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PubMed2006

The influence of method-related partner violence on covert pill use and pill discontinuation among women living in La Paz, El Alto and Santa Cruz, Bolivia.

Intimate partner violence is widespread worldwide. While assumed to impact women's ability to use contraceptive methods, few data are available to support this claim. In this study, eight focus group discussions were conducted to guide questionnaire development and to provide contextual information. Participants were women who were currently using the pill and women who had used the pill previously. In addition, 300 women were interviewed who initiated oral contraceptive pill use between December 1995 and April 1996. Participants were interviewed 3-6 months later to investigate the role intimate partner violence played in covert pill use and pill discontinuation. Special study procedures for asking women questions about violence were employed. Nineteen per cent of the women interviewed were using the pill covertly. The odds of covert pill use were four times higher in El Alto and La Paz than in Santa Cruz. Women who used the pill covertly were more likely to have experienced method-related partner violence (OR = 21.27) than women whose partners knew of their pill use. One-third of the women had discontinued pill use at the time of the interview. In the final multivariate analysis, having experienced side-effects (OR = 2.37) was a significant predictor of pill discontinuation and method-related partner violence was marginally predictive (OR = 1.91; 95% CI 1.0-3.66). While efforts are ongoing to incorporate men into family planning programmes, some male partners oppose, and in some situations violently oppose, contraceptive use. The needs of women with these types of partners must not be overlooked.

Bolivia↗
PubMed1991

Pregnancy interceptive efficacy and biological profile of 3-amino-6,7-dimethoxy-1H-pyrazolo [3,4-b] quinoline (compound 85/83) in rodents.

Administration of compound 85/83 during the peri- and post-implantation period intercepted pregnancy in hamster and guinea pig by parenteral route and in hamster by oral route also. The m.e.d. for hamster and guinea pig was 10 and 20 mg/kg, respectively; lower doses were less effective. Restricting the administration to early post-implantation schedule interrupted pregnancy partially in both species. The compound was, however, ineffective in rat and in the pre-implantation schedule (days 1-4 post-coitum) in hamster. When tested in vitro on growing trophoblasts at 13.8 x 10(-5) M concentration, it prevented growth and caused degeneration of the cells within 24 h; lower concentration (9.2 x 10(-5) M) was less effective. The compound was found to be devoid of estrogenic, antiestrogenic, progestational and antiprogestational properties in conventional bioassays. In hormone competition assays, its relative binding affinity (RBA) to estrogen receptor was negligible (0.002% of estradiol-17 beta), while for uterine cytosol progesterone receptors in rabbit and hamster was 0.06 and 0.08% of progesterone, respectively. The compound 85/83 appears to intercept pregnancy by interfering with development of trophoblast cells.

Administration, Oral↗
PubMed1994

Gender differences regarding preferences for specific heterosexual practices.

Few investigations of sexual attitudes have restricted their focus to individuals' preferences for specific behaviors within a heterosexual relationship. None have examined gender differences in a broad and multidimensional array of such behavioral particulars. As part of an effort to develop a measure of preferred scripts in heterosexual couples, 258 men and women reported how much they agreed or disagreed with 74 statements of preference. A reduced and factor analyzed questionnaire included 38 items and was administered to a second sample (N = 228). Results offer qualified support that, compared to women, men are more erotophilic and show a stronger preference for incorporating erotic materials as well as drugs and alcohol into sexual relations with their partner. These results were more robust in the second sample, in which almost half of the subjects were tested in same-sex groups. Across both samples, women showed stronger preferences for activities reflecting romanticism. No gender differences were evident in sexual conventionality or in preference regarding the general use of contraceptives. However, results suggest that both sexes respond more favorably to a partner-focused or unspecified contraceptive method than to a self-focused method.

Adolescent↗
PubMed1994

Contraception by the end of the 20th century--the role of the voluntary organizations.

