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PubMed1996

Oral contraceptives and invasive adenocarcinomas and adenosquamous carcinomas of the uterine cervix. The World Health Organization Collaborative Study of Neoplasia and Steroid Contraceptives.

Data from a hospital-based case-control study collected between 1979 and 1988 in 10 participating hospitals in eight countries were analyzed to determine whether use of combined oral contraceptives alters the risks of invasive adenocarcinomas and adenosquamous carcinomas of the uterine cervix. Information on prior use of oral contraceptives, suspected risk factors for cervical cancer, and history of cytologic screening was ascertained from interviews with 271 women with adenocarcinomas, 106 with adenosquamous carcinomas, and a large pool of hospitalized controls, from which 2,887 were matched to the cases included in this report. History of smoking and anogenital warts and blood specimens for measurement of herpes simplex and cytomegalovirus antibodies were obtained from subsets of these women, as was a sexual history from a subset of their husbands. The epidemiologic features and associations with oral contraceptives were similar for adenocarcinoma and adenosquamous carcinoma. For both types combined, risk increased with duration of oral contraceptive use, was highest in recent and current users, and declined with time since cessation of use. These trends in risk were strongest for cancers that occurred in women under age 35 years, and the association with risk was somewhat stronger for high compared with low progestin potency products. The strength of the observed relation with oral contraceptives was about the same as has been observed for invasive squamous cell cervical carcinomas. Women who have used oral contraceptives should be considered at increased risk of adenomatous cervical carcinomas.

Adenocarcinoma↗
PubMedDate not supplied

The presence of endometrial cells in cervical smears in relation to the day of the menstrual cycle and the method of contraception.

The presence of endometrial cells in cervical smears was studied in a large series of women participating in a population screening program for cervical cancer, in relation to different time periods of the menstrual cycle and to the method of contraception practiced. In the total group of women studied, endometrial cells were present in an average of 12% of the cervical smears. In women who were menstruating cyclically, the percentage of cervical smears containing endometrial cells was not age dependent. Only in women over 52 years was a lower number of endometrium-positive cervical smears found: in postmenopausal women, 0.6% of smears were found to contain endometrial cells. In menstruating women, the frequency of endometrial cells in cervical smears was highest during the menses. After day four, through the proliferative phase, the percentages of cervical smears containing endometrial cells markedly decreased. During the secretory phase, an average of 2% of the smears contained endometrial cells; in the premenstrual phase (after day 25), the percentages of endometrial cell-positive smears rose again. When related to the method of contraception practiced, significant differences in the percentages of cervical smears with endometrial cells appeared. In women using oral hormonal contraceptives, the average numbers of smears containing endometrial cells for the whole cycle as well as for each period of the cycle were significantly lower. This phenomenon might be due to endometrial atrophy on the basis of prolonged use of oral hormonal contraceptives. In women wearing an intrauterine device, at any moment the frequencies of smears with endometrial cells present were significantly higher than the values found in women using any other method of contraception or not using contraceptives. The evaluation of cells originating from the endometrium requires considerable experience. The identification of endometrial cells can be made with greater confidence when the cytologist is aware of the exact date of the menstrual cycle and of the impact on the presence of endometrial cells in cervical smears caused by different methods of contraception.

Adult↗
PubMed2005

Emergency contraception knowledge among women in a Boston community.

This study assesses the baseline knowledge of emergency contraception (EC) in a Boston neighborhood. A written survey was distributed to women aged 18-44 years in the Boston neighborhood of Jamaica Plain. Of the 188 participants, 82% have heard of EC. Knowledge disparities by race/ethnicity groups were seen, with only 51% of Latina women and 75% of Black women having heard of EC compared with 99% of White women (p < .0001 and p = .002, respectively). Of the entire cohort, 39% knew that EC works by preventing pregnancy, 48% knew that it should be taken within 72-120 h of unprotected intercourse and 44% knew that it is only available by prescription in Massachusetts. Only 25% of women have ever discussed EC with a health care provider, and only 12% have ever received an advance prescription. A community education campaign aimed at reproductive-age women, health care providers and pharmacists has been tailored to address these knowledge deficits.

Adolescent↗
PubMed1978

Thyroid hormone concentrations in a large scale community survey. Effect of age, sex, illness and medication.

Total thyroid hormone concentrations have been measured in the course of a large scale community survey to determine the distribution of these variables in the normal population and to assess the effect of age, sex, previously undectected thyroid disease and medication upon these parameters. 2779 subjects were studied. Serum T4 concentrations were normally distributed. A progressive increase in T4 levels with age was noted in the males, and a smaller increase in females which was concealed by the raised T4 values secondary to oral contraceptive therapy in females under the age of 45. Serum T3 levels were also normally distributed. There was a small reduction in T3 with age in the males but this fall was not seen in the females. T3 values were relatively higher in females under the age of 45 but this increase was not noted after exclusion of subjects taking an oral contraceptive. The changes in thyroid hormone concentrations with age are relatively minor (particularly with respect to T3) in a randomly selected sample from an English town. It is suggested that the changes reported by other authors reflect the process of selection used, and the high frequency of undetected thyroid disease, other illness and medication in hospital-based communities.

