Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Contraception Continuation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,351 records · Page 75Linked to original sources
PubMed1979

Use of contraceptives prior to and after conception and exposure to other fetal hazards.

In a large prospective study, set up to determine whether reproductive outcomes are affected by prior contraceptive use, 34,344 women were recruited at their first antenatal visit and followed until pregnancy termination. This paper summarizes the study methods and describes the demographic differences between subjects who used various contraceptives shortly before conception, and those who experienced contraceptive failures. Thirty percent of the women had used oral contraceptives (OCs) during the 5 months prior to conception and 2.4% had continued using them after their LMP. IUDs had been used by 5.8% of women before conception and 1.1% after. If these rates are also true for the whole population of the U.S., they indicate that approximately 70,000 babies are born each year following pill-failures and 30,000 following failures of IUD's. Exposure to other fetal hazards was common, with 48% of pregnant women drinking alcohol, 28% smoking, and 15% receiving diagnostic X-rays. OC use was more common among smokers and drinkers, and OC failures were significantly associated with the use of anti-epileptics, aspirin, and with exposure to radiation.

Adult↗
PubMed2004

Avoiding menstruation: a review of health and lifestyle issues.

This article (1) reviews the decades-long history of short-term dosing regimens delaying the onset of expected, spontaneous menses or withdrawal bleeding in oral contraceptive users up to 20 days; (2) outlines treatment schedules that suppress menstrual bleeding for several months; and (3) evaluates the recently approved extended dosing regimen of 3 months' duration. For single-term postponement of normal menses, estrogen-progestogen combinations can be employed, starting about 7 days after ovulation. Oral contraceptive users can skip the 7-day pill-free period and continue with the active pills in the next package. The main focus of this review is the development of extended dosing schedules that result in cycles lasting 7 weeks up to several months and reduce the number of periods of bleeding and menstrual discomfort. Recently a dosing schedule was introduced into clinical use consisting of ethinyl estradiol, 30 microg, plus levonorgestrel, 150 microg/d, for 84 days, followed by 7 days of placebo. The pregnancy rate was < 1% for compliant women and 1.5% for all participants. A monophasic 21 + 7-day combination using the same daily doses had slightly higher pregnancy rates. The discontinuation rate for unscheduled bleeding and spotting was higher with extended dosing than with the conventional, 21 + 7 schedule.

Contraceptives, Oral, Combined↗
PubMedDate not supplied

Use of combined oral contraceptives: retrospective study in Isfahan, Islamic Republic of Iran.

We carried out a retrospective cross-sectional study on 500 women in Isfahan who started taking combined oral contraceptives (COCs) during the period 21 March 1995-20 March 1997. The cumulative continuation rate fell from 77% to 12% over 60 months. The most common reason for discontinuation was side-effects. There was a significant correlation between side-effects and cumulative COC continuation rate (P < 0.05). The lowest rate was seen in women reporting nausea or vomiting. Women who are interested in COCs should receive extensive counselling about the possible side-effects and should be helped to find a method of birth control suited to their temperament and physiology.

Adolescent↗
PubMedDate not supplied

The effectiveness of contingency-planning counseling.

A longitudinal study assessed the effectiveness of contingency-planning counselling on contraceptive use and pregnancy outcomes among patients at a family planning clinic. Of 914 women enrolled in the study, 502 received traditional family planning counseling that focused on the provision of information and the selection of a contraceptive method, and 412 received contingency-planning counseling, which provided additional attention to possible problems that might arise with contraceptive use and the particular method selected. Although contingency-planning counseling was favorably received by both patients and staff members, patients in the two groups did not differ significantly on most of the outcomes considered. The two counseling groups had remarkably similar rates of clinic continuation at both the six- and 12-month follow-ups and analogous patterns of contraceptive use. In an exception to this pattern, the six-month pregnancy rate was significantly reduced among contingency-counseled patients who had ever been pregnant. However, the effectiveness of the intervention in reducing the likelihood of unintended pregnancy was short-lived: At 12 months, the pregnancy rate among ever-pregnant women was the same for traditionally counseled patients as for those receiving contingency-planning counseling.

Counseling↗
PubMed2004

[Contraceptive measures and HIV transmission protection among women with HIV/AIDS].

