Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CONTRACEPTIVES”

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 1,531 records · Page 85Linked to original sources
PubMed1992

Oral contraceptives and gynecologic cancer: an update for the 1990s.

The most recent statistical evidence confirms a protective effect of oral contraceptive use against ovarian and endometrial cancers. Studies of the association between oral contraceptive use and cervical cancer continue to be hampered by confounding factors; however, results suggest that the overall risk of invasive cervical neoplasia is not increased. Although the association between oral contraceptive use and breast cancer remains controversial, existing data strongly suggest that overall risk of breast cancer is not increased by the use of oral contraceptives. In most candidates for oral contraceptive use, the benefits greatly outweigh the risks.

Breast Neoplasms↗
PubMed1993

Contraception and sexually transmitted diseases: interactions and opportunities.

Today "safe sex" means protection from both unintended pregnancy and sexually transmitted disease and human immunodeficiency virus. These parallel complications of sexual activity have serious biologic and clinical sequelae that should be considered at the time of contraceptive selection. In addition, there is ongoing debate regarding potential interactions between antibiotic intervention and contraceptive steroids. This article assesses the impact of hormonal contraception, spermicides, barrier methods, intrauterine devices, and douching on the pathogenesis of sexually transmitted disease and the human immunodeficiency virus infection. It discusses the direct and indirect effects of contraception methods on clinical physiology and host immune responses while also considering the possible consequences on maternal and infant health if pregnancy results from the use of ineffective contraception. Counseling and care for both family planning and infectious disease protection must be provided to all sexually active individuals.

Contraception↗
PubMed1985

Oral contraceptives and cardiovascular disease: a critique of the epidemiologic studies.

Observational study designs used to investigate the relationship of oral contraceptive use to the occurrence of venous thromboembolism, stroke, myocardial infarction, and cardiovascular death include case-control, cohort, and mortality statistics studies. This analysis catalogs the findings of each of these epidemiologic studies, its statistical significance, and its performance with regard to scientific methodologic standards. An association between current oral contraceptive use and incidence of venous thromboembolism without predisposition has been consistently observed in case-control and cohort studies. Associations are less consistent for various types of stroke and for myocardial infarction. Only the Royal College of General Practitioners study found a significantly elevated risk of cardiovascular death with oral contraceptive use. The majority of mortality statistics studies offer little support for a relationship between oral contraceptive use and cardiovascular events. Major systematic problems in the epidemiologic studies include potential for bias in the detection of cardiovascular events and differences in the prognostic susceptibility of compared groups. Bias in the ascertainment of drug exposure is an unresolved issue for most of the case-control studies. Because of possible biases arising from methodologic deficiencies in these epidemiologic studies, questions as to the validity of the observed associations between oral contraceptive use and cardiovascular events should remain.

Australia↗
PubMed1990

Predicting contraceptive method usage among women in west Scotland.

Users of the six major methods of contraception are compared across a broad range of variables using data from a community sample. Differences between the groups were apparent for a range of socioeconomic and reproductive variables, and current users of the various methods also differed in their past use of contraception. Users of barrier methods fared particularly well. Few differences were observed for current health status or for the sociocultural variables examined, although users of natural methods differed from all others in their religious affiliation and commitment. Discriminant analysis showed that the most predictive variables distinguishing women who had opted for permanent methods of contraception (female sterilization and vasectomy) were the woman's stated reason for using her current method and her past contraceptive patterns; the inclusion of social, health and reproductive indicators did little to improve the prediction. It is argued that heightened expectations for contraceptive efficacy in the face of increasing concerns about long-term health consequences have contributed to the increased use of permanent methods.

Adult↗
PubMed1984

Breast cancer and oral contraceptive use.

