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PubMedDate not supplied

Knowledge of reproductive physiology and modern contraceptives in rural Peru.

This report is based on fieldwork conducted in a Peruvian community in 1986, which investigated Quechua-speaking Indians' knowledge of the female reproductive organs, perceptions of the way contraceptives work in the body, folk beliefs about conception and menstruation, and opinions about modern contraceptives. The findings reveal that the men have a more accurate knowledge of the female reproductive organs than the women do. However, the women are more knowledgeable about the action of modern contraceptives in the body. Most respondents perceived modern contraceptive methods as the best methods available, but the majority reported using the calendar rhythm method. This preference for rhythm is based on its economic advantage and on its adaptability to folk beliefs about physiology. The men's dominant role in reproductive behavior is related to cultural norms that emphasize traditional gender roles and that prohibit communication about sexual matters between men and women. Educational material, based on the respondents' knowledge of reproduction and taking into account their folk beliefs, might help to decrease the fear of contraceptive side effects and increase understanding of the function of contraceptives.

Contraceptive Agents, Female↗
PubMed1989

Fertility, menstrual characteristics, and contraceptive practices among white, black, and Southeast Asian refugee adolescents.

This study compares fertility and menstrual characteristics and contraceptive practices of white, black, and Southeast Asian refugee adolescents participating in the Minneapolis Health Department's Maternal and Infant Care Program between 1980 and 1982. Mean ages were similar among all racial groups; however, half the Hmong adolescents had a live birth as compared to less than 25% of the other racial groups. More than 75% of the Hmong and other Southeast Asian adolescents were married as compared to 11% of the whites and 8% of the blacks. Menarche was significantly later (2 years) for Hmong and other Southeast Asians, and the interval between menarche and first pregnancy was significantly shorter for the Hmong. While more than half of the whites and blacks previously used contraception, 14% of the Hmong and 29% of the other Southeast Asians had used contraception. Oral contraceptives were the most frequently used method for whites, blacks, and Southeast Asians; the Hmong were equally likely to choose oral contraceptives or barrier methods. The Hmong were less likely to choose contraception postpartum than were the other groups.

Adolescent↗
PubMed1985

Laparoscopic findings and contraceptive use in women with signs and symptoms suggestive of acute salpingitis.

Laparoscopic findings in women with clinical signs and symptoms of pelvic inflammatory disease were correlated with contraceptive use in a case-control study. Of the 738 women, 544 (73.7%) had laparoscopic signs of acute salpingitis, whereas 194 (26.3%) had visually normal fallopian tubes (nonsalpingitis). Acute salpingitis was seen in 59.8% of the 286 patients using oral contraceptives, in 80.6% of the 227 patients using an intrauterine device (IUD), and in 84.4% of the 225 patients using barrier methods or not using contraceptives (reference group). To estimate the relative risk of acute salpingitis, logistic regression analysis adjusting for age and duration of pain before laparoscopy was used. For oral contraceptive users versus the reference group the adjusted relative risk was estimated at 0.24 (95% confidence interval 0.15 to 0.38, P less than .0001), and for IUD users versus the reference group a relative risk was estimated at 0.83 (95% confidence interval 0.49 to 1.38, P = .46). The relative risk of salpingitis among oral contraceptive users versus the reference group was 0.22 (P = .005), and 0.06 (P = .001) for women infected with Chlamydia trachomatis and/or Neisseria gonorrhoeae, respectively. In patients with pelvic inflammatory disease, spread of the inflammation to the fallopian tubes seems to be inhibited in oral contraceptive users.

Adolescent↗
PubMed1983

Postmolar trophoblastic disease in women using hormonal contraception with and without estrogen.

