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PubMedDate not supplied

The effect of the sex of interviewers on the quality of data in a Nigerian family planning questionnaire.

Traditionally, female interviewers have been preferred to men for conducting fertility and family planning surveys. However, in West Africa, evidence for their superiority over male interviewers is mixed. In Nigeria, as part of a four-state pretest of the national family planning questionnaire, an experimental design was incorporated to quantify effects of the sex of the interviewer. In one state, reinterviews were also performed to measure the reliability of responses. In the conservative northern state of Kano, the use of male interviewers was problematic. However, in the other three states, only weak evidence was found to mitigate against the use of male interviewers. In fact, in two states, the proportion of respondents reporting knowledge of several contraceptive methods was significantly higher when male interviewers conducted the survey. Respondents' reports of contraceptive use were very unreliable for interviewers of both sexes.

Adolescent↗
PubMed1995

Complications of induced abortions and their preventions in Ghana.

Two hundred and twelve patients were admitted because of complications of induced abortions. 58% of those abortions had been performed outside designated health institutions despite the liberalisation of the abortion law in Ghana about ten years ago. Ghanaian society still seems to perceive abortions as illegal or unethical and hence to be procured clandestinely. The overall mortality rate was 2.4% whilst the case fatality rate for septic abortions was over three times this rate. The surgical intervention rate was high at about 94%. Over 50% of laparotomies were for ectopic pregnancy. Suspicion of ectopic pregnancy must always be borne in mind if undue delay in their management is to be avoided in all cases of complicated induced abortions especially when the patients have risk factors. None of the patients used a modern contraceptive method over the three months preceding the index pregnancy and post-arbortal contraceptive counselling was infrequent. Effective and widespread contraceptive use and continuing education of doctors remain pivotal if the incidence of abortions and their complications are to be reduced.

Abortion, Illegal↗
PubMed1996

[Emergency contraception with mifepristone and anordrin].

OBJECTIVE: To study the efficacy of mifepristone or with anordrin for emergency contraception. METHODS: 300 healthy women were recruited within 7.2 hours after unprotected intercourse or contraceptive failure and randomly allocated into 3 groups. Group 1 (n = 100), mifepristone 25 mg twice with 12 hours apart; group 2 (n = 99), single dose of mifepristone 25 mg; and group 3 (n = 101), mifepristone 25 mg and anordrine 7.5 mg given once. RESULTS: No pregnancy occurred in group 1, while 1 pregnancy in each group 2 and 3. The contraceptive effectiveness were 100.0%, 83.8% and 86.1% for the 3 groups respectively. The overall menstruation disturbances and side effects were low. CONCLUSIONS: Both mifepristone 50 or 25 mg were effective for emergency contraception and no synergetic effects of anordrin in combination with mifepristone was shown in this study.

Adult↗
PubMed2003

Knowledge of, attitudes towards, and practices relating to child-spacing methods in northern Burkina Faso.

This study was carried out to document current trends in knowledge of, attitudes towards, and practices relating to traditional and modern child-spacing methods in a remote area in northern Burkina Faso. Information on sexual abstention, weaning, and contraception was elicited from 296 women of reproductive age, involving 413 postpartum intervals. A number of older women and key informants were also interviewed. The findings depicted significant diversity in that durations of individual postpartum sexual abstinence varied between 40 days and 3 years, with shorter durations associated with stricter adherence to Islamic beliefs and, possibly, a trend towards a less collective and, for the family unit, more labour intensive, agro-pastoral subsistence economy. Although durations of amenorrhoea were relatively short at between (median) 9 and 11 months, they determined the length of non-susceptible periods in almost 90% of cases. The median timing of weaning was stable at 24 months across all three main ethnic groups. However, changes in the frequency and type of complementary feeds may have impacted on the duration of amenorrhoea. Both demand for modem contraception and contraceptive prevalence (< 1%) were very low. The creation of new child-spacing norms and the promotion of modern contraceptive methods are likely to be successful in areas like this one only, if the population can be sensitized to the idea that Islam does not necessarily discourage contraception.

Adult↗
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↗
PubMed2006

Knowledge of contraceptives and sexually transmitted diseases and contraceptive practices amongst young people in Ho Chi Minh City, Vietnam.

