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 1,567 records · Page 87Linked to original sources
PubMed1997

A case control study of breast cancer risk and exposure to injectable progestogen contraceptives. Methods and patterns of use among controls.

OBJECTIVE: To describe the patterns of use of injectable progestogen contraceptives (IPCs) among coloured and black women in the Western Cape. These data are part of an ongoing study in the Western Cape, the main aim of which is to explore the relationship between IPCs and breast cancer. DESIGN: A population-based case-control study of breast cancer risk in relation to the use of IPCs among coloured and black women. SETTING: The Western Cape, including the Cape metropole and surrounding rural areas. STUDY SUBJECTS: All coloured and black women with newly diagnosed breast cancer, resident in the study area and below age 55 years, who present at either of the two tertiary care hospitals in the Western Cape are recruited. Controls are a sample of hospitalised patients representative of the populations from which the patients are drawn. Cases are frequency-matched to controls according to cross-tabulation of age, ethnic group and residential area in a ratio of approximately 1:3. MEASUREMENTS: Questionnaires are administered by trained nurse interviewers, information is elicited on a wide range of variables, including sociodemographic variables, medical history, family history of breast disease, lifetime history of all methods of contraception and use of non-contraceptive female steroids, reproductive variables, cigarette smoking, alcohol consumption and other potentially confounding variables. RESULTS: Between January and December 1994, 122 incident cases and 389 controls were enrolled. Ever-use of IPCs among the controls was 72% (N = 280) and use for 5 years or more was 30% (N = 117). Use of IPCs in the distant past was common, with 61% (N = 232) of all controls having initiated use 10 or more years previously. Current use was also high (19%). Other contraceptive methods were used far less commonly. CONCLUSION: Coloured and black women in South Africa have been using and continue to use IPCs for more commonly and for longer periods than women anywhere else in the world. It is therefore especially important to evaluate the risk of breast cancer and other health effects of IPCs. The rates of use identified in this study ensure that there will be adequate statistical power to evaluate long-term use, use in the distant past and current use of IPCs.

Adult↗
PubMedDate not supplied

Tubal sterilization in the United States, 1994-1996.

CONTEXT: Although the number and rate of tubal sterilizations, the settings in which they are performed and the characteristics of women obtaining sterilization procedures provide important information on contraceptive practice and trends in the United States, such data have not been collected and tabulated for manyyears. METHODS: Information on tubal sterilizations from the National Hospital Discharge Survey and the National Survey of Ambulatory Surgery was analyzed to estimate the number and characteristics of women having a tubal sterilization procedure in the United States during the period 1994-1996 and the resulting rates of tubal sterilization. These results were compared with those of previous studies to examine trends in clinical setting, in the timing of the procedure and in patient characteristics. RESULTS: In 1994-1996, more than two million tubal sterilizations were performed, for an average annual rate of 1 1.5 per 1,000 women; half were performed postpartum and half were interval procedures (i. e., were unrelated by timing to a pregnancy). All postpartum procedures were performed during inpatient hospital stays, while 96% of interval procedures were outpatient procedures. Postpartum sterilization rates were higher than interval sterilization rates among women 20-29 years of age; interval sterilization procedures were more common than postpartum procedures at ages 35-49. Sterilization rates were highest in the South. For postpartum procedures, private insurance was the expectedprimary source of payment for 48% and Medicaid was expected to pay for 41 %; for interval sterilization procedures, private insurance was the expected primary source of payment for 68% and Medicaid for 24%. CONCLUSIONS: Outpatient tubal sterilizations andprocedures using laparoscopy have increased substantially since the last comprehensive analysis of tubal sterilization in 1987, an indication of the effect of technical advances on the provision of this service. Continued surveillance of both inpatient and outpatient procedures is necessary to monitor the role of tubal sterilization in contraceptive practice.

Adult↗
PubMed2001

Quality of care and contraceptive pill discontinuation in rural Egypt.

Indicators of family planning service access and quality were generated using the Egypt DHS-I (1988) and the Egypt Service Availability Survey (1989), and linked to episodes of contraceptive pill use. Multilevel analysis was used to ascertain whether or not these access and quality indicators influence the continuation of pill use, net of women's socioeconomic, demographic and motivational characteristics. A model with random components at the cluster and women levels was fitted for all reasons of discontinuation, except desire for pregnancy, at 24 months of use. Net of women's background characteristics, the results show that facilities with smaller numbers of health personnel trained in family planning, a lack of access to facilities with female doctors and a lack of range of available methods are associated with a high risk of discontinuation of pill use for all reasons except desire for pregnancy.