One hundred thirteen patients with a molar pregnancy evacuated from January 5, 1976, through February 15, 1980, had close follow-up at the Los Angeles County-University of Southern California Women's Hospital. Twenty-seven patients (23.9%) developed postmolar trophoblastic disease, all of whom achieved remission with treatment. Of the 113 patients, 71 (62.8%) used only oral contraceptives, 32 patients (28.3%) used only intramuscular medroxyprogesterone acetate, seven patients (6.2%) used both oral contraceptives and medroxyprogesterone acetate, and three patients (2.7%) used nonhormonal contraception after evacuation of their molar pregnancy and before titer remission. Analysis of significant clinical and laboratory correlates of postmolar trophoblastic disease for the study group revealed no substantial bias in assignment of contraceptive method. There was no significant difference between the oral contraceptive and the medroxyprogesterone acetate groups with respect to the development of postmolar trophoblastic disease or the time to spontaneous titer remission. The study shows no apparent adverse effect of the estrogen (50 mg mestranol) component in oral contraceptives on the frequency of postmolar trophoblastic disease.

Chorionic Gonadotropin↗
PubMed1984

Decreased plasma phosphate under hormonal contraceptives.

Plasma phosphate (Pi) and several indices of Ca-Pi metabolism were measured in 129 randomly selected healthy female individuals of the general population, of whom 59 were on hormonal contraceptives and 70 were not. Fasting plasma Pi was significant (p less than 0.01) lower in those taking hormonal contraceptives (0.96 +/- 0.17 mmol/l) than in those not taking them (1.06 +/- 0.16). Those on hormonal contraceptives had identical age, body weight and UVcr. Systolic and diastolic blood pressure was higher in those on hormonal contraceptives, and there was an inverse relationship between blood pressure and plasma Pi. Between those on hormonal contraceptives and those not on them, no significant difference of urinary cAMP (non-hormone 4.69 +/- 1.48 nmol/l GF; hormone 4.43 +/- 1.18) or iPTH could be shown. The present study documents that hormonal contraceptives with estrogen (less than or equal to microgram/dl) decrease plasma Pi and urinary Ca in premenopausal nonosteoporotic women.

Adult↗
PubMed1978

[Post-partum contraception (author's transl)].

The authors have come to the conclusion that the ideal time to start female contraception is when the periods return following delivery. They arrived at this conclusion after studying the disadvantages of the various methods of hormone contraception and of mechanical female contraception immediately following delivery. Directly after delivery contraception should be in the hands of the man and not the woman. If better information is given to the couple during pregnancy and in the postnatal period it should direct them towards such formations of contraception. The problem, however, of grand multipara who are feckless, ignorant and of low social class, still remains. Medroxyprogesterone, if it is used at all immediately after delivery, should be given in a dose of 150 mg. As far as tubal ligation by mini-laparotomy after delivery goes this is permanent contraception and its indications should be considered with very great care.

Contraception↗
PubMed1980

Clomipramine and oral contraceptives: an interaction study--clinical findings.

Forty-six depressed females were admitted to a study primarily designed to investigate the steady-state plasma levels of clomipramine and desmethyl-clomipramine in two groups of patients--one taking oral contraceptives, and one not. Twenty-one patients were taking oral contraceptives and twenty-five were not. Six 'pill'-takers dropped out of the study, two for drug-related reasons, and five non-'pill'-takers, two of whom also developed side-effects. Oral contraceptive takers were found to be significantly more depressed initially than controls, overall. Moreover, when the control group was examined in detail it was found to contain two sub-groups--one moderately depressed and one severely depressed. This latter sub-group was similar to the 'pill'-taking group. Both groups of patients improved similarly. There was no difference in the side-effects experienced. Clinically the study did not suggest that taking oral contraceptives had any influence on the effects of antidepressant medication. It did, however, suggest that either oral contraceptives cause depressed mood and loss of libido or, more likely, that when oral contraceptive takers become depressed these two factors interact to particularly influence mood and libidinous desire.

Adolescent↗
PubMed1980

[Menarche of young girls and tolerance of hormonal contraceptives-results of a field study of 33,000 cases (author's transl)].

