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PubMed1978

Studies on gonococcus infection. XIII. Occurrence of color/opacity colonial variants in clinical cultures.

Colonial variants of Neisseria gonorrhoeae differing in color and opacity characteristics are distributed differently between male urethral and female cervical cultures. Colonial characteristics of cultures isolated from female cervices differ with time of isolation within the menstrual cycle and use of oral contraceptives. These differences may reflect selective forces in the ecology of the cervix, particularly proteolytic enzymes in cervical mucus and menstrual blood. Cycle changes in the characteristics of gonococci isolated from females may have implications for pathogenesis of gonococcal infections and immune response to the gonococcus.

Cervix Uteri↗
PubMed2003

Ethinylestradiol/drospirenone: a review of its use as an oral contraceptive.

UNLABELLED: Ethinylestradiol 30microg/drospirenone 3mg (Yasmin, petibelle) [EE/DRSP] is a combined contraceptive pill (CC) for the prevention of pregnancy in women of reproductive age. Drospirenone is a novel progestogen with antimineralocorticoid, progestogenic and antiandrogenic activity. The theoretical (0-0.07) and corrected (0.41-0.71) Pearl indices and pregnancy ratios (0.3-0.84) in young, healthy women aged 18-35 years (or 18-30 years if smokers) given 13-26 cycles of EE/DRSP in large multi-center trials indicate that this CC is highly effective in preventing pregnancy. EE/DRSP is equally as effective as ethinylestradiol 30microg/desogestrel 150microg (EE/DSG; corrected Pearl index 0.28-0.41) in preventing pregnancy. EE/DRSP is generally well tolerated. The frequency and type of adverse event reported in clinical trials are typical of those observed with other CCs, and comparable to those in women receiving EE/DSG. The incidence of intermenstrual bleeding (spotting, breakthrough bleeding or both) during treatment with EE/DRSP in young, healthy women decreased rapidly after the first cycle to 9 to 18% in the second cycle and 6% after 26 cycles, indicating good cycle control. The incidence of intermenstrual bleeding was similar in recipients of EE/DSG (9 and 14% in cycle 2 and 10% in cycle 26). Bodyweight was maintained +/- 2kg in most young women who received EE/DRSP for up to 26 cycles. Neither EE/DRSP nor EE/DSG showed clinically significant effects on blood pressure. EE/DRSP improved premenstrual and menstrual symptoms (negative affect, water retention, increased appetite) compared with baseline in a noncomparative trial. A similar improvement in skin condition (acne, seborrhea) was observed in women receiving EE/DRSP or ethinylestradiol 35microg/cyproterone acetate 2mg in a randomized, double-blind trial. CONCLUSIONS: Data from several 1- to 2-year studies show that EE/DRSP is an effective oral contraceptive, with Pearl index values similar to those of established low-dose CCs. This combination is well tolerated, demonstrating good cycle control and a beneficial effect on skin condition and well-being (including some premenstrual and menstrual symptoms). EE/DRSP has demonstrated similar efficacy and tolerability to EE/DSG, but long-term clinical experience is required to establish the position of EE/DRSP among other available CCs and to clarify any potential tolerability advantages. Nevertheless, because the management of tolerability is complicated by the idiosyncratic nature of the response of women to CCs containing different progestogens, EE/DRSP appears to be a useful treatment option for women desiring oral contraception.

Absorption↗
PubMedDate not supplied

Coronary artery disease in premenopausal Indian women: risk factors and angiographic profile.

Coronary angiographic and clinical profile of 47 premenopausal women presenting with myocardial infarction (MI) or angina is presented. Seventeen patients (36%) had significant obstructive coronary artery disease (CAD) (Group I), while 30 (64%) had normal coronaries (Group II). The latter group included 4 who had MI and 26 who presented with angina. Risk factors in Group I included hypertension (53%), diabetes mellitus (24%), hypercholesterolemia (29%), oral contraceptives and a positive family history (11.8%). Frequency of one, two and three vessel disease was 47%, 18% and 35% respectively. The left anterior descending artery was most commonly affected (82%). In Group II the risk factors included hypertension (17%) and diabetes (7%). No patient in either group was a smoker. This analysis shows that significant obstructive CAD in premenopausal Indian females is more commonly associated with hypertension, diabetes and hypercholesterolemia. Smoking was not encountered and ingestion of contraceptive pills is uncommon.

