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PubMed1977

Continuous intrauterine copper contraception for 3 years: comparison of replacement at 2 years with continuation of use.

A total of 1245 women had a copper 7 intrauterine contraceptive device (IUD) inserted in 1971-3 were followed up for three years (22 761-5 women months of use). After 24 months 483 women elected to continue with the same copper 7 (continuation group), and 183 had their copper 7 replaced with a new one (replacement group). The subsequent pregnancy and expulsion rates were both significantly lower in the replacement group. The higher pregnancy rate among the women who continued to use their copper 7 device for a third year suggests that although the copper is still there, it is not available for contraceptive action. Replacing the device at 24 months did not seem to cause again the problems that usually occur in the first six months of IUD use.

Adult↗
PubMed1980

Contraceptive practice and tuboovarian abscess.

The hospital and operative records of 318 women with a discharge diagnosis of tuboovarian abscess (TOA) were reviewed to evaluate the possible relationship between contraceptive usage and the occurrence of TOA. A significantly higher (p < 0.10) proportion of the intrauterine contraceptive device (IUD) users had acute pelvic inflammatory disease and a significantly lower proportion (p < 0.10) compared to users of other contraceptive methods were surgically treated. The proportions of women with unilateral and bilateral TOAs were similar, regardless of the contraceptive method used. This was true whether diagnosis was based on physical examination alone or confirmed at operation.

Abscess↗
PubMed2004

Impact of common contraceptive methods on quality of life and sexual function in Hong Kong Chinese women.

The combined oral contraceptive (COC) pills, injectables, intrauterine contraceptive device (IUCD) and female sterilization are the most common contraceptive methods used by women. Women's choice, compliance and satisfaction with specific contraceptive methods are influenced by any impact of the method on their quality of life and sexual function. Anxiety regarding possible adverse effects of the contraceptive methods on their quality of life and sexual function is one of the common concerns. The aim of this prospective observational study was to determine the impact of the abovementioned contraceptive methods on the quality of life and sexual function of the users. A sample of 361 Hong Kong Chinese women who were first-time users of the following contraceptive methods completed the study: COC pills (n=87), injectables (n=67), IUCD (n=96) and female sterilization (n=111). Quality of life and sexual function of the subjects were assessed before and 3-4 months after use of the method by a standardized questionnaire. The questions were adopted from the validated Chinese versions of the World Health Organization Quality of Life (WHOQOL) questionnaire and the Derogatis Sexual Functioning Inventory (DSFI). In the female sterilization group, we found a significantly higher score for sexual satisfaction (p=.004) and sexual drive (p=.003) 3-4 months after sterilization, as well as an improved WHOQOL social domain score (p=.009). However, the other DSFI subscale scores and WHOQOL domain scores were not significantly different (p>.05). No significant difference was demonstrated in all the WHOQOL domain scores and DSFI subscale scores after use of COC pills, injectables and IUCD (p>.05). We conclude that the COC pills, injectables, IUCD and female sterilization all do not have significant adverse impact on quality of life and sexual function. After female sterilization, there is a significant improvement in sexual satisfaction and sexual drive.

Adolescent↗
PubMed2005

Knowledge, attitude and practice of family planning amongst community health extension workers in Kaduna State, Nigeria.

A self-administered opportunistic questionnaire was given to 232 community health extension workers (Chews) in Kaduna state, Nigeria. Seventy-eight were male and 154 female. All could recall at least one modern method of family planning. The oral contraceptive pill (OCP) (85.8%), injectable contraceptives (85.3%), and the intra-uterine contraceptive device (IUCD) (56.0%), were most widely known about. Emergency contraception was not known about. A high percentage of female Chews have practised family planning: 115 (74.7%) have used at least one method and this is more among the married women. Methods ever used included injectable contraceptive (57.4%), OCP (47.0%), and IUCD (22.6%). Fifty percent of females were current users. Non-current users were likely to be between the ages of 25 - 29 years especially when not married, and 35 - 39 years when married. Reasons for the non-use of family planning by female Chews were side effects, not being married, not being sexually active and religious beliefs.

Adult↗
PubMed1990

Development of human embryos in the presence of a copper intrauterine device.