In this article, we examine knowledge of contraceptives and sexually transmitted diseases (STDs) and contraceptive practices amongst young Vietnamese people. We conducted a qualitative study on sexuality and abortion with young people in Ho Chi Minh City, Vietnam. Twelve female and 4 male young people were individually interviewed using an in-depth interview technique. We found that condoms and pills were contraceptives known by almost all young people, but their knowledge of condoms and pills was still inadequate. Fears of side effects of taking pills and rumors and beliefs regarding condoms were quite common among young people. The limitations in young people's knowledge of contraceptives and STDs were a reflection of limited sources of their knowledge. Sexual education provided by educational institutions and within families was very basic. It did not provide clear knowledge on the sensitive topics such as contraceptive methods, and other issues related to sexuality for unmarried people. From a gender perspective, there are two points to note here: While sex issues were discussed openly among unmarried men, most unmarried women felt uncomfortable or expressed difficulty when talking about these issues; and the passiveness of unmarried women in making the decision of using condoms as well as contraceptives was marked. Amongst young people, the use of contraceptives was based mainly on ineffective methods including withdrawal and periodic abstinence. Further, young people's understanding of these methods was neither clear nor adequate. For the young people who did not use any contraceptives, sexual relations occurred unexpectedly. We conclude that creating a climate in which sexual issues can be discussed openly is an important step for the improvement of sexual health for young people. This will inevitably improve knowledge and understanding of contraceptives and STDs and may lead to a safer sexual life among this group of young people.

Adult↗
PubMedDate not supplied

Contraceptive failure of the ovulation method of periodic abstinence.

Previously published estimates of probabilities of method and user failure for all contraceptive methods suffer from a serious methodological error and are biased downward, with the extent of bias unknown. Data from a World Health Organization clinical trial of the ovulation method of periodic abstinence were used to provide the first correctly calculated measures of method and user efficacy and to determine the characteristics that distinguish women who consciously take risks from those who do not. Probabilities of pregnancy during the first year are 3.1 percent during perfect use (method failure) and 86.4 percent during imperfect use (user failure). Thus, if used perfectly, the ovulation method is very effective. However, it is extremely unforgiving of imperfect use. Because perfect compliance is difficult for many couples who desire intercourse when it is forbidden by ovulation method rules, and because the risk of pregnancy during imperfect use is so great, the ovulation method cannot be considered an ideal contraceptive method for the typical couple, who are likely to be less compliant than couples who volunteer for a clinical trial. The probability of an accidental pregnancy is greatest when any of the three most serious rules--no intercourse during mucus days, within three days after the day of peak fecundity or during times of stress--are broken. Those who have a poor attitude toward the rules are more likely to take risks, including serious risks. Those who get away with taking a risk (i.e., do not get pregnant) are very likely to take risks again. Because breaking the most serious rules entails a 28 percent risk of pregnancy per cycle, those likely to take risks should be counseled about the probable consequences.

Adult↗
PubMed1996

Contraceptive efficacy of testosterone-induced azoospermia and oligozoospermia in normal men.

OBJECTIVE: To determine contraceptive efficacy of hormonally induced sperm suppression to severe oligozoospermia or azoospermia. DESIGN: Prospective, noncomparative contraceptive efficacy study. SETTING: Multicenter study in 15 centers in nine countries. PARTICIPANTS: Three hundred ninety-nine normal, healthy, fertile men requesting a male contraceptive method. INTERVENTION: Weekly IM injection of 200 mg T enanthate. MAIN OUTCOME MEASURE: Incidence of pregnancies in efficacy when couples relied on T injections alone for contraception. RESULTS: Four pregnancies occurred during 49.5 person-years involving men with oligozoospermia (0.1 to 3 x 10(6)/mL) and none during 230.4 person-years in azoospermic men: pregnancy rates 8.1 (95 percent confidence interval [CI] 2.2 to 20.7) and 0.0 (95 percent CI, 0.0 to 1.6) per 100 person-years, respectively, or 1.4 (95 percent CI, 0.4 to 3.7) per 100 person-years for oligozoospermia and azoospermia (O to 3 x 10(6)/mL) combined. Pregnancy rates were related to sperm concentration. Inadequate suppression of spermatogenesis occurred in eight men and escape from suppression occurred in four. Discontinuations were due to personal reasons (50 men, cumulative annual life-table rate 12.2 percent [95 percent CI, 9.1 percent to 16.1 percent]) and dislike of the injection schedule (21 men, 5.1 percent [95 percent CI, 3.2 percent to 7.9 percent]). Thirty-five men discontinued for medical reasons (9.4 percent [95 percent CI, 6.7 percent to 13.2 percent]), with no serious treatment-related side effects. After stopping injections, sperm output recovered; additionally, fertility was demonstrated in 33 couples. CONCLUSION: Suppression of spermatogenesis to azoospermia or severe oligozoospermia (< or = 3 x 10(6)/mL) induced by weekly T enanthate injections results in sustained, reversible contraception with good efficacy and minimal short-term side effects. New hormonal regimens with more convenient delivery and improved spermatogenic suppression would provide practical male contraception.

