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PubMed2000

Fertility regulatory methods and development of complications after evacuation of complete hydatidiform mole.

In a prospective, simple randomised study, we evaluated the relative efficacy of hormonal (oral contraceptive pill) and non-hormonal (intrauterine contraceptive device) methods of contraception as fertility regulatory agents in patients with complete hydatidiform moles and assessed the development of complications and sequelae if any, following their use. Fifty-six patients each on oral contraceptive pills (OCP) and intrauterine contraceptive device (IUCD) were recruited into the study. Ten patients, six on OCP and four on IUCD discontinued for varying reasons. Five patients (two on OCP, and three on IUCD) developed a gestational trophoblastic tumour and were admitted for chemotherapy. There was no complication attributable to any of the methods.

Clinical Trial↗
PubMed2002

Intravesical migration of intrauterine device resulting in stone formation.

The intrauterine contraceptive device has been in use for many years, and migration of the device from the uterus to the pelvic cavity has been reported by many investigators. Although perforation of the uterus by an intrauterine contraceptive device is not uncommon, intravesical migration and secondary stone formation are rare complications. We report on a 27-year-old woman in whom an intrauterine contraceptive device (Copper-T) migrated from the uterus to the bladder and resulted in formation of a stone.

Adult↗
PubMed1982

Continuous sonographic monitoring of IUD extraction during pregnancy: preliminary report.

The significance of the location of intrauterine contraceptive device in relation to the gestational sac on pregnancy outcome was studied in 13 pregnant women after extraction of the device. Of the seven women (group 1) who had the intrauterine contraceptive device removed after initial localization by sonography, two (28.5%) miscarried. In both cases the device was located cephalad or lateral to the gestational sac. In six women (group 2) continuous sonographic scanning was undertaken to visualize the extraction procedure. Traction on an intrauterine device located laterally (two cases) or cephalad (one case) to the gestational sac was followed by distortion of the sac configuration. Gentle intermittent traction on the contraceptive device resulted in successful extraction procedure. These preliminary observations suggest that pregnancies with an intrauterine contraceptive device located laterally or cephalad to the gestational sac are at greater risk during extraction of the device. Sonographic monitoring of the extraction procedure during pregnancy may minimize the hazards of intrauterine contraceptive device failure.

Abortion, Spontaneous↗
PubMed1998

Characterization of calcified deposits on contraceptive intrauterine devices.

The formation of calcified deposits on > 200 contraceptive intrauterine devices (IUD) was quantitated as a function of time in healthy women, pregnant women, and women with a pathologic lesion. The incrustment formation was significantly enhanced when inflammation occurred, but change could not be observed in cases of pregnancy. The incrustments were analyzed by x-ray diffraction, infrared spectroscopy, x-ray microprobe, and ultramicrochemical stone analysis techniques. Major components and their average w/w percent quantities in the incrustments are as follows: calcium carbonate 75%, apatite 5%, and organic matrix 20%. Earlier hypotheses on the chemical processes of deposit formation are discussed, and a new, ionic mechanism of calcification on IUD surfaces is suggested.

Calcinosis↗
PubMed2002

Functional ovarian cysts in premenopausal and gynecologically healthy women.

The present study describes 29 women coincidentally found to have ovarian cysts while participating in a cross-sectional study. The prevalence of functional ovarian cysts is determined. In this study, 428 women, aged 14-45 years, were examined by transvaginal ultrasonography. The women were gynecologically healthy and were using either no contraception, intrauterine contraceptive devices, none of which were hormone releasing, or oral contraception (OC). Cysts were defined as cystic spaces larger than 30 mm. All women were asymptomatic and regularly menstruating.The prevalence of ovarian cysts was lower for women using OC than for women using no contraception or using intrauterine contraceptive devices. The relative risk (measured as the prevalence proportion ratio) of having an ovarian cyst when using OC was 0.22 (CI: 0.13-0.39), compared to women not using OC. No difference was found in the prevalence of ovarian cysts between women using intrauterine contraceptive devices and women using no contraception. The prevalence of ovarian cyst increased throughout the menstrual cycle in women not using OC. This relation was not found in the group of users of OC. The majority of the cysts resolved within the first few days of menstruation. Sixty-five percent of the cysts persisting after menstruation had resolved at the first control examination 3 months later, independently of use of OC. Low-dose monophasic contraceptive pills seem to have a protective effect against development of functional ovarian cysts, independent of the type of gestagen and the dose of ethinylestradiol used. Ovarian cysts resolved independently of treatment with OC. The use of intrauterine contraceptive device had no influence on the occurrence of functional ovarian cysts.

Adolescent↗
PubMed1986

Bacterial flora of the cervix in women using different methods of contraception.

