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PubMed1985

Prevalence and trends in oral contraceptive use in premenopausal females ages 12-54 years, United States, 1971-80.

Data from the second National Health and Nutrition Examination Survey (NHANES II) were analyzed to estimate the prevalence of oral contraceptive use in the United States, 1976-80. The overall unadjusted prevalence of oral contraceptive use was 16.7 per cent for premenopausal females ages 12-54 years (19.2 per cent for ages 15-44 years). Approximately 8.7 million females (95 per cent confidence interval, 6.9-10.5 million) were oral contraceptive users at the midpoint of NHANES II (March 1978). Comparison to the NHANES I, conducted in 1971-74, indicated a stable number of overall oral contraceptive users in the US population during the 1970s, with shifts in certain age groups: oral contraceptive use increased for females ages 12-19 years and decreased for females ages 20-49 years. The overall age-adjusted prevalences indicated a 2 per cent (95 per cent CI, 0.2-3.8 per cent) decline in oral contraceptive use from the early to the late 1970s. The NHANES provides comparative data and supports findings from another national survey showing a decrease in the per cent of females using oral contraceptives during 1973-82. Trends in oral contraceptive use are also presented by race, poverty level, rural-urban residence, marital status, and education level.

Adolescent↗
PubMed1987

Contraceptive needs and practices among women attending an inner-city STD clinic.

To assess the potential need, interest, and benefits of provision of contraceptive services in sexually transmitted disease (STD) clinics, we surveyed 516 women attending an inner-city STD clinic regarding contraceptive and sexual practices, STD prevalence, knowledge of contraceptive-related STD prophylaxis, and interest in contraceptive services within the STD clinic setting. The study population was at high risk for unintended pregnancy and STDs; at time of interview 46 per cent of women were not contracepting and 59 per cent were treated for STD or STD exposure. Two-thirds of women had at least one prior pregnancy and 50 per cent had at least one living child. Only 26 per cent of women knew that some contraceptive methods may reduce the risk of STD acquisition; however, 62 per cent expressed interest in contraceptive methods which would reduce their risk of STD acquisition. This study suggests that provision of contraceptive services in STD clinic settings may address dual needs in a group at high risk for both unintended pregnancy and STD.

Adolescent↗
PubMed1999

Is there an increased risk of stroke associated with oral contraceptives?

In the last few years several studies were published about the relationship between oral contraceptive use, estrogen dose, different types of progestogens, cigarette smoking and the risk of stroke. There is a persistent association between the use of oral contraceptives containing more than 50microg of ethinylestradiol and the risk of stroke. Also, cigarette smoking seems to be a strong additive risk factor, especially in women >35 years old even with lower doses (< or =30microg) of estrogen. Unlike oral contraceptives containing >50microg of estrogen, currently there is no convincing evidence that the use of oral contraceptives containing <50microg in the absence of smoking is associated with any meaningful increase in the risk of ischaemic or haemorrhagic stroke. Progestogen-only pills are not associated with an increased risk of stroke. A specific type of progestogen in combined pills was associated with an increased risk of stroke in a few studies. Data regarding this issue is, however, inconsistent and controversial and needs further investigation. There were few if any studies that have addressed the effects of new types of progestogens (i.e. norgestimate, norgestrel or gestodene) and formulations containing 20microg of ethinylestradiol. At the present time we find no reason to alter the current practice in prescribing oral contraceptives. We do concede, however, that there might be a slight causal relationship between use of oral contraceptives containing <50microg of ethinylestradiol and stroke that did not reach statistical significance. This relationship is rare and should be viewed in context with the many benefits of oral contraceptives. Underlying risk factors for stroke such as factor V Leiden mutation and other thrombophilias might explain the role of oral contraceptive-induced stroke.

Adult↗
PubMed1991

Clinical pharmacokinetics of contraceptive steroids. An update.

