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PubMed2005

Contraception in diabetic women: an Italian study.

Over 1 year, a survey on contraception and obstetric history was performed on a cohort of 667 Caucasian fertile diabetic women (446, type 1 and 201, type 2) living in Italy. RESULTS: Of these women, 30.4% used hormonal contraceptives, 12.0% intra-uterine device (IUD), 10.7% declared they used no contraception, 47.0% only utilised barrier and/or natural methods. However, irrespective of their previous contraceptive strategy, 7.2% of all the studied population was surgically sterilized during caesarean section. HORMONAL CONTRACEPTION: Of these women, 60.4% was prescribed by a gynaecologist, 11.2% by a diabetologist, 15% by both of them and 13.4% by others. The proportion using oral contraception was similar among types 1 and 2 women (29.4% versus 27.8%, chi(2) = ns). SMOKING HABITS: Of women taking hormonal contraception, 30.0% were smokers. EDUCATIONAL LEVEL: University graduates (37.1%), high school leaves (32.2%), secondary school (28.2%) and primary school leaves (15.5%) used oral contraceptives (OC). OBSTETRIC HISTORY: The mean number of deliveries was 1.14 +/- 1.1, of miscarriages was 1.3 +/- 0.7 and of induced abortions 0.17 +/- 0.5. Planning of at least one pregnancy was reported in 29.4% of patients.

Adult↗
PubMed2006

Past oral contraceptive use and angiographic coronary artery disease in postmenopausal women: data from the National Heart, Lung, and Blood Institute-sponsored Women's Ischemia Syndrome Evaluation.

OBJECTIVE: To evaluate past oral contraceptive use and angiographic coronary artery disease in women. SETTING: Academic medical centers. PATIENT(S): Six hundred seventy-two postmenopausal women enrolled in the Women's Ischemia Syndrome Evaluation (WISE) with coronary risk factors undergoing coronary angiography for suspected myocardial ischemia. INTERVENTION(S): Past oral contraceptive use, assessed by reproductive questionnaire. MAIN OUTCOME MEASURE(S): Quantitative coronary artery disease, assessed by a core angiography laboratory. RESULT(S): Past oral contraceptive use was associated with a lower mean coronary artery disease severity index score (mean +/- SD: 11.8 +/- 10.3 vs. 18.7 +/- 17.3) compared with non-prior users, despite age adjustment. Past oral contraceptive use remained a significant independent negative predictor of coronary artery disease severity when adjusting for coronary risk factors, including age, diabetes mellitus, triglycerides, low-density lipoprotein cholesterol, smoking, aspirin use, and lipid-lowering medication (model R2 = 0.19). The modeling indicated that past oral contraceptive use was associated with a 2.44 lower coronary artery disease severity score index. There was no apparent relationship between duration of past oral contraceptive use and the coronary artery disease severity index score. CONCLUSION(S): Past oral contraceptive use is associated with less coronary artery disease, measured by quantitative coronary angiography, among postmenopausal women with suspected myocardial ischemia. These findings suggest that a prospective study should address the hypothesis that past oral contraceptive use during the premenopausal years might offer women protection from atherosclerotic coronary disease later in life.

Academies and Institutes↗
PubMed1995

The role of oral contraceptives in the treatment of hyperandrogenic disorders.

