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The knowledge, attitude and use of contraception among secondary school girls in Port Harcourt.

BACKGROUND: Sexual activity is on the increase among teenagers worldwide, with a trend towards early onset. These activities are often unplanned and may lead to unintended pregnancies and sexually transmitted diseases including AIDS. Teenagers in developing countries exhibit little knowledge, and exposure to contraceptives. This study was undertaken to describe the knowledge, attitude and use of contraception among female students in Port Harcourt. METHOD: A self-administered questionnaire was used for the study. Five hundred and thirty four students selected from a female only secondary school in Port Harcourt Local Government Area of Rivers State were studied. RESULTS: The students were aged 8-23 years (mean 15.6 years). Two hundred and sixty four (49.4%) were in junior classes (JSS1-3) and 270 (50.6%) in senior classes (SS1-SS3). Two hundred ninety five (55.2%) of the respondents had heard of at least one contraceptive method. Age and not the academic level significantly influenced the knowledge (p < 0.05). Condom was the commonest method known by the students. Few students (< 10%) had knowledge of the modern contraceptive methods. One hundred and thirty five (25.3%) students believed that contraceptives could be harmful. Among the sexually active girls, only 45.3% had ever used any method of contraception. The use of contraception was more among junior students than senior students (64.5% vs 35.5%) (p < 0.05). CONCLUSIONS: We therefore recommend formal sex education in secondary schools in Port Harcourt, in order to improve the reproductive health knowledge and contraceptive use of sexually active girls. The education program must address students' misconceptions about effective methods of contraception targeting the senior students specifically.

Adolescent↗
PubMed2004

[Summary of the practice guideline 'Hormonal contraception' (second revision) from the Dutch College of General Practitioners].

When choosing a method of contraception, a woman must consider the pros and cons of various methods together with her family physician. In this process, the doctor provides information on the advantages and disadvantages, while the woman decides. A sub-50 pill of the second-generation preparation is the oral contraceptive of choice. If the woman chooses a newly developed method of contraception, she must be carefully informed about the uncertainties with regard to reliability and safety. Oral contraceptives are absolutely contra-indicated in the following cases: a history of myocardial infarction, stroke (CVA), venous thromboembolism, a known coagulation-factor deficiency, breast or endometrial carcinoma or severe liver-function disorders. Non-hormonal methods of contraception are preferred in such a case. If there are two or more risk factors for cardiovascular disease, the doctor and the patient must consider the pros and cons of hormonal contraception. In this connection, stopping smoking is more effective than not using an oral contraceptive. A prescription for an oral contraceptive can be given without a physical examination, not even a measurement of the blood pressure; follow-up is only necessary in the case of side effects or questions. Progestagen-only contraceptives are absolutely contraindicated in the following cases: current venous thromboembolism, vaginal bleeding of unknown origin, progestagen-dependent tumours such as breast cancer, and severe liver function disorders.

Contraceptives, Oral, Hormonal↗
PubMed2005

The influence of long-term hormonal contraception and smoking on plasma concentrations of nitrites and nitrates.

BACKGROUND: Higher estrogen levels in premenopausal women have a protective effect against arteriosclerosis. In contrast, hormonal contraceptives are often connected with an increased cardiovascular risk, and opinions differ on whether or not smoking increases this risk. The aim of this study was to determine the influence of oral hormonal contraceptives and smoking on the production of nitric oxide metabolites (nitrites/nitrates). MATERIAL/METHODS: We investigated plasma concentrations of nitrites and nitrates in a group of 24 young women using hormonal contraceptives and a group of the same size of women not using such contraception. Both groups were further divided into smokers and non-smokers. The measurements of nitrites and nitrates were performed by a sensitive high-performance liquid chromatography method with two connected detectors. RESULTS: Plasma nitrate levels in women using hormonal contraceptives were lower in comparison with the control group of women not using such contraceptives. A statistically significant difference was also found when comparing nitrate concentrations between both groups of female smokers as well as between both groups of non-smokers. The lowest values were recorded in female smokers simultaneously using oral contraceptives. CONCLUSIONS: We have demonstrated lower plasma concentrations of nitrites and nitrates in contrast with the control group in premenopausal women using oral contraceptives in the long-term. Hormonal contraception and simultaneous smoking substantially decreases the plasma concentrations of nitric oxide metabolites (nitrites/nitrates), which can be evidence of vascular homeostasis defect and increased cardiovascular risk.