The present article should be read in conjunction with the original review published in the Journal in 1983. There is no new information of major significance about the pharmacokinetics of levonorgestrel, norethisterone (norethindrone) or ethinylestradiol, although it has been shown that the concentrations of these hormones secreted in breast milk are small and mothers taking combined oral contraceptive steroids may breast-feed safely. Both levonorgestrel and ethinylestradiol can be successfully administered from appropriate vaginal formulations, but no clear advantages over oral administration have been demonstrated. Several new progestogens have been investigated. Desogestrel is a prodrug for its active metabolite 3-keto-desogestrel, gestodene is itself an active progestogen and norgestimate is a prodrug acting by conversion to norgestrel and its metabolites. All 3 compounds have good bioavailability with wide intersubject variation. The newer progestogens, like norethisterone and levonorgestrel, are bound to sex hormone binding globulin (SHBG). This causes their plasma concentrations to increase with time, since SHBG is induced by ethinylestradiol even in doses of 30 micrograms daily. The binding capacity and affinity of SHBG do not increase in direct proportion to its concentration. Further drug interactions with oral contraceptive steroids have been described. Contraceptive steroids may inhibit hepatic microsomal enzyme metabolism and increase the plasma concentration and effect of some tricyclic antidepressants, the hydroxylated benzodiazepines, some beta-blocking drugs, methylxanthines, prednisolone and cyclosporin. There are no significant effects on vitamins. Oral contraceptive steroids induce glucuronidation and hence decrease plasma concentrations of some benzodiazepines, clofibric acid, paracetamol (acetaminophen) and possibly morphine. The plasma concentration of ethinylestradiol may be increased by competitive sulphation with paracetamol. Plasma concentrations of contraceptive steroids are decreased by griseofulvin, which induces their hepatic metabolism. The role of other antibiotics remains controversial but there is probably a group of susceptible women who have lower plasma contraceptive hormone concentrations and experience breakthrough bleeding or pregnancy when given broad spectrum antibiotics. This may relate to interruption of the enterohepatic recirculation of ethinylestradiol. Anticonvulsants, other than valproic acid, all induce contraceptive steroid metabolism and therefore lower plasma hormone concentrations, thus reducing contraceptive effectiveness.

Contraceptives, Oral, Hormonal↗
PubMed1998

Oral contraceptives and venous thrombosis: end of the debate?

During the more than 30-year history of oral contraceptives, clinicians have received several official warnings issued by regulating agencies on cardiovascular risks. These have affected not only gynecological practice, but also generated research activities resulting in the refined third-generation products marketed in the 1970s. The alert sent out by the UK Committee on Safety of Medicines (CSM), October 1995, on increased risk of deep venous thrombosis during use of these compounds was, therefore, very much unexpected. The statements were referring to unpublished data and, thus, indicated new and highly alarming findings. However, during the following months, although four epidemiological studies reported a 2-4 fold relative increase compared with the second-generation oral contraceptives. This relative increase means, looking at absolute risks, an excess of 1-2 cases of deep venous thrombosis per 10,000 oral contraceptive users per year. In the academic discussions following the primary publication of the four papers, the possibility of confounding factors and bias was strongly emphasized and follow-up studies together with re-analysis of the original studies have not generated evidence for the suspicion of the increased risk with third-generation oral contraceptives. In contrast, a decreasing tendency was demonstrated for more serious events such myocardial infarction. Also, the biological plausibility for increased risk of deep venous thrombosis with third-generation products is lacking, although one study has pointed to a change in the natural anticoagulatory mechanism. Obviously, the authorities have a right to react on suspicion, but the psychological and social effects of the abrupt stopping of oral contraceptive use should not be ignored, and the public understanding of scientific results is manipulated by the mass media. Following confirmed evidence from both epidemiological and biological studies, with full acknowledgement of the contraceptive and non-contraceptive benefits from oral contraceptives, an official statement should have been part of the communication strategy to prevent pill scare. A more appropriate reaction from the authorities would have been to await action until publication and scientific validation of several peer-reviewed articles and to include also absolute risks instead of relative findings.