The clinical manifestations associated with hyperandrogenism, such as hirsutism and acne, are disturbing to most patients. In addition to correcting androgen-related problems, concerns such as contraception or other metabolic problems (for example, lipid/lipoprotein abnormalities, diabetes, hypertension) associated with these disorders and the effects of unopposed estrogen on the endometrium also need to be considered. Oral contraceptives are a therapeutic modality that may address these multiple problems. The potential mechanisms of action by which oral contraceptives correct excess androgen states include gonadotropin suppression, reduction of circulating androgens, increased androgen binding, suppression of adrenal androgen secretion and inhibition of 5 alpha-reductase, and androgen receptor binding. In normal women, there is good evidence that these actions occur with the use of oral contraceptives. Among women with anovulatory hyperandrogenic states, such as polycystic ovary syndrome, the response to oral contraceptives in each of these areas is somewhat more variable. However, oral contraceptive preparations that are more estrogen dominant appear to produce many of the desired effects. From a clinical standpoint, 60-100% of women with hirsutism improve on oral contraceptives; acne shows improvement in a high percentage of women as well. The use of oral contraceptives also reduces the risk of endometrial hyperplasia that may be associated with anovulatory states. Finally, current low-dose preparations containing the newer progestins (for example, norgestimate and desogestrel) appear to be either neutral, or perhaps beneficial, with respect to their metabolic impact.

Adrenal Glands↗
PubMed2003

Influence of smoking and oral contraceptives on bone mineral density and bone remodeling in young women: a 2-year study.

The objective of the study was to explore the influence of menstrual irregularities, oral contraceptives and smoking on bone mineral density (BMD) development and bone turnover with time. Healthy young women (n = 118) were divided into four categories: (a) women neither smoking nor using oral contraceptives; (b) women who were smokers; (c) women using oral contraceptives; (d) women who were smoking and using oral contraceptives. They responded to a validated questionnaire with 34 questions concerning lifestyle and the Sense of Coherence scale (SOC). BMD was measured by dual energy x-ray absorptiometry (DEXA). Deoxypyridinoline (DPD) was measured in urine. Data were analyzed by multiple linear regression analysis. Among smokers, BMD level decreased during a 2-year period and smoking was associated with a larger negative change in BMD. Use of oral contraceptives moderated the negative impact of smoking. Women using oral contraceptives at baseline and with regular bleeding induced by contraceptive pills had a significantly higher BMD at baseline and at follow-up. They also had lower SOC than women who had natural regular bleedings. Use of oral contraceptives in combination with smoking was linked to high alcohol consumption and higher frequency of self-reported body weight reduction, which reduced the negative BMD change in this category. DPD level and difference were strongly associated with estrogen influence. It is concluded that smokers without OCs had a negative BMD development and BMD in young women with irregular menstruations seems to be improved by OC.

Absorptiometry, Photon↗
PubMed1998

Hormonal contraception and risk of cardiovascular disease. An international perspective.

The most frequent major adverse effect of hormonal contraception is an increased risk of cardiovascular disease. The effect on the risk of venous thromboembolism (VTE), ischemic and hemorrhagic stroke, and myocardial infarction (MI) differs and is strongly influenced by smoking and the presence of other cardiovascular risks factors, such as hypertension and diabetes mellitus. The incidence of each disease rises with age and there are differences in risk among hormonal contraceptive preparations. This article provides a framework within which to assess the balance of risks among types of hormonal contraceptives according to individual circumstances. Data on cardiovascular disease mortality rates in women of reproductive age in different countries of the world were compiled from nationally reported statistics and supplemented where possible with reported disease incidence rates. Risks associated with current use of hormonal contraception were compiled from the most recent publications on the cardiovascular effects of steroid hormone contraception. These were combined to estimate the total cardiovascular incidence and mortality according to baseline cardiovascular risk and individual characteristics. Mortality rates for cardiovascular diseases are very low in women of reproductive age. Myocardial infarction mortality rates rise from < 0.4 per 100,000 woman-years at age 15-24 years to the range 2 to 7 per 100,000 woman-years at age 35-44 years. Stroke mortality rates similarly rise steeply with age and are between 3 and 5 times higher than those for MI. VTE mortality rates rise less steeply with age and are approximately one-tenth the MI mortality rates at age 35-44 years. The adverse effect of oral contraceptives (OC) on the risk of VTE is the most important contributor to the total number of cardiovascular cases attributable to OC use. The increased risk of stroke and MI dominate the patterns of mortality in OC users and smokers. The additional risks attributable to smoking are greater than the additional risks attributable to OC use. The risk attributable to OC use in women < 35 years of age is small, even if they smoke, but there are substantially increased risks in older women who both smoke and use OC. The additional mortality attributable to OC use can be reduced by screening users, as this results in lower relative risks of ischemic stroke and MI. Differences between OC types in the relative risk of VTE contribute little to the total cardiovascular mortality associated with OC use, even though the total number of cardiovascular events is increased. A potential reduction in the risk of MI with desogestrel and gestodene compared with levonorgestrel-containing OC would have little difference on overall mortality rates in women in their 20s and 30s, but may result in a net reduction in OC-attributable mortality in women aged 40-44 years who smoke. An overall quantification of the risks for different types of oral contraceptive users is necessary for an informed choice of contraceptive method, and any assessment of the balance of cardiovascular risks is complex. The model provides a tool to assess, at the level of the individual, the risks associated with use of different OC according to personal circumstances. It is important to consider the user's age and smoking status when determining OC attributable risks.