Adolescent↗
PubMed1994

Tissue specificity of the acrosomal protein SP-10: a contraceptive vaccine candidate molecule.

The tissue specificity of the intra-acrosomal protein SP-10 was examined by Northern blot and polymerase chain reaction (PCR) analysis. Messenger RNA from 36 tissues in the female baboon (Papio papio) was isolated, separated on agarose gels, transferred to nylon, and probed with either SP-10, beta-actin, or cyclophilin cDNA. Northern blots, which were processed at both low and high stringency, showed SP-10 to be expressed exclusively in the testis. The mRNA from each tissue was also reverse transcribed, and both SP-10 and beta-actin were amplified by PCR from the resulting cDNA. Ethidium bromide-stained agarose gels of the SP-10 PCR products showed three clear bands from the testis but no co-migrating bands from the other tissues. Southern blots of the PCR products showed that only the three bands in the testis were related to SP-10. The data demonstrate that the SP-10 gene products are testis specific, a characteristic essential for a contraceptive vaccine candidate molecule.

Acrosome↗
PubMed1998

The effect of oral contraceptive use on the prognosis of node positive breast cancer patients. German Breast Cancer Study Group.

The effect of oral contraceptive (OC) use as a risk factor for breast cancer was recently assessed in a large meta-analysis, but currently available data on the prognostic effect are still insufficient. We investigated the relationship between OC use and standard prognostic factors and the effect of OC use on recurrence-free survival (RFS) and overall survival (OS) in 422 premenopausal pT1a-3aN + M0 patients from two trials of the German Breast Cancer Study Group (GBSG). 137 patients (32.5%) were OC users. They were younger on average (mean age 41.5 years versus 45 years for non-OC users) and the percentage of patients with smaller tumours was higher in the group of OC users. Based on 163 events for RFS and 103 events for OS, no significant effect of OC use on RFS and OS could be demonstrated in univariate and multivariate analyses. In our study of node positive breast cancer cases, OC users were younger and had smaller tumours. This may be an effect of earlier detection of breast cancer, but OC users did not have a better prognosis, both before and after adjustment for tumour size and other prognostic factors.

Adult↗
PubMedDate not supplied

The quality of family planning services in rural China.

This article provides a preliminary analysis of three aspects of service quality in four rural counties in China--the availability of contraceptive methods, information given to users, and provider knowledge about methods. Contraceptive choice and characteristics of contraceptive use by women in the study areas are also examined. The data are derived from a survey carried out by the authors during 1987, under the auspices of China's State Family Planning Commission. The survey was conducted in four rural counties located in Fujian and Heilongjiang provinces. A total of 318 married women of reproductive age were randomly selected and interviewed. All family planning service sites serving the women were visited and a sample of service providers was interviewed. No shortage of contraceptives existed in any of the counties, but variations in community wealth and local procurement practices have resulted in the acquisition of an IUD with high failure rates. Although providers believe they inform women about method choices and side effects, women were poorly informed about the methods they selected. Not all providers who insert IUDs and distribute pills were knowledgeable about contraindications and side effects of the methods. Ever-use of contraception was nearly 100 percent, but most women, especially in Heilongjiang, have only used one method: the IUD or sterilization. Improvements in quality, especially in method mix, providers' level of knowledge, and the quality and quantity of information provided to users will likely improve contraceptive continuation, client satisfaction, and women's health.

China↗
PubMed1990

IUD (Nova-T) insertion following induced abortion.

In a prospective study, 86 women who had an IUD (Nova-T) inserted immediately after induced abortion were compared to 95 abortion patients who started another contraception (control I). Additionally, the rate of complications following IUD insertion in a Family Planning Clinic (control II) were studied in 83 non-pregnant women. The overall infection rate for post-abortion patients was 4.4% (5.8% in the study group, 3.2% in control I). No infections were observed in control group II. Confidence limits (95%) for the three groups were overlapping. Among the women in the study group, bleeding and pain were not more frequent, but if one of these complications occurred, it tended to be more serious and the duration was longer. The number of days before resumption of work after abortion was 3-4 days in both abortion groups. After three months, the continuation rate was 83% (71 of 86) in the study group, 76% (72 of 95) in control I and 93% (77 of 83) in control II. Sixty-nine of the 181 women admitted for legal abortion had been admitted for the same reason previously. In this study, the recurrence rate after 12 months was 0% in the study group and 4.2% (4 of 95) in control group I. The insertion of an IUD at the time of abortion seems to be an effective and acceptable solution to the problem of recurrent abortion.