Bacteriologic culture samples were taken from the cervix in three groups of 10 healthy, sexually active women using barrier contraception, oral contraceptives, or a levonorgestrel-releasing intrauterine contraceptive device. Culture samples for Candida albicans and Trichomonas vaginalis were taken, a cytologic vaginal smear was obtained, and an amine sniff test was performed; these were in addition to a routine gynecologic examination. Multiple bacteria were isolated from the cervix in women using oral contraceptives or an intrauterine contraceptive device, whereas lactobacilli alone dominated the flora of women using barrier contraception. Significantly more anaerobic bacteria were isolated from the cervix in oral contraceptive and intrauterine contraceptive device users when compared with the barrier method users. Symptoms and findings evident of anaerobic vaginosis were associated with the occurrence of anaerobic bacteria in the cervix of three patients using the intrauterine contraceptive device. The results showed that the cervical bacterial flora in sexually active healthy women is rich in anaerobes that can be regarded as a normal finding in women using oral contraceptives or intrauterine contraceptive devices. Barrier contraception with a condom prevents this anaerobic shift and maintains a lactobacilli-dominated flora in the cervix.

Adolescent↗
PubMed1996

Intrauterine contraceptive device-associated actinomycotic abscess and Actinomyces detection on cervical smear.

OBJECTIVE: To summarize clinical features and treatments in reported cases of actinomycotic pelvic abscess occurring in women using intrauterine contraceptive devices (IUD), and to review detection of Actinomyces by cervical smear. DATA SOURCES: The English-language medical literature accessed through MEDLINE. METHODS OF STUDY SELECTION: We identified 92 cases of actinomycotic abscesses associated with IUD use in 63 case reports. In addition, 31 studies of Actinomyces detection were found, 16 of which were studies of Papanicolaou smear-based detection. DATA ABSTRACTION AND SYNTHESIS: Data regarding clinical presentation and treatment were culled from case reports, whereas detection rates of Papanicolaou smear and other methods were obtained from studies of Actinomyces detection. The average patient was 37 years old, had been using an IUD for 8 years, and presented with abdominal pain, weight loss, vaginal discharge, and fever. Laboratory studies commonly revealed anemia, leukocytosis, and an elevated erythrocyte sedimentation rate. Most of these patients underwent operative procedures, usually hysterectomy and salpingoophorectomy. High-dose penicillin was found to be an effective antibiotic. Detection rates of organisms on Papanicolaou smear were somewhat variable; use of other detection methods, including endometrial biopsy, culture, and immunofluorescence, did not improve this variability. CONCLUSIONS: Pelvic actinomycosis associated with the use of IUDs can mimic pelvic malignancy; for that reason, it is often treated surgically. However, if the diagnosis of actinomycosis can be obtained preoperatively, antibiotic treatment may lead to complete resolution. The Papanicolaou smear may be useful in evaluating such patients.

Abscess↗
PubMed1995

Lea's Shield: a phase I postcoital study of a new contraceptive barrier device.

Lea's Shield is a new vaginal barrier contraceptive that may offer advantages over existing methods. It is made of silicone which is resistant to petroleum-based lubricants, does not absorb odors, and does not cause allergic reactions in users with latex sensitivity. It has an anterior loop for ease of insertion and removal and a one-way flutter valve. Its novel design has sufficient volume to fill the posterior fornix, which helps keep it in place and prevent sperm from entering the cervical os. This study evaluated with a standard postcoital test (PCT) the ability of the Lea's Shield used with spermicide or non-spermicidal lubricant to prevent sperm from entering midcycle cervical mucus. Ten sterilized women underwent four PCT cycles: one cycle in which no contraceptive barrier was used (a baseline cycle) and 3 cycles in which one of the following was used: Lea's Shield with spermicide, or with non-spermicidal lubricant, or the contraceptive diaphragm used with spermicide. All volunteers demonstrated more than 5 progressively motile sperm per high power field in the cervical mucus after intercourse in the baseline cycle. No motile sperm were found in the cervical mucus in any cycle in which Lea's Shield or the diaphragm was used with spermicide. No motile sperm were found in cervical mucus in 9 of 10 cycles in which Lea's Shield was used without spermicide. Only two progressively motile sperm were present in the cervical mucus of one volunteer who used the shield with non-spermicidal lubricant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Association between diaphragm use and asymptomatic bacteriuria.