Cardiovascular Diseases↗
PubMed2002

A comparative and pooled analysis of the safety and tolerability of the contraceptive patch (Ortho Evra/Evra).

OBJECTIVE: To review the safety and tolerability of the contraceptive patch (Ortho Evra/Evra) versus a standard oral contraceptive (Triphasil) and to present the pooled safety and tolerability of the patch across three pivotal studies. DESIGN: Three open-label, contraceptive studies of up to 13 treatment cycles. SETTING: 183 centers. PATIENT(S): Comparative study (812 patch, 605 oral contraceptive); pooled analysis (3,330 patch). INTERVENTION(S): The patch regimen was three consecutive 7-day patches (21 days) followed by 1 patch-free week per cycle; the oral contraceptive was dosed according to the U.S. physician package insert. MAIN OUTCOME MEASURE(S): Adverse events, laboratory tests, vital signs, and body weight. RESULT(S): The incidence of most events was similar between the patch and oral contraceptive groups, with the exception of a higher incidence of application site reactions, breast discomfort (cycles 1 and 2 only), and dysmenorrhea in the patch group. Pooled analysis demonstrated that most application site reactions (92%) and breast symptoms (86%) were mild or moderate in severity, and <2% of participants discontinued the patch because of either event. Only 7 (0.2%) participants experienced a serious adverse event classified as possibly, probably, or likely related to the patch. The mean change in body weight from baseline to the end of treatment was an increase of 0.3 kg. CONCLUSION(S): Overall, the contraceptive patch is well tolerated and has a side effect profile similar to an established oral contraceptive.

Administration, Cutaneous↗
PubMed2003

Effect of oral contraceptives and intrauterine devices on midcycle myometrial contractions.

OBJECTIVE: To determine the effects of oral contraceptives and intrauterine devices (IUDs) on midcycle myometrial contractions. DESIGN: Prospective cohort study. SETTING: Academic tertiary care center. PATIENT(S): Thirty four patients who received oral contraceptives, 20 patients with an IUD, 28 controls, and 6 patients who were evaluated before and after oral contraceptive use. INTERVENTION(S): All groups underwent endovaginal ultrasonography to visualize myometrial contractions at midcycle. MAIN OUTCOME MEASURE(S): Contractions were analyzed for direction, frequency, amplitude, and distance traveled. RESULT(S): Fifty percent of women taking oral contraceptives had no contractions, whereas all controls had contractions. Women taking oral contraceptives also had decreased frequency, amplitude, and distance traveled of contractions compared with controls. Women evaluated before and after taking oral contraceptives had decreased frequency, amplitude, and distance traveled of contractions. Women with an IUD had significantly more asymmetrical uncoordinated contractions, with decreased frequency and distance traveled, compared with controls. CONCLUSION(S): Oral contraceptives dramatically suppressed midcycle contractility. Since the normal midcycle peak of estrogen is suppressed by oral contraceptives, these contractions may be regulated by cyclic estrogen and progesterone. Uncoordinated contractions in IUD bearing women indicate that the foreign body reaction of the IUD affects the normal physiology of these contractions.