The risk of breast cancer in relation to oral contraceptive use was evaluated in a case-control study of 1191 patients with breast cancer and 5026 control patients. For ever-use compared with never-use, the estimated relative risk of breast cancer was 1.0 (95% confidence interval 0.9-1.2). Use of oral contraceptives for five or more years was not associated with breast cancer, regardless of whether use had ended as much as 10 or more years previously, or more recently. Within categories of women whose baseline risk was elevated, including nulligravidae, premenopausal women, and those with benign breast disease or history of breast cancer in first-degree relatives, the relative risk estimates for five or more years of oral contraceptive use approximated 1.0. For any use before first pregnancy, the relative risk estimate was 1.3, and for use lasting three or more years it was 0.9. These data suggest that long-term oral contraceptive use does not increase the risk of breast cancer even after a latent interval in excess of one decade; nor do oral contraceptives appear to increase the risk within categories of women at relatively high baseline risk.

Adult↗
PubMed1993

Contraception and women's health.

More and more women all over the world are opting for fertility by choice not by chance. Contraceptive use has a tremendous impact on women's health. The ability to regulate and control fertility is a basic component of health, positively defined as a state of physical, mental and social well-being. Contraception is saving the lives of women around the world from the hazards of unwanted pregnancy. Optimal childbearing is also contributing to infant and child survival. Contraception has a complex relationship to sexually-transmitted diseases. Contraceptive safety is a major public health concern. The risk/benefit assessment will differ for different populations, for different individuals, and even for the same individual at different periods of life. The family planning movement started as a movement by women for women. Women's perspectives and women's concerns should guide the future of contraceptive research and development.

Adolescent↗
PubMed1994

Male contraception: hormonal, mechanical and other.

Methods of male contraception that have been developed so far have mainly focused on the inhibition of spermatogenesis through suppression of the hypothalamo-pituitary secretion of gonadotrophins, and simultaneous supplementation with androgens. These methods include the use of combinations of progestogens or luteinizing hormone-releasing hormone antagonists and testosterone derivatives, or high dose testosterone. Though effective contraception can be obtained, side-effects and/or the high cost of treatment limit the widespread use of these approaches. Inhibition of sperm maturation in the epididymis, or direct interference with spermatogenic cells or the cells of Sertoli by e.g. gossypol have been abandoned because of toxic side-effects. Voluntary sterilization by vasectomy is the most commonly used method of male contraception, but its surgical nature, problematic reversibility and suspected link with subsequent prostate cancer render the method far from ideal. Non-surgical vas occlusion may overcome some of these problems, but data on long-term side-effects and reversibility are lacking. New contraceptive developments should focus on interfering with highly specific aspects of spermatogenesis such as unique enzymatic processes and intercellular communication through cytokines, or application of antibodies against antigens of the epididymis or the spermatozoa. Only through better understanding of normal and pathological spermatogenesis will it be possible to develop an acceptable male contraceptive.

Contraception↗
PubMed1991

Breast cancer risk and oral contraceptive use: results from a large case-control study.

The association between oral contraceptive use and breast cancer risk was examined using data from a case-control study of breast cancer in Long Island, New York. Cases were defined as female residents of Nassau and Suffolk Counties between the ages of 20 and 79, diagnosed with breast cancer between January 1, 1984 and December 31, 1986. Age- and county-matched controls were selected from driver's license files. Among all women under age 70 at diagnosis, there was no association between oral contraceptive use and breast cancer; there was, however, a positive association in the subgroup ages 20-49 (adjusted odds ratio = 1.68, 95% CI: 1.16-2.42). Risk increased with increasing duration of use, but did not differ between women who first used oral contraceptives before the first pregnancy and those who first used them later, or between women who first used oral contraceptives before age 25 and those who first used them at a later age. Risk also appeared to increase with number of years of use before the first pregnancy or before age 25, although numbers were small. History of benign breast disease did not influence risk. The association of breast cancer risk with oral contraceptive use appeared stronger in women from Suffolk County than Nassau County.

Adult↗
PubMed1985

The effect of altered prednisolone kinetics in patients with the nephrotic syndrome and in women taking oral contraceptive steroids on human mixed lymphocyte cultures.

