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PubMed1981

Effects of oral contraceptive combinations containing levonorgestrel or desogestrel on serum proteins and androgen binding.

The effects of the oral contraceptive combinations 0.125 mg Org 2969 (desogestrel) (13-ethyl-11-methylene-18,19-dinor-17alpha-pregn-4-en-20-yn-17-ol) + 0.05 mg ethinyloestradiol (EE) and 0.125 mg levonorgestrel + 0.05 mg EE on serum sex-hormone-binding globulin (SHBG), ceruloplasmin, transcortin and ratio free testosterone over total testosterone (percentage free testosterone) and ratio free 5alpha-dihydrotestosterone over total 5alpha-dihydrotestosterone (percentage free 5alpha-dihydrotestosterone) were compared in healthy female volunteers. Treatment was randomly distributed over the volunteers; 11 women received Org 2969 + EE and 11 women received levonorgestrel + EE. These combinations induced similar increases in transcortin levels (115 and 140%) and ceruloplasmin levels (115 and 123%) after 3 months of treatment. However, the combination Org 2969 + EE induced a substantial increase (213%) in SHBG capacity after 3 months of treatment, whereas a smaller increase (80%) was observed with levonorgestrel + EE. A return to pretreatment values was observed 2 months after termination of treatment for all parameters. The difference in the effects of both preparations oh SHBG was statistically significant and can be best explained by a difference in the androgenicity of the progestogens. A good correlation was free testosterone and the reciprocal value of the percentage free 5 alpha-dihydrotestosterone. These results confirm that SHBG is the major regulator of the biologically active free androgen fraction in women before, during and after combined oral contraceptive treatment.

Adolescent↗
PubMed1997

Antiserum to the egg coats of the fat-tailed dunnart (Marsupialia, Dasyuridae) cross-reacts with egg coats of other marsupial and eutherian species.

We are examining the extracellular coats of the brush-tailed possum as a possible target for an immunocontraceptive vaccine for biocontrol of this pest species in New Zealand. In this study we have compared the composition of the extracellular coats of the fat-tailed and stripe-faced dunnarts, brush-tailed possum, domestic rabbit, and laboratory mouse using histochemistry, immunocytochemistry, and immunofluorescence. The histochemistry of the luminal epithelium of the oviduct and mucoid coats of the marsupials and rabbit indicated that they contain acidic glycoproteins. Immunofluorescence showed that polyclonal antiserum raised against the extracellular coats of the oocyte and early embryo of the fat-tailed dunnart, cross-reacted with the extracellular coats of the oocytes of all five species. These results suggest that there are common epitopes on the extracellular coats of oocytes and early embryos of distinctly related therian species. Further work to characterise these proteins is required to determine whether there is close homology between the oviductal glycoproteins of these species.

Animals↗
PubMed2004

Female suprasegmental speech parameters in reproductive age and postmenopause.

During the female vital cycle verbal processes are influenced by secondary effects of steroid hormones. Verbal expression abilities favor more effective interpersonal communications. Verbal motor fluency is produced by the synchronization among voice, resonance and articulation. The present study compared phono-articulatory characteristics between women in reproductive age and postmenopause. Acoustic variations in vocal intonation, speed of the speech and the pause pattern were measured. Forty-five reproductive age women with regular menstrual cycles and taking no hormonal contraceptives and 45 postmenopause women receiving no hormonal replacement therapy for at least 3 years were interviewed and their verbal productions were recorded. Acoustic analyses were performed using the Kay Elemetrics Motor Speech Profile. Student's t-test was employed to compare data between the two groups when they presented normal distribution, and Mann-Whitney test when they were asymmetrical. Results showed that in the postmenopause group pause pattern was longer, the speed of the speech was slower, there was a vocal deepening without reduction of the vocal extension and there was also less vocal stability. A better understanding in this field will make possible to elaborate strategies to offer a better life quality for postmenopausal women.

Adult↗
PubMed2002

Medications taken by 26-year-olds.

