Hysterographic study of some side effects of the copper T 200 device.
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Africa↗
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Results for “Contraceptive Methods”
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Contraception for women with diabetes: an update.
Today several effective contraceptive methods are available for women with IDDM. Contraceptive guidance as part of the pre-pregnancy counselling needs to be more widely implemented by general practitioners and in non-specialized obstetrical and gynaecological departments. Women with diabetes are generally well motivated, and thus the barrier methods may prove both acceptable and reliable contraceptive agents for some of these women. When, however, a high risk of user failure can be predicted, the IUD or hormonal contraception may be the only reversible alternative. According to our findings, IUDs can be recommended without reservation to women with IDDM. In women with previous GDM it seems that low dose oral contraceptive compounds may be administered without running the risk of inducing glucose intolerance, but long-term results are still unavailable. Natural oestrogens may be administered in combination with a progestogen for a limited period as an efficient and acceptable mode of contraception in women with IDDM without any concomitant adverse effects on diabetic control. From our investigations it also appears that short-term administration of combined low dose OCs containing the traditional progestogens (e.g. norethisterone or levonorgestrel) or the new gonane progestogens (e.g. gestodene) does not alter glycaemic control in women with IDDM. Similarly, these compounds do not cause any significant changes in lipid/lipoprotein levels during short-term treatment, although the intake of monophasic ethinyloestradiol/norethisterone preparations may result in higher triglyceride levels and tends to increase lipid levels more than triphasic ethinyloestradiol/levonorgestrel compounds. The results from our clinic have shown that OCs can be safely recommended at pre-conception counselling so that women with diabetes can obtain both optimal glycaemic control and efficient spacing of their pregnancies.
Contraception↗
Sexual behavior, contraception and unintended pregnancy among young females.
Information about contraceptive usage and sexual experiences was sampled in 1985-86 from 16-20-year-old Danish females admitted for legally induced abortion on Funen (N = 140). In attempts to elucidate the causal relations behind undesired pregnancy among teenagers, data were in the present context compared with answers to the same questions from a representative Danish sample of sexually experienced, non-pregnant females of the same age (N = 201). Of the reference sample, 83.6% were using contraceptives at the time of the interview--mostly oral contraceptives (O.C.). Of the abortion sample, 90.7% said they had used contraception earlier in their reproductive life. Approximately one third conceived in spite of contraception (most frequently the condoms). O.C. was the contraceptive method used most recently (by 43.6%). Thus, a pause in an effective contraceptive often precedes an unintended pregnancy, pointing to the need for follow-up counselling when O.C. is prescribed to teenagers. Only the minority could state the total number of times they had experienced sexual intercourse. Significantly more females in the abortion sample were in an alliance with a male partner with whom they had regular sexual intercourse. However, they also reported a higher average number of different sexual partners, indicating an association between changing sexual relationships and undesired pregnancy. In the abortion sample significantly more pregnancies prior to the index pregnancy were reported during a corresponding period of risk of conception lasting only a few years. Taking the widespread use of contraception into account, it is possible that an increased fecundity might be a co-factor behind unsuccessful contraception.
Adolescent↗
[Oral contraception: failures and risks].
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Biology↗
Non-availability of the IUD and contraceptive choice.
The Copper 7 and Lippes Loop IUD are no longer distributed in the United States, and the cost of the Progestasert precludes usage in many family planning clinics. The impact of the loss of this widely used contraceptive method was assessed in a pilot study at the UCLA Family Planning Clinic. The clients who would have selected an IUD at the time of their clinic visit between March and December of 1986 instead chose oral contraceptive pills (55%) or barrier methods (45%) but their level of dissatisfaction with the methods they received was significantly greater than that of all other contraceptors, and this led to their subsequent selection of another method which, in the majority (66%), was of lower efficacy than the IUD. There were two unplanned conceptions amongst twenty women who would have chosen an IUD, both due to non-compliance with oral contraceptive pills; and at the time of survey in March 1987, no clients had opted for sterilization. Women who no longer have their choice of the IUD represent a high risk for contraceptive dissatisfaction and failure, but have not made precipitous decisions to undergo permanent sterilization.