Adolescent↗
PubMed1983

[Cholinesterase (EC 3.1.1.8) with butyrylthiocholine-iodide as substrate: references depending on age and sex with special reference to hormonal effects and pregnancy].

Referance values are reported for the assay of cholinesterase (substratae: butyrylthiocholine iodide) in serum at 25 degrees C. There was no evidence of any age-dependency or sex-specific distinction in children (1 to 15 years, N = 309), nor were there any age-dependent changes observed in males (16 to 94 years, N = 718). Compared with the reference range for children, there was no detectable difference in the location and distribution of catalytic cholinesterase concentrations. In females (16 to 99 years, N = 861), an age-dependent difference in cholinesterase values became apparent: Regardless of pregnancy or use of hormonal contraceptives, the catalytic concentrations were found to be lower in younger females (16 to 39 years) than in older ones (greater than or equal to 40 years); the reference values in the older age group (40 to 99 years) did not differ from those of males and children. Therefore the following reference values are proposed (in each case 2.5 to 97.5 percentile: Children, males and females above 40 Years: 3.5 to 8.5 kU/l, Females (16-39 years, nonpregnant, not taking hormonal contraceptives): 2.8 to 7.4 kU/l, Females (18-41 years, pregnant or taking hormonal contraceptives): 2.4 to 6.0 kU/l.

Adolescent↗
PubMedDate not supplied

Unintended pregnancy in the United States.

CONTEXT: Current debates on how to reduce the high U.S. abortion rate often fail to take into account the role of unintended pregnancy, an important determinant of abortion. METHODS: Data from the 1982, 1988 and 1995 cycles of the National Survey of Family Growth, supplemented by data from other sources, are used to estimate 1994 rates and percentages of unintended birth and pregnancy and the proportion of women who have experienced an unintended birth, an abortion or both. In addition, estimates are made of the proportion of women who will have had an abortion by age 45. RESULTS: Excluding miscarriages, 49% of the pregnancies concluding in 1994 were unintended; 54% of these ended in abortion. Forty-eight percent of women aged 15-44 in 1994 had had at least one unplanned pregnancy sometime in their lives; 28% had had one or more unplanned births, 30% had had one or more abortions and 11% had had both. At 1994 rates, women can expect to have 1.42 unintended pregnancies by the time they are 45, and at 1992 rates, 43% of women will have had an abortion. Between 1987 and 1994, the unintended pregnancy rate declined by 16%, from 54 to 45 per 1,000 women of reproductive age. The proportion of unplanned pregnancies that ended in abortion increased among women aged 20 and older, but decreased among teenagers, who are now more likely than older women to continue their unplanned pregnancies. The unintended pregnancy rate was highest among women who were aged 18-24, unmarried, low-income, black or Hispanic. CONCLUSION: Rates of unintended pregnancy have declined, probably as a result of higher contraceptive prevalence and use of more effective methods. Efforts to achieve further decreases should focus on reducing risky behavior, promoting the use of effective contraceptive methods and improving the effectiveness with which all methods are used.

Abortion, Induced↗
PubMed2003

A multicenter contraceptive efficacy study of injectable testosterone undecanoate in healthy Chinese men.