Adult↗
PubMed2002

ACOG practice bulletin. Emergency oral contraception. Number 25, March 2001. (Replace Practice Pattern Number 3, December 1996). American College of Obstetricians and Gynecologists.

Emergency contraception is a therapy for women who have had unprotected sexual intercourse, including sexual assault. It also has been called the "morning-after pill," interception, and postcoital contraception. Methods of emergency contraception include use of combination or progestin-only oral contraceptives, danazol, synthetic estrogens and conjugated estrogens, antiprogestins, and the insertion of an intrauterine device. One particular combination oral-contraceptive regimen is the Yuzpe method This document addresses only combination and progestin-only oral contraceptives because they are the most frequently used methods. This document will present evidence regarding the safety, efficacy, risks, and benefits of the use of oral contraceptives for emergency contraception. For widespread use of this therapy, physician familiarity with the method public awareness of the method's availability, prompt availability of these methods (because of their time-sensitive nature), and access to a physician who is available to prescribe the method must be increased.

Contraceptives, Postcoital↗
PubMed1998

Current reversible contraceptive methods: a global perspective.

Since the 1960's, there have been important gains in the efforts to make the benefits of family planning accessible to people around the world. However, prevalence of contraceptive use is still low in some areas, especially in sub-Saharan Africa. Making contraceptives accessible through good quality services should be a goal for reproductive health programs. In the absence of an ideal method of contraception which would suit every individual, there is a variety of contraceptive methods with advantages in some aspects and disadvantages in others from which people should be able to choose according to their particular characteristics and needs. Important aspects to take into consideration include effectiveness, convenience, and safety. In general, the most effective methods are more likely to have some side effects and method-related complications. However, when weighing the risks and benefits, the most effective methods have greater benefits on the health of women by protecting them better from the health risks of unwanted pregnancies. Most methods also have non-contraceptive benefits - for instance, combined oral contraceptives (COCs) provide important degrees of protection against endometrial and ovarian cancers, benign breast disease, pelvic inflammatory disease (PID), and ectopic pregnancy. They also reduce menstrual blood loss. Although barrier methods have lower effectiveness against pregnancy, their most important advantage is the protection they can provide against sexually transmitted diseases. The male condom in particular (and probably the female condom) has the special value of providing protection against HIV infection. This paper describes reversible methods of contraception including possible health risks and contraindications. Adequate counseling, however, is essential for people to make an appropriate choice of contraception and to secure safe and effective use of the method.

Choice Behavior↗
PubMed1999

Emergency contraception: an anomalous position in the family planning repertoire?

Emergency contraception (EC) can be used up to 72 h after sex to prevent pregnancy. Internationally there is wide variation in the availability of EC. In the USA it has only recently (1997) won approval from the FDA, while the UK and New Zealand have seen calls for over the counter availability. In recent years surveys, editorials and opinion pieces in medical journals have pointed out that increased access to EC could help to tackle the unwanted pregnancy rate, especially among teenagers, and concluded that lack of knowledge of EC is the major barrier to use. However, women in a UK study have expressed concerns that it is not safe to use the method repeatedly and cited general practitioners (GPs) as one of the sources of this belief, which contradicts the professional guidelines and the rationale for de-regulation. A subsequent study sought to seek the views of GPs about prescribing EC and explored reasons for the gap between the views of women using UK family planning services, GPs and professionals at the public policy level. Data from two studies are presented. In the first study, 53 women seeking emergency contraception were interviewed at two family planning clinics. In the second, semi-structured telephone interviews were completed with a random sample of 76 GPs from three English health authorities. Interviews were recorded, transcribed and thematic analysis was conducted using the constant comparative method. EC was rarely described, by users or GPs, as an acceptable contraceptive option. Consultations for emergency contraception were viewed by GPs as an important opportunity to discuss the woman's future contraceptive needs. Repeated use of EC was not encouraged and a discussion of contraceptive needs could range from a mild enquiry to quite forceful messages contrasting EC to 'regular' and 'proper' methods. The medical literature suggests that EC is underused because of a lack of awareness. Commentators have recommended educating health professionals and women about EC and increasing availability through de-regulation. The data presented in this paper show that British GPs are not enthusiastic about the de-regulation of EC, but the reasons are complex and related to concerns about planned contraception and sexual behaviour. It is suggested that it may be because EC is used after sex that it seems to occupy an uncomfortable place within the contraceptive repertoire.

