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PubMed2005

Use of a community sexual health information line.

BACKGROUND: Since 1989 Sydney Sexual Health Centre has provided a community phone information line (PIL). The service aims to educate and promote the sexual health of the community and facilitate efficient use of the centre's resources through the provision of information and advice to the community and health professionals; a referral service; and patient triage. In October 1997 a comprehensive computerised database was developed to collect caller information. In 2003, a 5-year review of the PIL database was undertaken with the express aim of describing the profile of people using the service. METHODS: We analysed data from the PIL from 16 October 1997 to end 20 December 2002 using SPSS. RESULTS: A total of 34,013 callers were in the PIL database. Every year the service has seen an increase in demand from 5295 calls in 1998 (first full year of service) to 8401 in 2002. The majority of callers lived in central and southeast Sydney geographical area, however, calls were registered from over 55% of postcodes in NSW and from interstate. The average caller age each year was 32 years with similar standard deviation and the distribution over time has not changed. There were equal numbers of male and female callers each year. Peak times for people to call the PIL were 2-4 pm with a high number of callers at 10 am. In general, calls were between 4 and 6 min duration. Overall, 14,098 (41.4%) of calls in the database were for general sexual health information. The majority of the information callers over the period who have been calling about infections have called about herpes simplex virus. CONCLUSIONS: As is evident the PIL meets a specific community need. This study did not, however, look at patient outcomes and this area needs investigation to fully evaluate the benefits of a community PIL.

Adult↗
PubMed1988

Ethinyl oestradiol and D-norgestrel is an effective emergency postcoital contraceptive: a report of its use in 1,200 patients in a family planning clinic.

We describe a prospective study of 1,200 patients using the Yuzpe regimen of hormonal postcoital contraception. There was an 85% follow-up rate, and of the 1,015 patients followed there were 13 pregnancies, giving a pregnancy rate of 1.3%. The number of expected pregnancies at mid-cycle was reduced by 83%; 12 of the 13 pregnancies went on to abortion. The patients were young: 86% were under 25, and 10% were under 15. The most frequent reason for presentation was that no contraception had been used (57%). All patients received an antiemetic; 57% experienced no side-effects, 28% had some nausea and 9.6% some vomiting. It is concluded that this is a safe form of emergency contraception, which is an effective way of reducing the number of unwanted pregnancies, especially in the very young.

Adolescent↗
PubMed1994

UK information service relaunched.

The nationwide public and professional information service operated by the FPA (Family Planning Association) in association with the UK health promotion agencies since 1977 is relaunched this year under the new name of the Contraceptive Education Service (CES). The service is offered in England, Scotland, Wales and Northern Ireland with some variations to meet specific local needs, but containing the same key elements. These are: 1) a nationwide telephone, postal and personal enquiry service on contraception, for both the public and professionals including details about local family planning clinics. This service is available Mondays to Fridays from 9 am to 5 pm, from the FPA national helpline 071-636-7866. A local service is also available from FPA Scotland, FPA Wales, and FPA N. Ireland; 2) public education leaflets on contraception and family planning, of which over 4 million are distributed a year via health promotion units throughout the UK; 3) professional information provided through factsheets on 21 key topics in family planning, contraception and sexual health and through Family Planning Today; 4) press and media publicity which helps to publicize the CES services and to spread information about contraception and family planning issues through articles and coverage on radio and television.

Communication↗
PubMed1999

Correlates of age at natural menopause: a community-based study in Alexandria.

Differences in the age at natural menopause were examined using a retrospective population sample of 289 naturally menopausal women. The mean age at natural menopause was 46.70 +/- 5.44 years. Earlier menopause occurred in women living in semiurban areas, divorced/separated and less educated women, and women who were younger at: first marriage, widowhood, divorce/separation and first or last full-term pregnancy. Later menopause occurred in women who had: irregular menstrual periods before 25 years, dysmenorrhoea and mid-cycle spotting. Duration of oral contraceptives use, weight and body mass index were significantly positively correlated with age at natural menopause. Multiple regression analyses indicated that age at last full-term pregnancy, residence, pattern of menstrual cessation and duration of oral contraceptive use were the significant predictors of the end of menstrual activity.

Adult↗
PubMed1995

Demographic perspectives on China and India.

