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PubMed1998

Oral contraceptive use: interview data versus pharmacy records.

BACKGROUND: If women tend to forget and underreport their past oral contraceptive (OC) use, but the recall among cases is enhanced by the presence of disease, recall bias may explain some reported health effects of OC use. METHODS: Two different sources of information on lifetime OC use were compared for 427 (84%) of a community-based sample of 511 women aged 20-34: (i) structured interviews, using a life event calendar and picture display as memory aids, and (ii) a register of all prescriptions dispensed by pharmacies in the county since 1970. RESULTS: Interview data and pharmacy records showed high levels of agreement for any OC use, current use, time since first and last use, total duration of use, and for duration of use in different 'time windows'. But there was a tendency to under-report specific kinds of OC used in the past. CONCLUSION: Underreporting of OC use among non-cases would usually introduce little or no bias (as compared to pharmacy records) for this kind of interview and women. However, it may be preferable to use interviews for current OC use, and pharmacy records for specific kinds of OC used in the past.

Adult↗
PubMed1988

The influence of method of contraception and cigarette smoking on menstrual patterns.

Self-perceived menstrual patterns have been investigated in a sample of 2115 women aged 18-49 years using a postal questionnaire. Seven aspects of 'abnormal' menstruation were defined: prolonged periods, heavy periods, frequent periods, irregular periods, intermenstrual bleeding, painful periods and severe premenstrual syndrome. Women who used oral contraceptives were less likely than other women to report any of the seven menstrual abnormalities except for intermenstrual bleeding and severe premenstrual tension. Women who used an intrauterine contraceptive device (IUCD) reported prolonged, heavy, and frequent periods and intermenstrual bleeding more often than other women, but they did not report painful periods with undue frequency. Women who had had a tubal sterilization generally reported menstrual patterns similar to, or slightly less favourable than, women using no contraception or contraceptive methods other than the pill or the IUCD. There was a significant association between smoking habits and each of the abnormal menstrual patterns except for severe premenstrual tension. In every case, the effect of smoking was unfavourable and in almost every case, current smokers reported the worst experience, with ex-smokers occupying an intermediate position. We believe that these data are of considerable clinical significance and that they offer a basis for a conservative approach to managing menstrual disorders in some women.

Adult↗
PubMed1991

Phase III clinical trial with a new oral contraceptive containing 150 micrograms desogestrel and 20 micrograms ethinylestradiol.

Results are presented of a Phase III international multicentre trial to study the effect of a new low-dose oral contraceptive (OC) containing 20 micrograms ethinylestradiol and 150 micrograms desogestrel (Mercilon) regarding efficacy, cycle control, blood pressure, and acceptability. Altogether 1,684 women from 12 European countries were included in the study. Four pregnancies occurred, 3 of them patient failures, one tablet failure. The overall Pearl Index was 0.20. The frequency of irregular bleeding was comparable to that recorded with other commonly used low-dose OCs. No serious side effects occurred. The incidence of the most frequently reported subjective side effects--headache, nausea and breast tension--was already low after the first cycle of treatment and decreased to below pretreatment levels with continued use. There was a small increase in mean body weight, which was confined essentially to young women. The preparation did not affect the mean systolic or diastolic blood pressure. This new preparation has thus proved to be an effective, safe and well-accepted ultra low-dose oral contraceptive.

Adult↗
PubMed1990

Long-term experience with a low-dose oral contraceptive.

Oral contraception has proved to be the most efficient reversible method of fertility control for over 25 years. During this period, various investigations and epidemiological studies have suggested that some risks may be involved, but, on the other hand, a number of non-contraceptive benefits have become obvious. The results of these investigations were taken into account when new formulations had to be developed, with an aim to improving hormonal fertility control with regard to its tolerance, cycle control, and impact on metabolism. Since then, the objective of research has been to contrive new hormonal contraceptives which ensure safety to the largest possible extent, from a medical point of view, for the sake of the patient, without affecting contraceptive effectiveness. The aim to reduce side-effects connected with the use of oral contraception, as well as to lower the risks possibly involved, has obviously been achieved by extensive research. Both by devising a new substance and reducing doses, the criteria of modern low-dose oral contraception have been met, as has become evident in the course of the clinical experience gathered with Femovan.

Acne Vulgaris↗
PubMed1981

Several factors influencing the colonization of group B streptococci--rectum probably the main reservoir.

Women (1 268) attending a gynaecological clinic or a venereal disease clinic had positive cultures of group B streptococci from urethra in 27.8% and from rectum in 29.4%. The colonization rate was highest in patients from the venereal disease clinic (p less than 0.001). In a study of 405 of the females at different parts of the menstrual cycle group B streptococci were detected during the last half of the cycle in specimens from cervix in 18%, from urethra in 29% (p less than 0.005), and from rectum in 35% (p less than 0.001). The correlation between contraceptive methods and isolation of group B streptococci was investigated for 435 women. Females with intrauterine devices but not those using oral contraceptives had a significantly increased colonization rate genitally. The colonization rate of group B streptococci was also studied in 271 women using sanitary tampons and 129 women using sanitary towel. Those using tampons were significantly more often colonized. Cultures for Neisseria gonorrhoeae were performed from 380 patients but no correlation between N. gonorrhoeae and group B streptococci was found. The study supports the view that rectum and not the genito-urinary tract is the main reservoir of group B streptococci in females, that genital colonization mainly represents contamination from the gastrointestinal flora and sexual transmission is only one of many factors influencing the colonization rate.