The prevalence of asymptomatic bacteriuria was assessed in women using different contraceptive methods. Three hundred and twenty women attending a family planning centre were studied, 80 in each of the following groups: diaphragms, intrauterine contraceptive devices (IUCDs), oral contraceptives (OCs) and no contraception. The numbers with asymptomatic bacteriuria in the 4 groups were as follows: diaphragm - 12 (all E coli); IUCD - 3 (E coli; P mirabilis; S saprophyticus); OC - 5 (all E coli); no contraception - 4 (3 E coli; 1 S saprophyticus). The prevalence of Gram-negative bacteriuria in women using diaphragms was significantly higher than for women in the other groups (chi 2 = 8.98; p less than 0.05). Factors such as parity, numbers of sexual partners and frequency of sexual intercourse had no apparent effect. The use of diaphragms may contribute to the risk of Gram-negative urinary tract infections in sexually active women.

Adolescent↗
PubMed1984

[Postcoital IUD insertion, a review].

Following the development of hormonal interception after coitus the post-coital insertion of an intrauterine contraceptive device was proposed by Tatum . The advantage of this treatment is the avoidance of the ingestion of large doses of estrogen which causes much nausea and vomiting although it is a very effective post-coital method of contraception. The recently proposed alternative administration of 200 micrograms Ethynol Estradiol combined with 2 mg of DL norgesterol in 2 equal doses at 12 hour intervals has the same disadvantage of a high percentage of side effects. The post-coital insertion of an intrauterine contraceptive device is the first method which is effective up to five days following unprotected intercourse which is three days longer than treatment by estrogen. In addition the method can be offered to women who would want to continue to wear the intrauterine contraceptive device for long term contraception. The disadvantage of the post-coital insertion of an intrauterine contraceptive device is the ability of serious complications if the patient has a vaginal or venereal infection or an asymptomatic cervicitis or salpingitis. Following appropriate physical examination women who present themselves for post-coital treatment are selected. Cases of rape are usually not suitable for treatment with intrauterine contraceptives devices. However, when cases of rape are seen early enough the appropriate investigations may be done and the treatment with the intrauterine device started within five days. The potential risk of future infertility must be considered since salpingitis is 7 times more common in nulliparous wearers of intrauterine devices than in nulliparous non-wearers. Young sexually active nulliparous women especially of lower socio economic background are patients with a high risk. Over 70% of the women who present themselves for interception treatment are nulliparous.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[Sociologic problems of contraception in the opinion of women from urban and rural areas].

The paper, having a diagnostic character, discusses the problems of birth control, family planning and contraception methods. The methods of the investigation were a questionnaire, interview and analysis of documentation. The investigation was carried out in two areas: urban--Katowice and rural--Istebna. The investigation was carried out among a group of 100 women between 20 and 55 years of age. All the women questioned have been married for 1-30 years. Most of them have two children--30%. Most women from both the urban and rural areas use natural methods of contraception, in. the town--Billings method and in the country--conjugal diary. Thermal method is less popular as it is time-consuming. The main reasons for choosing a natural method of contraception control are moral, religious and biological aspects, which give the women a psychic comfort and a strong feeling of attachment to the husband. Women from the urban area say that they started to use contraceptive methods after getting married whereas women from the rural area--after giving birth to a child. Contraceptive devices are used by about 30% of women. The most popular are: among women from the town--coitus interruptus, artificial abortion and less popular contraceptive devices such as oral contraceptives, intrauterine devices and chemical substances. Among women from the rural area the most common is coitus interruptus and then 2-1 cases of each of the remaining methods. Women applying contraceptive devices are aware of their harmful effects, their unreliability, immorality and violating nature. Women in the country face a lot of difficulties in buying contraceptive devices and they also (22%) use artificial abortion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2001

Contraceptive use in Jordan.

OBJECTIVE: To compare women in the child bearing age for the years 1983, 1990, 1997 regarding their use of contraceptives and the variations in the source of intrauterine contraceptive devices, as it was recently observed that women are more likely to use intrauterine contraceptive devices. METHODS: Three national surveys carried out in 1983, 1990, 1997 were compared. The samples selected in the 3 surveys were women in the child bearing age. A multistage sampling procedure was used to ensure the representativeness of the samples in the 3 surveys. RESULTS: The use of contraceptives increased from 26% in 1983 to 40% in 1990 and 53% in 1997. Women became more likely to use intrauterine contraceptive devices where the percentage of use increased from 32% in 1983 to 44% in 1997. The percentage of users of contraceptives in general and intrauterine contraceptive devices in particular was higher in urban areas and in educated women with a high number of children. CONCLUSION: Women at risk of not using contraceptives should be identified and contacted to convince them to use contraceptives. All barriers to access, use and quality of contraceptives should be investigated. The identification of such barriers will be useful for decision makers and health planners in the country.

Adolescent↗
PubMed1997

Traditional fertility regulation among the Yoruba of southwestern Nigeria. I. A study of prevalence, attitudes, practice and methods.