Adult↗
PubMed2001

Smoking cessation and the course of Crohn's disease: an intervention study.

BACKGROUND AND AIMS: To evaluate the benefit of smoking cessation in individuals with Crohn's disease, we performed an intervention study in a large cohort of smokers with the disease. METHODS: Repeated counseling to stop smoking, with easy access to a smoking cessation program, was given to 474 consecutive smokers with Crohn's disease. Patients who stopped smoking for more than 1 year (quitters) were included in a prospective follow-up study, which compared disease course and therapeutic needs with 2 control groups, continuing smokers and nonsmokers, paired for age, gender, disease location, and activity. RESULTS: There were 59 quitters (12%). Predictors of quitting were the physician, previous intestinal surgery, high socioeconomic status, and in women, oral contraceptive use. During a median follow-up of 29 months (1-54 months), the risk of flare-up in quitters did not differ from that in nonsmokers and was less than in continuing smokers (P < 0.001). Need for steroids and for introduction or reinforcement of immunosuppressive therapy, respectively, were similar in quitters and nonsmokers and increased in continuing smokers. The risk of surgery was not significantly different in the 3 groups. CONCLUSIONS: Patients with Crohn's disease who stop smoking for more than 1 year have a more benign disease course than if they had never smoked.

Adult↗
PubMedDate not supplied

Profile of patients attending a Dublin adolescent antenatal booking clinic.

A structured computer-coded questionnaire was administered to 120 consecutive teenage mothers attending a public adolescent antenatal clinic in order to examine their sociodemographic characteristics and sexual behaviour. The mean age of teenagers attending the clinic was 17.7 years (range: 14-19); only 5 (4.1%) were under 16 years. The mean gestation at booking was 16.4 weeks (range: 6.34); 90 (75%) had unreliable menstrual dates; 29 (24.2%) were over 20 weeks, 18 (68.9%) of these saying that they were afraid to attend hospital earlier. Ninety seven (80.8%) said that they had just one sexual partner to date and 105 (87.5%) said that they were involved in a continuing relationship with the father of the baby. Conception occurred within the first year of the relationship in 110 (91.6%). One hundred and seventeen (88.2%) were from social classes III-V, 15 (12.5%) were still at secondary school and 59 (49.2%) were unemployed. Of the 105 (87.5%) who had left school 80% had not sat the Leaving Certificate and 10% had not undertaken any state examinations. Sixty seven (55.8%) continued to smoke and 29 (24.2%) to drink alcohol during pregnancy. Sixty two mothers (51.7%) had used contraception in the past; only 33 (27.5%) had used it always. The age of first coitus, fertility awareness and the use of contraception were significantly influenced by social class and education. This study highlights the necessity for early commencement of sexual education programmes.

Adolescent↗
PubMed1978

Comparative electron-microscopic studies of benign hepatoma and icterus in patients on oral contraceptives.

The author compared the electron-microscopic picture of 6 benign hepatomas and 3 specimens of icteric liver tissue in female patients on oral contraceptives. The majority of ultrastructural changes seen were identical in the tumor and non-tumor cases. It is noteworthy that there is an accumulation of filamentous substance of unknown origin in the bile canaliculi and in the Disse's spaces associated with a damage to the cell membrane. The electron-microscopic picture of the sinusoidal endothelial cells suggested an increased protein producing activity. The most conspicuous feature of the tumours was formation of continuous capillaries at the site of the sinusoids. The importance of systematic electron-microscopic investigation in studying the effect of oral contraceptives on the liver cells is stressed by the author.

Adult↗
PubMedDate not supplied

Family planning choices and some characteristics of coitus interruptus users in Gemlik, Turkey.

The objectives of this study were to gain information about some fertility issues, contraceptive method choices, and the reasons for coitus interruptus (CI) use among married women aged 15-49, in Gemlik, Turkey. One thousand nine hundred ten women were interviewed for this cross-sectional study. The pregnancy rate per woman was 2.9. 716 women (37.5%) had at least one unwanted pregnancy. Of the study population, 79.6% were using a contraceptive method (45.1% were using a modern method, 34.5% a traditional method). CI was the most preferred method (33.7%). Fertility measures of women who had used CI continuously were compared with other women. It was found that most CI users were content with the method.

