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PubMed1982

A theoretical framework for studying adolescent contraceptive use.

This paper presents a theoretical framework for viewing adolescent contraceptive usage. Young adolescents are beginning to come to terms with their changed bodies, with their increased interest in members of the opposite sex and with their new reproductive capacity. At the same time, their cognitive and social skills are far from fully developed. Further, they may have limited access to the information they need for informed decision making. These immaturities may make the young, sexually active, adolescent, male or female, particularly likely to experience an unintended conception. The problem-solving process is used as a framework for examining developmentally the competencies that must be present for effective contraceptive use. The five major aspects of problems in this area are: problem recognition, motivation, generation of alternatives, decision making and implementation. Each of the aspects is seen as necessary but not sufficient for effective contraceptive use. Each aspect is discussed with respect to developmental changes, male/female differences and previous research.

Adolescent↗
PubMed1994

The value and use of different contraceptive methods.

Reductions in the rates of maternal and child mortality as well as in demographic growth are directly linked to contraceptive usage. The development and availability of safer, improved contraceptives which are convenient to use could be expected to be used by a larger group of individuals and thus make an impact on reproductive health as well as on population growth rates. Such arguments have been used to support contraceptive research. This article deals with some of the developments that have occurred as a consequence of such efforts.

Contraception↗
PubMed1975

Acute coronary artery disease and oral contraceptives.

The Waikato Hospital experience of women admitted or seen in the Cardiology Outpatient Clinic who were under the age of 40 and whose diagnosis was a recent acute coronary occlusive episode was reviewed. It was found that there were nine admissions in eight women in this category between December 1971 and November 1973, plus one further patient who was seen with a recent acute ischaemic episode as an outpatient. The histories of these patients were reviewed and their risk factors surveyed. Of the nine women in the study, seven were taking oral contraceptives. As opposed to previous studies, not all the women in this study showed risk factors other than oral contraceptive usage. Three patients in this group taking oral contraceptives and who were thought to have definite coronary ischaemic episodes had no other major risk factor though two of the three were obese. It is thought probable that oral contraceptives containing oestrogens should be considered as a coronary risk factor in young women.

Acute Disease↗
PubMed2000

The effects of family planning education provided to different gender groups.

OBJECTIVE: To determine whether women or men should be preferred as the target group of the family planning education. DESIGN: Community trial (educational intervention study). SETTING: Three villages having similar characteristics in Gaziantep, Turkey. POPULATION: Currently married women aged between 15-49 and their husbands in these villages. METHODS: Family planning education was given only to women in the first village, only to men in the second village and to both women and their husbands in the third village. MAIN OUTCOME MEASURES: Changes in knowledge, attitudes, the behaviour of married women and their husbands between surveys performed before and after family planning education. RESULTS: Important changes in knowledge, attitudes, and behaviour were determined in all intervention groups after family planning education. The rate of effective contraceptive usage among women using any one of the contraceptive methods described significantly increased in all groups, especially where family planning education was given to both sexes. CONCLUSIONS: Family planning education given to one of the couples may easily affect the other. Consistent and regular education is more important than selecting target gender groups for family planning education.

Adolescent↗
PubMed1995

Contraceptive and condom use adoption and maintenance: a stage paradigm approach.

The Transtheoretical Model of Behavior Change was examined for its applicability to contraceptive and condom use adoption and maintenance using N = 248 heterosexually active college-age men and women. The model posits that individuals do not go directly from old behaviors to new behaviors to new behaviors, but progress through a sequence of stages: precontemplation, contemplation, preparation, action, and maintenance. The stages of change offer a temporal dimension that provides information regarding when a particular shift in attitudes, intentions, and behavior may occur. The model also postulates a set of or outcome variables--the pros and cons of change and self-efficacy. The results demonstrated that individuals were furthest along in the stages of change for general contraceptive use, followed closely by condom use with other (e.g., casual) partners, and then condom use with main partners. Although no sex differences were found for the stages for the three separate contraceptive behaviors, males and females differed on the pros and cons and levels of self-efficacy when engaging in intercourse with the two types of partners. MANOVA/ANOVA results indicated that the relationship between stages and other constructs follows predicted patterns suggesting that the transtheoretical model may provide a useful framework or paradigm for understanding contraceptive and condom use behavior.