BACKGROUND: Most descriptive pharmacoepidemiological reports are from studies of older people, and little is known about medication use by younger adults. AIMS: The aim of the present study was to examine the prevalence of medication usage in the previous 2 weeks among young adults. METHODS: Detailed information was collected on medications taken by 26-year-old participants in the longstanding Dunedin Multidisciplinary Health and Development Study. RESULTS: At age 26, 980 (96.2%) of the surviving cohort participated; medication data were available for 978 individuals, of whom 78.1% had taken one or more prescribed or over-the-counter medications. Medication use was higher among females. The most prevalent drug categories were analgesics (taken by 22.8% of the sample), hormonal contraceptives (21.9%; 44.7% of females), nutrient supplements (17.6%) and anti-asthma drugs (11.1%). CONCLUSIONS: The prevalence and pattern of medication use among younger adults differ from those reported for older age groups. Asthma appears to be the most prevalent chronic medical condition requiring pharmacological intervention (and for which medical care has been sought) among younger adults. The low rates of use of antidepressants and anxiolytics suggest that common psychiatric disorders may currently go unrecognized or untreated among young adults, and the high prevalence of 'third generation' oral contraceptive use among females is of particular concern.

Adult↗
PubMed2003

Associations of mass media exposure with family planning attitudes and practices in Uganda.

This study examines the associations between multimedia behavior change communication (BCC) campaigns and women's and men's use of and intention to use modern contraceptive methods in target areas of Uganda. Data are drawn primarily from the 1997 and 1999 Delivery of Improved Services for Health (DISH) evaluation surveys, which collected information from representative samples of women and men of reproductive age in the districts served by the DISH project. Additional time-trend analyses rely on data from the 1995 Uganda Demographic and Health Survey. Logistic regressions are used to assess the associations between BCC exposure and family planning attitudes and practices, controlling for individuals' background characteristics. To minimize the biases of self-reported exposure, the analyses also explore cluster-level indexes of the penetration of BCC messages in the community. Results indicate that exposure to BCC messages was associated with increased contraceptive use and intention to use. Some evidence of self-reported bias is found, and the pathways to fertility-related behavioral change appear different for women and men.

Adolescent↗
PubMed2006

Does a competitive voucher program for adolescents improve the quality of reproductive health care? A simulated patient study in Nicaragua.

BACKGROUND: Little is known about how sexual and reproductive (SRH) health can be made accessible and appropriate to adolescents. This study evaluates the impact and sustainability of a competitive voucher program on the quality of SRH care for poor and underserved female adolescents and the usefulness of the simulated patient (SP) method for such evaluation. METHODS: 28,711 vouchers were distributed to adolescents in disadvantaged areas of Managua that gave free-of-charge access to SRH care in 4 public, 10 non-governmental and 5 private clinics. Providers received training and guidelines, treatment protocols, and financial incentives for each adolescent attended. All clinics were visited by female adolescent SPs requesting contraception. SPs were sent one week before, during (with voucher) and one month after the intervention. After each consultation they were interviewed with a standardized questionnaire. Twenty-one criteria were scored and grouped into four categories. Clinics' scores were compared using non-parametric statistical methods (paired design: before-during and before-after). Also the influence of doctors' characteristics was tested using non-parametric statistical methods. RESULTS: Some aspects of service quality improved during the voucher program. Before the program started 8 of the 16 SPs returned 'empty handed', although all were eligible contraceptive users. During the program 16/17 left with a contraceptive method (p = 0.01). Furthermore, more SPs were involved in the contraceptive method choice (13/17 vs.5/16, p = 0.02). Shared decision-making on contraceptive method as well as condom promotion had significantly increased after the program ended. Female doctors had best scores before- during and after the intervention. The improvements were more pronounced among male doctors and doctors older than 40, though these improvements did not sustain after the program ended. CONCLUSION: This study illustrates provider-related obstacles adolescents often face when requesting contraception. The care provided during the voucher program improved for some important outcomes. The improvements were more pronounced among providers with the weakest initial performance. Shared decision-making and condom promotion were improvements that sustained after the program ended. The SP method is suitable and relatively easy to apply in monitoring clinics' performance, yielding important and relevant information. Objective assessment of change through the SP method is much more complex and expensive.