This report describes a Phase II, multicenter, contraceptive efficacy clinical trial using monthly injections of testosterone undecanoate (TU) alone at a dose of 500 mg in healthy Chinese men. Three hundred eight healthy men were recruited in six centers distributed throughout China. Volunteers underwent a control period with no treatment, then a 12-month treatment period including a 6-month suppression phase followed by a 6-month efficacy phase and a 12-month recovery period. During the suppression phase, an initial loading dose of 1000 mg TU, followed by 500 TU at monthly intervals were given until azoospermia or severe oligozoospermia was achieved, up to a maximum of six injections. During the efficacy phase, 500 mg TU were administered at monthly intervals for 6 months. Nine of 308 men did not achieve azoospermia or severe oligozoospermia (<3 x 10(6)/ml) within the 6-month suppression phase. This gave a methodological failure rate of 2.9/100 couple years (95% confidence interval of 1.0-4.8/100 couple years). Two hundred ninety-six men entered the efficacy phase. The continuation rate during the efficacy phase was 95/100 couple years. There were no pregnancies caused by men who achieved azoospermia or severe oligozoospermia. Reappearance of sperm occurred in six men during the efficacy phase, and one pregnancy was attributed to sperm rebound. This gave a secondary failure rate of 2.3/100 couple years (95% confidence interval of 0.5-4.2/100 couple years). Thus, the total failure rate was 5.2%, and total efficacy was 94.8%. Spermatogenesis in all subjects returned to the normal reference range within the recovery period. The mean serum testosterone concentration increased 131%, and the mean serum LH and FSH concentrations decreased 72% and 70%, respectively, after TU injections during the treatment period. The mean level of serum high density lipoprotein cholesterol decreased (14%), and the mean hematocrit increased 6% compared with baseline. No serious adverse events and no significant changes in serum chemistry occurred during the study. The results showed that monthly TU injection at a dose of 500 mg after an initial loading dose of 1000 mg can effectively, safely, and reversibly suppress spermatogenesis in healthy Chinese men without serious adverse effects.

Adult↗
PubMed1981

An epidemiologic study of epithelial carcinoma of the ovary.

A case-control study to identify risk factors for epithelial ovarian cancer was undertaken among women in the age group 45-74 years who had been admitted to seven hospitals in Connecticut between July, 1977, and March, 1979. Characteristics that were found to increase the risk of epithelial ovarian cancer included being white, never having been pregnant, having a late age at menopause, having a family history of cancer of the ovary or endometrium, and having a long estimated number of years of ovulation. Prior use of post-menopausal estrogens did not alter the risk for epithelial ovarian cancer, but there was some indication that oral contraceptives protect against ovarian cancer. Women with ovarian cancer were somewhat more likely to have had a history of an underactive thyroid and were somewhat less likely to have had a history of an overactive thyroid than controls, although these trends were not statistically significant.

Aged↗
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↗
PubMed1979

Effect of intrauterine contraceptive device on uterine haemostasis: a morphological study.

The effect of the intrauterine contraceptive device (IUCD) on uterine haemostasis was studied at various stages of the menstrual cycle in a series of 46 patients by light- and electron-microscopy and by following the distribution of an infusion of 51Cr-labelled autologous platelets. The endometrium in contact with the IUCD in the majority of cases showed grooving with atrophy and mild chronic inflammation in the surrounding tissues. The adjacent stroma also showed increased vascularity and occasional foci of haemorrhage but the increased blood loss associated with the presence of the IUCD could not be attributed to mechanical erosion or stromal blood vessels by the device. During menstruation the presence of an IUCD does not appear to inhibit the formation of fibrin/platelet thrombi although both in control and IUCD patients there was a striking paucity of platelet/fibrin thrombi in circumstances where their formation should be enhanced. In contrast to other workers we have not observed that gaps or breaks in the endothelial lining of endometrial blood vessels occur with any greater frequency in patients fitted with an IUCD. The principal mechanism by which uterine haemostasis is achieved remains to be established.

Adult↗
PubMed1988

Risk factors in the development of cervical intraepithelial neoplasia in women with vulval warts.

Of 59 women referred with vulval warts whose cervices were assessed colposcopically for the presence of cervical intraepithelial neoplasia (CIN) before local treatment of the wart lesions, 17 had histologically proved CIN, 12 had histologically proved cervical wart virus infection, and 30 had abnormality on colposcopy or cytology. Seven of the 17 with CIN had no abnormality on cervical cytology. No differences in sexual behaviour, smoking habit, or oral contraceptive use were seen between women with CIN and those with no cervical abnormality. Viral DNA typing of the vulval lesions was carried out, but there were no differences in the distribution of viral types between the three different histological groups. Of the 30 women with no abnormality at the initial visit, 23 were followed up colposcopically and cytologically for one to two years. Three of them developed CIN after adequate treatment of the vulval lesions despite the absence of cervical abnormalities on colposcopy at the time of treatment. Studying the known factors linked with CIN failed to show why some women with vulval warts develop CIN, even after treatment of the warts, and others do not. The large number of false negative results on cervical cytology in our patients suggests that women presenting with vulval warts should be screened colposcopically in the first instance. Close follow up of women whose warts are treated and who are thought to have no cervical abnormality at that assessment is essential.