This paper compares levels and trends of population growth rates, age and sex composition, mortality, and fertility including family planning practices in the world's two most populous countries, China and India. Both countries are undergoing demographic transition but China is nearer than India to achieving a stationary population. Fertility in China has declined below replacement level while in India it is nearly one and a half children per woman above replacement level. Both countries have achieved large reductions in mortality but life expectancy at birth in China is currently about 10 years longer than in India. Both countries have young populations but China will precede India in the aging of population structure during the 21st century.

Adolescent↗
PubMed1989

Factors influencing the initial decision to use an intrauterine device.

This study analyses data from 104 women who elected to use an IUD for the first time. The reason they gave for requesting the IUD was evaluated against a number of personal and psychological characteristics. Parous women who had recently given birth were more likely to choose an IUD because of a fear of non-compliance with oral contraceptives and possible problems with other methods, eg, hormone injections. Nulliparous women, and women who had not recently given birth were much more likely to choose the IUD as their method of contraception because they felt it had health advantages and/or was more convenient than other methods. These reasons for choosing an IUD are not usually given a high priority by contraceptive methodology providers.

Adolescent↗
PubMed1999

Women's knowledge and attitudes about emergency contraception: a survey in a Melbourne women's health clinic.

The aim of the study was to determine the level of awareness of emergency contraception in women seeking pregnancy counselling and to investigate their attitudes towards emergency contraception. All women presenting for pregnancy counselling at a Melbourne women's health clinic in October 1997 were invited to complete a questionnaire detailing their contraceptive practices. One hundred and sixty-six questionnaires were distributed and 153 were completed (92% response rate). The majority of this sample population had heard of some form of emergency contraception and knew where to access it. However only 26% knew that emergency contraception should be taken within 72 hours of unprotected intercourse. Although 80% of the sample had heard of emergency contraception (or the morning after pill) only 9% used it in an attempt to prevent this pregnancy. The majority of the women surveyed support the increased availability of emergency contraception by rescheduling it to a non-prescription item and re-packaging as a single treatment.

Adolescent↗
PubMed2000

Repeated use of hormonal emergency contraception by younger women in the UK.

A cohort of women aged 14-29 in 1993 was identified from the General Practice Research Database and followed up for a period of 4 years. Patient files were searched for evidence of use of emergency contraception and regular contraception. Of the 95 007 women, 15 105 (16%) had received emergency contraception during the study period (an average of 5% per annum). There was a small year on year increase in uptake of emergency contraception between 1994 and 1997. Only 4% of emergency contraception users received emergency contraception more than twice in any year. More than 70% of those who had no previous record of use of regular contraception had used regular contraception within 1 year of using emergency contraception. Teenagers were more likely than other age groups to use emergency contraception, to be repeat users of emergency contraception and to fail to start regular contraception after first use of emergency contraception until later in the study period. These results disprove the notion of widespread repeated use of emergency contraception. They show that provision of an emergency contraception service does not result in failure to initiate regular contraception or abandonment of regular contraception; rather they show many women using regular contraception for the first time after use of emergency contraception.

Adolescent↗
PubMed2002

Contraceptive efficacy and cycle control with the Ortho Evra/Evra transdermal system: the analysis of pooled data.

OBJECTIVE: To present efficacy and cycle control data pooled from three pivotal studies of the contraceptive patch (Ortho Evra/Evra). DESIGN: Three multicenter, open-label, contraceptive studies that included up to 13 treatment cycles. SETTING: 183 centers. PATIENT(S): 3,319 women. INTERVENTION(S): Three consecutive 7-day patches (21 days) with 1 patch-free week per cycle. MAIN OUTCOME MEASURE(S): Contraceptive efficacy and cycle control. RESULT(S): Overall and method failure life-table estimates of contraceptive failure through 13 cycles were 0.8% (95% CI, 0.3%-1.3%) and 0.6% (95% CI, 0.2%-0.9%), respectively. Corresponding Pearl indices were 0.88 (95% CI, 0.44-1.33) and 0.7 (95% CI, 0.31-1.10). Contraceptive failure among women with a body weight < 90 kg (<198 lb) was low and uniformly distributed across the weight range. A subgroup of women with body weight > or = 90 kg (> or = 198 lb) may have increased risk of pregnancy. The incidence of breakthrough bleeding was low and decreased over time. CONCLUSION(S): In contraceptive patch users, the overall annual probability of pregnancy was 0.8% and the method failure probability was 0.6%. The efficacy of the patch was high and similar across age and racial groups. Among women < 90 kg (<198 lb), contraceptive failure was low and uniformly distributed across the range of body weights. In women > or = 90 kg (> or = 198 lb), contraceptive failures may be increased. Efficacy and cycle control have been shown to be comparable to an established oral contraceptive.