Adult↗
PubMed2006

[Relationship between contraceptive use behavior and related knowledge and cognition among vocational high school students].

OBJECTIVE: To study the relationship between contraceptive use behaviors and related knowledge and cognition among vocational high school students. METHODS: A computer-administrated anonymous cross-sectional survey was conducted among grade one students from three vocational high schools in a district of Shanghai. Based on Health Belief Model, four cognition indexes including perceived benefits, barriers, sex behavior related risks and self-efficacy were applied. RESULTS: Among 1612 respondents, the students who had sexual experience accounted for 7.01% (113/1612). At first sex, 56.64% (64/113) of respondents reported contraceptives use; and the methods most reported were condom (58.70%, 27/46) and oral contraceptive (27.78%, 5/18) respectively for male and female. Most reasons for non-use were feeling shy to buy it (26.53%, 13/49) and the opposite sex's unwillingness to use (18.37%, 9/49). Among those who had experienced sex, 68.35% (54/79) and 68.42% (52/76) of respondents thought withdrawal and rhythm were effective methods. Only 23.26% (10/43) of subjects who had ever used condom could gain the full score of knowledge on how to use condom. A few respondents (22.86%, 24/105) who had sex experience knew that "If a person is infected with STD, he/she may not have noticeable symptoms". And 40.63% (26/64) of respondents who had not use contraceptive at first sex considered that "Infrequent intercourse cannot cause a girl pregnant even she has experienced her menstruation". The level of perceived risks was lowest among four cognition indexes. Contraceptive related knowledge and cognition may contribute to respondents' contraceptive use behaviors at first sex, and only related cognition contribute to contraceptive use behaviors at recent sex. CONCLUSION: It should be urgent to improve contraception knowledge and cognition among vocational high school students and provide youth-friendly contraceptive services.

Adolescent↗
PubMed1989

[Sociologic problems of contraception in the opinion of women from urban and rural areas].

The paper, having a diagnostic character, discusses the problems of birth control, family planning and contraception methods. The methods of the investigation were a questionnaire, interview and analysis of documentation. The investigation was carried out in two areas: urban--Katowice and rural--Istebna. The investigation was carried out among a group of 100 women between 20 and 55 years of age. All the women questioned have been married for 1-30 years. Most of them have two children--30%. Most women from both the urban and rural areas use natural methods of contraception, in. the town--Billings method and in the country--conjugal diary. Thermal method is less popular as it is time-consuming. The main reasons for choosing a natural method of contraception control are moral, religious and biological aspects, which give the women a psychic comfort and a strong feeling of attachment to the husband. Women from the urban area say that they started to use contraceptive methods after getting married whereas women from the rural area--after giving birth to a child. Contraceptive devices are used by about 30% of women. The most popular are: among women from the town--coitus interruptus, artificial abortion and less popular contraceptive devices such as oral contraceptives, intrauterine devices and chemical substances. Among women from the rural area the most common is coitus interruptus and then 2-1 cases of each of the remaining methods. Women applying contraceptive devices are aware of their harmful effects, their unreliability, immorality and violating nature. Women in the country face a lot of difficulties in buying contraceptive devices and they also (22%) use artificial abortion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Oral contraceptive use and blood pressure levels among women workers in São Paulo, Brazil.