Adolescent↗
Contraceptive use and desire for more children in two rural districts of Sierra Leone.
Data from a 1993 household survey in rural Sierra Leone revealed that, among women aged 12-49 with at least one child younger than 5, about 13% were using a contraceptive method and about 67% wanted more children. These rates differ from those reported for the 1980s and 1970s, when the contraceptive use rate was around 6% and more than 85% of women desired more children, suggesting a trend towards fertility limitation over the years. Logistic regression analysis showed that contraceptive use was positively associated with age, number of living children, age at marriage, education, and economic status, and negatively associated with Islamic and traditional religious affiliations. Government and other health clinics, hospital, and government paramedical personnel were the major sources of contraceptive supplies. The lower desire for more children might relate to demographic pressure from the recent improved child survival rate compounded by recent economic hardship.
Adolescent↗
Contraception in the Spanish press: an analysis of the 1997-2002 period.
OBJECTIVE: Based on the hypothesis that the media represent an important source of information about contraceptive methods and sexuality, this paper reviews the news items about contraception published by four important Spanish newspapers and four women's magazines. MATERIALS AND METHODS: All news items appearing from January 1, 1997 to December 31, 2002 in the following publications: El País, El Mundo, ABC, La Vanguardia, Mía, Clara, Ragazza, and Epoca were collected during the first 6 months of 2003. Results Seven hundred and ten news items about contraception were identified during the period analysed, of which 117 (16.5%) had a negative character. CONCLUSIONS: Over 80% of news items appearing in the Spanish press in the 1997-2002 period give a positive information about contraceptive methods.
Bibliometrics↗
Contraceptive usage, knowledge and correlates of usage among female emergency department patients.
OBJECTIVES: For female emergency department (ED) patients, we sought to assess the prevalence of contraceptive usage as well as the extent of contraceptive knowledge and to determine if demographic and sexual health history factors, comprehension of contraceptive methods and moral/religious opinions on contraception were associated with current usage of birth control pills (BCPs), prior usage of emergency contraception (EC) and frequency of condom usage. METHODS: English-speaking female ED patients aged between 18 and 55 years at a northeastern United States urban ED were surveyed on their usage, comprehension and opinions regarding BCPs, EC and condoms. RESULTS: Of the 539 respondents (64.6% were aged </=35 years), most were White (63.1%), single (42.5%), Catholic (48.4%) and privately insured (55.3%). Among the 223 women at pregnancy risk [not currently pregnant, not using any form of nonsurgical birth control (except condoms) and with no prior tubal ligation or hysterectomy], about 25% were using BCPs, fewer than 10% had used EC and almost 40% never used condoms. Most women displayed good knowledge about BCPs and condoms but poor understanding about EC. In multivariate logistic regression analyses, current BCP usage among women at risk of pregnancy was associated with younger age [odds ratio (OR)=0.54; 95% confidence interval (CI)=0.37-0.79], private insurance (OR=2.52; 95% CI=1.30-4.86) and recent intercourse (OR=1.61; 95% CI=1.19-2.18). Among women at risk of pregnancy, those who had an abortion (OR=2.56; 95% CI=1.17-5.61) and those who displayed greater EC knowledge (OR=3.23; 95% CI=1.50-6.95) had greater odds of having used EC. Among all women, more frequent condom usage was associated with being younger (OR=0.57; 95% CI=0.46-0.70), having never been married (OR=0.44; 95% CI=0.28-0.68) and not having intercourse recently (OR=0.79; 95% CI=0.64-0.98). CONCLUSIONS: A high percentage of female ED patients (41.4%) were at risk of pregnancy. Demographic and sexual history factors can help identify women who might benefit from receiving referrals or education on contraceptive measures.
Adolescent↗
Emergency contraception for prevention of adolescent pregnancy.
