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PubMed1989

The effects of oral contraceptives on reproduction.

Early reports linking the use of contraceptive steroids to congenital malformations have not been substantiated. There is a delay in the return of fertility after cessation of oral contraceptive use, but this may be concentrated in childless women aged 30 to 34. Oral contraception does not influence the rate of infertility. After the cessation of oral contraceptive use, there is no increase in the incidence of spontaneous abortion in subsequent pregnancies, nor is there an increased risk of pregnancy complications. Women who use oral contraceptives do not breast-feed as long as nonusers, but no differences can be detected between the growth and development of the children of oral contraceptive users and nonusers. There is no relationship between oral contraceptive use and pituitary adenomas, or between oral contraceptive use and subsequent amenorrhea.

Adult↗
PubMed1988

Twenty-eight-day oral contraceptives: physician and user attitudes.

A 28-day regimen of oral contraceptives that uses seven iron tablets (each containing 75 mg of ferrous fumarate) instead of seven sugar placebos was designed to encourage user compliance. To determine professional and user attitudes toward the 28-day regimen, 192 obstetrician-gynecologists and 469 women who used oral contraceptives were surveyed. Over two-thirds of the physicians stated that they approved both the 28-day regimen and the inclusion of the seven iron tablets. Over 80% of the women surveyed expressed approval of a 28-day regimen that included seven iron tablets.

Adult↗
PubMed1986

Selection of steroid combinations for oral contraceptives of maximum benefit.

Low-dose oral contraceptives differ in the specific progestin component. Our review of available animal and human data revealed differences between the progestins as to their potencies for estrogenic, anti-estrogenic, androgenic and progesterone effects. Ideally, oral contraceptive formulations should have the minimal effective dose, sufficient to prevent pregnancy but with the fewest metabolic changes. The risk of cardiovascular disease may be predicted by changes in the composition and amount of circulating lipoproteins. Progestins with significant androgenic potency can lower high-density lipoprotein2; that is a possible adverse effect. Randomized, blind, comparative trials of the new multiphasic preparations are needed to determine which ones truly cause the fewest metabolic changes that might be of clinical significance.

Animals↗
PubMedDate not supplied

User characteristics and oral contraceptive compliance in Egypt.

Results from the 1988 Egypt Demographic and Health Survey show that many women are not taking oral contraceptives in a manner that ensures full protection by the method. Reports from 1,258 current pill users show a range of incorrect use; 63 percent of women surveyed reported an interruption in their use of the pill in the past month, and of those women, only 40 percent took the correct action when they missed a pill. The majority (89 percent) did not wait the correct number of days between packs. Multivariate analysis revealed that rural women were more likely to take pills out of sequence, compared with their urban counterparts. Failure to take a pill within the previous month was strongly associated with the experience of side effects. The younger women surveyed were more likely to know the correct interval between pill packs than were older women; and women who wanted more children were more likely to know the correct interval than those who did not. The use patterns exhibited by the pill users may be the result of their receiving confusing, incorrect, or incomplete information, and highlight the need to provide women with accurate, updated, and comprehensible information about oral contraceptives.

Adolescent↗
PubMed1985

Hormonal contraception in diabetic women: acceptability and influence on diabetes control and ovarian function of a nonalkylated estrogen/progestogen compound.

The clinical acceptability and the influence on diabetes control were investigated in 50 women with insulin-dependent diabetes mellitus (IDDM) during intake of a combined nonalkylated estrogen/progestogen compound (4 mg 17-beta estradiol, 2 mg estriol and 1 mg norethindrone) for one year. In 6 IDDM women, the influence of the hormonal treatment on diabetes control and on ovarian function was investigated by measuring the concentration of glycosylated hemoglobin (Hb-Alc), fasting plasma glucose, serum estradiol, serum estrone, serum progesterone and sex hormone binding globulin (SHBG) capacity. No pregnancy occurred during the study and the overall continuation rate of 60% compare well with the continuation rate normally found in non-diabetic women after administration of conventional type oral contraceptives. No difficulties with diabetes control was registered and no significant changes in insulin requirements, 24-h urinary glucose excretion nd Hb-Alc were found. Ovulation was inhibited during the hormonal intake as judged by serum progesterone measurements. Serum estrone increased (p less than 0.05), but this had no influence on SHBG capacity, indicating that the estrogen/androgen balance was unchanged during treatment.

Adult↗
PubMed1988

Sexual and reproductive life events in relation to duration of oral contraceptive use.