Contraceptives, Oral↗
PubMed2006

Contraceptive counselling and social representations: a qualitative study.

BACKGROUND: Contraceptive use is a complex issue and several studies have been conducted in an effort to understand user behaviour. It is of interest to explore the representations of professionals who give advice on contraception, since their views could have an impact on contraceptive use. METHODS: Individual in-depth interviews of 65 healthcare professionals likely to provide contraceptive advice to patients at a Swiss maternity unit. RESULTS: 83% of healthcare professionals interviewed were favourable to contraception in general while being highly critical of its practical efficacy. The methods most often spontaneously cited were oral contraceptive pills, male condom, intrauterine devices and hormonal implants. Theoretically, all methods should be proposed during contraceptive counselling but in practice interviewees have different social representations of user groups and associate them with specific contraceptive methods. Personal experience appears to play a bigger role than scientific knowledge. CONCLUSIONS: The counsellor's social representations probably play an important role in determining user behaviour. These representations should be taken into consideration in the training of healthcare professionals in this field.

Adult↗
PubMed2002

Effect of two oral contraceptives containing ethinylestradiol and levonorgestrel on serum and urinary surrogate markers of endothelial function.

OBJECTIVE: To investigate the effect of two oral contraceptives containing 0.02 mg ethinylestradiol and 0.1 mg levonorgestrel (Formulation A, Leios), and the other containing 0.03 mg ethinylestradiol and 0.15 mg levonorgestrel (Formulation B, Stediril 30) on the serum and urinary concentrations of various markers reflecting the status of vascular tone and development of atherosclerosis. The adhesion molecules E-selectin, inter-cellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and homocysteine were included as serum markers and cGMP, prostacyclin and its antagonist thromboxane as urinary markers. METHODS: In a comparative, double-blind, randomized, parallel group study, 34 women received formulation A and 33 women formulation B. Serum samples were collected before treatment and after 3, 6 and 12 cycles. Nocturnal urine was collected before treatment and during cyclic treatment after 3 and 12 cycles. Serum and urinary markers were measured by enzyme immunoassays. RESULTS: E-selectin levels were significantly reduced by both contraceptives after 3, 6 and 12 months compared to pretreatment levels. A slight increase in ICAM concentrations was observed for both contraceptives after 6 cycles, but this fell to pretreatment levels after 12 cycles. VCAM values were significantly lowered after 3, 6 and 12 months by both contraceptives. No significant changes were found in serum levels of homocysteine. No significant differences were found between treatment groups for the serum markers. Both contraceptives significantly enhanced urinary cGMP excretion after 12 cycles. The prostacyclin metabolite remained unchanged in the case of both formulations, but the excretion of the thromboxane metabolite was significantly decreased after 12 cycles. Thus, the ratio of prostacyclin to thromboxane, decisive for the resulting effect on vascular tone, increased significantly. CONCLUSION: These results indicate that the low-dose oral contraceptives can reduce the production of adhesion molecules which play a crucial role in the early stages of atherosclerosis. In addition, these contraceptives can shift the balance of vascular tone towards dominance of vasodilatory substances after 12 cycles of treatment. Thus, the positive influence of these contraceptives on the various markers investigated may improve vascular tone and impede development of atherosclerosis.

Adult↗
PubMed2000

[Development of reproductive health in women in the Czech Republic 1993-1997. IV. Relation between contraception and induced abortion].