The purpose of this study was to examine the influence of altered prednisolone kinetics in patients with the nephrotic syndrome and women taking oral contraceptive steroids on mixed lymphocyte cultures (MLC). After oral and iv prednisolone treatment, blood samples were collected over 24 h. The area under the plasma concentration vs. time curve (AUC) of unbound, transcortin- bound, and albumin-bound prednisolone was determined. All plasma samples were incubated with MLCs, and the area under the inhibition vs. time curve of the MLC (AUIC), a measure of the effect over time, was calculated. The steroid concentrations required to produce half-maximal inhibition (EC50) were calculated. The 10 women taking oral contraceptives had higher AUCs of unbound and transcortin-bound prednisolone than the 10 normal subjects. The mean biological effect (AUIC value) was more pronounced in women taking contraceptive steroids. An analysis of the concentration-response curves revealed that the EC50 values of total, but not unbound, prednisolone were higher in women taking contraceptives. Compared with the normal subjects, the 9 nephrotic patients had lower total and comparable unbound AUCs of prednisolone. The AUIC values were higher whereas the EC50 values of unbound and total prednisolone were lower in the nephrotic patients. These findings indicate that the increased steroid effect in women taking oral contraceptives is explained by higher concentrations of prednisolone, while the increased effect in nephrotic patients is not attributable to the abnormal kinetics or protein binding of prednisolone.

Adult↗
PubMed1984

Use of oral contraceptives in women with cystic fibrosis.

Oral contraceptive pills (OCP) represent the most common contraceptive method among teenagers and young adults. Because many women with cystic fibrosis (CF) are now surviving into childbearing age and are at risk for the complications of pregnancy in CF, oral contraceptive use may be indicated. However, it has been suggested that OCP use by CF patients may be associated with deterioration in pulmonary function. Ten adolescent and young adult women with CF and moderate-to-severe obstructive lung disease were studied while taking a combination oral contraceptive pill (Ovral 28). No significant deterioration was found in clinical status or pulmonary function. Careful follow-up should nevertheless be continued to monitor for other adverse effects of oral contraceptive use in CF, such as cholelithiasis.

Adolescent↗
PubMedDate not supplied

Contraceptive choice in Lagos, Nigeria.

Among 1266 contraceptive acceptors (median age 30 years, median parity 4.5) attending a family planning clinic, mostly after referral from the post-natal clinic, two thirds chose the intrauterine device, almost all the remainder choosing oral contraception. Oral contraception was, however, the main choice among women parity 0 or 1. A definite intention to have no more children was given by none of the women of parity 3 or under, and only by 15% of those of parity 8 or more, so that child spacing was the main reason for accepting contraception. By 12 months, the discontinuation rate among oral contraceptive users was 17% (IUD 11%) of which 11% (IUD 6%) was for personal reasons or to plan pregnancy, 4% (IUD 5%) through adverse effects and 0.6% (IUD 0.8%) through accidental pregnancy.

Adult↗
PubMed1984

Luteinizing hormone releasing hormone analogues for contraception.

Peptide contraception based on LH-RH analogues is an interesting, fundamentally new lead to fertility control in women and men. A major advantage of using peptides instead of steroids for contraception is the fact that the hypothalamic peptides exert specific actions on the hypothalamic-pituitary-gonadal system and lack systemic effects. They are therefore less likely to cause metabolic derangements and other generalized adverse effects. Antagonistic analogues of LH-RH have been synthesized but until recently they have not been potent enough for clinical trials. However, chronic treatment with low doses of superactive stimulatory analogues of LH-RH paradoxically results in desensitization of the pituitary processes responsible for gonadotrophin release. This leads to a reversible inhibition of gonadal function. In women, ovulation can be inhibited by continuous intranasal LH-RH agonist treatment. In men, higher doses of LH-RH agonists have to be administered to suppress the gonadotrophin secretion enough to affect spermatogenesis. Optimal gonadotrophin suppression is, however, accompanied by a depression of the serum concentration of testosterone with loss of libido and impotence. The superagonists of LH-RH therefore have to be administered in combination with testosterone to induce oligo- or azoospermia without impotence. The overall results of clinical trials with superagonists of LH-RH for induction of inadequate corpus luteum function, luteolysis or early abortion in women are not impressive. The contraceptive effectiveness of these approaches to peptide contraception remains to be demonstrated in the human female. Inhibition of normal ovulation can, however, be consistently achieved by daily intranasal superagonist administration in women. This approach to fertility control has already been shown to provide safe and effective contraception in women.