OBJECTIVE: Sexual intercourse is currently the route of transmission among women that has most contributed to the feminization of the HIV/AIDS epidemic. As an ongoing effort to establish more appropriate standards for health counseling, the study's purpose was to investigate the use of contraceptive methods that would also prevent HIV/AIDS women against disease transmission. METHODS: An exploratory study was developed in an outpatient clinic of a public university hospital, a reference center of HIV/AIDS patients in the mid-south region of the state of São Paulo, Brazil, during a 5-month-period (2000 and 2001). The study was carried out in 73 HIV/AIDS women. Data were collected using a semi-structured questionnaire exploring subjects' sociodemographics, contraception method used and HIV status of their sex partners. A descriptive data analysis was performed and the contents of open answers were grouped into themes. Fischer's exact test was applied for analyzing some variables at a 5% significance level. Content analysis was carried out according to Bardin's proposal.(2) RESULTS: Most women at reproductive age were married and had been infected almost exclusively through heterosexual contact. Of them, 35.4% reported having an HIV discordant partner and 13.7% used inadequate contraceptive methods that failed to protect them against HIV transmission. CONCLUSIONS: The study results call for the need of continuous education on safer sex among HIV/AIDS women to empower them to discuss with their partners alternative options of exercising their sexuality and to raise awareness on their contraceptive choices in a way to protect their own health, their partner's and even their unborn offspring's health.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Short and long-term impact of adolescent pregnancy on postpartum contraceptive use: implications for prevention of repeat pregnancy.

PURPOSE: To describe patterns and changes in contraceptive use among pregnant adolescents in early and later postpartum compared with nonpregnant adolescents. METHODS: One-hundred-seventy-six pregnant and 187 nonpregnant adolescents, recruited through community clinics, were interviewed three times (baseline, 6-month follow-up, 12-month follow-up) about their condom and hormonal contraceptive practices. Changes in contraception use and patterns of consistent hormonal and/or condom use were examined. Statistical analyses included General Estimating Equations (GEE) and multinomial regression. RESULTS: Pregnant adolescents increased hormonal contraceptive use from baseline to early postpartum, but decreased use from early postpartum to late postpartum. Nonpregnant adolescents did not change their hormonal contraceptive use over time. Neither group changed condom use over time. Pregnant adolescents were more likely to be consistent dual users and hormonal-only users during the 6-month follow-up compared with nonpregnant adolescents. These findings persisted at the 12-month follow-up, although there was a decline in hormonal contraception use. CONCLUSIONS: Adolescents change their contraceptive use during the postpartum period. Given the slight decline in contraceptive use in late postpartum in this sample, more work is necessary to maintain motivation to continue these positive postpartum trends.

Adolescent↗
PubMed1993

Pregnancy and birth control in CAPD patients.

This report summarizes the experience with 17 pregnancies in 16 continuous ambulatory peritoneal dialysis (CAPD) patients. Early experience suggests that the outcome of pregnancy in CAPD patients may be better than in hemodialysis patients. Catheter placement can be undertaken during pregnancy with little increased risk. Peritonitis can precipitate premature labor. Blood-tinged dialysate may herald serious obstetric problems. Hypertension, anemia, and prematurity are serious problems in CAPD patients. Cesarean section can be done, with only a brief interruption in CAPD. The major modification of the usual regimen is the need for smaller exchange volumes and increased frequency.

Birth Weight↗
PubMed1985

Absence of chorionic gonadotropin in sera of women who use intrauterine devices.

A controlled study was undertaken to determine whether unnoticed pregnancies routinely occur in users of the intrauterine contraceptive device (IUD). Starting on day 10 of the menstrual cycle and continuing through the onset of menstruation or until the diagnosis of pregnancy, we collected daily blood samples from three groups of normally menstruating young women. The study groups were (A) IUD users (n = 30), (B) women with tubal ligation (n = 30), and (C) women trying to become pregnant (n = 15). The sequential serum samples were analyzed by radioimmunoassay for progesterone (P), human luteinizing hormone (hLH), and human chorionic gonadotropin (hCG). No positive hCG assays in luteal phase blood sera of IUD users were observed. The only positive hCG determinations of IUD users coincided with the preovulatory surge of hLH. Two subjects who became pregnant, as judged by progressive increases in hCG and P levels in the luteal phase, belonged to the group planning pregnancy. The finding of two pregnancies in 15 months of exposure is consistent with the assumption of natural fertility. The probability of no pregnancies in 30 months at risk, as observed among the IUD users, is between 1 in 200 and 1 in 100,000, depending on the assumption made for natural fertility. The study demonstrates that IUD users do not retain their natural fertility, and that IUDs do not exert their antifertility effect as abortifacient agents. If a confirmed pregnancy is detected in an IUD user, it may be assumed to represent an isolated case of contraceptive failure.

Adult↗
PubMedDate not supplied

Compliance and other issues in contraception.