Adolescent pregnancy remains a significant problem in the United States today, despite availability of effective contraceptive methods. Not all sexually active adolescents use contraception, and even those who do use contraception sometimes use it incorrectly. Emergency contraception, which refers to methods of pregnancy prevention used after unprotected intercourse, has the potential to prevent most unplanned adolescent pregnancies. Emergency contraceptive pills (ECP) containing estrogen and progestin or progestin alone are more than 75% effective when the first dose is taken within 72 hours after unprotected sex and the second dose is taken 12 hours later. However, barriers to accessing ECPs include lack of knowledge of the method, fear of loss of privacy, difficulties in finding a provider, and cost. Another barrier is that controversy exists about the mechanisms of action of emergency contraception about its role in pregnancy prevention. As a result, some nurses are not comfortable with suggesting emergency contraception to their patients. Nurses can play a critical role in providing ECPs to adolescents by developing programs to streamline distribution of ECPs, while maintaining adolescent privacy. Other essential roles for nurses include providing education about ECPs to parents, other healthcare providers and community members, and advocating for political and legal changes that will ease restrictions on ECP distribution. Nurses who are personally uncomfortable discussing emergency contraception can refer their patients to other providers for information and access to this method.
Adolescent↗
High-risk adolescents and female condoms: knowledge, attitudes, and use patterns.
PURPOSE: To explore data on high-risk male and female adolescents' attitudes towards female condoms, compared with male condoms. METHODS: Exploratory survey research was utilized with a convenience sample of 65 high-risk adolescents at an emergency homeless shelter. A peer-led intervention was conducted and pre-test and post-test interviews explored barriers to female condom use. The intervention consisted of 15- to 30-minute small group sessions, discussing female condoms' construction; purpose of the rings; efficacy preventing pregnancy and sexually transmitted infection (STIs); and how to lubricate, insert, and use. Content and Chi-square analyses were utilized. RESULTS: Sixty-three percent used male condoms as their primary contraceptive method; almost half (48%) said they always used male condoms, but 44% reported having sex without a male condom at least once in the 2 weeks prior to pre-test. Ninety-five percent had heard of the female condom, half 'good' and 24% 'bad' things, but only 15% had ever used one. At post-test all respondents gave reasons they might use female condoms in the future, and 77% gave reasons why they might not. Most (73%) adolescents said they would still prefer the male to the female condom. The major potential barriers to adolescents' female condom use were not having female condoms available and/or females feeling uncomfortable inserting them. CONCLUSIONS: Female condoms should be offered to adolescents as an additional choice rather than as replacements for male condoms. Further research is needed to assure access, availability, and comfort with female condoms and male participation in their use.
Adolescent↗
Determinants for contraceptive use in young, single, Danish women from the general population.
Determinants for contraceptive use were studied in 5031, non-pregnant women aged 20-29 years from the general population in Denmark. Most women (72%) had never been pregnant, 34% had a history of a sexually transmitted disease, and 22% had ever had a legal abortion. Current contraception was most frequently condoms (60%) or oral contraceptives (33%). Among the women who used OCs or IUD, 32% reported additional condom use (double contraception). Important predictors of using one contraceptive method were lifetime number of sexual partners, parity, and age at first sexual intercourse for condoms and age for oral contraceptives. Also, women with a previous legal abortion were more likely to use condoms currently and women with a history of STDs were less likely to use condoms, but more likely to use OCs. Lifetime number of sexual partners was the only predictor of double contraception. Our data suggest a potential for reducing the number of unintended pregnancies and STDs in single women by increasing the information about the double principle in contraception.
Abortion, Induced↗
Impact of patient counseling on acceptance of the levonorgestrel implant contraceptive in the United Kingdom.