Adolescent↗
PubMed1993

[Use of oral contraceptives in Denmark 1980-1990 and smoking habits among fertile women in 1990].

The purpose of this study has been to chart the changes in usage of different types of oral contraceptives (the pill) throughout the 1980's, as well to estimate the extent to which these changes can be expected to influence the incidence of cerebral thromboembolic attacks amongst fertile women. The use of different types of the pill and smoking habits in different age groups are also investigated. The work is based om cross-sectional studies during the period 1980-1990; the use of the pill is documented by national sales statistics from 1980-1990 as well as from questionnaires answered by 1370 healthy women from 1990. The total sale of the pill has been fairly stable throughout the decade, corresponding to a theoretical user percentage of 23-26. The proportion of pills sold containing 50 micrograms oestrogen has fallen steadily from 51% in 1980 to 11% in 1990, while the proportion of pills containing 30-40 micrograms oestrogen (this group includes the mulit-phase pills) has doubled from almost 40% to almost 80% over the same period. Finally, the proportion of minipills has fallen from 10% to 5%. It is estimated that the changed distribution in use of the different types of the pill through the eighties can be expected to reduce the incidence of cerebral thromboembolic attacks among fertile women by 4.5%. Since the 95% confidence limits on the incidence of such attacks among fertile women in Denmark is +/- 14%, one cannot expect to show significant changes in the total incidence of cerebral thrombo-embolic attacks among these women as a consequence of the change in contraceptive pill profile.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2006

The evolution of the birth control handbook: from student peer-education manual to feminist self-empowerment text, 1968-1975.

Peer education has been recognized as a significant means of educating youths, especially about sexual health issues. Although considered a relatively recent development, there are, however, older examples of its existence. In Canada, the Birth Control Handbook (1968) stands out as a stellar example of one student peer-education manual. This article establishes the Handbook's student peer-education roots. But it also charts the Handbook's evolution from a revolutionary student peer-education manual to a key feminist self-empowerment text within the Quebec context between 1968 and 1975. Finally, this article includes the recollections of some of the key individuals involved in the development, production and distribution of the Handbook. In so doing, this article confirms the Handbook's significance to both anglophone and francophone student and feminist politics as well as to women seeking information about birth control.

Contraception↗
PubMedDate not supplied

[Statistical analysis on andrological patients. I. Frequencies].

According a collective of 1619 andrological patients of the year 1975 some statistical data were given: age distribution, frequencies, frequency of sexual intercourse, anticonception and relation to age, coitus frequency and relation to age, impotence and relation to age, previous andrological treatment.

Adolescent↗
PubMed2000

The associations among pediatricians' knowledge, attitudes, and practices regarding emergency contraception.

OBJECTIVES: To quantify practitioner administration of the emergency contraceptive pill (ECP) among adolescent patients, and to determine if such administration is associated with physician knowledge and attitudes regarding efficacy, side effects, and appropriate use. DESIGN: Survey of pediatricians. SETTING: The survey address list was generated from a database of active Fellows of the American Academy of Pediatrics in the District of Columbia metropolitan area. MAIN OUTCOMES MEASURES: Prescription of the ECP in the previous 12 months, or counseling of an adolescent patient about the ECP. RESULTS: Of the 236 questionnaires distributed, 143 (61%) were returned and 121 (51%) were usable. Twenty-four pediatricians (20%) reported prescribing the ECP, and 29 (24%) had counseled adolescent patients about the ECP. Of the practice-related variables surveyed, both the number of adolescents seen per week and the practice setting were significantly associated with these outcomes. Of the knowledge-related variables surveyed, knowledge of the timing and the Food and Drug Administration-labeled status of the ECP were significantly associated with outcomes. None of the attitude-related variables surveyed were associated with outcomes. CONCLUSIONS: This study demonstrates that knowledge deficits, not attitude-related variables, are significantly associated with the low level of ECP administration and counseling among District of Columbia pediatricians. Because knowledge deficits are amenable to educational interventions, our data suggest that informing pediatricians about the ECP may increase its administration among their adolescent patients.emergency contraceptive pill, pediatricians, adolescents.