Adolescent↗
PubMed1990

Risk factors for gallstone disease in the Hispanic populations of the United States.

The 1982-1984 Hispanic Health and Nutrition Examination Survey used ultrasonography to investigate risk factors for gallstone disease (gallstones or cholecystectomy). Mexican American, Cuban American, and Puerto Rican men (n = 968) and women (n = 1,325) aged 20-74 years were selected from household samples in nine states. Among men, the risk of gallstone disease increased with age, education, and subscapular skinfold thickness. Among women, the risk of gallstone disease increased with age, body mass index, four skinfold measures, diabetes, impaired glucose tolerance, and oral contraceptive usage, but not with parity. Women currently using oral contraceptives were also found to be at increased risk of current gallstones. Menopause was a risk factor for gallstone disease and cholecystectomy. Alcohol consumption was negatively related to the risk of gallstone disease. In men, the cholesterol/high density lipoprotein cholesterol ratio was positively related to gallstone disease and, in women, this ratio was negatively related. This interaction between the effect of sex and the cholesterol/high density lipoprotein cholesterol ratio on gallstone disease was highly significant (p = 0.002). Mexican Americans were at increased risk of gallstone disease even when other risk factors were controlled in multiple logistic regression analysis.

Adult↗
PubMed1989

Ovarian hormones and oral health: pregnancy gingivitis.

The most common oral manifestation of increased levels of ovarian hormones is an increase in gingival inflammation with an accompanying increase in gingival exudate. Although plaque has been identified as the major etiologic agent of gingivitis, there are a number of known situations that exacerbate the condition. It is well-documented that pregnancy, puberty, menstrual cycle, and oral contraceptives all have been coupled with transient, self-limiting periods of gingivitis. A common feature these conditions share is an elevation in the plasma concentration of estrogens and progestins. This article will review the basic physiology of the estrogens and progestins and discuss the possible role these hormones play in the gingivitis occurring during pregnancy or oral contraceptive usage.

Adolescent↗
PubMed1975

Effects of oral contraceptives on tryptophan metabolism and vitamin B6 requirements in women.

To evaluate the effect of oral contraceptive usage on the nutritional requirement for vitamin B6, control women and oral contraceptive users were depleted of vitamin B6 for 1 month followed by a month of repletion with 0.8, 2.0, or 20.0 mg of pyridoxine hydrochloride per day. At weekly intervals a number of indices of vitamin B6 nutrition were measured. Marked elevation in excretion of tryptophan metabolites occurred in oral contraceptive users after tryptophan loads. However, other indices of vitamin B6 nutritional state, including urinary 4-pyridoxic acid excretion, urinary cystathionine excretion, plasma pyridoxal phosphate concentrations, and erythrocyte aspartate and alanine aminotransferases were not different between controls and oral contraceptive users. The excretion of metabolites after oral loading doses of L-kynurenine (which bypasses tryptophan oxygenase) was elevated in oral contraceptive users indicating that abnormal metabolism of tryptophan was not due only to induced tryptophan oxygenase. The data indicate that use of oral contraceptives does not generally change the requirement for vitamin B6 but rather produces a specific change in activity of enzymes beyond kynurenine in the pathway of tryptophan metabolism.

Adult↗
PubMed1993

Oral contraceptive use among young women in southern Sweden.

