Long-acting methods of contraception.
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While most new contraceptives currently in development incorporate existing contraceptive agents into new delivery systems, several types of contraceptives with novel mechanisms of action are making steady progress. The antiprogestin mifepristone (better known as RU 486) is being tested as an ovulation inhibitor, as a once-a-month pill, and as a postcoital contraceptive. An antiestrogen, Centchroman (Hindustan Latex, India), is in use in India as a once-a-week, nonsteroidal pill. The development of more potent pituitary gonadotropin antagonists has improved their potential to block ovulation in women and to inhibit spermatogenesis in men (which requires concurrent administration of testosterone). Another promising male contraceptive is an intraluminal vas occlusion plug tested extensively in China that can be removed with no apparent detriment to future fertility. Finally, several types of immunocontraceptives could become the most specific form of fertility control by directing an antibody response against the fertilized or unfertilized egg or against sperm.
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Basis of this trial are examinations of 100 patients with colposcopic and/or cytologic suspicion for precancerous or early stages of cancer of the uterine cervix and of 100 patients in the same age with normal cervical findings. The meaning discussed in literature about cigarette smoking as cofactor for developing cervical cancer and its prestages can be confirmed by our results. The portion of smoking patients with 74 per cent in the cervical groups was higher than in control group (42 per cent). Three times so much patients of the cervical group than in the controls smoked 20 cigarettes per day or more. More than 20 years smoking patients could be found only in the cervical group. 97 patients of the cervical group compared with 55 of the controls had been in the pill. Patients with cervical lesions on the average had been 3 years younger starting with hormonal contraception than the controls. The portion of pill users more than 10 years had been twice frequent in cervical group. The use of condoms was significantly more frequent in the control groups than in the cervical one (22/6). Therefore condoms are to be preferred be cause of protection against sexual transmitted diseases and indirectly cervical carcinom.
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Forty-four cervical cancer inpatients and 44 individually age-matched controls were surveyed. As a result, the number of the cases whose partners used condoms for contraception was significantly lower than that of the controls (P less than 0.01; the odds ratio = 0.2). The same result was obtained after adjusting possible confounding variables such as the number of pregnancies and use of other contraceptive methods. Barrier-type contraceptives like condoms may reduce the incidence of sexually transmitted viral infections, which it has been suggested are associated with the disease.
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