A field study was undertaken into an oral contraceptive with medium oestrogen content for the purpose of finding out from 13,603 women, aged below 20 years, if correlations with relevance to counselling existed between the age of menarche and acceptance of hormonal contraceptives. Cycles of 34 days and more were recorded from probands in whom menarche had occurred above the age 14 twice as often they had been recordable from probands with early menarche, that is below the age of twelve. Shortened cycles in response to hormonal cycles in response to hormonal contraception were most often recorded from the late-menarche group. -The trend towards heavier withdrawal bleedings and more frequent spottings in women with late menarche should be taken into account, when oral contraceptives are first prescribed. -Growing menarche age was found to be accompanied by growing incidence of mental depression and headache of women who were on the pill. The number of adolescent women with late menarche who reported weight gains in excess of 2 kg was higher than the number of probands with early menarche. Weight gains over the first three months on the pill in the adolescent group were three times as often as in the whole group. -More women with early menarche reported increase in libido. Young women with late menarche wished more of than others to discontinue oral contraception, which seemed to suggest the existence of psychosocial differences between the two groups. The recorded trend towards declining acceptance of oral contraceptives along with growing menarche age may be used for orientation in counselling.

Adolescent↗
PubMedDate not supplied

Contraception: awareness and practice amongst Nigerian tertiary school girls.

Contraception is analysed in 498 Nigerian Tertiary School Girls--228 from the Medical Discipline (MD) of study and 270 from the Non-Medical Discipline (NMD). Pregnancy occurred in 30.5% of the sexually exposed students. Overall mean awareness of contraception was 70.9% while mean contraceptive usage was 23.5%. The most commonly used contraceptive method was the safe-period. Peer group constituted the highest source of information on contraception (42.6%) while lectures constituted the lowest (11.2%). Sex and contraceptive education entrenched into the country's education policy is advocated.

Adolescent↗
PubMedDate not supplied

The impact of women's employment and education on contraceptive use and abortion in Kinshasa, Zaire.

This report examines contraceptive behavior and abortion among women residing in Kinshasa, Zaire's capital city, with particular emphasis on women's employment and education. A data set collected in 1990 covering 2,399 women of reproductive age was used. While the practice of contraception is a common event in Kinshasa, dominated by the rhythm method, the use of modern contraceptives remains limited, but is on the rise. Induced abortion is reported by 15 percent of the ever-pregnant women in the survey. Women's employment and education are strongly linked to contraceptive use and abortion, and differences in the incidence of abortion by schooling and employment status appear to play an important role in contributing to corresponding observed differences in fertility. Modern contraceptives and induced abortion appear to be used as complementary fertility-control strategies in Kinshasa, and analyses of the findings suggest that better-educated women employed in the modern sector are most likely to be in the forefront of the contraceptive revolution.

Abortion, Induced↗
PubMedDate not supplied

[The effect of contraception on fertility in the border region of Chiapas, Mexico].

OBJECTIVE: To estimate the effect of contraception on fertility in the border region of Chiapas, Mexico. MATERIALS AND METHODS: In 1994 an epidemiological cross-sectional study was carried out on a representative sample of 1,560 non-indigenous women between ages 15 and 49 in the border region of Chiapas. The prevalence of contraception practices and the total fertility rates (TFR) were obtained and stratified by rural, intermediate and urban communities. TFR were compared between women who had never used contraceptives and those who had used them. RESULTS: The estimated TFR was 3.67 and varied from 4.14 in rural areas to 3.36 in urban areas. There were no differences in the TFR (3.74 and 3.88) nor in the average live births (3.47 and 3.48) between women who had never used contraceptives and those who had used them. CONCLUSIONS: The major effect of contraception on fertility was observed in rural areas. Factors which influence the small impact of contraception on fertility include the late use of these methods and the early age of first union among users.

Adolescent↗
PubMed1996

Barriers to contraceptive use in Kenya.