OBJECTIVE: Overall objective is to detect changes in reproductive health of women due to changes in the system of social and health care. The particular objective of this part of the study (part IV) is to identify the changes in the relationship of decreasing number of induced abortions and increased use of contraception in 1997 compared to 1993. DESIGN: Retrospective comparative epidemiological study. SETTING: Institute for the Care of Mother and Child, Praha 4--Podolí. METHODS: Input data for the comparison of number of induced abortions and extent of contraceptive use came from the results of two previous parts of the study (parts II and III). The relationship of contraceptive use and induced abortions was analyzed with regard to possible effect of concurrent development of selected social-demographic factors. RESULTS: The highest decrease of absolute number of induced abortions, together with higher-than-average decrease of absolute number of women not using one of three effective methods of contraception, was among married women, women with two children and women with secondary education without exam. On the opposite, the highest relative decrease of women not using one of the three contraceptive methods was among women 20-24 year of age, women without children and women with university education, although such change was not reflected in relative decrease of number of induced abortions in these groups. Furthermore, their relative decrease was even smaller than the national average. Similarly, the highest relative decrease of number of induced abortions among divorced women and women 25-29 year of age was linked with less-than-average decrease of number of women not using one of three effective methods of contraception. CONCLUSIONS: Different values of changing relationship of contraception and induced abortions in relation to analyzed social-demographic factors during period of observation document the influence of these factors without dispute. Due to complex influence of these factors on the relationship of contraception and induced abortions, the particular contribution of each of them is difficult to asses during simple analysis one-by-one.

Abortion, Induced↗
PubMed2000

First sexual intercourse and contraception: a cross-sectional survey on the sexuality of 16-20-year-olds in Switzerland.

BACKGROUND: The onset of sexual activity represents an important development stage with positive aspects, such as love, discovery, intimate relationships, plans for the future, but also with fears of pregnancy, of sexually transmitted diseases and of AIDS. OBJECTIVE: To study perceptions, attitudes, and behaviour related to sexual life, AIDS and contraception; to explore the onset of first sexual relationships and the process of choice of a contraceptive method by the adolescents, in order to improve prevention programmes for young people. METHOD: Analysis of data from a Swiss national survey on adolescent sexuality using a computerised self-administered questionnaire, involving 2075 girls and 2208 boys between the ages of 16 and 20. The use of computers helps improve confidentiality, response rates and acceptability since survey questions are limited to the subjects' sexual experience only. RESULTS: The young people's responses emphasised the importance of emotion in sexual relationships, girls choosing intimacy and fidelity while boys attached more importance to physical pleasure. Three out of four respondents have had a sexual experience and one out of two have had penetrative sexual intercourse. The percentages of condom or oral contraception use are high: at first sexual intercourse, 86.5% used one or the other, while 7.4% did not declare any contraceptive method. The percentages are lower when age at first intercourse is below 15 years, when a girl had an older partner (age difference 7 years and more) and when the 1st relationship is a casual one. During their first stable relationship 41.1% of girls and 30.9% of boys say they have changed their contraceptive method from condom to contraceptive pill, 2.4% of girls and 2.9% of boys say they have given up any form of contraception. Among girls, condom use at first sexual intercourse with a new partner decreases in favour of oral contraception between first and last steady relationships (75.6 vs 58.0%, p < 0.05), the decrease being insignificant between the first and last casual relationships (73.5 and 62.2%, n.s.). Among boys the rates of condom use are equal at first intercourse with the first and last partner (steady relationship: 74.1 and 77.2%; causal relationship: 78.3 and 76.2% respectively). CONCLUSION: The use of condoms is high among Swiss adolescents, particularly at first sexual intercourse. By integrating the prevention of sexually transmitted diseases and of unwanted pregnancies, preventive programmes would address adolescents' needs more effectively.

Adolescent↗
PubMed2000

The acceptability of a novel oral contraceptive containing drospirenone and its effect on well-being.