Adult↗
PubMedDate not supplied

When and why do young people in the United Kingdom first use sexual health services?

CONTEXT: Many young people think about and take steps to obtain adequate protection only after having sexual intercourse for the first time. Consequently, they are at increased risk of unintended pregnancy and sexually transmitted infections. METHODS: Between June and August 1999, a self-administered questionnaire was distributed to attendees at UK youth-targeted sexual health services to investigate when and why they first use a sexual health service, reasons for delaying use, and sexual behavior and contraceptive practice before first use. RESULTS: Of the 747 respondents, 29% had used a sexual health service before ever having sex, most commonly "to be prepared." In contrast, 61% of respondents had used a service after sexual debut; some of these had obtained condoms elsewhere (25% of women and 33% of men who gave a reason for delay) or had not known about services or their location (11-19%). Among the women, 20-24% had been embarrassed or scared, or concerned about confidentiality or age; 32% had visited a provider because they had had unprotected sex. Sixty-three percent of men who had delayed using a service reported that the ability to obtain free condoms had prompted their first visit. Only 43% of respondents who postponed service use had practiced contraception consistently before visiting a provider. CONCLUSIONS: Young people need to be realistic about the possibility of having sex. Service use could be increased by providing more youth-specific services and by improving publicity and links between the youth, education and health sectors to dispel fears and myths about services.

Adolescent↗
PubMed1980

Impaired elimination of caffeine by oral contraceptive steroids.

The effect of OCS on the disposition and elimination of caffeine was examined. Caffeine (250 mg) was administered orally to 13 healthy males, nine healthy females taking no OCS, and nine healthy females on OCS. The t1/2 (beta) was significantly prolonged in women on OCS (10.7 +/- 3.0 hr vs. 6.2 +/- 1.6) (p less than 0.001) as compared to women taking no OCS. Women on OCS had a significantly lower total plasma clearance (0.79 +/- 0.21 ml/min/kg vs. 1.3 +/- 0.35) and free clearance (1.12 +/- 0.28 ml/min/kg vs. 1.97 +/- 0.57) that women not taking OCS. Volumes of distribution and plasma binding were similar in both groups of females. When women taking no OCS were compared with men, all pharmacokinetic parameters were similar except for volume of distribution, which was significantly larger in the women (p less than 0.05). We conclude that OCS impair the elimination of caffeine.

Absorption↗
PubMed1995

Who are the Zimbabwean loop users? The social and demographic characteristics of Zimbabwean IUCD users.

As part of a study into the reasons for the low utilization of the intra-uterine contraceptive device (IUCD) among Zimbabwean women, a records' review of IUCD users over the period 1985 to 1989 was carried out. A 10 pc sample of the records of women inserted over this period was taken. This paper reports on the social demographic and selected screening characteristics of these women. A total of 1,179 records were reviewed. The IUCD users had a higher socio-economic status than the Zimbabwean population as a whole. Nearly 20 pc of the IUCD users were professional, technical and related workers, (mostly nurses and teachers), compared to 4.3 pc among the general population. Clients had apparently better reproductive histories than the population as a whole, probably reflecting their socio-economic status and possibly the screening process. The women were in their mid to late twenties in age at the time of insertion, and had been married an average of nine years. A quarter of the clients did not want any more children. They were using the IUCD to suspend their conception indefinitely after completion of their families. About 74 pc of the women had learnt about the family planning clinic from the local clinic/nurses or the community based distributor, indicating the importance of these sources of information. Eighty pc of the women were previous acceptors of modern contraceptives, but only 6 pc had apparently used the IUCD before.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