About 5% of women in the United States (approximately three million) are not using contraception despite being at risk of unintended pregnancy. Teenagers have the highest rate of unintended pregnancy. Women 40 years and older most frequently terminate unintended pregnancy. Multiple theories and models, including the health belief model, the health decision model, the Prochaska change model, and the conviction-confidence model, have been developed to address choices and change in health behavior. Despite this information, current data on contraceptive compliance show considerable need for improvement. Side effects and patients' beliefs and preferences appear to influence strongly whether a method will be used appropriately. Systems improvements that address issues such as access and enhancement of provider-patient interaction appear to be areas of potential opportunity. Despite continued need for improvement, there is a paucity of information testing new approaches to improve contraceptive compliance.

Adolescent↗
PubMed2003

Contraceptive practice before and after termination of pregnancy: a prospective study.

This study is part of a larger prospective research program focusing on termination of pregnancy (TOP). One hundred and three women requesting TOP were interviewed before the intervention and 6 months later using open and closed questions and psychological tests. This paper focuses on contraceptive practices before and after abortion. The analysis took into account specific aspects of contraceptive practices and patients' behaviors. The aims were to assess: the level of women's knowledge and practice of contraception at the time of request for a TOP; the behavioral modifications following professional counseling 6 months after TOP; the influence of psychological and sexual factors, and those linked to the women's use of contraception. Most women (n = 101) had already used recommended contraception. During the cycle that had resulted in pregnancy, more than half (n = 58) had used recommended contraception and one third had not used any contraception. Six months later, 86 women used recommended contraception, and 17 did not. The majority of women reported changes in their contraceptive methods (n = 82). Most changes were within recommended methods. The women (n = 10) who continued to practice unprotected intercourse post-TOP were slightly older, satisfied with their sexual relations with their partner, often involved in a long-term and good relationship. During post-TOP period, it is essential to take into account the psychological dynamics involved in the choice of contraceptive methods. Counseling should emphasize not only protection against an unwanted pregnancy but also protection against sexually transmitted diseases, which is often perceived as a less important issue following TOP.

Abortion, Induced↗
PubMed1991

The long term benefits of a comprehensive teenage pregnancy program.

A comprehensive program was founded in 1982 to provide adolescents with prenatal and family planning care. The program's impact through its first five years of operation on medical aspects of pregnancy course and fetal outcome will be the subject of a separate report. This study examines subsequent maternal and infant health of the patients attending the program compared to a control group. Four hundred ninety-eight adolescents and their newborns attending the program's mother-baby family planning clinic from 1982 to 1989 (subject group) were compared to ninety-one adolescents and their newborns receiving postpartum family planning and pediatrics clinics from 1980 through 1989 (control group). Seventy-five percent of the subject group regularly attended mother-baby clinic, compared to 18% of the control group attending family planning and pediatric clinics (P less than or equal to .0001). The subject group experienced less maternal and infant morbidity, greater school attendance, graduation, employment, and contraceptive use than the control group (P less than or equal to .0001). Many parameters improved with each program year indicating continued wide acceptance of our program by area adolescents.

Adolescent↗
PubMed2004

Long-cycle treatment with oral contraceptives.

The conventional regimen of oral contraceptive (OC) use mimics the natural cycles by causing regular withdrawal bleeding, which can be avoided by omission of the hormone-free interval of 7 days. Consequently, long-cycle regimens with continuous administration of OCs for 3 or 6 months followed by a hormone-free interval of 7 days may reduce the frequency of menstruations and cycle-dependent complaints. Surveys have revealed that, despite a higher rate of irregular bleeding, the majority of women prefer the long-cycle regimen to the conventional OC regimen with regular bleeds every 4 weeks because it may improve quality of life. As this regimen increases the contraceptive efficacy to a large degree, continuous treatment with OCs may prevent unintended pregnancies in women who miss a pill or are concomitantly treated with drugs that are able to impair the efficacy of OCs. Postponement of withdrawal bleeding may also reduce or prevent menses-associated disorders such as hypermenorrhoea and dysmenorrhoea, and have beneficial effects in patients with haemorrhagic diathesis, endometriosis, uterine leiomyoma and polycystic ovary syndrome. Continuous use of OCs prevents the cyclic fluctuations of serum levels of ethinylestradiol and progestogen and, hence, the cyclic variations of metabolic serum parameters. Although the long-cycle regimen is initially associated with an elevated rate of irregular bleeding, the total number of bleeding days that require sanitary product protection is lower than during conventional OC treatment. Many physicians tend to prescribe extended OC cycles for postponement of menstruation or reduction of frequency of regular bleeding. This review summarises and examines the available data on OC long-cycle regimens. The data suggest that the rate of treatment-related side effects with OCs according to the long-cycle regimen is similar to that of conventional OC regimens. However, clinical trials are necessary to assess the impact of long-term OC long cycles on safety, particularly the risk of cancer and cardiovascular disease, and fertility after discontinuation of treatment.