Oral contraceptive use has been increasing in Brazil since the late 1970s, and oral contraceptives have been associated with higher incidence of cardiovascular diseases, including hypertension, since their release in the United States and Europe. We examined the association between oral contraceptive use and blood pressure levels in 1457 workers from 10 sectors of the economy, between the ages of 15 and 49 years, in São Paulo, Brazil. Oral contraceptive use was associated with higher age, lower parity, higher income, white ethnic group, and administrative occupations. Using multiple linear regression and logistic regression techniques, we evaluated blood pressure and hypertension differences between users and nonusers. Oral contraceptive users had a mean systolic blood pressure 2.6 mm Hg higher than nonusers after adjustment for multiple potential confounders, including age, income, parity, ethnicity, body mass index, and occupation. There was a statistically significant positive trend between length of time on oral contraceptives and mean systolic blood pressure levels. After adjustment for demographic and social variables, there were no differences between whites and blacks. Oral contraceptive users have an adjusted odds ratio for hypertension of 2.66 (95% CI: 1.51-4.70). The finding of an increasingly positive association between oral contraceptive use and mean systolic blood pressure level suggests cause and effect. This observation has substantial importance because systolic blood pressure is considered the primary predictor of blood pressure-associated morbidity and mortality. This may pose a particular problem in Brazil, since most women on oral contraceptives are not under medical supervision.

Adolescent↗
PubMed1993

Sexual activity and contraceptive use amongst teenagers under the age of 15 years.

AIMS: The aims of this study were to document patterns of sexual activity and contraceptive use in a sample of 952 Christchurch born children studied to the age of 15 years. METHOD: Data on sexual activity and contraceptive use was collected on the basis of self report at ages 14 and 15 years. RESULTS: By the age of 15 years, 8.5% of this sample had engaged in sexual intercourse. Early sexual activity was more common amongst girls, amongst children of Maori or Pacific Island ethnicity and among children from families of unskilled or semi-skilled socioeconomic status. Of those who were sexually active just under half (49.4%) reported having intercourse with only one partner while 17.3% (1.5% of the total sample) reported sexual experience with more than three partners by the age of 15 years. There was a high rate of contraceptive usage in the sample with 88.9% of those who were sexually active having used a recognised form of contraception and it was estimated that approximately 87% of sexual acts reported by this sample involved the use of contraception. The high rate of contraceptive usage for the sample was accounted for largely by the use of the condom and over 80% of those who were sexually active reported using this method. Despite the high rate of contraceptive usage evident for the sample just under one third of those who were sexually active reported having unprotected intercourse on at least one occasion. CONCLUSIONS: Bearing in mind the possibility of under reporting of sexual activity, the results suggest that by the age of 15 years in the region of 1 in 10 teenagers were sexually active. The major finding to emerge from the study was a high rate of utilisation of contraceptive methods, particularly the condom. It seems likely that this high rate of condom usage is a reflection of the effects of publicity and public education campaigns about the risks of HIV infection, AIDS and the need for safe sex. Despite the high rate of contraceptive usage for this sample it is suggested that those engaging in early sexual behaviour are a high risk population in need of support, assistance and counselling.

Adolescent↗
PubMed1996

[Significance of hereditary thrombophilia for risk of thrombosis with oral contraceptives].

Oral contraceptives increase the natural incidence of venous thromboses of 1-2/10,000 women per year 3-to 4fold. Recent investigations have shown that during intake of desogestrel or gestodene containing formulations the risk is twice that with older low-dose ovulation inhibitors. This difference is larger in first time users than in women who had previously used an oral contraceptive. During pregnancy, the incidence of thromboses rises up to 10/10,000 women-years and post partum up to 40/10,000 women-years. In about 60 % of thromboses no causal explanation can be found. It is suggested that in 40 % of all cases an inherited thrombophilia is present. Among the hereditary types of thrombophilia, the resistance against activated protein C (APC-resistance) represents nearly 50 %, while altogether 15 to 20 % is based on a deficiency of antithrombin III, protein C or protein S. APC-resistance the prevalence of which is 3-5 % in the general population, increases the risk of thrombosis 8fold and in users of oral contraceptives 35fold. Protein C-deficiency (prevalence 0.1-0.5 %) increases the risk of thrombosis 9fold and in users of oral contraceptives 15fold, while antithrombin III-deficiency (prevalence 0.02-0.05 %) enhances the risk in pill-users 8fold. Ovulation inhibitors do not influence risk of thrombosis in women with protein S-deficiency. Antiphospholipid-antibodies the concentration of which may increase during treatment with oral contraceptives, represent a considerably enhanced risk of thrombosis, too. A positive family history (before age of 40 years) indicates an inherent thrombophilia. In these risk groups, the cost/benefit ratio of a selective screening is unfavorable, as at most 70 % of the hereditary thrombophilias can be diagnosed by laboratory analysis, and only very few patients will actually experience a thrombotic event: only 3 of 1000 carriers of APC-resistance will suffer from thrombosis during oral contraception per year. On the other hand, a negative result of laboratory tests does not exclude a hereditary thrombophilic disorder which as yet cannot be substantiated. It is not yet clarified whether a selective screening is superior to a careful assessment of individual and family history. A general screening cannot be justified because of the unfavorable cost/benefit ratio. If the individual or family history or pathological laboratory parameters indicate an enhanced risk of thrombosis, this risk has to be carefully weighed against the consequences of discontinuation of pill use. Those few individuals with risk factors who will experience a thrombosis, cannot be identified in advance. If in patients with thrombophilic disorders and/or other risk factors the use of oral contraceptives represents a particularly high risk, other contraceptive methods should be taken into consideration. If a patient with risk factors decides for the use of oral contraceptives, she has to be informed that in the case of symptoms indicating a thrombosis, the physician has to be consulted immediately. The earlier an appropriate therapy is initiated, the more effectively an acute pulmonary emboli or permanent damages, e.g. the post-thrombotic syndrome, can be prevented.

