Effect of CSM's warning about safety of third generation oral contraceptives. Contraceptive effectiveness may be being sacrificed for safety.
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Abortion Applicants↗
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Public scare has not deterred Finnish teenagers from using oral contraceptives.
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Adolescent↗
Never underestimate the force of reproduction.
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Adolescent↗
Impact on contraceptive practice of making emergency hormonal contraception available over the counter in Great Britain: repeated cross sectional surveys.
OBJECTIVE: To examine the impact on contraceptive practice of making emergency hormonal contraception available over the counter. DESIGN: Analysis of data on contraceptive practice for women aged 16-49 years in the period 2000-2 from the Omnibus Survey, a multipurpose survey in which around 7600 adults living in private households are interviewed each year. SETTING: Private households in Great Britain. MAIN OUTCOME MEASURES: Use of different types of contraception and rates of unprotected sex. RESULTS: After emergency hormonal contraception was made available over the counter, levels of use of different types of contraception by women aged 16-49 remained similar. No significant change occurred in the proportion of women using emergency hormonal contraception (8.4% in 2000, 7.9% in 2001, 7.2% in 2002) or having unprotected sex. A change did, however, occur in where women obtained emergency hormonal contraception; a smaller proportion of women obtained emergency hormonal contraception from physicians and a greater proportion bought it over the counter. No significant change occurred in the proportion of women using more reliable methods of contraception, such as the oral contraceptive pill, or in the proportion of women using emergency hormonal contraception more than once during a year. CONCLUSIONS: Making emergency hormonal contraception available over the counter does not seem to have led to an increase in its use, to an increase in unprotected sex, or to a decrease in the use of more reliable methods of contraception.
Adolescent↗
The effect of dislike of school on risk of teenage pregnancy: testing of hypotheses using longitudinal data from a randomised trial of sex education.
STUDY OBJECTIVE: To examine whether attitude to school is associated with subsequent risk of teenage pregnancy. To test two hypotheses that attitude to school is linked to pregnancy via pathways involving young people having "alternative" expectations or deficits in sexual health knowledge and confidence. DESIGN: Analysis of longitudinal data arising from a trial of sex education. Examination of associations between attitude to school and protected first sex, unprotected first sex, unprotected and protected last sex, and pregnancy, both crude and adjusting in turn for expectation of parenting by age 20, lack of expectation of education/training at age 20, and sexual health knowledge and confidence. SETTING: Schools in central and southern England. PARTICIPANTS: Girls of median age 13.7 years at baseline, 14.7 years at follow up 1, and 16.0 years at follow up 2. MAIN RESULTS: In unadjusted analysis, attitude to school was significantly associated with protected and unprotected first sex by follow up 1, protected first sex between follow up 1 and 2, unprotected last sex, and pregnancy. Dislike of school was more strongly associated with increased risk of these outcomes than was ambivalence to school. These associations remained after adjusting for socioeconomic status and for expectation of parenting, lack of expectation of education/training, and various indicators of knowledge and confidence about sexual health. CONCLUSIONS: Dislike of school is associated with subsequent increased risk of teenage pregnancy but the mechanism underlying any possible causal link is unlikely to involve "alternative" expectations or deficits in sexual health knowledge or confidence.
Adolescent↗
Prostitution in Sheffield: differences between prostitutes.
This study to assess differences between street walking prostitutes and sauna girls who attended this clinic in 1986 and 1987 showed that fewer street walkers used barrier methods for disease prevention with clients or accepted tests for antibody to human immunodeficiency virus (HIV) when offered and more street walkers practised their profession in both Sheffield and London. They therefore represent a potential pathway for the heterosexual spread of HIV to the region. Trichomonas vaginalis was the only organism more commonly isolated from street walkers. Other sexually transmitted diseases diagnosed, and the sources of acquisition of gonococcal cervicitis, were similar in both groups of prostitutes. Prostitutes rarely used barrier methods with their regular consorts, who were found to be responsible for most cases of gonorrhoea in both groups. As 11 out of 58 prostitutes attending were found to have dysplasia on routine cervical cytological examination, we suggest that all prostitutes be advised to undergo cytology yearly.
Contraception Behavior↗
Emergency hormonal contraception usage in genitourinary medicine clinic attenders.