Adult↗
PubMed1980

Contraceptive efficacy: the significance of method and motivation.

The relationship between contraceptive failure and selected characteristics of users is examined using data collected in the 1970 and 1975 rounds of the National Fertility Study. Intention regarding future childbearing and choice of contraceptive method are found to be the most important considerations. Within categories of intention, choice of method appears to have an important influence on differentials by age and other characteristics. The longitudinal aspect of the study design permitted the inclusion in the analyis of certainty of intention, coital frequency, and women's perceptions of their own ability to control fertility.

Adolescent↗
PubMed2001

The promise and performance of progestogens as contraceptives.

Progestogens were first suggested as possible contraceptives in the 1920s, but it was not until the early 1960s that effective progestogen-only contraceptive methods were developed. Since then it has become possible to deliver a range of different progestogens at varying doses, by a variety of routes, over greatly differing durations of time. Some of these systems have demonstrated extraordinarily high contraceptive efficacy with relatively few side-effects apart from unpredictable, but almost universal, disturbances of the menstrual pattern. It is now recognized that some systems may exhibit substantial non-contraceptive health benefits, which should become an important part of the overall performance profile of each method. The high technology and differing attributes associated with some of the systems raise important considerations in relation to user's perceptions and programmatic requirements. Overall, progestogens are able to offer women a varied range of valuable choices for contraception. The differing performance characteristics of these methods now provide women with a major portion of their current contraceptive choices.

Animals↗
PubMed1989

Adolescent contraceptive use and parental notification.

Little research exists regarding the relationship between family communication and the sexual behavior and contraceptive use of adolescent females. A self-administered questionnaire was used to survey 196 adolescent females regarding communication with their parents about sexual issues and their reaction to proposed parental notification of the dispensing of prescription contraception. Parents of 80% of the subjects who were sexually experienced were aware of this activity. Parents of 80% of those subjects who had used contraception were aware of this use; 59% of these subjects informed their parents before their family planning visit. The majority of female adolescents (57%) were unwilling to communicate with their parents about sexual issues; 64% felt they should be able to receive prescription contraception without parental knowledge. Communication regarding sexual issues was related to lifetime contraceptive use. Eighteen percent of the sexually experienced subjects would not allow their parents to be notified of their family planning visit; 86% would use less effective contraception if family planning services were not sought. Our findings suggest that a parental notification policy will not compel all adolescents to inform parents about their contraceptive use; most adolescents will resort to less effective contraceptive methods.

Adolescent↗
PubMed1981

Research activity on systemic contraceptive drugs by the U.S. pharmaceutical industry, 1963-1976.

The process of drug development and regulation in the U.S. is first reviewed, with special reference to contraceptives. We next summarize recent data on all pharmaceutical innovation in terms of new chemical entities (NCEs) developed by the U.S.-owned pharmaceutical industry from 1963-1976, and then examine the data on all contraceptive NCEs brought to the stage of clinical investigation by the U.S.-owned firms during that period. Of the 956 NCEs studied in man by 39 U.S.-owned firms, 20 NCEs from ten firms were identified as antifertility agents. Of these, 17 had INDs filed, three of the INDs reached NDA submission, and two of the submissions were approved. Since the mid-1960s there has been a decline in the number of antifertility NCEs taken into human testing anywhere in the world and in the number filed as INDs by U.S. firms. Apart from the approved NDAs, there were only two antifertility NCEs with active INDs at the end of 1976. There have been no marked differences between the oral systemic contraceptive NCEs marketed in the U.S. or Britain since 1963. However, taking both countries together, no true NCE has been introduced for systemic contraceptive use since 1968. Although this study shows declining activity in research on contraceptive NCEs by the U.S. industry, thus supporting to some extent Djerassi's prediction of a decade ago, it should be recognized that it does not include complete data on the research activities in this area by the U.S. government or other non-industrial organizations, or on research sponsored by any group on new contraceptive methods other than NCEs.

Contraceptive Agents↗
PubMedDate not supplied

Progestin implants.