Abortifacient Agents↗
PubMed1978

Correlates of contraceptive behavior among unmarried U.S. college students.

The contraceptive behavior of 213 sexually active never-married U.S. college students was examined using multiple regression analyses. The type of relationship--casual or steady--was a major determinant of contraceptive use: 77 percent of the respondents involved in steady relationships reported using condoms or the pill, compared with 58 percent of the respondents involved in casual relationships. Frequency of intercourse was the best predictor of contraceptive method used within steady relationships. Several variables emerged as predictors of contraceptive method used within casual relationships, including method used at first coital experience, age, and frequency of intercourse. Situational and background factors were found to have an important impact on adolescent contraceptive behavior and to warrant further research.

Adolescent↗
PubMedDate not supplied

[Abortion or contraception (author's transl)].

The period immediately following an abortion, spontaneous or induced, has been considered favourable to the initiation of high efficicy contraception: sterilization, oral contraceptives, or intrauterine devices. The rate of post-abortal complications associated with these contraceptive methods was evaluated using data drawn from published and unpublished studies. The following conclusions were reached: sterilization is advisable only for women who do not desire additional children, and is obviously not recommended for young nulliparous women. The effective use of oral contraceptives requires a high motivational level and is therefore advisable only in cases where such motivation exists. The insertion of an intrauterine device seems to be the most adequate contraceptive method for women with low motivational level.

Abortion, Spontaneous↗
PubMed1994

Methods of contraception and rates of genital infections.

Bacterial vaginosis, trichomoniasis and candidiasis are the most common genital infection. The aim of this study was to evaluate the various methods of contraception with regard to the prevalence of bacterial vaginosis and vulvo-vaginitis over a period of four years. We also evaluated in the same period the rates of trichomoniasis, candidiasis, bacterial vaginosis and vulvo-vaginitis between users and non users of contraceptional methods and the relationship between ages of patients and types of contraceptives. Finally we considered the change of contraceptive use with regard to age among two different periods. The IUD users showed a significant increase of B.V., T.v. and other bacteria and a decrease of the negatives compared to OC users. Barrier contraceptive users had a reduction (0.01 > p > 0.001) of B.V. and an increase (p < 0.001) of the negatives compared to IUD users. OC users had a significant (p < 0.05) increase in candidiasis, B.V. together with a reduction of the negatives compared to non users group. IUD users had a significant (p < 0.001) increase of B.V. and vulvo-vaginitis from other bacteria, and the reduction of the negatives. Teenagers use OC much more than adults, but less IUD (p < 0.001). The use of OC has increased and the use of IUD decreased among adults (p < 0.001). The barrier methods were seen to be statistically reduced.

Adult↗
PubMedDate not supplied

Contraceptive knowledge, attitudes, and practice in Russia during the 1980s.