OBJECTIVE: To assess the indications for usage of emergency hormonal contraception amongst a population of London genitourinary medicine clinic attenders. METHODS: In a prospective study, 150 consecutive women receiving emergency hormonal contraception (EHC) were enrolled. The attending doctor completed a questionnaire of patient details and prescribed EHC with prophylactic prochlorperazine. Follow-up was arranged three weeks later, at which time outcomes and side-effects of therapy were recorded. For those women who did not reattended as planned case notes were reviewed at three months. RESULTS: Of 150 women surveyed, 100 (66%) reported contraceptive method failure, 48 (32%) had used no contraception at the time of last sexual intercourse and two requested EHC after sexual assault. Ninety three (62%) reported condom failure, 7 (5%) oral contraceptive pill failure. Seventy five (50%) had used EHC before (range 1-10 times). Seventy one (47%) women reattended within three months. Five (3.3%) of the 150 women were pregnant; none of these cases had experienced nausea or vomiting whilst taking EHC. Side-effects were reported by 22 (31%) of the 71 patients who reattended. Nine (6%) women had been followed-up in the family planning advisory clinic. Of the 71 women who reattended, 39 (55%) reported that their preferred future method of contraception would be condoms. Of the 150 women 19 (13%) underwent tests for sexually transmissible infections within one month of presentation. CONCLUSIONS: EHC usage in this population was associated with a failure rate of at least 3.3% and an overall side effect rate of 31%. Despite requests for emergency contraception because of condom failure many elected to continue using condoms as their preferred method of contraception. The majority of women (53%) did not return for follow-up or family planning advice, and so we believe that future contraceptive plans must be addressed at the time EHC is prescribed.
Adolescent↗
[Contraception in young adolescents].
The continuing increase in teenage pregnancies and abortions calls for more effective sex education on the one hand, including a detailed explication of the (perfectly normal) changes an adolescent body is undergoing, but we also need to understand the way teenagers actually do use contraceptives. Modern contraception for teenagers should not cause any side effects and its efficacy must not be linked to compliance. Gynaecologists must acquaint themselves with the laws covering the prescription of contraceptives to adolescents. Whether hormonal contraceptives for men are also suitable for teenage boys remains to be seen. Advising mentally or physically handicapped teen-agers or those with chronic diseases on their contraceptive options is particularly challenging. Adolescents are more prone to contract HPV infections and thus need to be screened, counselled and told about the association between HPV and cervical dysplasia.
Adolescent↗
An ecological analysis of pregnancy resolution decisions among African American and Hispanic adolescent females.
Using data from the 1988 National Family Growth Cycle, IV, this study sought to identify specific individual, family, sociocultural, and social structure factors that influence pregnancy resolution decisions of first conception among African American and Hispanic adolescents aged 15 to 21 years. A hierarchical discriminant function analysis was used to determine the extent to which selected variables could distinguish those who terminated their first pregnancy from those who decided to carry their first pregnancies to full term. Three individual factors (age at conception, contraceptive behavior pattern, degree of self-disclosure about the pregnancy), two family-level variables (family sexuality socialization, family income), and each of the selected social structure (access to sexual health care facilities) and sociocultural factors (religious affiliation and church attendance) were found to discriminate between the two groups. However, the discriminating power of these variables differed depending on race/ethnicity.
Adolescent↗
Contraceptive use in a rural general practice.
All women aged 20-49 in a general practice were sent a questionnaire about their reproductive health, and 72% responded. 78% of respondents were using a method of fertility control. More than a quarter of women were obtaining their contraceptive supplies (condoms especially) from non-medical outlets. Knowledge of the existence of emergency contraception was high (83%). The general practitioner (GP) was the most popular source of contraceptive supplies for those aged under 40 years and more than four-fifths of women said that they would rather turn to their GP than to other sources for future contraceptive advice.
Adult↗
Emergency contraception: who are the users?
The objective was to describe the demographic and sexual characteristics of clients attending a Sexual Health Clinic for emergency contraception (EC). Information about women attending the Parramatta Sexual Health Clinic (PSHC) who received EC between January 1999 and July 2002 was derived from the clinic database. Age-matched controls were randomly selected. Univariate and logistic regression analysis was performed to establish which factors were associated with use of EC. Two hundred and sixty-seven women requesting EC, and an equal number of controls, were studied. Factors that were independently associated with EC use were being a student, (OR=1.7 [95% CI 1.02-2.69]) and having a regular sexual partner (OR=2.3 [95% CI 1.14-4.73]). Women requiring EC were significantly less likely to have had a sexually transmitted infection (STI) (OR=0.3 [95% CI 0.16-0.60]) or a previous pregnancy (OR=0.2 [95% CI 0.09-0.67]) than controls. We concluded that users of EC are at low-risk for STIs, but need counselling about safer sex.
Adolescent↗
Indigenous notions of the workings of the body: conflicts and dilemmas with Norplant use in rural Bangladesh.
The discourses of the female body in rural Bangladesh illustrate gender relations in rural society and the degree to which village ideologies of shame, purity, and pollution affect women's attitudes toward contraceptive practices. Women's understanding of their body and perception of flow, buildup, and blockage related to Norplant use reveal a belief in the disruption of the internal state of the body. Humeral notions underlie descriptions of Norplant use, which are understood to agree with women differently. Bengalis believe that blockage in the body can endanger the wider social and moral sphere. Culturally promoted fears of illnesses motivate individuals to conform to social norms. Some rural women chose to ignore their health problems, some dropped out, and some preferred Norplant.
Bangladesh↗
Motherhood plans among young Australian women: who wants children these days?