Low-dose combined oral contraceptives are generally well tolerated and represent an excellent reversible form of contraception that is suitable for most women. Certain aspects of the clinical profile of combined oral contraceptives, such as intermenstrual bleeding and a tendency to weight gain, are, however, known to have an adverse effect on compliance, which may in a few women lead to contraceptive failure or pill discontinuation. Conversely, factors that have a positive effect, such as relief from the symptoms of premenstrual syndrome, can enhance compliance. An oral contraceptive that minimizes the adverse and enhances the positive effects would, therefore, be likely to improve compliance. Recently, a new combined oral contraceptive containing 30 microg ethinylestradiol and 3 mg drospirenone (Yasmin, EE/DRSP) has been developed. The pharmacological profile of drospirenone is very similar to that of natural progesterone; in particular, it has antimineralocorticoid activity. This counteracts estrogen-mediated fluid retention, resulting in stable or slightly lowered body weight. In addition, drospirenone has antiandrogenic activity and therefore a positive effect on skin conditions. Present data also indicate that EE/DRSP has a favorable effect on the symptoms of premenstrual syndrome. In order to evaluate whether the positive effects of drospirenone on body weight, skin and the symptoms of premenstrual syndrome are also observed on well-being, a survey was carried out. This asked women who had been involved in two major clinical trials how they felt after these trials had ended, in comparison with the study periods when they were taking EE/DRSP or a combined oral contraceptive containing 30 microg ethinylestradiol/150 microg desogestrel (Marvelon, EE/DSG). The returned questionnaires demonstrated that, with respect to their disposition before and during menses, women who had taken EE/DRSP felt worse after the trial had ended and they had returned to taking a conventional preparation. This was also evident on the basis of their body weights and the condition of their skin and hair. These results from clinical trials with EE/DRSP indicate that it is a well-tolerated combined oral contraceptive that has a positive effect on body weight, skin and the symptoms of premenstrual syndrome. Overall, the combination of 30 microg ethinylestradiol/3 mg drospirenone appears to improve specific aspects associated with feelings of well-being, which may result in better compliance.

Adolescent↗
PubMedDate not supplied

U.S. agencies providing publicly funded contraceptive services in 1999.

CONTEXT: Nearly one-quarter of women who obtain medical contraceptive services receive care from clinics operated by publicly funded agencies. In light of changes in government policy and funding and in the structure of health care financing, an assessment of agency policies and programs is essential for monitoring women's access to contraceptive care and services. METHODS: In 1999, 637 of a nationally representative sample of 1,016 U.S. agencies that receive public funding to provide contraceptive services responded to a 12-page survey. Responses were analyzed according to agency type, receipt of Title X funding and main focus. RESULTS: More than nine in 10 agencies offer the pill, the male condom and the injectable; 80% offer emergency contraceptive pills, compared with 38% in 1995. Some agencies allow clients to delay a pelvic exam when beginning use of oral contraceptives (56%), the injectable (42%) or the implant (23%). On average, agencies receive funding for contraceptive services from 4.9 sources; the proportion relying on private insurance and contributions has risen since 1995. Virtually all family planning agencies provide screening and testing for sexually transmitted diseases (STDs), and at least two-thirds offer treatment for most STDs. The vast majority of agencies offer general health care and perinatal or pediatric services; half offer general gynecologic care or infertility services. Services provided, costs and clinic policies vary according to agency type. CONCLUSIONS: Agencies offering contraceptive services also offer a wide range of reproductive health and related services. There remain services for which provision could be increased and policies that need to be modified to facilitate clients' access to contraceptive care.

Contraception↗
PubMed2002

[Sexual activity and contraception habits among adolescents over the last 14 years. An investigation among 9th grade pupils in the municipality of Viborg].

