapore and Szeged. Of the 925 women who entered the study, 458 received the product containing "natural" estrogens and 467 received the product containing ethinyl estradiol. Analysis of admission characteristics showed that the two groups were very closely matched. There was no statistically significant difference in contraceptive efficacy between the two products; both have annual failure rates of approximately 1 per 100 women. The discontinuation rate after one year was 51.5 for the "natural" estrogen product and 48.4 for the one containing synthetic estrogen. Discontinuation for menstrual irregularities was significantly higher for the "natural" estrogen preparation. During both the first three treatment cycles and the tenth to twelfth cycles, the incidence of various menstrual irregularities was significantly higher in the "natural" estrogen contraceptive. Adverse clinical associations were those commonly reported with other combined oral contraceptives for both preparations. It is concluded that the high incidence of menstrual irregularities associated with the particular combination of norethisterone acetate and "natural" estrogens renders it less suitable for general use in family planning programmes than combinations containing synthetic estrogens, such as ethinyl estradiol.

Adolescent↗

Contraception and dyslipidemia.

The risks of cardiovascular disease associated with dyslipidemia differ in women and men, being more strongly associated with triglyceride/high-density lipoprotein in middle-aged women than in men. Although the incidence of heart disease is lower in women because they live longer, over a lifetime, cardiovascular disease in women is equal to that in men, with the greatest incidence after age 65 years. Major coronary events are rare among reproductive-age women who use oral contraceptives and are related to the concomitant effects of age, smoking, diabetes, hypertension, and obesity. Low estrogen-progestin dose oral contraceptives appear not to promote cardiovascular disease and can be used in women with controlled cholesterol elevations. Alternative contraceptive measures should be considered for patients with severe uncontrolled hypercholesterolemia or a lipid disorder that carries a high risk of coronary heart disease. In these conditions, thrombotic propensity associated with supraphysiologic doses of estrogen in oral contraceptives might accelerate coronary thrombosis should an arteriosclerotic plaque rupture. Treatment of hypercholesterolemia should follow the guidelines of the National Cholesterol Education Program and emphasize hygienic measures. Contraceptive selection in hyperlipidemic patients should reflect a balance between the risks--and their management--of developing cardiovascular disease versus the risks of pregnancy.

Cardiovascular Diseases↗

IUD compared with oral contraception in nulliparae.

172 nulliparae attending a Swedish family planning clinic were studied. Doctors and midwives with various experiences gave the contraceptive method. Continuation rate at 12 months was 58 per cent for IUD and 86 per cent for OC. The expulsion rate in the IUD group was 11 per cent and in 30 per cent of IUD users the device was removed because of adverse effects. 10 per cent of the IUD group and 5 per cent of the OC group discontinued their method without introducing another one, thereby risking an unwanted pregnancy.

Adolescent↗

The influence of type of information, somatization, and locus of control on attitude, knowledge, and compliance with respect to the triphasic oral contraceptive Tri-Minulet.

The possibility of improving attitude, knowledge, and compliance with respect to the oral contraceptive (OC) Tri-Minulet (Wyeth, Hoofddorp, The Netherlands) by supplying brochures and information on audiotape was studied in 1239 healthy women, aged between 15 and 45. One group was orally informed, a second group additionally received brochures, and a third group received, in addition to the above two, information on audiotape. At baseline and after the first and third cycle, OC-attitude, missed pill handling, and compliance were assessed. Somatization and locus of control were also assessed. Knowledge of the medical advantages of the pill was increased by the audiotape and the compliance by the combination of brochures and audiotape. The brochures alone and in combination with tape improved the knowledge of how to handle missed pills. In somatizers and externals, who particularly showed a poor knowledge and a negative pill-attitude, this knowledge was increased by the combination of brochures and tape.

Adolescent↗

Attitudes about condoms and condom use among college students.

The authors assessed the relationships of ethnicity, gender, previous condom use, and intended condom use to perceived attributes of the condom and the contraceptive pill in a multiethnic sample of 197 college students. Factors that appeared to underlie attitudes toward the condom and the Pill included prevention of health problems, peer acceptance, sexual pleasure and spontaneity, convenience, embarrassment, and effectiveness in preventing HIV and sexually transmitted diseases. African American participants viewed the condom more positively than did students from other ethnic groups and were more likely to use condoms than White participants were. The African Americans appeared to know less about the characteristics of the Pill and were less likely to use it than were the White respondents. Only 60% of the persons in the student sample had used condoms in the last 6 months, and less than one half definitely intended to use condoms in the next month. Those who had used a condom at their most recent intercourse and those who intended to use a condom in the next month viewed the condom more favorably than others did. Intended condom use was associated with a perception of oral contraceptives as a less convenient method of birth control.

Adolescent↗