The formation and activities of several voluntary organizations (non-governmental organizations or NGOs) are described. They were formed in response to the social needs arising from the vast population changes in the last century. Many of them have undertaken active roles in the introduction or improvement of various forms of contraception. They have an urgent need for more funds in order to pursue their activities. Even a small diversion of money from other uses would permit the development of several new, safe and effective contraceptive methods acceptable to men and women in all countries of the world.

Contraception↗
PubMed2005

Enhancing contraception: a comprehensive review.

This review covers familiar and emerging contraceptive methods, comparing the risks and benefits of each. These basics will help you connect patients with the most acceptable form of contraception for them.

Contraception↗
PubMed1995

Family planning in genitourinary medicine: an opportunistic service?

OBJECTIVE: To evaluate and serve the need for contraception in those not using conventional sources of family planning services. SETTING: South London outpatient genitourinary medicine department at King's College Hospital. DESIGN AND SUBJECTS: Prospective study of 200 women seen consecutively in the clinic by the same doctor (LM) during 1993. Women at risk of unwanted pregnancy were identified, and offered immediate contraceptive provision or referral. RESULTS: 15 women (7.5%) were using no contraception, despite being sexually active and not wishing to conceive; of these two presented with an unwanted pregnancy. A further 23 women (11.5%) were not using their chosen contraception effectively, and another 20 women were unclear about contraceptive methods and wanted advice. Young women were most at risk; 14% of those aged 25 years and under were using no contraception. Eight women wished to defer contraceptive advice; of these four defaulted from follow up. Eighteen women (9%) wanted immediate contraceptive supplies. Ten of 18 returned a follow up questionnaire; all these women were satisfied with the contraceptive advice service received. CONCLUSIONS: Absent or ineffective contraception is common in women attending an inner city genitourinary medicine clinic. Immediate provision of contraceptive education, advice and supplies is welcomed by patients.

Adolescent↗
PubMed1981

Several factors influencing the colonization of group B streptococci--rectum probably the main reservoir.

Women (1 268) attending a gynaecological clinic or a venereal disease clinic had positive cultures of group B streptococci from urethra in 27.8% and from rectum in 29.4%. The colonization rate was highest in patients from the venereal disease clinic (p less than 0.001). In a study of 405 of the females at different parts of the menstrual cycle group B streptococci were detected during the last half of the cycle in specimens from cervix in 18%, from urethra in 29% (p less than 0.005), and from rectum in 35% (p less than 0.001). The correlation between contraceptive methods and isolation of group B streptococci was investigated for 435 women. Females with intrauterine devices but not those using oral contraceptives had a significantly increased colonization rate genitally. The colonization rate of group B streptococci was also studied in 271 women using sanitary tampons and 129 women using sanitary towel. Those using tampons were significantly more often colonized. Cultures for Neisseria gonorrhoeae were performed from 380 patients but no correlation between N. gonorrhoeae and group B streptococci was found. The study supports the view that rectum and not the genito-urinary tract is the main reservoir of group B streptococci in females, that genital colonization mainly represents contamination from the gastrointestinal flora and sexual transmission is only one of many factors influencing the colonization rate.

Adult↗
PubMed1997

Adolescents' access to reproductive health and family planning services in Dakar (Senegal).

This paper analyses the issue of adolescents' access to family planning services and information on reproductive health. The data used in this paper are a part of a broader study conducted in 1995 in Dakar (Senegal) by the Committee for Studies on Women, Family and Environment in Africa (COSWFEVA/CEFFEVA) and Family Health International. The findings present information on adolescents' perceptions of premarital sexual activity and contraceptive use and the different types of barriers to access to family planning, using data obtained primarily from focus group discussions with adolescents 16 to 20 years old and a mystery client study. In this approach, 12 of the adolescents participating in the focus group discussions visited clinics as clients and requested contraceptive methods or information. The results indicate that adolescents did not approve of premarital sexual relations, were less likely to approve of contraceptive use by adolescents than by married men and women, and felt embarrassed to go to the services. They were also disappointed by the providers' reception and response to their needs. The content of the counselling offered by the providers was moralistic, encouraging girls to abstain from having sexual intercourse until marriage. The discussions of the findings related adolescents' and providers' attitudes to the socio-cultural context in which adolescent sexuality takes place. In this context, sexuality is closely linked to marriage and childbearing, which affects the impact of classical programs on adolescent health. Alternative solutions such as the life skills development approach could be promoted in order to reach both in-school and out-of-school adolescents.