Progestin implants for contraception are highly effective, safe, and the most convenient choice for many women. Progestin implants currently on the market, preparing for launch, or under investigation are reviewed here. Their basic galenic and pharmacokinetic features, as well as their contraceptive effectiveness, are described. The first progestin-only contraceptive implant placed on the market was Norplant, a multiunit system. Since then, several single- and double-rod implants have been developed, each using one of four different progestins: levonorgestrel, etonogestrel, Nestorone and nomegestrol acetate. Jadelle is similar to Norplant but consists of only two, rather than six, Silastic rods to simplify insertion and removal; nevertheless, levonorgesterel serum levels are identical, and performance is the same for both systems. The single implant systems reviewed here are: Implanon with a 3-year duration; Nestorone implants for breast feeding and non-breast feeding women lasting up to 2 years; and Uniplant, which is effective for 1 year. The advantages and disadvantages of progestin implants, the importance of counseling for increasing user satisfaction, and the future outlook for this contraceptive method are also discussed.

Administration, Intravaginal↗
PubMed1998

The use of testosterone as a male contraceptive.

Testosterone functions as a contraceptive by suppressing secretion of the pituitary gonadotropins luteinizing hormone and follicle stimulating hormone. Low levels of these hormones decrease endogenous testosterone secretion from the testis and deprive developing sperm of the signals required for normal maturation. Interference with sperm maturation causes a decline in sperm production and can lead to reversible infertility in men, raising the possibility that testosterone could be utilized in a commercially available contraceptive. To this end, testosterone has been studied alone and in combination with either gonadotropin releasing hormone analogues or progestins in efforts to improve its contraceptive efficacy. In this chapter, we will review efforts to use testosterone to create a safe, convenient, efficacious contraceptive method for men.

Contraception↗
PubMed1995

[Male contraception by hyperthermia].

Assessment of the contraceptive efficacy of a daily mild increase (1 degree C to 2 degree C) in testicular temperature during waking hours is reported in nine couples using two techniques of immobilization of the testes in a supra-scrotal position (close to the inguinal canal). With technique 1 (3 couples and 42 cycles), immobilization was achieved with a specific underwear; there was one undesired pregnancy from a man who stopped the heating for 3 weeks. With technique 2 (6 couples and 117 cycles), immobilization was achieved by adding a supplementary ring to the specific underwear; there was no pregnancy. Reversibility and safety were evaluated. These results suggest that a daily mild increase in testis temperature could be a potential contraceptive method for men.

Adult↗
PubMed1990

Reproductive mortality and its relation to different methods of birth control.

This report evaluates the decrease in maternal mortality and its relation to family planning methods in Sweden during the years 1911-80. In the 1930s fertility was low but illegal abortions were at a high level and the associated maternal death rate was 18.5 per 1000 women. With the legalization of abortion and the introduction of modern contraceptive methods, the crude reproductive mortality rate in 1965-70 was 1.7 per 100,000 women and this was reduced still further, especially for younger women, by the late 1970s. Standardized reproductive mortality was then 80% higher than the crude rate, indicating the importance of modern family planning methods. Mortality associated with oral contraceptive or IUD use in Sweden during the 1960s and 1970s was lower than in England and the US. Mortality associated with sterilization was 6.2 per 100,000 procedures.

Abortion, Induced↗
PubMed2004

Lactational amenorrhea as a method of family planning in Egypt.

Because of the potential importance of the lactational amenorrhea method (LAM) as a family-planning option in Egypt, we analyzed data from the 1995 Egyptian Demographic and Health Survey (EDHS) to study breastfeeding practices, use of contraception, reproductive history and sociodemographic factors for 5504 mothers with children under 3 years. According to the EDHS data, about 80% of Egyptian women breastfed for at least 6 months, and 40% breastfed for 15-18 months. Over half of breastfeeding mothers used no additional contraception. Thirty-six percent of mothers breastfeeding children younger than 6 months who reported using no additional contraception were exclusively breastfeeding and amenorrheic, but only 4% reported relying on breastfeeding for family planning. We also held eight focus group discussions with breastfeeding mothers from urban and rural Upper and Lower Egypt on their use of contraceptive methods, breastfeeding, lactational amenorrhea and LAM. Participants showed strong recognition of the contraceptive effects of breastfeeding but differed widely in their understanding of lactational infecundability and knowledge of LAM as a method. These results suggest that LAM would be widely acceptable to Egyptian women, but that an educational program about the method is needed.

Adolescent↗