Attitude↗
PubMed2001

Adolescent contraceptive non-use and covariation among risk behaviors.

PURPOSE: To investigate whether adolescent contraceptive non-use is associated with other risk behaviors. METHODS: A multistage sampling procedure produced a sample of 913 sexually active high school students. They completed a self-administered questionnaire that required mainly "yes" or "no" answers to questions involving participation in a range of risk behaviors. A series of multivariate logistic regression models investigated the relationships between contraceptive non-use and selected hypothesised correlates, controlling for key demographic variables. RESULTS: Contraceptive non-use was not significantly associated with use of cigarettes, alcohol, or inhalants; perpetration or being a victim of violence; exposure to risk of physical injury; and suicidality. For males only, there was a significant inverse association between contraceptive non-use and use of cannabis in the previous month. This was not the case for lifetime cannabis use for either gender. There was a significant inverse relationship between contraceptive non-use and knowing the most recent partner for more than 7 days, but no association for the number of partners nor duration since the last intercourse. For females only, there was a significant inverse association between contraceptive non-use and both age and age of first intercourse. CONCLUSIONS: This study does not support the hypothesis that contraceptive non-use is a component of the "risk behavior syndrome." Decisions to participate in intercourse and to use contraception have different psychosocial foundations. Prevention efforts should prioritize relationships with new partners and younger girls who commence intercourse early.

Adolescent↗
PubMed2001

Contraceptive choices in HIV infected and HIV at-risk adolescent females.

PURPOSE: To describe reported contraception use in HIV infected and HIV uninfected but at-risk female adolescents, and determine associations with the reported consistent use of effective contraception methods, including its association with pregnancy. METHODS: HIV infected and at-risk female youth, aged 13-18 years, who were sexually active and reporting no intention to become pregnant, were included. Contraception use data from three consecutive visits (approximately 6 months apart) were used. RESULTS: Ninety-four percent of HIV infected and 89% of at-risk subjects reported choosing a main contraception method with demonstrated efficacy when used consistently. Approximately 50% chose partner condoms. HIV infected youth were more likely to report 100% partner condom use in the past 3 months (73% vs. 46%; OR 3.3; 95% CI: 1.7-5.6). At-risk youth were 2.5 times more likely than HIV infected subjects to report using nothing (95% CI: 1.1-5.8). Slightly more than half (56%) demonstrated the consistent reporting of effective methods (CREM) of contraception. In multivariate analysis, HIV infection (OR 4.0; 95% CI: 2.2-8.2) and African-American race (OR 2.7; 95% CI: 1.1-6.6) were significantly associated with CREM. Subjects reporting inconsistent or unreliable contraception use had higher 1-year pregnancy rates than CREM subjects (32% vs. 14%; p = .002). CONCLUSIONS: Only half of HIV infected and at-risk youth reported using effective contraception consistently, despite its availability. Additionally, regardless of reported contraceptive use, the rates of unplanned pregnancy were unacceptably high.

Adolescent↗
PubMed1999

Pregnancy prevention using emergency contraception: efficacy, attitudes, and limitations to use.