Fertility rates in the developed world have been below replacement level for 25 years, and it is often assumed that this results from deliberate, unconstrained individual choice. Data from 7448 childless women aged 22 to 27, participating in the Australian Longitudinal Study on Women's Health, indicate that 9 per cent aspire to childlessness, with 72 per cent wanting 1 or 2 children and 19 per cent more. Differences in psychological functioning disappear after adjustment for socioeconomic variables. Women wanting 1 or 2 children also want paid work, while those wanting many children generally have traditional aspirations. Policy-makers need to consider strategies that support women to negotiate motherhood and paid work.
Adult↗
Contraceptive use in random samples of Greenlandic and Danish women--changes from 1986 to 1988.
As part of a study of risk factors for cervical cancer, the possible change was assessed in the use of condoms after AIDS campaigns. In 1986, samples of 800 women aged 20-39 years were drawn at random from Nuuk/Godthåb (Greenland) and Nykøbing Falster (Denmark). A total of 586 and 661 women were interviewed in Greenland and Denmark, respectively. In 1988, new random samples of 150 women were drawn from the same areas. Totally, 129 Greenlandic and 126 Danish women were included in the study. From 1986 to 1988 the prevalence of ever having used condoms increased significantly among Greenlandic women aged 20-29, whereas no statistically significant changes were observed in Denmark. This pattern was independent of the lifetime number of sexual partners. Neither in Greenland nor in Denmark did the mean lifetime number of sexual partners change from 1986 to 1988.
Contraception Behavior↗
Induced abortion and effecting factors of ever married women in the Southeast Anatolian Project Region, Turkey: a cross sectional study.
BACKGROUND: Nearly 10% of the population of Turkey lives in the Southeast Anatolian Project (SEAP) region. The population growth rate and the rate of unintended pregnancies are high and family planning services are insufficient in this region. Lifetime induced abortion rate is also high in this region. Public health problems of the SEAP region were investigated in the "SEAP Public Health Project" in 2001 and 2002. As it is one of the most important health problems of the women living in this region; induced abortion was also investigated in this project. METHODS: An optimumsample size representing the rural and urban area of the region (n = 1150) was chosen by the State Institute of Statistics by a sampling method proportional to size. 1126 of the area's 1150 houses have been visited and data about induced abortions have been obtained by applying a questionnaire to 1491 ever married women who live in the region. RESULTS: It has been found that 9.0% of these women who had at least one pregnancy in their life had at least one induced abortion. The lifetime induced abortion per 100 pregnancies was found to be 2.45. The primary reason given for induced abortions was "wanting no more children" (64.6%). Lifetime induced abortions were 5.3 times greater with women using a family planning method than women not using family planning methods. Lifetime induced abortions were 4.1 times greater with unemployed women than working women. Most of the women have used private doctors in order to have an induced abortion. Although 32.29% have not yet begun to use a contraceptive method after their last induced abortion, 43.75% of the women have since started to use an effective contraceptive method. 23.96% of them have begun to use an ineffective contraceptive method. CONCLUSIONS: Induced abortion is still an important problem at the SEAP region. The results of the study remind us that unemployed women and women who have more than four children is our target group in the campaign against induced abortions. Most of the women use private doctors in order to have an induced abortion. Thus, priority must be given to educate private gynecologists with respect to induced abortion. After induced abortions, a qualified family planning consultant can be given to women and they can be secured to use a suitable contraceptive method.
Abortion, Induced↗
Sterilization: a review of 98 sterilized women.
The details of 98 women sterilized over a three-year period are presented. They show that female sterilization is a safe procedure which has a satisfactory result in many cases and confers many secondary benefits. However, some regret is common and is associated with a high incidence of psychiatric and marital morbidity, and this is shown to be related to pre-operative factors. A method of pre-operative assessment is outlined which should minimize the risk of a poor outcome following female sterilization.
Affective Symptoms↗
The influence of family and friends' basic conditioning factors and self-care agency on unmarried teenage primiparas' engagement in contraceptive practice.
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Adolescent↗
Male contraception.
The provision of safe, effective contraception has been revolutionized in the past 40 yr following the development of synthetic steroids and the demonstration that administration of combinations of sex steroids can be used to suppress ovulation and, subsequently, other reproductive functions. This review addresses the current standing of male contraception, long the poor relation in family planning but currently enjoying a resurgence in both scientific and political interest as it is recognized that men have a larger role to play in the regulation of fertility, whether seen in geopolitical or individual terms. Condoms and vasectomy continue to be popular at particular phases of the reproductive lifespan and in certain cultures. Although not perfect contraceptives, condoms have the additional advantage of offering protection from sexually transmitted infection. The hormonal approach may have acquired the critical mass needed to make the transition from academic research to pharmaceutical development. Greatly increased understanding of male reproductive function, partly stimulated by interest in ageing and the potential benefits of androgen replacement, is opening up other avenues for investigation taking advantage of nonhormonal regulatory pathways specific to spermatogenesis and the reproductive tract.
Condoms↗