Adolescent↗
PubMed2001

Glucose tolerance during moderate prolonged exercise in women with oral contraceptives as compared to non-users.

BACKGROUND: The purpose of this study was to assess gluco-se tolerance during exercise in women on oral contraceptives. METHODS: To this end, we investigated the effects of glucose ingestion on glucose and hormonal responses in 7 women on oral contraceptives (OC(+); 21.3+/-1.3 yrs) and 7 normally menstruating (OC(-); 22.6+/-1.3 yrs) during an ergocycle test (30 min, 60% VO2max). Venous blood samples were withdrawn at 0, 3, 5, 10, 15 and 30 min exercise and at the 30th min postexercise. Glucose was ingested per os (0.5 g x kg(-1) b.w) between the 2nd and the 3rd min of the exercise. RESULTS: Under resting condition, plasma glucose and catecholamine concentrations were similar in both groups whereas plasma GH and insulin levels were greater in OC(+) (p<0.05). Glucose/insulin ratio (G/I), used as an indicator of insulin resistance, suggested a reduced insulin sensitivity at rest in the OC(+) (p<0.05). No significant differences were observed between OC(+) and OC(-) in plasma glucose, insulin, and catecholamine concentrations during exercise. Plasma GH values were greater in OC(+) from the 15th min of the exercise and during the recovery period (p<0.01). CONCLUSIONS: This study indicated that oral glucose ingestion at the onset of prolonged submaximal exercise induced similar glucose tolerance in women taking or not oral contraceptives.

Adult↗
PubMed1991

[Levonorgestrel releasing subcutaneous implants. 1st year's experience].

This multicentric study was done in order to know the contraceptive efficacy and side effects of subdermal implants liberating levonorgestrel, in Mexican women. Results analysis, at one year, of 246 women, at four medical centers of Mexican Institute of Social Security (IMSS), showed that this contraceptive is highly efficacious, as there were no pregnancies in 2326 months of observation. The main side effects were: menstrual disorders in 34.8% of women; soreness in implantation site in 3.6%; headache in 13.4% and nausea, dizziness and vomiting in 11.6%. The most frequent causes for implant retirement were menstrual cycle alterations, and soreness at implantation site, with 7.3 and 3.5 respectively. The continuity rate at one year was 84.3, which was higher to what has been seen at the Institution with other temporal contraceptive methods, so the implants may be considered as one more alternative in family planning methods.

Adult↗
PubMed1987

Young adults' contraceptive practices: an investigation of influences.

This study investigated young adults' contraceptive behaviors and attitudes through application of a comprehensive, theoretical framework. Specifically, a social-psychological approach to understanding preventive behaviors (e.g., contraceptive practices), was developed, incorporating the Health Belief Model and other factors, which offered a means for evaluating the extent to which contraceptive behaviors were influenced by individual and group characteristics. The study group consisted of 283 unmarried students at several schools who were, on average, 19 years of age. Results suggested that effective contraceptive behavior associated most strongly with respondents' perceiving relatively few barriers to their use of contraception, their maintenance of extensive interpersonal skills, and their regarding peer norms as consistent with effective contraceptive behavior. Findings also underlined a need for continuing education about sexuality and contraception. Dangerous misinformation prevailed regarding respondents' knowledge of areas that include anatomy, physiology, and appropriate use of effective contraceptive methods. Finally, results implied a need to consider broad behavioral, social, and interpersonal issues as they relate to young adults' effective contraceptive behavior. Future studies of contraceptive risk taking are encouraged to examine both individual and social factors affecting sexual and contraceptive practices if unplanned pregnancy is to be minimized, if not eliminated.

Adolescent↗
PubMed1988

Twenty-eight-day oral contraceptives: physician and user attitudes.