Adult↗
PubMed1992

Changes in coagulation and anticoagulation in women taking low-dose triphasic oral contraceptives: a controlled comparative 12-month clinical trial.

OBJECTIVE: The effects of two triphasic oral contraceptives on coagulation and anticoagulation factors were compared in a 12-month open-label study. STUDY DESIGN: Fifty-two women (mean age 26 years) were enrolled in and completed the study; 20 had been randomly assigned to receive levonorgestrel plus ethinyl estradiol, 24 had been randomly assigned to receive norethindrone plus ethinyl estradiol, and eight surgically sterile women acted as untreated controls. Coagulation and anticoagulation factors were measured at baseline and during the sixth and twelfth months. RESULTS: Both oral contraceptives produced significant decreases from baseline in prothrombin time and partial thromboplastin time; there were also significant changes in laboratory control times. Factor XII was significantly increased in both oral contraceptive groups after 6 and 12 months. Fibrinogen antigen was significantly increased for norethindrone plus ethinyl estradiol after 6 and 12 months and for levonorgestrel plus ethinyl estradiol after 12 months. Platelet counts were unchanged. There was a significant increase in antithrombin III activity with norethindrone plus ethinyl estradiol at 12 months. Antithrombin III antigen was unchanged with the oral contraceptives; however, significant increases existed for alpha 1-antitrypsin antigen and plasminogen antigen and activity after 6 and 12 months and for alpha 2-macroglobulin antigen after 12 months for both oral contraceptives. alpha 2-Antiplasmin antigen was significantly increased for norethindrone plus ethinyl estradiol at the 12-month evaluation. There were no significant differences between the oral contraceptives for any coagulation or anticoagulation factor, and mean values generally remained within reference ranges. CONCLUSIONS: Levonorgestrel plus ethinyl estradiol and norethindrone plus ethinyl estradiol had equivalent, minimal effects on hemostasis, and changes in coagulation factors appeared to be balanced by changes in anticoagulation factors.

Adult↗
PubMed1997

A twelve-month comparative clinical investigation of two low-dose oral contraceptives containing 20 micrograms ethinylestradiol/75 micrograms gestodene and 30 micrograms ethinylestradiol/75 micrograms gestodene, with respect to efficacy, cycle control, and tolerance.