Adolescent↗
PubMed2000

Demystifying medical complexities.

Although dentists often fear treating medically complex patients, in many cases this fear may be based not on scientific facts but rather on a "mythology" of the dangers of dentistry. Dentistry is a remarkably safe profession, even for most medically complex patients. The myths of endocarditis, artificial joint infections, local anesthetics and vasoconstrictors, dental surgery in anticoagulated patients and patients on antiplatelet drugs, and antibiotic interference with oral contraceptives are discussed. Although dental treatment is not usually a risk factor for endocarditis, practitioners should consult the 1997 American Heart Association statement for recommendations for endocarditis prevention. Most artificial joint patients should not receive antibiotic prophylaxis. Local anesthetics and vasoconstrictors can be used safely in most medically complex patients. Neither continuous anticoagulation nor antiplatelet medications should be withdrawn for dental surgery. Scientific studies have failed to document an interaction between antibiotics used in dentistry and oral contraceptives.

Anesthesia, Dental↗
PubMed2006

Uncovering and responding to needs for sexual and reproductive health care among poor urban female adolescents in Nicaragua.

BACKGROUND: To meet the needs of female adolescents from low-income urban areas for sexual and reproductive health (SRH) care, vouchers providing free-of-charge access to SRH care at 19 primary care clinics were distributed in Managua, Nicaragua. These vouchers substantially increased the use of services, demonstrating that many adolescents are willing to use such services, if readily accessible. The voucher redemption made it possible to identify the nature of existing, but largely unmet, needs for SRH care. METHOD: The medical files from 3301 consultations with female adolescents were analysed using descriptive statistical methods and multiple logistic regression. RESULTS: Female adolescents presented SRH problems that merited medical attention. The mean number of problems presented was 1.5 per consultation: 34% of the vouchers were used for contraceptives, 31% for complaints related to sexually transmitted infection (STI) or reproductive tract infection (RTI), 28% for advice/counselling, 28% for antenatal check-up and 18% for pregnancy testing. A new category of health care users emerged: sexually active girls who were neither pregnant nor mothers and who sought contraceptives or STI/RTI treatment. Contraceptive use doubled among the sexually active non-pregnant voucher redeemers. Consultation with a female doctor younger than 36 years was associated with a higher chance of having contraceptives prescribed. CONCLUSION: Accessible and appropriate SRH care has the potential to make an important contribution to the increased contraceptive use, decreased risk of unwanted teenage pregnancies and decreased prevalence of STIs/RTIs among underserved adolescents. Once adolescents access the services, providers have a crucial role in ensuring current and continuing needs are met.

Adolescent↗
PubMed2004

Poland's syndrome and premature ovarian failure.

A 19-year-old female with Poland's Syndrome with associated left amastia, scoliosis, and left Sprengel deformity developed secondary amenorrhea from premature ovarian failure. Her menarche was at 13 years of age, and periods were regular and monthly until 15 years of age when her periods suddenly stopped. Her hormonal evaluation was significant for elevated FSH (46.5 mIU/ml) and LH (28.5 mIU/ml), and low estradiol (23 pg/ml). Anti-ovarian antibody level was less than 2 units (normal < 4 units). Her chromosomes were 46XX, by both standard karyotype and by fluorescence in situ hybridization. On transabdominal and transvaginal ultrasonography, ovaries were not visualized, the uterus was of normal size and anteverted and both kidneys were normal. The patient began hormone replacement therapy with conjugated estrogen (Premarin) 0.625 mg po daily and progestin (Provera) 5 mg on days 20 to 25. Because of menopausal symptoms, she was switched to a combination oral contraceptive (OC) with 20 mcg ethinyl estradiol that was eventually increased to 30 mcg. Her menopausal symptoms (hot flashes and sweating) improved on the continuous 30 mcg ethinyl estradiol combination OC. Following a comprehensive review of the literature, this is the first reported case of Poland's Syndrome associated with premature ovarian failure; however, this association may be coincidental.

Adult↗
PubMed2006

The combined contraceptive vaginal ring (NuvaRing): first experience in daily clinical practice in The Netherlands.

