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At least 1,639 records · Page 91Linked to original sources
PubMed1995

Dirithromycin increases ethinyl estradiol clearance without allowing ovulation.

OBJECTIVE: To use a novel, sensitive study design to detect a potential oral contraceptive (OC) and dirithromycin drug interaction by assessing the pharmacokinetics of the ethinyl estradiol (E2) component of a common OC and the potential failure of OC effectiveness. METHODS: In this nonblinded study, 20 healthy women using Ortho Novum 7/7/7-28 were selected for a three-OC-cycle study. Baseline measures included E2 and progesterone serum levels on days 21, 23, 25, and 27 of cycle one and days 1, 3, 5, and 7 of cycle two. During cycle two, 24-hour blood sampling and radioimmunoassay analysis for ethinyl E2 pharmacokinetics were performed on day 8 and pelvic ultrasound on day 13. Oral dirithromycin 500 mg/day for 14 days began on day 21 of cycle 2. After starting dirithromycin, cycle two and three serum E2, progesterone, and serial ethinyl E2 levels and pelvic ultrasound replicated the baseline schedule. Ovulation was assumed if E2 concentration was greater than 50 pg/mL, progesterone concentration was greater than 3 ng/mL, or if an ovarian cyst greater than 10 mm was present on ultrasound. RESULTS: Pharmacokinetic analysis demonstrated a small (7.6%) but statistically significant decrease (P = .03) in the mean ethinyl E2 24-hour area under the curve and an increase in apparent oral clearance. No woman ovulated, based on E2 levels and progesterone concentrations or ultrasound. CONCLUSION: Dirithromycin increased the apparent oral clearance of ethinyl E2. The clinical importance of the interaction may be negligible because no woman ovulated or had compromised OC effectiveness in this small series.

Adolescent↗
PubMed1980

Ultrasound scanning of ovaries to detect ovulation in women.

Healthy volunteers with regular ovarian function, women taking oral contraceptives, and infertile patients being treated with clomiphene were studied longitudinally from day 7 of the cycle to menstruation. The main objective was to determine whether ovulation or failure to ovulate could be detected accurately by the use of ultrasound. The ovaries were scanned with a Kretz Combison 100 sector scanner every 1 to 3 days for morphologic changes consistent with follicle development, ovulation, and development of the corpus luteum. The morphologic changes were correlated with daily urinary hormone profiles. The estimated times of ovulation according to ultrasound and luteinizing hormone peak overlapped by 24 hours in 19 of 23 normal cycles and in 5 of 6 cycles of patients treated with clomiphene. Both techniques indicated that three of three women taking oral contraceptives did not ovulate. The ultrasound studies indicated a wide range in the diameter of the preovulatory follicle, which precludes follicular diameter as a single index for prediction of ovulation. However, by measuring the maximal diameter of the follicle and observing the morphologic changes within the ovary from follicle to corpus luteum, it was possible to detect ovulation in more than 80% of cycles studied. This technique was found to be quick, inexpensive, and efficient.

Clomiphene↗
PubMed2003

Sex in Australia: contraceptive practices among a representative sample of women.

OBJECTIVES: To document the use of contraception by a representative sample of Australian women aged 16-59 years. METHOD: Between mid-2001 and mid-2002, computer-assisted telephone interviews were completed by 9,134 women aged 16-59 years from all States and Territories selected by modified random-digit dialling of households (response rate 77.6%). Respondents were asked about contraceptive methods used in their current regular relationship(s) and during recent sexual encounters, or in general, or their reasons for non-use. Responses were allocated to 14 categories. RESULTS: 70.8% of respondents were using a method of contraception, over 95% of those apparently at risk of pregnancy. Most common reasons for non-use were not having intercourse (41.6%) and being past menopause (21.6%). Among those apparently at risk of unplanned pregnancy (i.e. who were heterosexually active and fertile but not pregnant or trying to become pregnant; 13.0% of non-users), the most common reasons for non-use were experience of side-effects or contra-indications (23.0%), leaving it to chance (20.2%), forgetting/not caring (18.9%), breast feeding (16.5%) and believing it unnatural/unhealthy (13.7%). No women cited religious objections or lack of access to services. The most used methods were oral contraceptives (33.6% of users), tubal ligation/hysterectomy (22.5%), condom (21.4%) and vasectomy of partner (19.3%). Tubal ligation rates were higher and condom use lower in regional and remote areas. CONCLUSION: Given the high levels of use and knowledge and lack of evidence of unmet service need, most unplanned pregnancies in Australian adults are likely to be attributable to method failure or inconsistent use.