The aim of this study was to compare contraceptive reliability, cycle control, and tolerance of an oral contraceptive containing 20 micrograms ethinylestradiol (EE2) and 75 micrograms gestodene (GSD), with a reference preparation containing a similar dose of gestodene but in combination with 30 micrograms ethinylestradiol. A higher incidence of intermenstrual bleeding was apparent under the 20 micrograms EE2 oral contraceptive. For the 20 micrograms EE2 preparation, 47.4% of all women reported spotting at least once over a period of 12 treatment cycles, whereas this figure was 35.5% for the 30 micrograms EE2 pill (p < 0.05). However, the incidence was within a range that corresponds to that of other OCs. The cumulative breakthrough bleeding rates (at least once during the one year of treatment) of 14.5% (20 micrograms EE2) and 11.8% (30 micrograms EE2) of women were not significantly different. In relation to all cycles, the intermenstrual bleeding rates were remarkably lower, indicating that the majority of the volunteers experienced such events only in few cycles under treatment: the spotting rate was 11.5% (20 micrograms EE2) and 7.2% (30 micrograms EE2) of all cycles, and the breakthrough bleeding rate was 2.6% and 1.6% of all cycles, respectively. Three pregnancies were recorded during the study (one in the 20 micrograms EE2 + 75 micrograms GSD group, two in the 30 micrograms EE2 + 75 micrograms GSD group). All three could be explained either by intake irregularities or by circumstances impairing the contraceptive effect. The influence of both treatments on the blood pressure and body weight proved to be extremely slight. Adverse events in both groups were rare and differences in the frequency of adverse events were not apparent. The discontinuation rate due to adverse events, including intermenstrual bleeding, was low (9.8% for 20 micrograms EE2 + 75 micrograms GSD, and 7.2% for 30 micrograms EE2 + 75 micrograms GSD) and was in the lower range known for other oral contraceptives. Both preparations were well accepted by the volunteers. The data obtained demonstrate clinically acceptable cycle control, good tolerance, and a high standard of contraceptive reliability for both drugs. Prescription of the 20 micrograms EE2 preparation could be the first-line therapy in order to provide the lowest amount of EE2 possible. In case of persistent cycle control problems, a switch to the 30 micrograms EE2 drug should be considered.

Adult↗
PubMed1991

Contraception for women with diabetes: an update.

Today several effective contraceptive methods are available for women with IDDM. Contraceptive guidance as part of the pre-pregnancy counselling needs to be more widely implemented by general practitioners and in non-specialized obstetrical and gynaecological departments. Women with diabetes are generally well motivated, and thus the barrier methods may prove both acceptable and reliable contraceptive agents for some of these women. When, however, a high risk of user failure can be predicted, the IUD or hormonal contraception may be the only reversible alternative. According to our findings, IUDs can be recommended without reservation to women with IDDM. In women with previous GDM it seems that low dose oral contraceptive compounds may be administered without running the risk of inducing glucose intolerance, but long-term results are still unavailable. Natural oestrogens may be administered in combination with a progestogen for a limited period as an efficient and acceptable mode of contraception in women with IDDM without any concomitant adverse effects on diabetic control. From our investigations it also appears that short-term administration of combined low dose OCs containing the traditional progestogens (e.g. norethisterone or levonorgestrel) or the new gonane progestogens (e.g. gestodene) does not alter glycaemic control in women with IDDM. Similarly, these compounds do not cause any significant changes in lipid/lipoprotein levels during short-term treatment, although the intake of monophasic ethinyloestradiol/norethisterone preparations may result in higher triglyceride levels and tends to increase lipid levels more than triphasic ethinyloestradiol/levonorgestrel compounds. The results from our clinic have shown that OCs can be safely recommended at pre-conception counselling so that women with diabetes can obtain both optimal glycaemic control and efficient spacing of their pregnancies.

Contraception↗
PubMed1996

Why pregnant adolescents say they did not use contraceptives prior to conception.