In order to disclose differences between users and non-users of oral contraceptives (OC), 620 women aged 15-54 were invited to participate in an in depth interview about sexual, contraceptive, and reproductive life events. Of the 585 women who participated, 459 were consecutive gynecological in- or outpatients, and 126 were selected from visitors in general practice. Data was analysed by multivariate test statistics. After correction for present age and social class, the duration of use of OC (DOC) among women 15-34 years of age correlated negatively to age at menarche and coital debut and positively to number of sexual partners, oral-genital sexual practice, and number of pelvic inflammatory diseases. Among women over 35, DOC was positively associated only to cigarette smoking. No correlation was found to coital frequency (whether earlier, present or during pregnancy or menstruation), number of births and abortions, or to social classification. In epidemiological research on benefits and risks of oral contraceptives, confounding influence of one or more variables is of crucial importance. The present findings point at sexual and life-style habits as potential confounders in the study of OC and associated diseases.

Adolescent↗
PubMed1991

Open prospective multicenter trial with a new monophasic contraceptive combination containing gestodene.

In a large and open prospective multicenter trial of 12,250 cycles from 2,378 women, contraceptive efficacy, clinical tolerance and acceptability of a new monophasic contraceptive combination containing 75 mcg gestodene (delta-5-levonorgestrel) and 30 mcg ethinyl oestradiol were studied. The objective was to assess efficacy, safety, side effects and cycle control of this oral contraceptive on healthy women using no other additional birth control methods. Two women became pregnant (0.016%) during the trial; both were patient failures. There was no effect on systolic or diastolic pressures. An average weight increase of 0.3 kg was noted. Cycle control was excellent with 95% of the cycles free of spotting and 98% free of breakthrough bleeding after six cycles. No serious complications occurred. There was an overall incidence of 14% reported side effects (after six cycles), indicating that the hormonal combination is well tolerated. It should be noted that 41.4% of the patients had some complaint before starting the treatment. For all complaints, a highly significant improvement was seen during the treatment.

Adolescent↗
PubMed1994

Contraceptive use and attitudes in Great Britain.

In order to update current knowledge on contraceptive use and attitudes in Great Britain (i.e. England, Scotland and Wales), a survey was conducted among 1753 randomly selected British women aged 15-45. Replies were received from 967 women (55.2%). Seventy-three percent (73%) of fertile, sexually active women who wished to avoid pregnancy were using reliable methods of contraception, viz. oral contraceptives (OCs), intrauterine devices (IUDs) or sterilization. However, it was found that adolescents and women over 40 who wished to avoid pregnancy were, nevertheless, especially likely not to be using any contraceptive method at all. The women surveyed were concerned about weight gain, cardiovascular and cancer risks associated with OC use, and infection and infertility risks associated with IUD use. Sixty percent (60%) perceived sterilization as a major and risky surgical operation. It was concluded that contraceptive practice in Britain had not improved greatly in recent years. The latest scientific findings regarding the true advantages and disadvantages of OCs, IUDs and sterilization, therefore, need to be brought to the attention of the lay public more effectively. Special efforts need to be directed towards providing adolescents and women over 40 with proper information. Physicians and the mass media could play a considerable role in this respect.

Adolescent↗
PubMed1994

Obstacles to use of hormonal contraception.

Enabling women to control the timing of their childbearing has positive consequences on their physical and mental well-being as well as for society as a whole. Identifying and removing the obstacles to effective contraceptive use, coupled with improvements in the delivery of contraceptive services, must be given high priority from all sectors, both private and governmental. The consequences to a woman of an unintended pregnancy can be physically, psychologically, and economically far-reaching. Assisting women to control the timing or spacing of their childbearing or to help women effectively prevent any future childbearing is a challenge that must be addressed by health professionals and educators. Therefore identification of women who are at risk of unintended pregnancy as a result of inadequate use of contraception, lack of its use, or use of inappropriate methods is important to help women and couples achieve their reproductive goals as well as to reduce the high rate of unintended pregnancy in the United States. In addition, overcoming common obstacles to effective contraceptive use as well as those within the health service delivery arena will enable women to take better control of and improve their lives.

Contraception↗
PubMed1984

Chlamydia trachomatis: important relationships to race, contraception, lower genital tract infection, and Papanicolaou smear.

Chlamydia trachomatis is a common cause of sexually transmitted disease in adolescent girls. Of 366 adolescent patients screened, 15.3% were found to have chlamydial endocervical infections, with an infection rate of 23.3% in blacks, 14.3% in Hispanics, and 10.3% in whites (P = 0.01, excess for blacks). Of Chlamydia-positive patients, 63.6% had a diagnosis of lower genital tract infection, compared with 35.4% of Chlamydia-negative patients (P = 0.004). Oral contraceptive users had a higher prevalence of infection (23.8%) compared with those using a barrier method (16.2%) or with nonusers (9.3%) (P = 0.004). Inflammatory changes on Papanicolaou smears were associated with chlamydial infection (P = 0.0001). Other variables identified as risk factors for chlamydial infection included both a younger age at first intercourse (P = 0.02) and more years of sexual activity (P = 0.02). Chronologic, menarchal, and gynecologic age, biologic age of the cervix, the number of sexual partners in the last month and during a lifetime, and parity were not found to be associated with recovery of Chlamydia.