Adolescent↗
PubMed1976

Action of midcycle contraceptive (R 2323) on the human endometrium.

Over 2,148 cycles of midcycle oral administration of R 2323 (50 mg. per day on Days 15,16, and 17), the authors recorded a drug-failure pregnancy rate of 5 per cent and an unusually regular cycle length of 28 +/- 2 days. During this trial, endometrial biopsies obtained in the luteal phase were examined by light and electron microscopy and compared to pretreatment biopsies. Light microscopy indicated a weakly secretory endometrium suggestive of some, albeit low, progesterone impregnation. Ultrastructural examination revealed deleterious changes in the development of the nucleolar channel system and giant mitochondria and a delay in the migration of glycogen granules. This low progesterone impregnation could be explained either by a direct effect of R 2323 on cell ultrastructure or by interference with progesterone availability. It would appear that R 2323 acts as a temporary substitute for progesterone at the receptor level but that it does not induce all the biological manifestations of this hormone, in particular, the endometrial changes required for implantation.

Biopsy↗
PubMed1994

Once-a-month injectable contraceptives: efficacy and reasons for discontinuation.

Reports of the phase III clinical trials on four combined progestogen-estrogen once-a-month injectable contraceptives, Deladroxate, Cyclofem, Mesigyna and Chinese Injectable No. 1, are reviewed focussing on efficacy and reasons for discontinuation. Deladroxate, currently used in many Latin American countries has proved to be highly effective and well accepted. However, this combination was withdrawn by the original manufacturer because the progestogen component of this drug induced a high number of breast cancers in dogs and very curious pituitary hyperplasia in rats. Cyclofem and Mesigyna were found to be highly effective and highly acceptable drugs. Side-effects were minimal and were of minor importance. The Chinese Injectable No. 1 had unacceptably high failure rates with a monthly injection schedule. After doubling the dose in the first month of use, the efficacy was satisfactory. It was found that all monthly injectable contraceptives provided better cycle control than the every 3 months depot-medroxyprogesterone acetate, although abnormal bleeding was still the main drug-related complaint and reason for discontinuation. Missed appointment is another reason for discontinuation which might reflect the problem of frequent injection schedule, thus indicating the need for proper selection of the users and good counselling.

17 alpha-Hydroxyprogesterone Caproate↗
PubMed1987

Multi-centre open study of a triphasic levonorgestrel-ethinyloestradiol combined oral contraceptive ('Trinordiol').

A long-term, multi-centre open study was carried out to evaluate the efficacy, cycle control and side-effects with a triphasic, combined oral contraceptive containing levonorgestrel and ethinyloestradiol ('Trinordiol'). A total of 2517 women completing at least 1 cycle of treatment was followed up at 2 to 3-monthly intervals; the overall number of cycles on treatment was 37,090. During treatment, only 2 pregnancies occurred which were attributable to pill failure. Cycle control was good: cycle irregularities were 9.6% overall, but were most common (19.6%) during the first 3 cycles. Only 3.8% of patients withdrew from the study for this reason. Side-effects were those commonly seen with oral contraceptives, and they produced a drop-out rate of only 13.9%. There were no clinically significant effects on blood pressure or body weight. The results also suggested that 'Trinordiol' has a beneficial effect on pre-existing acne.

Acne Vulgaris↗
PubMed1998

Norplant failure: an adolescent case study and review of the literature.

STUDY OBJECTIVE: To alert clinicians to risk factors associated with levonorgestrel implant (Norplant; Wyeth-Ayerst Laboratories, Philadelphia, PA) failures in the adolescent population and discuss alternatives. DATA SOURCES: Medline search of articles pertaining to the use of levonorgestrel implants in the adolescent population. STUDY SELECTION: All articles pertaining to the use of levonorgestrel implants in adolescents. CONCLUSIONS: Levonorgestrel subdermal implants, Norplant, have been successfully used worldwide as contraceptives. Clinical trials suggest that pregnancy rates while using levonorgestrel implants are positively correlated with increased body weight. In addition, pregnancy rates may be higher in women below age 25 years. Finally, patients who report regular menstrual cycles on levonorgestrel implants may be at greater risk for method failure. Consequently, despite its apparent success, levonorgestrel implants have some significant but little-known limitations that should be considered in initial adolescent patient selection, education, and postinsertion medical supervision.

Adolescent↗
PubMed1988

Parents' behavioral norms as predictors of adolescent sexual activity and contraceptive use.