This study was conducted among Yoruba women and traditional healers with the aim of identifying and describing the practice, preparation, and administration of traditional contraceptives. The data were obtained in 1990 from a random sample of 1,400 women of childbearing age and 42 traditional healers in Nigeria's Oranmiyan area, using questionnaires and in-depth interviews. Findings revealed that knowledge of the traditional contraceptives is nearly universal among the Yoruba population, and the traditional contraceptive prevalence rate is 7.1 percent. The use of traditional contraceptives was significantly more common among uneducated women and among women aged 20 to 29 years old. Findings also revealed the existence of four main varieties of traditional contraceptive devices, the methods of preparation of the traditional contraceptives, varieties of herbal and animal products used, methods of administration, and taboos against usage. The easy accessibility of traditional medical practitioners and the belief that traditional contraceptive devices are devoid of complications, especially among those experienced with modern contraceptive devices, were the main reasons women cited for patronizing the traditional practitioners. The paper concludes with policy implications for family planning programmers in Nigeria.

Adolescent↗
PubMed1978

Oral and intrauterine contraception: a 1978 risk assessment.

This report reviews the current literature on the various risks associated with the use of oral contraceptives and intrauterine contraceptive devices. Reports on oral contraceptives from large prospective studies are not beginning to supplement the detailed reports resulting from earlier case-control studies. These studies suggest that in Western societies there is an increase in the incidence of a variety of circulatory diseases, with an increased risk of death. With intrauterine contraceptive devices it now has been fairly well documented that there is an increased risk of pelvic inflammatory disease. After reviewing and assessing the risks of both methods in some detail and comparing these risks to the benefits, the resultant conclusion is that the benefits continue to outweigh the risks for both methods, except for older women who choose oral contraceptives and also are heavy smokers.

Abnormalities, Drug-Induced↗
PubMed1990

Levonorgestrel-releasing intrauterine device.

An intrauterine contraceptive device releasing 20 micrograms levonorgestrel daily has been studied for 15 years. The international clinical experience covers over 8000 woman years. Main characteristics of the levonorgestrel-releasing intrauterine device are its great effectiveness in preventing unplanned pregnancies and a reduction in menstrual bleeding and pain as well as a low infection rate.

Contraceptive Agents, Female↗
PubMed1978

Rise in female-initiated sexual activity at ovulation and its suppression by oral contraceptives.

This study was designed to test the hypothesis that women exhibit peaks of sexual activity at ovulation, as would be predicted from estrous effects in animals. Married women who used contraceptive devices other than oral contraceptives experienced a significant increase in their sexual behavior at the time of ovulation. This peak was statistically significant for all female-initiated behavior, including both autosexual and female-initiated heterosexual behavior, but was not present for male-initiated behavior except under certain conditions of contraceptive use. Previous failures to find an ovulatory peak may be due to use of measures of sexual behavior that are primarily determined by initiation of the male partner. Women using oral contraceptives did not show a rise in female-initiated sexual activity at the corresponding time in their menstrual cycles, probably owing to the suppression of ovulatory increases in hormone secretion by the oral contraceptives.

Adult↗
PubMed1987

Act No. 167, 8 June 1987.

This Act provides that "No contraceptive device or contraceptive medication may be distributed in or on the school grounds of any public elementary or secondary school. No school district may contract with any contraceptive provider for their distribution in or on the school grounds."

Americas↗
PubMed1995

[Profile of the user and tolerance of main contraceptive methods in primary care: hormonal contraceptives, intrauterine devices (IUD) and diaphragm].

OBJECTIVE: To analyse the psycho-social profile of women using hormonal contraceptives (HCC), the intrauterine device (IUD) and the diaphragm; and to evaluate their tolerance to these methods. DESIGN: A prospective observation study. SETTING: The basic unit of family planning at an urban health centre. PATIENTS AND OTHER PARTICIPANTS: 503 patients, for whom contraception was provided between january and may 1992, with a clinical follow-up throughout the year. MEASUREMENTS AND MAIN RESULTS: HCC were administered to 285 women, with an average age of 24.8# 4.38 years. Secondary effects were detected in 14.73% of cases, with good metabolic tolerance. The IUD was provided to 216 users, with an average age of 35.4#-6.39. There was acceptable tolerance, with it being withdrawn in 18 cases, mainly due to spontaneous shedding. There were only two diaphragm users during the study period; and these had good tolerance. CONCLUSIONS: HCC were the contraceptive method chosen most often by younger women. The high tolerance to these methods and easy out-patient control of them make Primary Care, in coordination with other professionals, the ideal level for their prescription. User profiles approach the ideal recommended in the bibliography consulted.

Adult↗