Adult↗
PubMedDate not supplied

Conflicting advice? Australian adolescents' use of condoms or the pill.

CONTEXT: Teenagers are exposed to two potentially conflicting sexual health messages, one emphasizing the prevention of sexually transmitted diseases (STDs) and the other stressing pregnancy prevention. To protect teenagers from both STDs and unwanted pregnancy, it is important to know what method choices they make and why. METHODS: Data from a 1997 national survey of 3,550 Australian secondary school students were used to examine teenagers' method choice and patterns of advice-seeking about contraception and STD prevention. Logistic regression analyses were conducted to identify factors associated with the exclusive use of condoms or the pill. RESULTS: Virtually all 961 currently sexually active students were using at least one contraceptive method--primarily condoms (78%) or the pill (45%). Some 31% were using condoms exclusively, and 10% were using the pill exclusively. Older students and those who had sought contraceptive advice had elevated odds of using the pill rather than condoms exclusively (odds ratios, 4.4 and 2.6, respectively), while those who had had only casual partners in the last year had a reduced likelihood of exclusive pill rather than condom use (0.1). Furthermore, the more students believed that their peers used condoms, the less likely they were to report exclusive pill use (0.4). Parents were the most frequent source of advice about contraception, followed by physicians and teachers. The most common sources of advice about HIV and other STDs were parents, teachers and then physicians. CONCLUSIONS: Young people must be educated about the distinction between safer sex and contraception, and about how to prevent both STDs and pregnancy. Providing parents with current sexual health information may help to improve young people's sexual health.

Adolescent↗
PubMed1981

Birth control practice in Khartoum.

The results presented here are based on a fertility survey carried out in Khartoum in 1978. It was shown that the knowledge of family planning is widespread in the city and that the level of ever-use of birth control is becoming significant. The popularity of the different methods of birth control is investigated, revealing that the pill is used by nearly all ever-users. IUDs, rhythm, and withdrawal are also relatively popular. A great degree of consistency was found to exist between reports given by husbands and their wives in this respect. The purpose of using birth control is not yet clear. The significant ever-use, noted before the 3rd live birth, indicates that these methods are used for the purpose of spacing births rather than limiting the number of children.

Africa↗
PubMed1992

Surprising success in Kenya's FP programme.

Mrs. Margaret Gachara, Deputy Director of the Ministry's Family Health Division, explained that the strengths and weaknesses of the program have recently been examined using a new operations research approach, known as situation analysis. "If family planning was not working in Kenya, we had to know why in order to decide what to do about it. We began the study to find out where our weaknesses lay. To our surprise, we found that we were not weak, but moderately successful," she said. The Kenya Situation Analysis Study, conducted by the Health Ministry and the Population Council, revealed that contraceptive prevalence increased by 2%/year between 1984-89, from 17% to 27%. "That is quite acceptable by World Bank and WHO standards. Our total fertility rate has dropped from 7.9% to 6.7%, and in urban areas is down to 3.8%. We are now continuing with in-depth studies, but we expect to be able to say next year that our family planning program should have a moderately high rating, especially in terms of quality of care." Since the 1st results of the Analysis Study were published, family planning agencies in several other African, Asian and Latin American countries have requested similar studies. The Kenyan study showed that the Pill is the most popular method of contraception, used by about 80% of family planning acceptors. However, the use of injectable contraceptives has risen about 4-fold in recent years, from 0.5 to 1.8 million doses a year, Mrs. Gachara said. When the study was conducted, availability of injectable contraceptives was very poor and did not have strong logistical support. This has now been changed, and its use is going up very fast in rural areas. 1 of the reasons is that women who want to use contraception, but do not have support from their husbands, can have injection without their husbands knowing. Although the 3 monthly injectable initially had a very bad press and little Parliamentary support, research has shown that many of the fears were unfounded. Kenyan policy is to make the injectable available to women with 4 children and to those over 35. Guidelines have recently been changed, to require 1 live birth before injectables are offered, rather than 2. The government is also making efforts to promote the use of Noristerat, and a pilot program is currently underway to study implants. The situation analysis did reveal problems in a number of areas, and a list of recommendations has now been drawn up to improve the quality of care. The recommendations include improved supply of information on permanent contraceptive methods and on the side-effects of other contraceptives, a reduction in waiting times for family planning services and an increase in follow-up. "The future looks good for family planning in Kenya, but we have to match our services to contraceptive health benefits and to focus more on maternal health in its totality," Mrs. Gachara said.

Africa↗
PubMed1983

Contraception.

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Contraception↗