Abortion, Induced↗
PubMed1990

Hormonal postcoital contraception with an ethinylestradiol-norgestrel combination and two danazol regimens.

The ethinylestradiol-norgestrel combination (EE-NG) for postcoital contraception, as described by Yuzpe, has been shown to be an effective method but with frequent side effects. To overcome the problem of adverse effects a new approach using danazol was proposed, but the efficacy and acceptability of this treatment have not yet been tested in large studies. In a 5-year period at the AIECS Family Planning Centre in Milan we treated 2448 women requesting postcoital contraception using Yuzpe's regimen and two danazol regimens (800 mg/1200 mg). The patients' acceptability for danazol treatment was higher than for Yuzpe's regimen due to fewer, milder and shorter side effects. Nine pregnancies occurred in the EE-NG group (2.21%), 17 in the 800 mg group (1.71%) and 6 in the 1200 mg group (0.82%). Our study shows a statistically significant efficacy against expected pregnancy rates both with Yuzpe's regimen and with danazol. The 1200 mg danazol treatment seems to be more effective and can be considered a valid alternative to the EE-NG combination for hormonal postcoital contraception.

Adolescent↗
PubMed1977

[Brain infarctions during treatment with ovulation inhibitors (author's transl)].

392 cases of cerebrovascular disturbances in women while taking oral contraceptives are reported since 1962. There has been a remarkable change of the distribution of age among these women. Till 1970 were mostly women involved between the age of 30 and 34 years. Today this type of distribution is no more to be seen because of the growing number of reports about complications in other age-groups. Complications were till 1970 mostly reported in the period from ten days till six months after taking oral contraceptives. The publications of the last three years are showing that many women are involved, who had taken oral contraceptives more than two years. New publications and our own results are showing no changes of the clinical syndromes and of the prognosis. Our investigation shows no decrease in the number of young women suffering of thromboembolic cerebral disorders of unknown aetiology in the last years. In this group is the percentage of the women, which had taken ovulation inhibitors, no reduced. The conception, that there is a connection between oral contraceptives and cerebrovascular occlusions seems more possible as before. Especially attention in prescription of oral contraceptives should be given to the fact of a known predisposition. The rareness of these complications leads to the conclusion that one or more predisponating factors of a nature not yet known have to be existent.

Adult↗
PubMed1977

The risk of post-pill amenorrhea: a preliminary report from the Menstruation and Reproduction History Research Program.

Menstrual cycle lengths prior to and after oral contraceptive use were prospectively recorded for 245 women. In this preliminary study, a difference in the distributions in the pre- and post-pill cycle lengths was observed. An increase of 5 days in the medial cycle length occurred after oral contraceptive use had been discontinued. Although there was an approximately twofold relative risk of amenorrhea of 90 days' duration or more after discontinuing pill use, the differences in the rates of amenorrhea between the pre-pill and post-pill cycles were not statistically significant.

Adult↗
PubMed2005

Mortality from venous thromboembolism in young Swedish women and its relation to pregnancy and use of oral contraceptives--an approach to specifying rates.

BACKGROUND: Pregnancy and use of combined oral contraceptives (COCs) are major risk factors for venous thromboembolism (VTE) in young women and we wanted to obtain accurate VTE mortality data overall, by age, associated with the use of COCs and pregnancy. METHODS: From the Swedish Cause of Death Register (CDR) we identified women aged 15-44 with VTE as underlying or contributory cause of death during the period 1990-1999. We scrutinized medical records and included verified VTE cases without active cancer or terminal disease. Pregnancy statistics and COC utilization data were obtained from national databases. RESULTS: Of the 120 cases included, 9 (8%) were associated with pregnancy and 28 (23%) with current COC use. The overall refined VTE mortality rate in current COC users was 7.5[4.7; 10.3] per million user-years and the corresponding pregnancy-related rate was 8.9[4.1;17.0] per million pregnancy years, rates increasing with age. For ages 15-24, the rate was significantly higher in current COC users than in non-pregnant women not using COCs: 6.0[3.1; 10.5] per million user-years vs. 0.3[0.0; 1.2] per million woman years. Underlying cause mortality data included 82% of VTE deaths associated with COCs, and 56% of maternal deaths had a pregnancy-related code. CONCLUSION: Mortality figures from VTE associated with the use of COCs and pregnancy were similar. COC use had an important impact on the total VTE mortality in the youngest age group. Standard mortality statistics do not allow accurate monitoring of VTE mortality in young women due to missing data, misdiagnoses and coding rules.

Adolescent↗
PubMed1990

Family planning in rural Africa: can it work?