STUDY OBJECTIVE: The aim was to survey oral contraceptive usage among women under 25 years of age. DESIGN: This was a cross sectional population study based on information collected by questionnaire mailed to randomly selected individuals. SETTING: The study population consisted of Swedish women born between 1960 and 1964 and living in the southern Swedish health care region which has about one and a half million inhabitants. PARTICIPANTS: The sample consisted of 3477 women, of whom 2573 or 74% agreed to participate in the study and were interviewed between November 1990 and April 1991. MAIN RESULTS: Of the 2573 women participating, 2254 (88%) reported having used oral contraceptives at some time, 77% of them having started during their teens. Teenage start of oral contraceptive use was found to be related to a lower age at menarche, a higher marriage/cohabitation rate, a lower rate of teenage full term pregnancy, a higher rate of spontaneous abortion, a lower frequency of teetotalism, and a higher frequency of smoking. Longterm use of antipsychotic drugs appeared to be less common among women who started oral contraceptive use early, but no relationship with other pharmaceutical drug usage was found. No relationship was found between oral contraceptive use and the presence of a first degree relative with cancer. CONCLUSIONS: A large proportion of Swedish women start using oral contraceptives during their teens, and report long duration of usage both before their first full term pregnancy and before the age of 25 years. The few women who have never used oral contraceptives do not appear to be representative of the general population.

Abortion, Induced↗
PubMed1993

Breast cancer risk factors in African-American women: the Howard University Tumor Registry experience.

This retrospective case-control study examines risk factors for breast cancer in African-American women, who recently have shown an increase in the incidence of this malignancy, especially in younger women. Our study involves 503 cases from the Howard University Hospital and 539 controls from the same hospital, seen from 1978 to 1987. Using information culled from medical charts, an analysis of various factors for their effect on breast cancer risk was made. The source of data necessarily meant that some known risk factors were missing. Increases in risk were found for known risk factors such as decreased age at menarche and a family history of breast cancer. No change in risk was observed with single marital status, nulliparity, premenopausal status, or lactation. An increased odds ratio was found for induced abortions, which was significant in women diagnosed after 50 years of age. Spontaneous abortions had a small but significant protective effect in the same subgroup of women. Birth control pill usage conferred a significantly increased risk. It is of note that abortions and oral contraceptive usage, not yet studied in African Americans, have been suggested as possibly contributing to the recent increase in breast cancer in young African-American women.

Adult↗
PubMed2002

Prevalence and determinants of contraceptive practice in a defined Nigerian population.

This study investigates the prevalence and determinants of contraceptive practice in Ile-Ife, Nigeria. A prospective study of 500 rural women in the reproductive age group was conducted between April to June 1999 in the Igboya health district of Ife central local government area of Osun State. A comprehensive contraceptive promotion and distribution had been carried out in this area by the University Teaching Hospital, the State Ministry of Health and many non-governmental organisations in the past 10 years. It is therefore expected that the contraceptive awareness and use in this environment would be high. Unfortunately, although all the respondents (100%) were aware of contraception and 78% were sexually active, only 18.8% used contraception. A majority of the non-users gave no reasons for failure to use contraception. Among reasons given by others include fear of side effects, no need for contraception, not married, religion, need for more children and student status. The most common contraceptive method among users was intrauterine contraceptive device followed by pills, condoms and injectable contraceptives. Factors which were significantly associated with utilisation of contraception were availability of family planning services, parity, knowledge of contraception and child spacing (P < 0.05). Religion, literacy level, attitudes of family planning providers and distance to family planning services were not found to be significant (P > 0.05). Recommendations that will improve wide contraceptive usage are preferred.

Adolescent↗
PubMed1996

Attitudes to current oral contraceptive use and future developments: the women's perspective.

OBJECTIVES: The study was planned to determine current trends in contraceptive usage and to examine the attitudes, needs and preferences of women with respect to oral contraceptives. METHODS: Semi-structured interviews were carried out with women (n = 1201, aged 16-45 years) in Germany, the UK and France. RESULTS: The study revealed that oral contraceptives were the most popular method of contraception employed, followed by condoms, and that the majority of respondents were aged 16-19 years when they first used an oral contraceptive. An important finding of the study was that an oral contraceptive was first used only after having sexual intercourse for the first time (within 1 year), emphasizing the importance of effective contraceptive information and education for adolescents. Regarding non-contraceptive health benefits, protection from ovarian and endometrial cancer was perceived by respondents to be of the greatest importance; however, few women were spontaneously aware of this benefit. When given a number of different oral contraceptive intake options to assess, the established 'once daily for 21 consecutive days' option remained the most popular, although a 'once weekly' alternative was cited by many women. When asked about the preferred frequency of menstrual bleeding, there was a polarization between women favoring the normal monthly bleed and those wanting a 'no-bleed' regimen. CONCLUSION: Women are poorly informed about oral contraceptive use, and are largely unaware of the important long-term non-contraceptive benefits. Many women would prefer alternative pill intake options and a significant number would favor a 'no-bleed' regimen.