Adolescent↗
PubMed2005

Ease of insertion, contraceptive efficacy and safety of new T-shaped levonorgestrel-releasing intrauterine systems.

OBJECTIVE: The objective of the study was to evaluate ease of insertion, contraceptive performance and safety, in parous and nulliparous women, of two new T-shaped levonorgestrel (LNG)-releasing intrauterine systems (LNG-IUS), Femilistrade mark (parous women) and Femilis Slim (nulliparous women), releasing 20 mug of LNG per day. An ancillary objective was to evaluate expulsion and user continuation. DESIGN AND METHODS: An open, prospective, noncomparative study (interim analysis). Two hundred thirty-five insertions were performed in fertile women seeking contraception. Of these, 143 (60.8%) parous women were fitted with Femilis and 92 (39.2%) nulliparous women were fitted with Femilis Slim. The LNG-IUS was inserted using a simplified push-in technique (without folding the cross-arms in the insertion tube). RESULTS: This paper is the first report with the Femilis LNG-IUS. The push-in technique of insertion was considered simple and safe. Insertion was reported "easy" in virtually all women (97.9%). Pain at insertion was absent in 24.7% and "mild" in 67.7% of women. With respect to pain, there were no statistical differences between the parous and nulliparous group. At the time of study analysis, the total number of women-months of use was 1769.7. Seventy-six women had the Femilis IUS in place for periods in excess of 1 year. The study was well followed up with lost to follow-up of only two women. No pregnancies were observed. There was one expulsion in the nulliparous and one in the parous group. Ten removals were performed for medical reasons (mainly bleeding and pain). One pelvic infection occurred in a nulliparous woman caused by Chlamydia trachomatis, which was resolved without removing the IUS. There were no other serious adverse events reported. Both Femilis and Femilis Slim were well tolerated, which resulted in a high continuation rate (94.04%). CONCLUSION: The Femilis LNG-IUS is an effective contraceptive and is easily inserted. The simple and safe insertion procedure could be an advantage for use by nonspecialist providers such as nurses, midwives, general practitioners, and for those not inserting intrauterine devices regularly. Femilis Slim could be an attractive long-term contraceptive option in young and adolescent women.

Adolescent↗
PubMed1975

Carbon monoxide production and reticulocyte count in normal women. Effect of contraceptive drugs and smoking.

Endogenous production of carbon monoxide (VCO), serum bilirubin (SB) and reticulocyte (retic) count have been followed during the menstrual cycle in 12 women (4 of them smokers) without contraceptive drugs and in 10 women (5 of them smokers) on contraceptive drugs. During the progesterone phase (Pph), VCO in the non-smokers was 18.2 +/- 2.1 mumol/mmol total body heme (TBH) and day (mean +/- 1 S.E.M.), compared with 10.1 +/- 1.0 during the estrogen phase (Eph). In the smokers, VCO was 10.4 +/- 1.9 during Pph and 12.5 +/- 0.7 during Eph. SB for the non-smokers was 5.2+/- 1.0 mug/ml during Pph and 3.9 +/- 0.5 during Eph, compared with 3.2 +/- 0.8 and 3.9 +/- 1.2, respectively, for smokers. The retic count for the non-smokers was 64.1 +/- 4.7 times 10(3)/mul during Pph and 17.7 +/- 5.1 during Eph. In the smokers the corresponding counts were 93.6 +/- 15.9 and 60.8 +/- 7.6. These results confirm earlier reports that VCO is increased during Pph and indicate that the rise could be due to a change in red cell catabolism, since it is concomitant with a significant increase in retic counts, which has not been found in earlier works on VCO, but which is known from reticulocyte studies. Furthermore, the results may indicate that persistent smoking affects the metabolism of CO and/or heme, since the smokers did not react with any change in VCO during Pph. In subjects using contraceptive drugs, VCO was significantly higher (14.9 +/- 0.6 on combined estrogen-gestagen drugs and 14.5 +/- 1.1 on continuous gestagens, respectively) than during Eph in non-smokers (10.1 +/- 1.0 mumol/mmol TBH and day), which might be taken as the baseline group. This indicates that the increased VCO in subjects on contraceptive drugs may be related to the activity of gestagens, which were concluded in all contraceptive drugs tested.