High fertility is the major demographic problem presently affecting rural Kenya. Chogoria Hospital has attempted to provide a community based family planning service to address this issue. This paper describes the intervention used and analyses the current contraceptive practice in the area. It is concluded that community based distribution of family planning commodities may be associated with a marked decrease in fertility rate and family size within a relatively short period. Family planning initiatives in Africa may be remarkably cost-effective interventions in the development of a nation and be associated with well spaced and healthy children.

Adolescent↗
PubMed1993

A national study to monitor the safety of IUCD use.

OBJECTIVE: To determine whether the known adverse effects of IUD use were being kept to a minimum in a population of women. DESIGN: A national survey of all doctors purchasing IUDs in a three-month period. Information was sought on the doctors' training, experience and usual insertion practice, and also on characteristics of each woman receiving an IUD in the study period. MAIN OUTCOME MEASURES: Published national and international guidelines on selection of users for IUDs and on training for IUD insertion were compared with our findings on these measures. RESULTS: Not all IUD insertions were in accordance with published guidelines. Very few IUD insertions (0.9%) were carried out in the face of absolute contraindications to this type of contraception. However, 126 insertions (27%) were for women who had a relative contraindication, excluding an incomplete family. Gynaecologists were significantly less likely to fit an IUD in the presence of contraindications than other doctors. Few doctors reported training to the standard recommended. CONCLUSIONS: That the known adverse effects of IUD use are not being kept to a minimum for New Zealand women. The study design could be used to estimate the potential for adverse effects in populations for other types of contraceptives.

Adolescent↗
PubMed2002

Attitudes of mothers toward their daughters' use of contraceptives in Israel.

The objective of the study was to examine mothers' knowledge about contraception, their attitudes to their daughters' use of contraception, and their communication with their daughters on the subject. A 20-item questionnaire was distributed in gynecological clinics throughout Israel for completion by women who had daughters over the age of 14 years. The questionnaire covered the mothers' demographic data, use of contraception, knowledge of contraception, attitude to their daughters' contraceptive use and sexual relationships, and communication with their daughters about contraception. Only 36% of the women received contraceptive information from physicians. Almost half felt their daughter should begin sexual relations when she felt she was ready; over two-thirds felt she should begin using contraception before or at the time of beginning sexual relations. Over three-quarters spoke with their daughters about contraception. Higher educational level of the mother was associated with high rate use of contraception by the mother, her support of earlier use of contraception by her daughter, a greater likelihood of her discussing contraception with her daughter, and a lesser likelihood to view contraceptives as dangerous to one's health. It is concluded that mothers of teenage daughters in Israel are involved in their daughters' decisions to begin sexual relations and the use of contraceptives. Their knowledge of contraception is adequate, although some gaps are still apparent. Clear correlation is found between higher educational level of the mothers and a more liberal attitude toward their daughters' sex life.

Adolescent↗
PubMed1995

The epidemiology of vulvovaginal candidiasis among university students.

Vulvovaginal candidiasis affects approximately 20% of women annually, but it is not well characterized epidemiologically. Of 1027 respondents to two mailed cross-sectional surveys at a large university, 37.5% reported a prior clinical diagnosis of vulvovaginal candidiasis. The frequency of first diagnosis increased rapidly after age 17, with an estimated 54.7% of women experiencing the condition by age 25. In a proportional hazards model of age at first diagnosis, vulvovaginal candidiasis was associated with initiation of sexual activity (rate ratio [RR] = 2.9; 95% confidence interval [CI] = 2.2, 3.8), oral contraceptive use (RR = 1.7; CI = 1.4, 2.2), and White (RR = 3.1; CI = 1.7, 5.7) and Black (RR = 5.9; CI = 3.0, 11.5) race vs Asian.

Adolescent↗
PubMed2003

Early patterns of sexual activity: age cohort differences in Australia.

Patterns of first sexual activity among Australians born between the 1940s and 1980s were analysed using data from a national telephone survey of 1784 adults (876 males; 908 females). Sixty-one percent of those randomly selected from the Australian electoral roll and contactable by telephone responded. Many trends, including earlier first intercourse--from 20 to 18 years (females) and 18.8 to 17.8 years (males)--were established with the 40-49 year cohort, whose sexual debut was in the late 1960s-70s. Significant age-cohort effects saw women in the contemporary (18-29 year) cohort draw level with males for age at first intercourse and first sex before age 16 and before leaving school. First intercourse contraceptive use climbed from 30% to 80%. Condom use quadrupled to 70%. Australian age-cohort effects are remarkably consistent with those in similar western cultures: gender convergence in sexual experience and increasing avoidance of sexually transmitted disease and pregnancy. If such trends continue, positive long-term outcomes for health and social wellbeing should result.

Adolescent↗