OBJECTIVES: The combined contraceptive vaginal ring (NuvaRing) has been shown to be safe and effective, with high levels of user compliance, acceptance and satisfaction. However, the data collected from registration studies may differ from the clinical situation. The Dutch NuvaRing Experience Project was initiated to gain insight into NuvaRing use in daily clinical practice. METHODS: A total of 1,130 women, recruited by 257 general practitioners, participated in this observational study. Data on compliance, acceptance, satisfaction, and adverse events were collected during the first 3 months of ring use via an online questionnaire. RESULTS: The results of this study were almost identical to those of the international registration studies. The majority of women complied with the prescribed regimen and were (very) satisfied with NuvaRing, primarily because of the once-a-month administration, low hormonal dose, and ease of use. Only one pregnancy was recorded throughout the study period. The bleeding pattern was better than with the pill, and there were few estrogen-related adverse events. Only a small proportion of women discontinued because of local adverse events such as discomfort during intercourse and expulsion. Following study completion, 80% of women continued with NuvaRing. CONCLUSIONS: In The Netherlands, the first clinical experiences with NuvaRing in daily practice confirm that the contraceptive ring is a reliable, safe, and convenient method of contraception.

Adolescent↗
PubMed2005

Effects of low dose oral contraceptives on serum total cholesterol, TAG, HDL-C & LDL-C levels in contraceptive users.

This study was done to appraise the effects of low-dose oral contraceptives (OC(s)) containing synthetic estrogen ethinyl estradiol and synthetic progestin levonorgestrel on serum total cholesterol, TAG, HDL-C and LDL-C levels. Ninety young women within reproductive age group were picked for this study. Sixty women using low-dose oral contraceptives served as experimental group and thirty age matched hormonal contraceptive non-users were selected for control group. Experimental group was again subdivided into OCP users for last one-year group, three-year groups and five-year group. The results showed that there were no significant differences on most of the study parameters between users and non-users women. But there was a significant accession of serum triacylglycerol only in OCP user groups. The results hint that low-dose oral contraceptives regimens partly impaired the lipid metabolism. So, the safeness of low-dose OCP used in National Population Control Program is further inspired. The value of studied parameters for serial longer continuation of OCP uses need to be renegotiated.

Adult↗
PubMed1990

Effects of oral contraceptives on lipid metabolism.

A randomized, comparative study of two low-dose oral contraceptives was carried out in 60 nonpregnant women for 12 cycles. Twenty-eight women took a preparation containing 150 micrograms of desogestrel and 30 micrograms of ethinyl estradiol; 32 took 75 micrograms of gestodene and 30 micrograms of ethinyl estradiol. Baseline values in the two groups were in good agreement. During the first three cycles, serum cholesterol levels remained unchanged, but triglyceride and high-density lipoprotein cholesterol levels increased significantly and to the same extent (about 20%). Low-density lipoprotein cholesterol levels decreased slightly. Apolipoproteins A1 and A2 and low-density lipoprotein B increased significantly and similarly. Except for continued increases in low-density lipoprotein B, no further changes were noted during subsequent cycles. We concluded that the two contraceptives have the same impact on lipid metabolism, with all lipid and apolipoprotein values remaining within the normal range. The changes with both pills reflect a mild estrogenic dominance. Implications for coronary artery atherosclerosis appear to be minimal.

Adult↗
PubMed2001

[Men's acceptance of continuous hormone therapy].

The aim of the study was the assessment of males' willingness to long-term administration of hormonal drugs in substitutive and contraceptive means. Eighty males in their third and fifth decade were inquired a questionnaire. The patients were divided according to age into two groups: A (20-30 yrs of age) 55 males, and B (41-50 yrs of age) 25 males. University education was a condition required to be enrolled into the study. The results was statistically analyzed with Chi 2 test. 65.5% of males in their third decade would not accept hormonal contraception. 40% of males declared their acceptance for hormonal substitutive therapy and they were also aware of the necessity of prophylactic examinations, 7.3% accepted the therapy but without regular follow-ups, 16.3% did not accept the therapy and 36.4% did not consider it as necessary. 56% of the respondents from group B would accept an administration of contraceptive pill. 44% would not accept hormonal substitutive therapy, 24% did not see the necessity of the therapy, 16% would accept the therapy and the necessity of regular prophylaxis, and the last 16% would accept the therapy, however without control examining.

Adult↗
PubMed1994

Multicentred, phase III clinical trial of norethisterone enanthate 50 mg plus estradiol valerate 5 mg as a monthly injectable contraceptive; final three-year report.