A 28-day regimen of oral contraceptives that uses seven iron tablets (each containing 75 mg of ferrous fumarate) instead of seven sugar placebos was designed to encourage user compliance. To determine professional and user attitudes toward the 28-day regimen, 192 obstetrician-gynecologists and 469 women who used oral contraceptives were surveyed. Over two-thirds of the physicians stated that they approved both the 28-day regimen and the inclusion of the seven iron tablets. Over 80% of the women surveyed expressed approval of a 28-day regimen that included seven iron tablets.

Adult↗
PubMed1993

A multicenter comparative trial of triphasic and monophasic, low-dose combined oral contraceptives.

A comparative multicenter clinical trial of two combined oral contraceptives (OCs) was conducted at clinics located in the Sudan, Sri Lanka, Chile, the Dominican Republic and Ecuador. The trial was designed to determine if there were differences in efficacy, safety and acceptability between a triphasic and a low-dose monophasic OC. This report includes analysis of 1088 women. At each center, subjects were randomly allocated to one of the two OCs. Follow-up visits were scheduled at 1, 4, 8 and 12 months after admission. There were two accidental pregnancies attributed to user failure reported during the study period; one in the triphasic group and one in the monophasic group. Adverse experiences were mainly minor with headaches and dizziness being the most common complaints; frequency of reports was similar in both groups. Cycle control was good in both groups with women in the triphasic group reporting fewer complaints of intermenstrual bleeding. Both OCs were safe and effective.

Adolescent↗
PubMed1997

[Norplant. Experiences at the maternity services of Orangers in Rabat during two years].

Norplant is a pure progestative method which couples efficaciousness, reversibility and a period of prolonged action. We have counted 189 insertions since March 1993, the date of the introduction of this contraceptive method in the center of family planning at the university maternity of Orangers. The analytical study of different parameters collected in admission files and preestablished control allowed to draw the epidemiologic profile of the patients as well as acceptability, the tolerance and the efficiency of this method.

Adult↗
PubMed1995

Multicenter trial of two monophasic oral contraceptives containing 30 mcg ethinylestradiol and either desogestrel or gestodene in Thai women.

The efficacy and acceptability of two third generation oral contraceptives in Thai women were evaluated in a prospective, open, group-comparative, randomized, multicenter trial of women asking for contraception. In six Family Planning Centers and Outpatient Gynaecological Clinics in urban areas in Thailand, 783 healthy women who were at risk for pregnancy and did not have contraindications to oral contraceptive use were randomly allocated to one of the two study groups. An oral contraceptive containing 30 mcg ethinylestradiol and 150 mcg desogestrel was given to 394 women and an oral contraceptive with the same amount of ethinylestradiol and 75 mcg gestodene to 389 women during 6 cycles. Criteria of cycle control, side effects and the presence and severity of acne vulgaris were assessed and blood pressure and body weight measured at pretreatment and after cycles 1, 3 and 6. Furthermore, the efficacy was evaluated after the last cycle. No pregnancies occurred with either of the contraceptives. The incidences of irregular bleeding and minor side effects in both groups were very low and decreased after an initial increase in the first cycle. Acne improved in both groups. Blood pressure and body weight remained unchanged. The two oral contraceptives were found to be effective and acceptable in Thai women. Compared to Caucasian women, the incidences of irregular bleeding and side effects were apparently lower in these Asian women. Furthermore, the effects of both oral contraceptives were comparable.

Adult↗
PubMed1996

The quality of abortion services in Turkey.

The quality of abortion in Turkey's public sector hospitals is investigated using multiple research methods including observations of actual procedures, interviews with medical staff and clients, and an inventory of materials and equipment. The results suggest that women who obtain abortions in public sector hospitals have a higher abortion rate than the general population. They are likely to receive a vacuum aspiration with minimal pain control medication. Clinical infection control procedures are insufficient, as are interpersonal communication practices including counseling on reproductive health issues and providing factual information. Links with family planning services are strong and the majority of abortion patients who desire family planning receive a contraceptive method, either through direct provision of postabortion contraceptives or referral.

Abortion, Induced↗