In the former Soviet Union, there was a lack of valid and reliable social research on knowledge, attitudes, and practice of contraception. The few available studies have not been published outside the Soviet Union. This article reviews five surveys that were conducted in Moscow and two other cities (Saratov and Tartu) during the period 1976-84. In addition, some data from a large-scale survey conducted in 1990 and covering the entire former Soviet Union are presented. The surveys indicate that the rhythm method, condoms, vaginal douches, and withdrawal were the main contraceptive methods used; only 1 to 3 percent of the women interviewed were using oral contraceptives, and about 10 percent used intrauterine devices. The low prevalence of use of reliable modern methods may explain the high incidence of induced abortion in Russia. The chronic unavailability of reliable contraceptives is one of the main factors of poor family planning. Lack of knowledge and negative opinions about modern contraception also play an important role. Some possibilities for improving the family planning situation in Russia are discussed.

Adult↗
PubMed1993

Contraception choice and sexually transmitted disease.

Sexually active couples need to be concerned with the risk of sexually transmitted diseases (STDs) and how their choice of contraception influences that risk. Condoms provide the best documented protection against such pathogens as: gonorrhea, herpes simplex virus (HSV), hepatitis B, HIV, and chlamydia. Female dependent barrier methods also provide protection against most STDs and also possibly HIV. Most hormonal non-barrier contraceptives, although providing excellent protection against unwanted pregnancies, provide little protection against STDs. Oral contraceptive pills (OCP) may increase the risk of infection with human papillomavirus (HPV) and cervical infections of chlamydia. Individuals at high risk for both an unwanted pregnancy and an STD should be counseled to use both a hormonal and barrier contraceptive. Recently, nonoxynol-9 (N-9) and OCP use have been associated with an increase in HIV infection in African women at high risk for HIV. This association has not been found in other studies and currently does not outweigh the proven benefits of these contraceptive methods.

Choice Behavior↗
PubMed2004

Fertility awareness-based methods for contraception.

BACKGROUND: "Fertility awareness-based methods" (FAB) of family planning "involve identification of the fertile days of the menstrual cycle, whether by observing fertility signs such as cervical secretions and basal body temperature, or by monitoring cycle days. FAB methods can be used in combination with abstinence or barrier methods during the fertile time" (WHO 2000). Several names have been used to describe this approach to contraception, including "rhythm," "natural family planning" and "periodic abstinence." Fertility awareness-based methods can be used with abstinence from sexual intercourse. Alternatively, they can be used with barrier contraceptives or withdrawal during presumed fertile times. OBJECTIVES: We retrieved and analyzed all randomized controlled trials that examined any fertility awareness-based methods used for contraception. SEARCH STRATEGY: We searched the computerized databases Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, POPLINE, EMBASE, and LILACS (each from its inception to January, 2004) for randomized controlled trials of fertility awareness-based methods. We examined the reference list of each trial as well as that of review articles. SELECTION CRITERIA: We included all randomized controlled trials in any language that compared any fertility awareness-based methods for contraception with a placebo; another method, including an alternative fertility awareness-based method; or fertility awareness-based methods used in conjunction with another contraceptive. DATA COLLECTION AND ANALYSIS: We assessed all titles and abstracts found for inclusion. We evaluated the methodological quality of the trials for potential biases by qualitatively assessing the study design; randomization method; allocation concealment; blinding; premature discontinuation rates; and loss to follow-up rates. Because of methodological weaknesses, we could not enter the trial results in RevMan, calculate measures of association, or aggregate data. MAIN RESULTS: Because of poor methods and reporting, pregnancy rates could not be determined. A trial in Colombia found similar numbers of pregnancies among women randomized to the ovulation and symptothermal methods. In contrast, a companion trial in Los Angeles observed more pregnancies in the group assigned to the ovulation method. In the two U.S. trials, recruitment of participants was unexpectedly difficult; this aspect was not mentioned in the report from Colombia. Continuation rates were poor. In the two larger trials, most participants discontinued their assigned method before entering the observation phase of the trial. REVIEWERS' CONCLUSIONS: The comparative efficacy of fertility awareness-based methods of contraception remains unknown. Despite intensive training and ongoing support, most participants in these trials discontinued prematurely. Contraceptive methods should be properly evaluated, preferably in randomized controlled trials, before adoption and dissemination.

Awareness↗