Emergency contraception, also called postcoital contraception, is the use of hormonal or mechanical methods to prevent pregnancy after an episode of unprotected intercourse. Although a number of methods of emergency contraception exist, its use in the United States is not widespread. This report reviews studies on the efficacy of hormonal methods of emergency contraception, as well as the literature on women's and physicians' knowledge of and attitudes toward this method of preventing pregnancy. Articles were selected for this review from a MEDLINE search using the term "postcoital contraception." These studies show that a variety of hormonal regimens are effective in reducing the chance of pregnancy when administered within 72 hours of an episode of unprotected intercourse. Failure rates range from 0%-4.66%, depending on the regimen and the study, although some controversy exists about how to calculate efficacy. Recent studies indicate that mifepristone (RU486) may be more effective than other methods, with fewer side effects. However, the more significant issue surrounding emergency contraception may be the reasons for its infrequent use in this country. A number of limitations to use have been identified in the literature, including lack of knowledge of the method among patients and physicians, inadequate counseling, and fears that widespread use of emergency contraceptives would lead to less consistent use of other methods of contraception.

Adolescent↗
PubMed2001

Will the pill make me sterile? Addressing reproductive health concerns and strategies to improve adherence to hormonal contraceptive regimens in adolescent girls.

UNLABELLED: PAPER OBJECTIVE: This paper is designed to help clinicians understand the relationship between hormonal contraceptive side effects and the potential development of general and reproductive health concerns that can impact on adherence to hormonal contraception. By understanding the concerns raised by young women, we can then make our counseling more specific to the factors that affect compliance in this population. DESIGN: Studies that specifically addressed hormonal contraceptive compliance, side effects, and method selection in adolescents and young women were chosen for this paper. All articles were from peer-reviewed journals. Medline-Ovid articles from 1980-2000 were used with the following search keywords: Contraception, Patient Compliance, Hormonal Contraception, Oral Contraceptive Pills, Norplant, Depo Provera, and Adolescents. DATA SYNTHESIS: The general public has many concerns about the safety of hormonal contraception. The development of side effects, especially those that are menstrual-related, seem to cause adolescents and young women to feel that their general and reproductive health is being threatened. CONCLUSIONS: Hormonal contraceptive counseling should include 1) explaining, in a nontechnical manner, how these methods work; 2) addressing negative information the patient has heard about the methods; 3) providing factual information about cancer risks, blood clots, and other general health concerns; 4) discussing the potential side effects and what each means to her health; 5) asking specifically about possible reproductive health worries, especially in light of the menstrual irregularities that may occur; and 6) assuring the patient that she should always feel free to share her concerns and worries with you, the provider.

Adolescent↗
PubMed2002

High-risk teen compliance with prescription contraception: an analysis of Ohio Medicaid claims.

STUDY OBJECTIVE: This study examines utilization of and compliance with prescription contraception by adolescents. DESIGN: Retrospective cohort analysis of billing and pharmacy claims. SETTING: Ohio Medicaid fee-for-service enrollees. PARTICIPANTS: Claims data of 12- to 19-year-olds identified at high risk for pregnancy by sexually related service billing or procedure code. MAIN OUTCOME MEASURE: Prescription contraception use and compliance patterns were examined over a 12-month study period. RESULTS: During a 6-month enrollment period, 3338 females were identified at risk for pregnancy. Over one-fourth (920) became pregnant. Across the 12-month follow-up, 40% (1328) used no prescription contraception and 33% (1090) used some prescribed contraceptive. Most teens used injectable medroxyprogesterone (517) or oral contraceptive pills (492). About 20% of those using any type of prescribed contraceptive were compliant for the full year; less than 30% used a method for 3 months or less. Whites were more compliant with contraception than nonwhites. Younger age and concurrent mental health condition were also predictors of noncompliance. CONCLUSIONS: Teens at risk for pregnancy demonstrated poor compliance with prescribed contraceptives. Billing/pharmacy claims analysis is a useful tool for identifying teens at risk for pregnancy in order to target and evaluate interventions or to benchmark care provided to adolescents.

Adolescent↗
PubMed1989

Contraceptive prevalence and continuation: a longitudinal analysis of traditional and other method users in the Philippines.