Patient counseling is an important aspect of family planning. Patient choice, compliance, and satisfaction with a contraceptive method depend heavily on the counseling experience. This is especially true in the United Kingdom where contraceptives are provided to patients at no direct cost to them. Women are therefore more likely to choose a contraceptive option based on perceived desirability as opposed to cost. We surveyed physicians from six family planning centers in the United Kingdom who have extensive experience with levonorgestrel contraceptive implants with respect to counseling issues and patient acceptability of levonorgestrel implants. The physicians reported on their experience with 521 women. They acknowledged the need for and importance of counseling, and these centers provided preinsertion counseling 100% of the time. Primary responsibility for counseling was handled by the physician who spent, on average, 19 minutes per patient discussing the advantages and risks of levonorgestrel implants. Physicians felt that the majority of women (82%) accepting levonorgestrel implants had a positive experience. The incidence of bleeding irregularities was consistent with that reported in clinical trials, and this did not substantially affect the postinsertion acceptability of the product. Effective counseling is no doubt responsible for the high level of patient acceptance of these side effects. In a review of the literature, we found counseling to be a significant factor in a woman's tolerance of contraceptive-induced bleeding irregularities, which are frequently experienced with levonorgestrel implants. The results of our survey support the literature findings.
Adolescent↗
Current use of an intrauterine device and risk of tubal pregnancy.
Using data from a population-based, case-control study, we assessed risk of tubal pregnancy associated with use of an intrauterine device (IUD) at the time of conception. Cases were 249 members of Group Health Cooperative of Puget Sound who experienced a tubal pregnancy between 1981 and 1986. Controls were 831 members at risk of ectopic pregnancy who were similar to cases with respect to age and county of residence, but otherwise selected at random. Risk of tubal pregnancy associated with current IUD use was compared separately to that among users of various other (or no) contraceptive methods. Tubal pregnancy was more likely to occur among IUD users than among women using oral contraceptives [relative risk (RR) = 3.8, 95% confidence interval (CI) = 1.5-9.9] or barrier methods (RR = 3.6, 95% CI = 1.6-8.1), or, to a lesser extent, among women who had been surgically sterilized (RR = 1.6, 95% CI = 0.8-3.5). In contrast, IUD users were much less likely to experience a tubal pregnancy (RR = 0.2, 95% CI = 0.1-0.4) than were women who were currently not contracepting. For most women, the decision to use an IUD occurs within the context of choosing among various contraceptive methods. Our results indicate that, for these women, the decision to use an IUD results in increased risk of ectopic pregnancy while the device is in use.
Adolescent↗
[Contraception without risk of breast disease: epidemiologic and physiopathologic arguments].
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Age Factors↗
[Current issues in contraception].
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Biology↗
Hormonal contraception.
Increased sexual activity among adolescents demands that the health care provider have a thorough understanding of contraceptive methods and application. In this article, the principles of hormonal contraception are discussed, providing relevant information for use in advising and managing the sexually active adolescent.
Adolescent↗
[Acceptance and subjective well-being with a norgestimate combination pill].
683 women were assessed in the present study. All study participants were subjected to an overall clinical examination before and after a 4-month regimen of a low-dose norgestimate-containing combination oral contraceptive (Cileste); in addition, their subjective well-being was investigated by an appropriate questionnaire. 63.3% of the study participants rated drug tolerance as 'very good' and 23.0% rated it as 'good' at evaluation in the 4th cycle. Between the first and second evaluation, we observed a significant improvement of the depressive mood and of skin and hair problems. Women with skin and hair problems often suffer from 'severe dysmenorrhea'. This difference was statistically significant only at the first evaluation (i.e. before the combined norgestimate regimen) and was not observed in the 4th cycle (i.e. during the Cileste regimen), while the incidence of menstrual disturbances was generally found to decrease.
Adolescent↗
Women's knowledge of, and attitudes to, contraceptive effectiveness and adverse health effects.
Our objectives were to determine women's knowledge of the effectiveness of different contraceptive methods and the risks of thrombosis with use of hormonal contraceptives, and their attitudes regarding the acceptability of bleeding irregularities and weight change. An additional aim was to determine what information women want to be given about contraceptives. In order to satisfy the study objectives, a series of semi-structured focus groups was conducted with women of differing life-stage and background from Oxford. Quantitative data were collected using a structured questionnaire. Qualitative data were collected through discussion with group members. Forty-five women attended four focus groups. Women were segregated into the following groups: professional working mothers; non-professional mothers; young, unmarried professional women; and undergraduate students. Women tended to overestimate the risks and underestimate the effectiveness of hormonal contraceptives. They were resistant to interference with their bleeding patterns and weight.
Adolescent↗