This study was designed to examine the teratogenic potential of copper releasing intrauterine contraceptive devices on the developing embryo. The tissues and organs of 11 whole embryos between 7 and 12 weeks of gestation were histologically examined for copper absorption after exposure to a copper intrauterine device in utero. The findings were not significantly different when compared with a control group of 7 embryos. No malformation or copper aggregates were observed in the various organs and placentas. The observations in this small sample would suggest that the copper-releasing intrauterine device has no deleterious effects on fetal development. The question remains whether malformations reported in some cases are associated with copper deposits in the tissues or with free copper ions in the fetal circulation. The implications are discussed.

Adult↗
PubMed1990

Altered ciliary substructure in the endosalpinx in women using an IUCD.

Fallopian tube segments were removed from 20 women undergoing sterilization by laparoscopy or laparotomy. Ten of these patients used an intrauterine contraceptive device (IUCD). The other 10 had used neither IUCD nor oral contraceptives and served as controls. The ciliary ultrastructure was examined by light- and transmission electron microscopy. The IUCD users had a significantly reduced ciliary length and less well oriented cilia, as compared with the control group. Also, the proportion of cilia with a ciliary crown structure was significantly smaller in IUCD users than in the non-users. The mechanism that may cause these alterations and their putative consequences are discussed.

Adult↗
PubMed1999

Large bowel obstruction due to intrauterine device: associated pelvic inflammatory disease.

Pelvic actinomycosis associated with the use of intrauterine contraceptive devices (IUDs) can mimic pelvic malignancy. Recognizing this rare, but not uncommon complication of IUD use can spare a patient from an extensive surgical procedure. If recognized preoperatively, a simple regimen of antibiotics can be curative; however, if symptomatic, a limited surgical procedure is warranted. We present the case of a 55-year-old woman with a slow, indolent course of partial large bowel obstruction and a history of IUD use for over 20 years. A preoperative CT scan revealed a frozen pelvis mimicking a pelvic malignancy. Exploratory laparotomy revealed a firm, indurated, fibrotic reaction in the pelvis involving the uterus, adnexa, and sigmoid colon. A diverting loop colostomy was performed, and pathology revealed sulfur granules from the extracted IUD that grew Actinomyces. The patient was treated with the appropriate antibiotics, and during the takedown of the colostomy 6 months later the pelvic inflammation was completely resolved. An extensive review of the literature involving actinomycotic abscesses associated with IUD use reveals a limited number of studies reported in the general surgical literature. It behooves the general surgeon to be aware of this unusual case so that the appropriate consultation and treatment can be performed with limited morbidity to the patient.

Actinomycosis↗
PubMed1995

[Laparoscopic surgery of an intraperitoneal intrauterine device].

This study involved 13 cases of patients fitted with intra-uterine contraceptive devices which migrated in the abdominal cavity. Laparoscopy enabled localization of the IUCD and full lesion assessment. It was removed by celio-surgery in all 13 cases. Difficulties encountered were due to parietoepiploic adhesions and IUCD impacted in the wall of the rectum.

Female↗
PubMed1978

Longer though lighter menstrual and intermenstural bleeding with copper as compared to inert intrauterine devices.

A randomized serial study of uterine blood loss was made of 281 women fitted with one of three intrauterine contraceptive devices (IUCDs): a Lippes loop D, a Dalkon shield or a Copper 7. The increase in the amount of blood loss was greatest with Lippes loop D users and least with Copper 7 users. However, the duration of menstrual and intermenstrual bleeding and of spotting was significantly greater among Copper 7 users than with the two inert devices. Thus the mechanisms whereby IUCDs increase the duration as opposed to the volume of uterine bleeding may be different. Previous users of oral contraceptives were found to have significantly less bleeding before IUCD insertion, but showed a similar pattern of increase of uterine bleeding after IUCD insertion to those who had not used oral contraceptives. For all three IUCDs, the increment in amount and duration of uterine bleeding after insertion decreased between the first and the sixth period, on average by about 15 ml and one to two days. No subsequent improvement was found and after 12 cycles the Copper 7 users had longer but less heavy uterine blood loss than users of the Lippes loop D.

Contraceptives, Oral↗
PubMed1991

[Activities of a family planning clinic incorporated to a public medical service over a 4-year period].