OBJECTIVE: In this study we attempted to learn why childbearing adolescents failed to use contraceptives prior to conception. We hypothesized that among adolescents who elect to bear their children, positive and/or ambivalent feelings about having a baby are the most frequently cited reasons for not having used contraceptives. STUDY DESIGN: This is a cross-sectional, clinic-based survey of a racially and ethnically diverse group of 200 consecutively enrolled, poor, pregnant, 13-18-year-old patients in an adolescent-oriented maternity program. The participants completed a self-administered questionnaire which elicited information about environmental and personal risk factors for inconsistent use of contraceptives and information about the reasons they had not used contraceptives consistently prior to conception. Student's t-tests, Chi-square, and logistic regression analyses were used. RESULTS: The most frequently cited reasons for not using contraceptives prior to conception were: "I didn't mind getting pregnant" (20%) and "I wanted to get pregnant" (17.5%), followed by "I was using birth control but it didn't work (broke)" (12%), "I thought there was something wrong with me and I couldn't get pregnant" (9%) and "I just didn't get around to it" (9%). Teenagers who cited positive and/or ambivalent attitudes toward childbearing as their primary reason for not using contraceptives at the time of conception did not differ from others with regard to age, Medicaid status, gravidity, parity, frequency of living with parents, partner's age, depressive symptoms, or perceived family support. They were, however, more likely to have known the father of the baby for more than 6 months at the time of conception [odds ratio (OR) 2.53; 95% confidence interval (CI) 1.22-5.26) and to have dropped out of school (OR) 2.15; 95% CI 1.10-4.26]. CONCLUSIONS: The study hypothesis was supported. The absence of negative attitudes toward having babies rather than negative attitudes toward contraceptives is the most commonly cited reason for nonuse of contraceptives among childbearing adolescents. The results of this study may enable health care and social service providers to design more effective programs for preventing first and subsequent adolescent pregnancies.

Adolescent↗
PubMed2005

Emergency contraception.

Emergency contraception is increasing in use and has become a universal standard of care in the United States. This article reviews available forms of emergency contraception, their indications, contraindications, adverse effects and efficacy at preventing pregnancy. This article describes the mechanism of action of different forms of emergency contraception and provides recommendations on when to start or restart an ongoing method of contraceptive after emergency contraception use. Literature on the impact of the advance provision of emergency contraception on contracepting behaviors is reviewed, and behavior change counseling related to emergency contraception is described.

Adolescent↗
PubMed1992

Awareness and practice of contraception among female students at the Institute of Management and Technology (IMT), Enugu.

A study of the knowledge, attitudes to and practice of contraception among the female students at the Institute of Management and Technology (IMT), Enugu, was carried out, involving 266 female students out of a total female student population of 1,510. The mean age of the population sample was 19.1 years and 254 (95%) were single. Ninety-six percent were aware of the availability of contraceptives. Knowledge relating to the practice of contraception was superficial since as many as 61% of the objectors believed that contraception subsequently led to infertility. One hundred and thirty (49%) of the studied population had used one form of contraception or another sometime in their lives. Seventy-six percent had not used any contraception for initial intercourse. The rhythm method followed by the barrier method were the most popular forms of contraception. Practice of contraception by the studied population was inconsistent as 21% of the students eventually had an unwanted pregnancy and 18% had an induced abortion. Health education is strongly recommended to our women folk in order to reduce the high incidence of unwanted pregnancy and its associated medical and social complications.

Adolescent↗
PubMed1997

Predicting contraceptive vigilance in adolescent females: a projective method for assessing ego development.

PURPOSE: To test the hypothesis that ego development would predict contraceptive use. Problems in ego development were defined in terms of three factors: (1) realism, (2) complexity, and (3) discontinuity. METHODS: Forty-one respondents aged 14-17 years were selected from a group of 233 adolescents who were administered a projective pregnancy scenario and participated in a 12-month follow-up. Twenty of these adolescents were randomly selected from the group determined to be effective contraceptive users, while 21 were randomly selected from the group of poor contraceptors. RESULTS: Chi-square test revealed a significant association (p < .0005) between the composite ego maturity (EM) measure and contraceptive outcome (chi 2 = 13.82, with df-1). Low scores on the ego maturity measure predicted poor contraceptive use. EM was unrelated to age but was associated with race (chi 2 = 7.535, .025 < p < .05). However, EM predicted contraceptive use when controlling for the effects of race. CONCLUSIONS: A simple, time-efficient projective pregnancy scenario is an effective way of determining adolescent females at risk for poor contraceptive effectiveness and, therefore, untimely pregnancy. These stories are analyzed using factors related to the ego development of the adolescent. Subjects who scored lower on this measure have poor contraceptive effectiveness while subjects with higher levels demonstrated effective contraception use, at 1-year follow-up.

Adolescent↗
PubMed1997

Determinants of contraceptive use among women of reproductive age in Great Britain and Germany. II: Psychological factors.