Norethisterone enanthate (NET-EN) 50 mg combined with estradiol valerate (EV) 5 mg was studied as a once-a-month injectable contraceptive with regard to effectiveness, cycle control, adverse events and acceptability. In eight Family Planning Centres from five Latin American countries, 931 fertile women were followed-up for a period of 36 months, providing a total of 15,787 woman-months of experience. Only one pregnancy occurred: in the first treated month a few days before the second injection (failure rate 0.08 per 100 woman-years). Under treatment, the first cycle was drastically shortened in most cases, but thereafter cycles tended to recover to pre-treatment patterns. There was a significant decrease of hypermenorrhoea and dysmenorrheic cycles. Intracyclic bleeding and spotting appeared in 1.8% and 2.2%, respectively, and amenorrhea in 2.8% of cycles. The incidence of other adverse events was very low with the exception of weight gain of more than 2 kg (36.8%). The continuation rate at 12 months was 64.7%, at 24 months 31.0% and at 36 months 20.4%. The cumulative discontinuation rate due to bleeding problems was 6.1% and 7.2% due to adverse events at 36 months. The treatment was shown to be a highly effective contraceptive method that offers fairly good cycle control, good tolerance and a continuation rate that makes it suitable for use in family planning programmes in the Latin American area.

Amenorrhea↗
PubMedDate not supplied

Differences between physicians and nurses in providing family planning services: findings from a Bogota clinic.

Having nurses provide a variety of services generally available only from physicians is one way to overcome shortages of physicians in family planning programs. To aid in determining if the quality of care provided by nurses is comparable to that of physicians, a study at a Profamilia clinic in Bogota, Colombia, evaluated the management of family planning clients by physicians and nurses. The study found significant differences between physicians and nurses in the prescription of contraceptives on the client's first visit, in prescription of methods to be used temporarily, in deferment of IUD insertions, and in changing of methods for the client. Continuation rates among the physicians' and nurses' clients, however, did not differ significantly, and clients of physicians and nurses were equally successful in preventing unwanted pregnancies.

Colombia↗
PubMed1997

RU 486 (mifepristone). A short overview of its mechanisms of action and clinical uses at the end of 1996.

RU 486 (mifepristone) has proved to be a remarkably active antiprogesterone and antiglucocorticosteroid agent in humans. The mechanism of action of RU 486 involves the intracellular receptors of the antagonized hormones progesterone and glucocorticosteroids. At the molecular level, the most important features are high binding affinity to the receptor, interaction of the phenyl-aminodimethyl group in the 11 beta-position with a specific region of the receptor binding pocket, and RU 486-induced transconformation in the ligand binding domain. These properties have consequences at different steps of the receptor function as compared with agonists. However, this cannot be limited to the RU 486-receptor interaction; for instance, a switch from an antagonistic property to an agonist activity is possible, depending on the intervention of other signaling pathways. Derivatives with only one of the two antagonistic properties (antiprogestin, antiglucocorticosteroid) would be desirable in spite of similarities between the steroid structures, receptors involved, and responsive machineries in target cells. Clinically, the RU 486 plus prostaglandin method is ready to be used on a large scale, and is close to being as practical and safe as any medical method of abortion may be. The early use of RU 486, as a contragestive--that is, for use by a woman as soon as she fears a pregnancy she does not want--will help to defuse the abortion issue. Research should now be conducted to define an efficient and convenient contraceptive method with RU 486 or other antiprogestins. The usefulness of RU 486 for obstetrical indications, including facilitation of difficult delivery, has to be assessed rapidly. Gynecological trials, particularly in leiomyomata, should also be systematically continued. The very preliminary results obtained with tumors, including breast cancers, do indicate that further studies are necessary.

Animals↗
PubMed2006

Women's educational attainment and intergenerational patterns of fertility behaviour in Kenya.

There is a strong theoretical and empirical relationship between educational attainment and fertility behaviour. However, a fundamental issue that has largely been neglected is the change in this relationship across cohorts resulting from differential improvement in educational opportunities for women over time and how it relates to fertility transition. Utilizing the 1998 DHS data from Kenya this study examines the differential effect of educational attainment on women's use of modern contraception and desire for cessation of childbearing across generations. The findings indicate that even after controlling for husband's education and other relevant factors, a woman's advanced education is positively associated with use of modern contraception. However, support for a similar hypothesis on a woman's desire for family limitation was only found among the youngest cohort of women. The results suggest that for Kenya's incipient fertility transition to be sustained the government needs to continue efforts to improve female education and support access to family planning among younger women.

Adolescent↗