Administration, Cutaneous↗
PubMedDate not supplied

Effects of vaginal spermicides on pregnancy outcome.

The effects of spermicide use around the time of conception on fetal loss, birth weight and sex were examined using data from the 1976 National Survey of Family Growth (NSFG). There was no evidence that cessation of spermicide use at least one month prior to conception had any effect on the pregnancy outcomes examined. However, the proportion of female births was approximately 25 percent higher among women who used spermicides around the time of conception than among nonusers of spermicides. In addition, women who used spermicides after conception were found to have approximately double the rate of fetal loss experienced by former users, including those who had used spermicides close to the time of conception. The effects of spermicides on birth weight were not statistically significant.

Birth Weight↗
PubMed1993

Liver damage from low-dose oral contraceptives.

OBJECTIVE: To study whether the decrease in the content of oestrogen and gestagen in modern low-dose oral contraceptives (OC) has yielded a lower incidence of adverse liver reactions, and to describe the biochemical pattern of the adverse liver reactions from low-dose OC. DESIGN: We surveyed all liver reactions from OC reported to SADRAC (Swedish Adverse Drug Reactions Advisory Committee) from 1966 to 1989. MAIN OUTCOME MEASURE: Incidence of reported adverse liver reactions (number of reported adverse reactions/OC sales in defined daily dose [DDD]). RESULTS: There was a sharp decline in the number of reports during the studied period, suggesting changes in reporting habits. However, there was also a significantly lower incidence of reports for medium-compared to high-oestrogen dose OC, and a further decrease, albeit non-significant, in incidence with low-oestrogen dose OC. Furthermore, in three comparisons of pairs of OC that differed only in the gestagen dose, there was a strong trend towards a higher reporting rate with higher gestagen dose. Cholestatic and hepatocellular liver enzyme patterns were equally frequent in patients with adverse reactions from low-dose oestrogen OC. There was no report of liver tumours related to use of low-oestrogen dose OC. CONCLUSION: There seems to be a decrease in the incidence of adverse liver reactions related to lower contents of both oestrogen and gestagens in OC of the combined-preparation type.

Chemical and Drug Induced Liver Injury↗
PubMed1977

Note of dissent.

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Contraceptives, Oral↗
PubMed1986

Metabolic effects of a biphasic oral contraceptive preparation containing ethinyloestradiol and desogestrel on serum lipoproteins and apolipoproteins.

The effect of the administration of a biphasic oral contraceptive containing ethinyloestradiol and desogestrel on the distribution and composition of serum lipoproteins was studied in a group of 17 healthy female volunteers. The women were treated for a period of 6 months and compared with a control group of ten untreated volunteers. The serum lipoproteins were fractionated by density gradient ultracentrifugation into very low density lipoproteins (VLDL), low density lipoproteins (LDL), and into the high density lipoprotein (HDL) subfractions 2 and 3 (HDL2, HDL3). Lipids and apolipoproteins were assayed in the various fractions. No modification of either the lipid or apolipoprotein concentrations was observed in the control group. In the treated group, sex hormone-binding globulin (SHBG) and cortisol-binding globulin (CBG), and the serum content of cholesterol, triglycerides, HDL-cholesterol, apolipoprotein A-I (apo A-I) and apolipoprotein A-II (apo A-II) increased significantly after 3 and 6 months. The cholesterol and apolipoprotein B (apo B) content of VLDL increased significantly after 3 and 6 months, but remained unchanged in LDL. High density lipoprotein subfraction 2 (HDL2)-cholesterol was significantly increased after 3 and 6 months but apo A-I only after 6 months. Since apo A-II did not change, the apo A-I/A-II ratio increased significantly after 6 months of treatment. In the HDL3 fraction, the apo A-I increase was significant after 3 and 6 months, while the increase of apo A-II was significant after 6 months. The apo A-I/A-II ratio remained constant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