INTRODUCTION: The purpose of the investigation was to illustrate changes in sexual activity, the use of contraceptive methods, and age at the first coitus during the last fourteen years. MATERIAL AND METHODS: Twenty-one ninth grade classes in schools in the municipality of Viborg were asked to complete a questionnaire. Altogether 372 questionnaires were distributed and 344 pupils (92%) were entered in the investigation. Neither the teachers nor the pupils knew anything about the investigation before distribution. Identical questionnaires had been completed by the same age group in 1986 and 1993, which enabled us to compare the results and point out differences. RESULTS: We found no changes in age at the first coitus. One third of the pupils had had their first intercourse, 15% before the age of 15. Previously girls were sexually more active than boys, this difference was now equalised. Most (53%) of the experienced pupils had not had coitus in the preceding four weeks, but, compared with 1986, more of the pupils had been sexually active within the preceding week. As found in 1993, the use of condoms had increased, which was still unchanged. There was a continuing decline in the use of the pill at the first intercourse. However, the pupils changed the condoms for the pills as they became more experienced. Ten per cent of the pupils still did not use any contraception at the first intercourse. Occasional use of contraception was more common. In 1986, 75% used contraception at every intercourse, that proportion had fallen to 51% in the year 2000. DISCUSSION: Age at the first intercourse remained unchanged over the 14 years examined, and the change in contraceptional habits seen in 1993 had persisted, except that the proportion using contraception at every intercourse had decreased. The explanation for not using contraception was generally that the intercourse was unplanned. The girls were at a greater risk of unwanted pregnancies and sexually transmitted diseases, as they, more often than the boys, used unsafe methods of contraception.

Adolescent↗
PubMed2002

Continuation and compliance of contraceptive use.

Choosing a method of contraception is an important decision as regards user satisfaction, continuation of use and compliance. The issues of continuation of and compliance with contraceptive use are presented. The continuation rate of a method of contraception is the indicator of the acceptability of that method. The highest continuation rates at the end of the first year are recorded for subdermal implants, intrauterine devices (IUD), the pill and Depo-Provera. Lower continuation rates are found for periodic abstinence, male condom, female condom, diaphragm and spermicides. Continuation rates are highest for methods not affected by compliance. Compliance indicates the degree to which the patient adheres to a prescribed regimen. Lack of compliance can lead to adverse effects of contraceptive use (unintended pregnancy, side-effects, diminished non-contraceptive health benefits) and to discontinuation of the contraceptive method. Also, differences between method effectiveness and user effectiveness can largely be attributed to compliance with the prescribed contraceptive regimens. Health-care professionals have to empower the patient to increase compliance with the existing methods. In addition, the development and use of new contraceptive methods, which take into account the issues of non-compliance, should be encouraged.

Contraception↗
PubMed1992

Safety of oral contraceptives for teenagers. ACOG Committee opinion: Committee on Adolescent Health Care number 90--February 1991.

By age 18, 51% of adolescent women will be sexually active. Oral contraceptives are a safe method to avoid the potentially disastrous outcome of an unwanted pregnancy. The overall risks of taking oral contraceptives are much less than the risks of pregnancy (20). Specifically, the risks associated with the use of oral contraceptives by teenagers are negligible. Low-dose oral contraceptives have not been linked with either heart attack or stroke in contemporary U.S. studies. While the risk of thromboembolism in oral contraceptive users as a whole may be increased over that of the general population, the risk to teenagers, especially those who do not smoke, is minimal. The risk of death from oral contraceptive use for teenagers is virtually nil (12). As with all medical choices, the benefits of a treatment must be weighed against any potential risks. For adolescents, the benefits associated with the use of oral contraceptives outweight the risks, particularly those of pregnancy. However, teenagers at risk for sexually transmitted diseases should be advised to use a barrier method along with oral contraceptives.

Adolescent↗
PubMedDate not supplied

[Postpartum contraceptive practice in hospitals of the Federal District].