Over a period of four years, 1769 women, all of whom were married with at least 2 children, agreed to use an intra-uterine contraceptive device (IUD), 1199 women (predominantly unmarried) preferred to use an oral contraceptive (in most cases, two- or three-phase, low-estrogen pills) and 62 a local contraceptive (spermicide or diaphragm). The period of use was 89.65% for the IUDs, with a single case of acute inflammation of the genital tract. As expected, we diagnosed a large number of cases of asymptomatic Chlamydia trachomatis infections in 24% of the women using oral contraceptives and in 15% of the women fitted with an IUD. Symptomatic cases took the form of abdominal discomfort, vaginal discharge and metrorrhagia. In the opinion of the authors, the successful results obtained were due to the cooperation between the GP and the gynecologist and to a clear and firm policy towards the choice of the optimum method of contraception. In this article, the authors describe the principles behind this policy.

Adolescent↗
PubMed1977

Microbial flora of the vagina and cervix.

The microbial flora of the vagina and cervix was assessed qualitatively and semiquantitatively in 40 women attending an intrauterine contraceptive device clinic. Both sites harboured many types of macroorganism, the mean number of microbial types isolated being five from the vagina and four from the cervix. Typical lactobacilli were detected in 61% of vaginal and in 53% of cervical specimens; faecal bacteria, including anaerobes, were even more frequently found at both sites. No differences in the microbial populations at either the vagina or the cervix were detected after fitting of the devices, in the different weeks of the menstrual cycle, or with various previously used contraceptive methods.

Adult↗
PubMed2003

[Intrauterine device appendicitis: an exceptional complication].

We report a case of migration of an intrauterine contraceptive device to the appendix. In this patient with a clinical presentation suggestive of appendicitis, transvaginal ultrasonography visualized a device located outside the uterus, near the small bowel. The device, which was partially embedded in the appendix, was removed via laparoscopy and laparotomy. Appendicular migration of an intrauterine device is exceptional. A literature review spanning the past years only revealed a few reported cases. Most of the authors recommend removal because of the potential for inflammatory reactions that can cause bowel obstruction and perforation.

Adult↗
PubMed1986

[Incrustation of marker threads of intrauterine devices in the uterine cavity and cervix uteri].

If the indicating thread of intrauterine contraceptive devices is situated inside the uterine cavity, it is incrustated in the same way with calcium carbonate like the device itself. In 20 per cent the intracervical part of the thread is incrustated, too. The danger of an ascending inflammatory disease is increasing with the precipitation of substances, probably, denaturated fibrine or mucine according to the infrared spectral analysis.

Calcium Carbonate↗
PubMed1997

A phase I study of Femcap used with and without spermicide. Postcoital testing.

The objectives of the study were to assess the ability of the Femcap, a new vaginal contraceptive device made of silicone and designed to fit snugly around the cervix to prevent the penetration of sperm into midcycle cervical mucus when used with and without spermicide; and to compare it with the standard contraceptive diaphragm used with spermicide. Eight women underwent two baseline cycles of postcoital testing in which no device was used, followed by three test cycles in which Femcap with spermicide, Femcap with nonspermicidal lubricant (K'Y gel) or the Ortho All-Flex diaphragm with spermicide was used. The sequence of testing cycles was randomized. In each cycle, condoms were used prior to midcycle, then a midcycle cervical mucus specimen was examined to ensure midcycle characteristics and the absence of sperm. Each woman then had intercourse using either no device (baseline cycles) or the prescribed device (test cycles) and returned 2-3 h afterwards. Cervical mucus was again assessed for adequacy and the presence of spermatozoa. The average number of progressively motile sperm seen per high power field was as follows: first baseline cycle, 18.0; second baseline cycle, 17.8; test cycle with Femcap used with nonspermicidal lubricant, 0.1; test cycle with Femcap used with spermicide, 0.2; and test cycle with the diaphragm used with spermicide, 0.0. There was no significant difference between baseline cycles or among test cycles in the average number of progressively motile sperm seen (p > 0.05). The average number of progressively motile sperm seen in each test cycle did, however, differ significantly from the average number seen in either baseline cycle (p < 0.05). Femcap, used with either a spermicidal lubricant or a nonspermicidal lubricant, appears to be comparable with the diaphragm used with spermicide in preventing sperm from entering midcycle cervical mucus.

Cervix Mucus↗
PubMed1994

Detection of Chlamydia trachomatis in asymptomatic women: relationship to history, contraception, and cervicitis.