This study was designed to identify and to better understand the barriers to contraceptive use among Kenyan-couples. Data were collected through structured interviews and focus group discussions among couples not planning for pregnancy and not using any effective contraceptive method. The study was conducted in the Baba Dogo urban slum area of Nairobi, and Chwele, a rural sub-location in Bungoma, western Kenya. Some important barriers to contraceptive use were identified in couples wishing to space or limit further births. Those barriers included lack of agreement on contraceptive use and on reproductive intentions; husband's attitude on his role as a decision maker; perceived undesirable side effects, distribution and infant mortality; negative traditional practices and desires such as naming relatives, and preference for sons as security in old age. There were also gaps in knowledge on contraceptive methods, fears, rumours and misconceptions about specific methods and unavailability or poor quality of services in the areas studied. This paper recommends that information and educational programmes should be instituted to increase contraceptive knowledge, to emphasise the value of quality of life over traditional reproductive practices and desires, and to improve availability and quality of services.

Adolescent↗
PubMed1998

[Pill cycle disturbance in simultaneous use of itraconazole and oral contraceptives].

Since the introduction of itraconazole in the Netherlands, the Netherlands Pharmacovigilance Foundation LAREB and the Inspectorate for Health Care received 15 reports of pill cycle disturbances and one of pregnancy occurring during simultaneous use of itraconazole and oral contraceptives. Twelve women used oral contraceptives containing ethinylestradiol and desogestrel. In these women, the withdrawal bleeding was either delayed or did not occur at all; one of these women reported a transiently positive pregnancy test after previous breakthrough bleedings. Three women who used a contraceptive containing ethinylestradiol and levonorgestrel had a breakthrough bleeding. One woman who used an oral contraceptive containing ethinylestradiol and cyproterone acetate became pregnant during the concomitant use of itraconazole. The possible mechanism involved remains to be explained. Although an influence of itraconazole on the reliability of oral contraceptives is uncertain, additional contraceptive measurements might be considered.

Adult↗
PubMed1998

Socio-demographic characteristics of family planning clients and their possible influence on contraception in Malawi.

In a survey of family planning clients at the central Teaching Hospital, Blantyre, between July 1 and December 31, 1993, to determine their social, biological and reproductive profiles, contraceptive awareness and previous use, 766 new clients were recruited and interviewed by means of partially structured questionnaire. Their mean age was 27 years, with a range of 15-43 years. Adolescents formed 10.1% and those above 35 years of age were 17.1%. 91.3% were married. While 12.6% had no formal education, 29.7% had secondary school education and higher. Their mean parity and living children were 3.6 and 3.1 respectively. The mean desired fertility was 4.5. 93.3% of all clients had live births in their last pregnancies. Contraceptive awareness was quite high, about 98.0%. However, only 30.9% had ever-used contraceptives before then. When these are looked at against a background of the corresponding situations in the country, it appears that the individuals seeking, accepting and using contraceptives in Malawi, are better off in the various aspects of life, thus suggesting their possible influence on contraceptive use. There is need to review the national family planning programme, address the contraceptive needs of adolescents and women aged above 35 years, improve formal female education, change the prevailing socio-cultural and traditional beliefs and practices which affect women adversely, thus empowering them over affairs of their health.

Adolescent↗
PubMed1998

Covert contraceptive use: prevalence, motivations, and consequences.

This article examines women's covert use of contraceptives, that is, their use of a method without their husbands' knowledge. Three questions are addressed: (1) How is covert use measured? (2) How prevalent is it? and (3) What are the factors underlying covert use? Existing studies are used together with survey and qualitative data collected in 1997 in an urban setting in Zambia from married women and their husbands. Women's covert use of contraceptives is estimated to account for 6 to 20 percent of all current contraceptive use, and it is more widespread when contraceptive prevalence is low. The multivariate analysis indicates that difficult spousal communication about contraception is the strongest determinant of covert use. Husbands' disapproval of contraception works through spousal communication rather than as a direct influence on covert use. Husbands' pronatalism had no significant effect. The article concludes with implications of covert use for reproductive health and family planning programs, especially women's (and men's) needs for confidential services.