For many women living in developing areas, childbirth is the only time when they receive medical care in a clinical setting. These women may not return until they are ready to deliver their next baby. Without access to family planning counseling and effective contraceptive methods, they are likely to become pregnant again within a year or two. Where contraceptive information and services are available to women receiving maternity care, many choose to begin using contraception in the postpartum period. Some elect to have an IUD inserted immediately after delivery or to undergo sterilization while still in the hospital. Under a postpartum contraceptive program administered by the IMSS in one hospital and the same program established in another hospital of the SSA, more than half of postpartum and postabortion women began using contraception or underwent sterilization before they left the hospital. In contrast, the other hospitals under the analysis showed a wide range of contraception coverage from 7 to 55 percent. A formal postpartum contraception program is necessary to establish in all the hospitals in order to improve coverage. Counseling is an important component for all women who must have adequate information before they choose a contraceptive method.

Contraception↗
PubMed1992

Safety of oral contraceptives for teenagers. American College of Obstetricians and Gynecologists.

By age 18, 51% of adolescent women will be sexually active. Oral contraceptives are a safe method to avoid the potentially disastrous outcome of an unwanted pregnancy. The overall risks of taking oral contraceptives are much less than the risks of pregnancy (20). Specifically, the risks associated with the use of oral contraceptives by teenagers are negligible. Low-dose oral contraceptives have not been linked with either heart attack or stroke in contemporary U.S. studies. While the risk of thromboembolism in oral contraceptive users as a whole may be increased over that of the general population, the risk to teenagers, especially those who do not smoke, is minimal. The risk of death from oral contraceptive use for teenagers is virtually nil (12). As with all medical choices, the benefits of a treatment must be weighed against any potential risks. For adolescents, the benefits associated with the use of oral contraceptives outweigh the risks, particularly those of pregnancy. However, teenagers at risk for sexually transmitted diseases should be advised to use a barrier method along with oral contraceptives.

Adolescent↗
PubMed2001

Effect of technical traning program on intern physicians' and nurses' knowledge and attitudes regarding emergency contraceptives.

In spite of the effectiveness of modern contraceptives, unwanted pregnancies occur in large number throughout the world and many seek termination so emergency contraceptive methods can be used by women in the first few days, following unprotected intercourse to prevent unwanted pregnancy, induced abortion, and its consequences for women and couples. So this study was conducted to determine the effect of technical training program on upgrading a newly graduate physician and nurses knowledge and attitude regarding emergency contraceptives. The study included 50 intern physicians and 50 intern nurses who are working at El-Shatby maternity university hospital during 1st of march 2001. The study used pre and post test with no control group design. An interview questionnaire sheet was used to assess intern physician and nurses, knowledge about emergency contraceptives while 3 point Likert scale was used to assess the attitude of both groups (physician and nurses) were divided into two sub group. A four hours technical training program were implemented for each group separately on two successive days (2 hours/day). Before implementing the technical training program the study depicted a general lack of knowledge among all physician and nurses regarding emergency contraceptives. Methods added to that the majority of intern physician and nurses 70%, 84% respectively had negative attitude toward emergency contraceptives however, the technical training program had an obvious effect on intern physicians and nurses. Knowledge regarding emergency ,contraceptives. Although improving in the study subjects, Knowledge had a positive impact of their attitude toward emergency contraceptives.

Adult↗
PubMed2006

Community-based study of contraceptive behaviour in Nigeria.

A cross sectional, community-based, descriptive study among women of reproductive age group (15-49 years) in Nigeria to explore the possible reasons for contraceptive non-use despite reported high awareness was carried out. Data were obtained using a standard questionnaire instrument and applied on 2001 respondents. Contraceptive prevalence among sexually active respondents was 14.8% for all methods, 10.1% for modern methods and only 0.8% for emergency contraceptives. The most frequently stated reasons for non-use of contraceptives, among those who had never used any contraceptives but who did not want more children were: "did not think about it", "against religious belief" and "fear of side effects." Prior counseling significantly improved the continuation rate of contraception. Multivariate analysis showed that older, married and more educated women tended to use contraceptives more. Health-care providers should be trained to offer counseling services to all clients in general, and young, unmarried and uneducated women in particular in order to improve their acceptance of contraceptives.

Adolescent↗