The presence of Chlamydia trachomatis antigen was examined in 400 endocervical samples collected from an equal number of asymptomatic sexually active women. The overall prevalence was found to be 4%, using the enzyme-linked immunosorbent assay. Chlamydia infection was correlated with younger age (5.8%, p < 0.05), a history of pelvic inflammatory disease (30%, p < 0.0001), and more than four lifetime sexual partners (7.9%, p < 0.01). Women who used oral contraception had more infections (9.7%), than did women who used the intrauterine contraceptive device (4.8%, p > 0.05), condom (0%, p < 0.01) or no contraception (3.1%, p < 0.05). Infection was strongly associated with cervical erythema (8.2%, p < 0.0001), ectopy (7%, p < 0.05), friability (20%, p < 0.0001), and endocervical discharge (100%, p < 0.0001). These results support the view that Chlamydia trachomatis infection is associated with younger age, intense sexual life, and use of oral contraceptives. Given that the majority of infected women revealed cervical pathology, the detection of chlamydia in the high-risk female population with cervical changes seems to be essential.

Adolescent↗
PubMed2005

Vaginitis in Turkish women: symptoms, epidemiologic - microbiologic association.

OBJECTIVE: To determine the relationship between clinical-epidemiologic findings and microbiologic results in vaginitis. METHODS: A prospective study of 212 women with vaginal symptoms was undertaken. Each patient underwent an evaluation that included standardized history, interview after pelvic examination and vaginal culture. RESULTS: Only 45% of patients received diagnosis. Only two symptoms were more frequently noted with diagnosis. Itching was more frequent in vulvovaginal candidiasis (VCC) whereas odor was more frequent in Bacterial vaginosis (BV). BV was associated with a history of spontaneous and induced abortion, increased number of pregnancy, vaginal douching practice and intrauterine contraceptive device usage. VVC was found to be associated with no contraceptive usage and previous vaginitis history. CONCLUSION: Presenting symptoms alone or with microbiologic studies has limited value, and that of the women with vaginal symptoms may lack a microbiologic diagnosis. Evidence-based approaches that produce highly accurate diagnostic and effective treatment regimens would be expected in the future.

Adult↗
PubMed1999

Copper.

Copper is an essential trace element, which is an important catalyst for heme synthesis and iron absorption. Following zinc and iron, copper is the third most abundant trace element in the body. Copper is a noble metal, like silver and gold. Useful industrial properties include high thermal and electrical conductivity, low corrosion, alloying ability, and malleability. Most of the metallic copper appears in electrical applications. Copper is a constituent of intrauterine contraceptive devices and the release of copper is necessary for their contraceptive effects. The average daily intake of copper in the US is about 1 mg Cu with the primary source being the diet. The bioavailability of copper from the diet is about 65-70% depending on a variety of factors including chemical form, interaction with other metals, and dietary components. The biological half-life of copper from the diet is 13-33 days with bilary excretion being the major route of elimination. Copper sulfate is a gastric irritant that produces erosion of the lining of the gastrointestinal tract. Chronic copper toxicity is rare and primarily affects the liver. Wilson's disease and Indian childhood cirrhosis are examples of severe chronic liver disease that results from the genetic predisposition to the hepatic accumulation of copper. The serum copper concentration ranges up to approximately 1.5 mg/L in healthy persons. Gastrointestinal symptoms occur at whole blood concentrations near 3 mg Cu/L. Chelating agents (CaNa2EDTA, BAL) are recommended in severe poisoning, but there are little pharmacokinetic data to evaluate the effectiveness of these agents.

Animals↗
PubMed1990

Globulines anormalment precipitables (GAP) in Nigerian users of progestogen-only pill.

The globulines anormalment precipitables (GAP), which have been reported to be raised in current and former oral contraceptive users, were measured in Nigerian subjects which included male volunteers. The results showed that GAP were present in males who had never used contraceptives and that the mean values were lowest in intrauterine contraceptive device (IUD) users and highest in females who had never used any contraceptives. However, current contraceptive users had lower mean GAP values than either former users or never users. It was therefore concluded that GAP levels alone cannot be used to predict the development of thromboembolic complications in pill users, and that ethinyl estradiol cannot be the main physiological stimulus for GAP synthesis.

Adult↗