Contraceptive prevalence rates and estimates of continuation rates are derived from unique longitudinal data on post-partum behaviour collected in the Cebu region of the Philippines. Continuation rates vary by base-line and time-varying socioeconomic characteristics for certain contraceptive methods and for using no contraception. Calendar rhythm users have a much lower relative continuation rate than has been found in cross-sectional samples. For women who use a contraceptive method, breast-feeding does not appear to influence contraceptive continuation, but for those who use no methods, breast-feeding appears to substitute for other forms of contraception. Profiles by socioeconomic characteristics of those who continue to use each type of contraceptive method and who use no method could be used to direct family planning programmes towards population sub-groups. The results suggest that for women wishing to postpone a pregnancy, a family planning programme aimed at the young and less educated could effectively increase contraceptive use and continuation.

Adolescent↗
PubMed2003

Effects of oral contraceptive use on body mass index and blood pressure among female villagers in north-east Thailand.

The use of contraceptives has become prevalent among females in Thailand in the past 20 years, and oral contraceptive use has been suggested to trigger changes in fat intake, energy expenditure, fat metabolism and blood pressure. Based on field investigations of 391 married women aged 20 years or over in Yasothon Province, North-east Thailand, this study aims to elucidate the effects of oral contraceptive use on body mass index (BMI: kg/m2) and blood pressure, taking into account reproductive histories and socioeconomic conditions. The proportion of obese (BMI > or = 25) subjects was high in the age groups 30-39, 40-49 and 50-59, accounting for, respectively, 39.4%, 51.1% and 48.5% of these populations. The proportion of women with hypertension (90/140 mmHg) was 23.7%, 18.5% and 26.2% in the 40-49, 50-59 and 60-69 age groups. Current contraceptive practices in the studied population included sterilization by operation, oral contraception and injection. These methods accounted for 43.0%, 12.8% and 8.2% of the population, respectively. Sociodemographic factors such as reproductive history, years of education and household income were not significantly related to BMI or to blood pressure (ANOVA with age adjustment). In contrast, oral contraceptive users had significantly higher BMIs and diastolic blood pressures (p<0.01, ANOVA with age adjustment). Multiple regression analysis also revealed that oral contraceptive use was a weak but significant contributing factor to both high BMI and blood pressure when sociodemographic factors were taken into account and controlled for statistically. It can thus be concluded that the use of contraceptive pills, which contain oestrogen and progestin and are provided free of charge to Thai women, tend to increase BMI and to elevate blood pressure.

Adult↗
PubMed1999

Contraception in teenage Nigerian school girls.

Contraception is reviewed in 314 teenage Nigerian school girls comprising 128 students at secondary and 186 at tertiary levels of institution. Out of all the teenagers, 26.8% were sexually exposed, among whom there was a total pregnancy rate of 19.05%. The rate of sexual exposure was higher in teenagers from tertiary institutions, 38.7% compared with 9.4% from secondary institutions. However, the pregnancy rate was higher among the sexually exposed secondary school girls, 33% vs. 16.7% for tertiary school girls. The mean level of contraceptive awareness for the various methods of contraception was 38.2% for the entire survey group: 22.6% for the secondary school girls and 54.4% for the tertiary school girls. Mean true contraceptive usage (TCU) among sexually active students, on the other hand, was 17.7%: 5% and 16.5% for the secondary school girls and tertiary school girls, respectively. The source of information on contraception for the study group was highest from 'a friend' (37.3%) and from the 'newsprint' (36.9%) and was lowest from routine 'lectures and sex instructions' (9.2%). Twenty-five point five per cent of the entire study group, 43% of the secondary school girls and 13.4% of the tertiary school girls, had never had any information on contraception. Instruction on contraception, as part of the academic curricula at the primary, secondary and tertiary levels of education, would improve contraceptive knowledge and forestall the emotional and social problems resulting from unwanted teenage pregnancies.

Adolescent↗