Adult↗
PubMed1971

Oestrogen-progestogen oral contraception and blood clotting: a long-term follow-up.

In a long-term study of women taking the combined oestrogen/progestogen oral contraceptives Ortho-Novin and Norinyl-1 the follow-up has been continued for three years and four years respectively.Acceleration of both "intrinsic" and "extrinsic" clotting tests and of specific factor VII and X assays, reported previously at the nine-month stage, persisted throughout the period of study. Acceleration of Chandler's tube platelet aggregation and hypercoagulable thrombelastographic patterns were recorded. There was, however, no evidence of a cumulative effect after the first nine months.

Blood Coagulation↗
PubMed2006

Evaluation of a continuous regimen of levonorgestrel/ethinyl estradiol: phase 3 study results.

OBJECTIVE: This study was conducted to evaluate the safety and efficacy of a continuous daily regimen of levonorgestrel (LNG) 90 microg/ethinyl estradiol (EE) 20 microg (continuous LNG/EE). METHODS: Healthy women aged 18-49 years with regular menstrual cycles for 3 months enrolled in this single-treatment open-label study and took one pill of LNG 90 microg/EE 20 microg daily for 12 months. RESULTS: For the 2134 subjects enrolled, the Pearl Index method failure was 1.26, and user failure was 0.34. While on Pill Pack 13, 58.7% of subjects reported amenorrhea and 79.0% reported absence of bleeding. Overall, the number of bleeding and spotting days per pill pack declined progressively. Adverse events and discontinuations were comparable to those reported for cyclic oral contraceptive (OC) regimens, except for higher rates in those related to uterine bleeding. CONCLUSIONS: Continuous LNG/EE demonstrated a good safety profile and efficacy similar to cyclic OCs. The regimen continuously inhibited menses, increased the incidence of amenorrhea over time and, except for a subset of women, decreased the number of bleeding and spotting days.

Adolescent↗
PubMed1991

Contraceptive effects of extended lactational amenorrhoea: beyond the Bellagio Consensus.

We have recorded the duration of lactational anovulation and amenorrhoea in a well-nourished group of Australian women who breastfed their babies throughout the study. The data enabled us to compare the theoretical cumulative probability of conception among breastfeeding women who had unprotected intercourse irrespective of their menstrual status with that of those who had unprotected intercourse only during lactational amenorrhoea. Breastfeeding alone is not an effective form of contraception, since all the women in our study resumed normal ovulation while still breastfeeding. However, among women who have unprotected intercourse only during lactational amenorrhoea but adopt other contraceptive measures when they resume menstruation, only 1.7% would have become pregnant during the first 6 months of amenorrhoea, only 7% after 12 months, and only 13% after 24 months. Thus for our women it would be possible to extend the Bellagio Consensus Conference guidelines which stated that lactational amenorrhoea can only be relied on as a contraceptive for the first 6 months post-partum in women who are fully or almost fully breastfeeding. The lactational amenorrhoea method can be relied on for excellent contraceptive protection in the first 6 months of breastfeeding, irrespective of when supplements are introduced into the baby's diet; for women who continue to breastfeed the method can also give good protection for up to 12 months post partum. Once menstruation has returned, other forms of contraception are essential to prevent pregnancy.

Amenorrhea↗
PubMed2005

Extended cycle hormonal contraception in adolescents.

PURPOSE OF REVIEW: There is increasing interest in the use of extended cycles of hormonal contraception to manage menstrual cycle-related complaints in adolescents and to accommodate the menstrual preferences of patients using hormonal contraception. This review summarizes recent findings related to the use of extended cycles and highlights their relevance to adolescents. RECENT FINDINGS: Many adolescents would prefer to menstruate less frequently. Among health care providers who prescribe hormonal contraceptives, the majority believe suppressing withdrawal bleeding is well tolerated and prescribe extended cycling regimens to their patients. Shortening or eliminating the hormone-free interval results in greater ovarian suppression and thus may increase contraceptive efficacy. Studies in adult women have not identified changes in metabolic parameters beyond what would be expected from traditional cyclic use. New endometrial biopsy data have found no pathologic changes; most women using an extended cycle had atrophic endometriums. Extended cycling is frequently associated with breakthrough bleeding. In some women, this can be managed with a brief hormone-free interval. SUMMARY: Recent findings demonstrate high levels of interest in extended cycling among adolescents and providers, and continue to add to the growing body of literature supporting the safety and improved contraceptive efficacy of extended regimens. Further research is warranted to focus on issues including cancer, thrombotic disease and fertility, and should enroll a sufficient adolescent sample.

Adolescent↗