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A case of toxic shock syndrome (TSS) associated with diaphragm use is presented. Adolescents who use a diaphragm should be informed of the symptoms of TSS, and those with the syndrome should be questioned about diaphragm use.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Data on the efficacy of vaginal contraceptive suppositories and foams available in the United States are reviewed, and data on a new vaginal contraceptive, the Collatex sponge, is presented. The efficacy of this device appears to be similar to that of the diaphragm.
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A follow-up study on 130 women fitted with a cervical cap over a 12-month period drew a response rate of 43% (56 respondents). The group was young, well educated, and highly motivated. The failure rate was 16.9 per 100 women years (Pearl method), with inconsistent use and dislodgement being of major importance. The continuation rate was 75% (minimum 3 months of use), and 84% expressed satisfaction with the method. No significant side effects or risks to health were encountered. The conclusion is that there is a significant demand for alternative contraceptive methods among a select group of women. However, in the present state of knowledge, use of the cap should probably not be encouraged as a primary means of contraception, but should be reserved for those women with multiple contraceptive problems or for highly motivated women who seek out this means, understand its limitations, and can accept the relative uncertainty of its effectiveness.
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Physicians are important gatekeepers of women's access to effective methods of contraception. An understanding of physician behaviour in this domain is therefore important. This cross-sectional survey examined physician beliefs, attitudes, intentions and behaviour with respect to contraceptive prescription. Physician gender was associated with attitudes to diaphragm prescription, while year of medical graduation was associated with attitude to IUCD prescription. Age and gender in turn were related to differing perceptions of methods pertaining to efficacy, adverse effects, women for whom the methods were suitable and possible impacts on the physician. Regional differences in prescribing of these methods may be due to variations in physician age and gender.
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A review of the literature yielded no scientific basis for current recommendations on the length of time spermicide-filled cervical caps can be worn while continuing to protect against pregnancy. Ten cervical cap users provided 99 samples of cap contents after a variety of insertion periods using Gynol II, Ortho Creme and vehicle controls. Testing for spermicidal effect was performed in the laboratory using quality semen from two donors and employing the Multiple Exposure Photography system of semen analysis. Criteria for determining spermicide effectiveness were developed. Results suggest that 3 to 4 days is the reasonable limit for cap use with Gynol II and 5 days with Ortho Creme, contrasted with 1 day limits for Gynol II and 2 day limits for Ortho Creme using existing criteria. Limited experience with samples exposed to semen in vivo suggest that spermicidal potency is not lost through repeated intercourse. Recommendations for validating these limits with clinical studies are made.
A literature review yielded no scientific basis for the currently accepted recommendations on the length of time spermicides used with diaphragms continue to kill sperm. Twelve volunteers provided 68 spermicide samples representing 6, 12, 18, and 24 hours of in vivo insertion in a contraceptive diaphragm using Ortho Creme, Gynol II, and vehicle controls. Testing for continued spermicidal effect was performed in the laboratory using quality semen from 2 donors and employing the Multiple Exposure Photography system of semen analysis. Results showed effective spermicidal action after 12 hours of insertion, mixed effectiveness after 18 hours, and poor effectiveness after 24 hours with both products, with Ortho Creme being more effective in the longer insertions. Placebo jelly enhanced sperm activity while placebo creme had a moderate inhibitory effect. Recommendations for further study are made.