Adult↗
PubMed1993

The effects of levonorgestrel, desogestrel and gestodene on the pulsatile release of luteinizing hormone in oral contraceptive users.

The dynamics of luteinizing hormone (LH) and follicle stimulating hormone (FSH) release were investigated in 60 long-term oral contraceptive (OC) users. Five different types of OC, all containing the same amount of estrogens were studied: three monophasic preparations containing levonorgestrel, desogestrel and gestodene, respectively, and two triphasic formulations, containing levonorgestrel or gestodene. Thirteen healthy, normally cycling volunteers served as controls. Blood sampling was performed at 10-min intervals during a 6-h period to determine the pulsatile release of LH. LH and FSH were measured using a sensitive immunoradiometric assay. Pulse patterns were classified on the basis of the overall LH level, as well as on the character of the LH pulses, according to both frequency and amplitude characteristics. Pulsatile LH release was maintained during OC use. After the 7-day pill-free interval, FSH levels as well as the LH pulse patterns were comparable to those of early follicular-phase controls. FSH levels and FSH release in response to a gonadotropin releasing hormone (GnRH) challenge were profoundly suppressed in all OC users, as early as day 8 of the pill cycle. LH release during the pill cycle was characterized by either a low frequency (median 1 pulse/6 h), high amplitude (median 2.5 IU/l) pulse pattern or by a pattern of low-amplitude pulses (median 0.2 IU/l) and low basal LH levels (median 0.2 IU/l). The distribution of these pulse patterns showed marked differences between different OC preparations and depended on both the type and dose regimen of the gestagenic component of the OC.

Adult↗
PubMed1994

The prevalence of cervical infection with human papillomaviruses and cervical dysplasia in Alaska Native women.

Alaska Native women historically have high rates of sexually transmitted diseases (STDs) and invasive cervical cancer. Their prevalence of cervical infections with human papillomavirus (HPV) in relation to cervical dysplasia was determined with a commercial dot hybridization test for seven HPV genotypes. Type-specific HPV DNA, similarly distributed between genotype groups 16/18 and 31/33/35, was detected in 234 cervical specimens (21%) from 1126 Alaska Native women seeking routine care and colposcopy or from population-based lists. The prevalence of HPV DNA declined with age and increased with sexual activity and cigarette smoking. It was unrelated to use of oral contraceptives or condoms or to STDs. Relative risks associating HPV with increasing severe grades of cervical dysplasia increased markedly with HPV infection, up to 7.1 for high-risk genotypes 16/18 and 14.4 for coinfection with 31/33/35. These genotypes were detected in 8% of women without dysplasia seeking routine care. Screening for strain-specific HPV DNA may identify women at highest risk for cervical neoplasia.

Adolescent↗
PubMed1992

Zimbabwe's success story in education and health: will it weather economic structural adjustment?

The beginning of the 1980s saw the birth of Zimbabwe as a result of a protracted liberation war. It coincided with global interest in primary health care, the concept of universal primary school education and, unfortunately, moves towards economic stabilization and structural adjustment programmes. Economic structural adjustment was adopted by several sub Saharan African countries with dire consequences for the poor and vulnerable. Zimbabwe's commitment to social justice and to equitable distribution of resources demonstrated a practical move away from the culture of rhetoric so characteristic of many governments and non-governmental organisations and agencies. This commitment has been translated into impressive improvements in health and education. Current evidence shows that education has had a positive impact on health and related areas like contraceptive use, child mortality and the nutrition status of children. Conversely nutrition and health conditions among school children are important determinants of educational outcomes. Hitherto Zimbabwe's economy has been sufficiently strong to avoid excessive dependence on the International Monetary Fund, the World Bank and other foreign financial institutions. Unfortunately, however, the current economic recession together with economic structural adjustment programmes are beginning to have a negative impact on health and education. Will true synergism between health and education weather these structural problems? It seems that the people and government of Zimbabwe have the capacity and resolve to weather such a storm.

Economics↗