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Resolution, 1 June 1987.

This Resolution requires all pharmaceutical dispensaries to maintain a stock of condoms for supply to the public. The condoms are to be furnished to clients on request, without any formality.

Condoms↗

European Society of Contraception oral contraceptives survey update: birth control methods in "Europe of the 12".

The European Society of Contraception developed a survey to examine birth control methods in the 12 countries++ of the European Community. Responses to those questions relating to prescribing++ practices of oral contraceptives (OCs) are presented herein. The survey was sent to 400 physicians. One hundred two responded, most from France, Belgium, and the United Kingdom. The responses revealed that the most popular OCs are modern combined formulations containing low doses of ethinyl estradiol and progestogens such as norgestimate, desogestrel, gestodene, and levonorgestrel. More than half of physicians prescribe a particular formulation because of its tolerability and 20% because of its hormonal content. More than 90% prescribe OCs to healthy, nonsmoking women over 40. However, three fourths will not prescribe OCs to smokers over 35. Half of physicians recommend mammography for their older OC patients. Half also recommend cholesterol screening, but 8% only for women over 30. Most physicians are no longer reluctant to prescribe OCs to their diabetic patients: 61% prescribe OCs for women with non-insulin-dependent diabetes, 56% for those with insulin-dependent diabetes, and 85% for those with a history of gestational diabetes. Despite recent studies showing no relation between past OC use and cardiovascular disease, 42% of physicians said that their greatest OC-related health concern is cardiovascular disease. One third cited noncompliance as their greatest concern. These results reveal inhomogeneous prescribing practices for OCs among European physicians. ¿Over-screening¿--not prescribing the pill because of perceived (but not necessarily real) health risks--may be depriving many women of the contraceptive and noncontraceptive benefits of OCs. Complete and accurate information--as promoted by the European Society of Contraception--is one way to combat such overscreening.

Adult↗

Post-"pill" amenorrhoea--cause or coincidence?

The relationship of contraceptive history to diagnostic category of amenorrhoea was analysed in 131 consecutively investigated cases of secondary amenorrhoea. Amenorrhoea occurred in 52 patients immediately after discontinuing the oral contraceptive. Twenty-two had had amenorrhoea before oral contraceptive treatment and 23 patients before the episode of non-contraceptive-related amenorrhoea investigated here. When these cases were excluded from analysis there was no significant difference in the distribution of any of the diagnostic categories between those who had used the oral contraceptive and those who had not. The results suggest that using oral contraceptives does not cause subsequent amenorrhoea.

Age Factors↗

Contraceptive care by family physicians and general practitioners in Japan: attitudes and practices.

BACKGROUND AND OBJECTIVES: Japan has one of the highest rates of unintended pregnancies among developed countries. Family physicians and general practitioners (FPs/GPs) have unique opportunities to provide family planning. The purpose of this research was to elucidate the attitudes and practices about contraceptive care by FPs/GPs in Japan. METHODS: In this cross-sectional study, we distributed to physician members of the Japanese Academy of Family Medicine a survey that addressed their educational experiences with contraceptive care, frequency of contraceptive care in their practices, attitudes toward providing it, and attitudes toward providing medical students and residents with contraception education. RESULTS: A total of 265 physicians responded (response rate 77.2%). Many physicians reported receiving limited education about contraception, and 75% reported offering no contraceptive care in practice. While 60% of participants reported a desire to provide information about contraception, one of four physicians reported no interest. About 90% of the physicians indicated that medical students should have contraception education. Eighty percent reported that residents should receive such education. CONCLUSIONS: Most FPs/GPs in Japan have received limited education about contraception. Few provide it currently, but 60% are willing to do so. Further investigation is needed to fully understand barriers to Japanese FPs/GPs providing contraceptive care.

Adult↗

Dihydroxyprogesterone acetophenide 150 mg + estradiol enantate 10 mg as monthly injectable contraceptives.

A survey among users and health personnel participating in the Salvadorian Social Security Institute (ISSS) Family Planning Program revealed interest in including a monthly preparation for injection as a contraceptive method offered by this Institution. The formulation containing dihydroxyprogesterone acetophenide (DHPA) 150 mg + estradiol enantate (E2EN) 10 mg was chosen for conducting an open and prospective study of efficacy and tolerability. Between January 1992 and March 1994, 7054 women were treated with this product for a total of 60010 months. A sample composed of 4505 women treated at this Institution confirmed that average users are young, have one or two children, do not show a particular geographical distribution and choose the monthly injection instead of oral contraceptives as the first contraceptive method or for the puerperium. The study formulation showed a high efficacy (Pearl Index: 0.018) and tolerability (general withdrawal rate throughout the study: 27.09%). The most frequent adverse events included bleeding disorders, headache and mastalgia; their incidence decreased spontaneously from the sixth month (3.9%), reaching 0% after two years. Treatment was discontinued due to adverse events in 3.47% of women. No significant bodyweight or systolic and diastolic blood pressure alterations were observed. Based on these results, the monthly injectable contraceptive was included in the basic product list at ISSS.

Adolescent↗

Fertility following ectopic pregnancy with special reference to previous use of an intra-uterine contraceptive device (IUCD).

A group of 304 women operated on for ectopic pregnancy were followed up with respect to subsequent reproductive performance. The group was distributed into current users, earlier users and non-users of an intra-uterine contraceptive device (IUCD). Pelvic inflammatory disease (PID) and infertility were more common among non IUCD users. Reproductive performance was statistically significantly better in ever-users of an IUCD than in never-users. The proportions of women wishing to become pregnant and who later gave birth to a live baby in the three groups were 69.2%, 61.4% and 38.0% respectively.

Adolescent↗