The influence of parental factors on adolescent sexual behavior and contraceptive use has been examined previously, and findings have been contradictory. Previous studies, which found little relationship between parental norms and adolescent sexual activity, have been limited by their failure to recognize developmental differences in the relative weight of parent and peer influences between younger and older teens and by use of selected samples, resulting in a restriction of range. The current study differs in that it utilizes a clustered sample household survey of 329 males and females, aged 14 to 17, and 470 of their parents. Using multiple regression analysis, it was found that parents' reported behavioral norms account for 5% of the variance in whether adolescents have had intercourse, and for 33% of the variance in use of contraception at last intercourse. The study suggests that while parents' normative beliefs have limited effect in the decision to become sexually active, they have considerable impact on later contraceptive use.

Adolescent↗
PubMed1990

Duration of use of copper releasing IUDs and the incidence of copper wire breakage.

The incidence of copper wire breakage for IUDs (Multiloads) using 0.3 and 0.4 mm diameter copper wire was evaluated by examining 969 devices that had been removed for various reasons. The IUDs were examined by light microscopy to determine the integrity of the copper wire. As expected, the incidence of breakage increased with increasing duration of IUD use. The cumulative breakage rate (life table) was significantly lower (p less than 0.05) for the Multiload 375 that used 0.4 mm diameter wire, compared to the Multiload 250 that used 0.3 mm diameter wire. The cumulative rates were 5.4 per 100 IUDs after 3 years for the Multiload 250, and 3.8 per 100 IUDs after 5 years for the Multiload 375. In only 1 (0.1%) of the 969 Multiloads examined, the breakage of the copper wire was sufficiently extensive to adversely affect the user's risk of pregnancy.

Equipment Failure↗
PubMed1978

Evaluation of single-stitch tubal ligation in postpartum women.

Permanent contraception by tubal surgery on completion of the family unit is increasingly becoming acceptable to younger women. Contraception by spacing methods during the long span of the reproductive period is impractical because of the cost involved, the fear of failure, and the possibility of side effects. Reversal of tubal surgery may be necessary in some young women as a result of unforseen infant deaths. Old and new techniques of tubal surgery,with or without endoscopy, still require the interruption of a long segment of the tubes (more than 1 cm) except in the spring-clip method, in which only 4 mm of tube is involved. These clips are expensive and not easily available. In a study of 463 women, the clip method was replaced by a single-stitch method to interrupt a small segment (1 mm) of the tubes. However, 24 failures occurred in the 230 women followed for a period of 6-36 months. In view of the high failure rate, use of this method was discontinued. This experience demonstrates that methods causing minimal tubal damage and providing maximum potential reversibility have greater risk of failure.

Evaluation Studies as Topic↗
PubMed2000

Evidence-based counselling for vasectomy.

Couples requesting vasectomy need to be properly counselled. Vasectomy is generally safe but it can fail in up to 6% of cases. Reversal is possible but not always successful. Most men are azoospermic six weeks after vasectomy. They must be warned that the procedure may have to be repeated if there are persistent motile sperm in their post-vasectomy semen analysis.

Adult↗
PubMed1977

Ethinylestradiol and dl-norgestrel as a postcoital contraceptive.

Six hundred and eight women were treated with 200 microgram of ethinylestradiol and 2 mg of dl-norgestrel, administered in two divided doses, as a postcoital contraceptive. Criteria for entry into the study included definite unprotected coital exposure within the previous 72 hours and the absence of any contraindications to the use of estrogen/progestin-containing compounds. Women with coital exposures outside of the 72-hours-to-treatment time frame were excluded. Four hundred and sixty-four of the patients were cycling regularly and, of these, 152 were exposed at midcycle. Only one patient became pregnant as a result of probable method failure as compared with the minimal estimated number of 12 to 30 pregnancies.

Adolescent↗
PubMed1992

[A clinical trial of a monophasic contraceptive preparation containing ethinyl estradiol and desogestrel].

A multicenter trial was conducted in 267 centers in Italy to evaluate the efficacy, acceptability and safety of a monophasic oral contraceptive containing 30 micrograms ethinyl estradiol and 150 micrograms desogestrel (Marvelon). 13,290 women were followed up for a total of 74,967 cycles. No pregnancies due to method failure were reported and only three because of patient failure. Cycle control was good. There was a decrease in the occurrence of irregular cycles and in the duration and amount of menstrual bleeding; the incidence of breakthrough bleeding and spotting was low. No severe side effects occurred and the incidence of minor complaints was generally lower during treatment than in the pretreatment cycle. Body weight and blood pressure were not significantly altered.

Adult↗