Adolescent↗
PubMed1977

The effect of contraceptive steroids on hypothalamic-pituitary function.

A study was performed to obtain additional information about the effects of oral contraceptives on pituitary function. A sequential pituitary stimulation test (SST) was used to study normal control women who then received either a combination pill with 50 mug of ethinyl estradiol or an injectable or oral progestin for three weeks, after which the test was repeated. The same test was also performed on five long-term oral contraceptive users. The SST consists of measurement of growth hormone (GH), thyroid-stimulating hormone (TSH), prolactin (PRL), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) at frequent intervals after stimulation by hypoglycemia, thyrotropin-releasing hormone, and gonadotropin-releasing hormone. GH and TSH release following stimulation were unaffected by the use of contraceptive steroids, while PRL release was increased by both the combination pill and the progestin alone. LH and FSH release was decreased in the three short-term and most of the long-term users of the combination pills but was not decreased in two of the long-term users as well as in those receiving the progestin alone. These results indicate that the combination oral contraceptives have a direct effect upon the pituitary gland, causing an increase in prolactin release and a decrease in gonadotropin release. This effect varies among individuals receiving the same formulation and may be related to the development of syndrome of postpill amenorrhea-galactorrhea.

Contraceptives, Oral↗
PubMed1992

Oral contraceptive type and functional ovarian cysts.

OBJECTIVE: We tested the hypothesis that multiphasic, low-dose monophasic, and high-dose monophasic oral contraceptives share a common protective effect against functional ovarian cysts. STUDY DESIGN: We conducted a cohort study using the automatic files of Maine Medicaid to assemble a population of 7462 women between the ages of 15 and 44 who were prescribed an oral contraceptive between Jan. 1, 1987, and Dec. 31, 1988. We included as cases 32 women with a principal diagnosis of a functional ovarian cyst confirmed by medical records as being greater than 20 mm in diameter. RESULTS: At comparison with the absence of an oral contraceptive prescription, we observed decreasing rates of functional ovarian cysts among women prescribed multiphasic pills (rate ratio 0.91, 95% confidence interval 0.3000 to 2.31), low-dose monophasic pills with less than or equal to 35 micrograms estrogen (rate ratio 0.52, 95% confidence interval 0.17 to 1.33), and high-dose monophasic pills with greater than 35 micrograms estrogen (rate ratio 0.24, 95% confidence interval 0.01 to 1.34). CONCLUSIONS: The protective effect of oral contraceptives against functional ovarian cysts reported previously for high-dose monophasic pills may be attenuated with newer pills of lower hormonal potency.

Adolescent↗
PubMed1981

Comparison of the metabolic effects of two hormonal contraceptive methods: an oral formulation and a vaginal ring. II. Serum lipoproteins and apolipoproteins.

In a long-term, prospective study the effects on lipoprotein lipids and apolipoproteins (apo) of a combined oral contraceptive (OC) (30 micro gram ethinylestradiol and 150 micro gram levonorgestrel) and a contraceptive vaginal ring (CVR) releasing estradiol (about 180 micro gram per day) and levonorgestrel (about 290 micro gram per day) were compared. The two treatments induced significantly different effects. In the OC group the lipoprotein-lipid concentrations showed only minor changes, but apolipoproteins (apo) B and A-I increased by about 15%. In contrast, during treatment with the CVR there was a 25% decrement of cholesterol in high density lipoprotein (HDL) and at most 10% in low density lipoprotein (LDL) cholesterol, with only minor effects on apo B and A-I. The ratio of LDL and HDL cholesterol increased in the CVR group but not in the OC group. The results also indicate a change in the composition of the LDL and HDL particles, with an altered lipid/protein ratio, during both contraceptive treatments. Despite the impressive relative increase in LDL:HDL ratio in the contraceptive ring group, the average absolute value of this ratio did not reach the mena for healthy men.

Adolescent↗