Adolescent↗
PubMed2006

Oral contraceptive induced thrombi of the right heart of a heterozygous protein C-deficient woman--a case report.

We reported a 42-year-old heterozygous protein C-deficient woman whose oral contraceptive drug induced thrombi in the right heart and pulmonary artery are resected successfully. In this article, we tried to determine the triggering effect of oral contraceptive usage on thrombus formation in a patient with heterozygous protein C deficiency. Cessation of the oral contraceptive therapy without any additional anticoagulant drug prevented the recurrence of the thrombus formation.

Adult↗
PubMed1992

Changes in contraceptive practice in a multiracial urban-based community over a ten-year period.

There have been changes in the national policy regarding population growth in Malaysia from 1982. This report studies the changes in contraceptive practice among the three racial groups in this country, i.e. Malays, Chinese and Indians, over a 5-year period with an interval of 10 years. This is a retrospective study based on the attendance at the same family planning clinic in an urban setting. The striking change noted is the change in the racial composition of contraceptive usage in the two study periods with a shift from the Chinese being predominant in 1975-1979 to Malays in 1985-1989. There was no change among the numbers of Indians using contraception. The results also reveal a significant trend of change for users of the pill and those undergoing sterilization. There were no significant changes in IUD, condom and injectable usage. The study demonstrates how national policies, level of education and rural urban migration can significantly alter contraceptive practice.

Adolescent↗
PubMed2000

[Effect of oral contraceptive administration on the frequency of estrogen receptor and cervical intraepithelial neoplasia].

A study of 56 sexual active women with cervical intraepithelial neoplasia (CIN) was conducted in Mexico City, to determine wether the risk for this condition is altered by using oral contraceptives. Responses of a standardized questionnaire compared 29 patients under oral contraceptive (OC) treatment and 27 control subjects selected from the same screening program, though which the cases were detected. Estrogen receptor (ER) levels were determined in each hyperplastic tissue. The ER frequency was approximately the same in women under oral contraceptive (OC) treatment and in women without it. (P > 0.05). Among other risk factors, first intercourse at an early age, first pregnancy age, number of pregnancies and multiple sexual partners were consistently no significant (p > 0.05) when both groups were compared. In this study, we have found no evidence of an etiologic relationship between neither oral contraceptive usage or non usage and CIN.

Adolescent↗
PubMed1992

Socio-democratic characteristics of women presenting with abortion--a hospital based study.

OBJECTIVE: To determine socio-demographic characteristics and clinical features of women presenting with abortion, and to define factors associated with complications of abortion. DESIGN: A prospective descriptive study. SETTING: Women in Gynaecology casualty department at Harare Central Hospital, Harare, Zimbabwe. PATIENTS: 307 women with features of complete or incomplete abortion were interviewed during February to June 1991. They were randomly selected and represented 53pc of all women with the problem. RESULTS: Three quarters of the women were married and lived with their spouses. In 23.1pc this was a first pregnancy. Over a quarter of the women who were on the pill claimed to have fallen pregnant whilst on the pill, mainly because of poor compliance. One hundred and twenty-two were not on the pill but in only 16pc it was intended to fall pregnant. In nearly 30pc the pregnancy was not wanted but only 2.3pc admitted to having induced the abortion. Sepsis was present in 25.6pc and they tended to be younger, not presently married and have an unplanned pregnancy. Although there was some evidence of trauma in 6.2pc, it was not possible from the study to assess the percentage of abortion likely to have been induced. CONCLUSION: Contraceptive usage is generally low and cultural and traditional factors may play a role, but expanded sex education programmes and continued contraceptive counselling need reinforcing before attempts are made to review the legal issues regarding termination.

Abortion, Illegal↗