Chlamydia Infections↗
PubMed1989

Differences in biologic maturation, sexual behavior, and sexually transmitted disease between adolescents with and without cervical intraepithelial neoplasia.

Because several cofactors may influence the development of cervical intraepithelial neoplasia (CIN) in young women, we compared differences in behaviors (sexual activity, contraception, and cigarette use), sexually transmitted disease (STD) infection rates (Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and herpes simplex virus), and cervical maturation (age of menarche and percentage of cervical ectopy) in groups of sexually active female adolescents with and without CIN. Those with CIN were compared with three non-CIN groups: (1) teenagers who were referred to a teen colposcopy clinic but had no evidence of CIN (high-risk group), (2) teenagers seen at a gynecology clinic without STD symptoms (asymptomatic group), and (3) teenagers seen at the gynecology clinic with STD symptoms (symptomatic group). The percentage of cervical ectopy was measured by colpophotography. Subjects with CIN had more lifetime sexual partners than the asymptomatic group (p less than 0.001) and were more likely to smoke cigarettes than either gynecology clinic group (p less than 0.01). No differences in behaviors existed between the CIN and high-risk groups. The mean age of menarche in those with CIN was 1 year older than all three non-CIN groups (p less than 0.05), and those with CIN had a greater area of ectopy than those without CIN (p less than 0.02). Those with CIN were more likely to have a past or present history of C. trachomatis infection than the two gynecology clinic groups; no difference was found between the CIN and high-risk groups. We conclude that cofactors such as smoking, sexual promiscuity, and C. trachomatis infection may influence cervical vulnerability. However, cervical biologic immaturity is an important risk factor for development of CIN in adolescent girls.

Adolescent↗
PubMed2000

Use of birth control pills, condoms, and withdrawal among U.S. high school students.

PURPOSE: To examine the use of contraception at last sexual intercourse among currently sexually active adolescents. METHODS: We analyzed data from national school-based Youth Risk Behavior Surveys (YRBS) conducted in 1991, 1993, 1995, and 1997. The YRBS is a self-administered, anonymous survey which uses a national probability sample of U.S. students in public and private schools from grades 9 through 12. RESULTS: From 1991 to 1997, condom use significantly increased (from 46% to 57%), birth control pill use decreased (from 21% to 17%), and use of withdrawal significantly decreased (from 18% to 13%). In 1997, although more students were using condoms, 13% reported using withdrawal and 15% reported using no method to prevent pregnancy at last sexual intercourse. In 1997, condom use among females was significantly lower in the 9th grade than in the 12th grade (p <.001), whereas birth control pill use was higher (p <.001) and use of withdrawal remained stable. Among males, condom use and withdrawal use remained stable from 9th to 12th grade, whereas birth control pill use by their partner increased (p <.001). CONCLUSIONS: Inadequate contraceptive use among sexually active adolescents continues to be a major public health problem in the United States. For young people who will not remain sexually abstinent, families, health care providers, schools, and other influential societal institutions should promote the correct and continued use of condoms as essential protection against sexually transmitted diseases and human immunodeficiency virus infection.

Adolescent↗
PubMed1993

Contraception and women's health.

More and more women all over the world are opting for fertility by choice not by chance. Contraceptive use has a tremendous impact on women's health. The ability to regulate and control fertility is a basic component of health, positively defined as a state of physical, mental and social well-being. Contraception is saving the lives of women around the world from the hazards of unwanted pregnancy. Optimal childbearing is also contributing to infant and child survival. Contraception has a complex relationship to sexually-transmitted diseases. Contraceptive safety is a major public health concern. The risk/benefit assessment will differ for different populations, for different individuals, and even for the same individual at different periods of life. The family planning movement started as a movement by women for women. Women's perspectives and women's concerns should guide the future of contraceptive research and development.

Adolescent↗
PubMed1975

Clinical evaluation of a new oral contraceptive, 'Pregnon'.

'Pregnon', a new oral contraceptive containing 1 mg. lynestrenol and 0.05 mg. ethinyl oestradiol, was administered cyclically to 639 women of fertile age over a total of 9,159 cycles. There were no pregnancies. In most cases the withdrawal bleeding resembled normal menstruation. The incidence of metrorrhagia was relatively low and when it did occur it was usually confined to the early treatment cycles and was of very limited duration. The objective and subjective tolerance was excellent.

Adolescent↗