Psychological determinants of contraceptive use were investigated in Great Britain and Germany, using national data obtained in 1992. It was hypothesised that current contraceptive use among sexually active, fertile women aged 15-45 was related to their attitude towards the various contraceptive methods, social influences, perceptions of being able to use a method correctly and consistently, a correct estimation of fertility, and communication with their partner. Effects of age and country were also taken into account. The attitude of respondents towards the various contraceptive methods was ambivalent and no method was seen as ideal. On medical methods (OCs, IUDs and sterilisation) many respondents expressed doubts as to their safety for health. Social influences most frequently concerned the use of OCs. Respondents considered themselves able to use oral contraceptives correctly, but expressed general fear about intrauterine devices and sterilisation, and many women believed they were not able to use condoms and periodic abstinence consistently. Multifactorial analyses revealed that current contraceptive use was principally determined by social influences, attitude and self-efficacy with respect to medical methods. Age and country, and, for use of unreliable methods, fertility awareness also played a role. Communication with the partner was less relevant. Contraceptive choice (and the use of non-medical methods) depended greatly on encouragement to use and being in favour of medical methods. A lack of social support for use of medical methods and a negative attitude towards them was related to higher use rates of condoms, periodic abstinence, withdrawal and reliance on 'luck'. In the case of withdrawal and/or no method, underestimation of fertility played an additional role. Contraceptive choice appears to be determined more by a general like or dislike of medical methods rather than on a weighing of the merits of individual available methods.

Adolescent↗
PubMed2002

Comparison of cycle control with a combined contraceptive vaginal ring and oral levonorgestrel/ethinyl estradiol.

OBJECTIVE: The purpose of this study was to compare cycle control and tolerability of the NuvaRing (NV Organon, Oss, The Netherlands), a novel combined contraceptive vaginal ring, with a standard combined oral contraceptive pill. STUDY DESIGN: Healthy women aged 18 to 40 years who requested contraception received either NuvaRing or a combined oral contraceptive containing 30 microg ethinyl estradiol and 150 microg levonorgestrel for 6 cycles in 3 similarly designed studies. Each cycle comprised 3 weeks of ring or pill use, followed by 1 ring- or pill-free week. RESULTS: Two hundred forty-seven women began the studies, 121 women with NuvaRing and 126 women with the combined oral contraceptive. Withdrawal bleeding occurred in virtually all cycles in both groups. In the NuvaRing groups, the incidence of irregular bleeding was < or =5% in all cycles; this was lower than the combined oral contraceptive groups (5.4%-38.8%). Furthermore, the incidence of a normal intended bleeding pattern was significantly higher in the NuvaRing groups than in the combined oral contraceptive groups (P <.01). Both contraceptives were well tolerated. CONCLUSION: NuvaRing has excellent cycle control and is well tolerated.

Administration, Oral↗
PubMed2005

Understandings of the 'natural' body: a comparison of the views of users and providers of emergency contraception.

BACKGROUND: 'Natural' is a pervasive discourse with mixed meanings in contemporary society. I was interested in how users and providers of emergency contraception conceptualised the 'natural' body in contraceptive decision making. METHOD: Thirty-two users and 19 providers of emergency contraception from three sites in metropolitan Melbourne were interviewed, or participated in focus groups, about emergency contraceptive use, contraceptive decision making and perceptions of risk. The qualitative data were transcribed and coded to identify the key ways that both users and providers perceived the 'natural' body. RESULTS: Providers and users adopted different frameworks for interpreting the discourse of the 'natural' body. Thirteen of the 32 users identified the 'natural' body as a factor in their decision making. They identified a 'natural' body as a body experiencing no interruption with ovulation, and/or free from unwanted side effects. Six of the 13 women who discussed the 'natural' body used a contraceptive that allowed them to preserve their natural body (e.g. condoms). The remaining seven women identified it as an ideal that they could not achieve. Providers in general discredited the idea of a 'natural' body and instead conceptualised contraceptive decision making as a 'simple' risk-benefit analysis. CONCLUSIONS: The differences between the two groups can be understood in a number of different ways. The important conclusion however, is that the different perspectives present a potential barrier to effective communication in the contraceptive consultation, and may be able to be resolved through the development of an embodied risk-benefit analysis that may be meaningful to both groups.

Adult↗