Sexual experience, contraceptive usage, and source of contraception among never-married women: Albany (NY) Health Region.
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Adolescent↗
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Community-based distribution and contraception usage in Iran.
OBJECTIVE: Despite the availability of free contraception from family planning clinics, the rate of unwanted pregnancy in Iran is still high. The effectiveness of other methods for contraceptive supply should, therefore, be evaluated. The aim of this study was to determine the effects of community-based distribution (CBD) on contraceptive usage in Iran. METHODS: This controlled field trial study involved 297 individuals (100 subjects in the CBD group and 197 subjects in the control group) from four major remote areas of Hamedan, Iran. Stratified random sampling was used. RESULTS: Data analysis suggested that using CBD has four major effects: (1) it increases the level of contraceptive knowledge (p<0.0001), (2) it enhances correct contraceptive choice by couples (p<0.0001), (3) it improves contraceptive usage (p<0.0001) and (4) it improves contraceptive continuation rates (p<0.0001). CONCLUSIONS: CBD facilitates better knowledge, proper choice, and correct and continuous usage of contraception. This method should, therefore, be adopted for family planning services in remote areas of Iran.
Adult↗
Religious affiliation and contraceptive usage: changing American patterns, 1955-82.
This paper presents national estimates of contraceptive usage patterns among white women from 1955-82 for the major religious populations in the United States. Drawing on several surveys, the data show that in 1955 differences in contraceptive use between white Protestants and Catholics were very large and corresponded to the higher fertility levels among Catholics. By 1982, all the major religious groups had experienced downward changes in expected family size and all used effective contraceptive methods, including sterilization, the pill, and the IUD. Despite some convergence in the patterns of contraceptive usage over time, significant differences in contraceptive use styles remain among Catholics, Protestants, Jews, and those of no religious affiliation after multivariate controls eliminated socioeconomic and sociodemographic differences among these subpopulations. The evidence points to the multiple contraceptive paths to similar levels of low fertility. A series of hypotheses are proposed to account for these different contraceptive use styles that relate to religious communities, peer pressure and social norms, differential sex roles, male-female communication patterns, and the differential use of physician-based versus other sources of contraceptives.
Adolescent↗
Histologic changes associated with oral contraceptive usage.
Histologic changes associated with oral contraceptive usage have been described in the cervix, endometrium, myometrium, ovaries, breast, liver and blood vessels. Several types of lesions have been shown to occur frequently in women taking hormonal contraceptives. These include: (1) microglandular hyperplasia of the cervix; (2) endometrial gland regression and stromal decidualization (combination agents); (3) ovarian size reduction associated with cortical fibrosis, suppression of follicle growth and decreased luteinization; and (4) endothelial proliferation and subendothelial fibrosis in blood vessels generally. In addition, cases have begun to be reported in the past few years of adenocarcinoma of the cervix, carcinoma of the endometrium and tumors of the liver. Atypical but benign changes have also been described in myometrium and breast tissue, and neoplastic lesions in animals given hormonal contraceptive agents have been reported in these sites as well as in the ovary. The various types of changes that occur, both benign and malignant, correlate with known actions of the sex steroids.
Blood Vessels↗
Influence of discipline of study on contraceptive usage among undergraduates in Southwest Nigeria.
OBJECTIVE: To determine the influence of discipline of study on contraceptive usage among undergraduates in southwest Nigeria. METHODS: A comparative cross-sectional study of students from medical and nonmedical disciplines was carried out. RESULTS: A total of 387 undergraduates were investigated, out of which 198 (55.8%) were from medical disciplines (MD), and 189 (44.2%) were from nonmedical discipline (NMD). Out of the total number of respondents (387), 229 (59.2%), were sexually active, out of which 26.2% had been sexually active without contraception with a greater proportion of students of NMD being affected (p < 0.05). Students from MD had a better knowledge (71.9%) of contraception than those from NMD (28.1%). However, more students from NMD use contraceptives (62%) compared to those from MD (54%) (p < 0.05). Despite this, more students from NMD became pregnant despite contraceptive use (11%) compared to those from MD (5.1%) (p < 0.05). The condom was the most commonly used contraceptive among both disciplines. The peer group was the commonest source of information on contraception. CONCLUSION: Discipline of study has an important influence on contraceptive usage. This is a pointer to the absolute need for adequate contraceptive education for every student, irrespective of the discipline of study.
Adolescent↗
Down's syndrome and oral contraceptive usage.
We examined the history of oral contraceptive usage in a group of 103 mothers of infants with Down's syndrome and an equal number of matched normal controls. We found no evidence of increased pill use among mothers of the abnormal infants either during the pregnancy or in the year before pregnancy.
Abnormalities, Drug-Induced↗
Contraceptive usage, knowledge and correlates of usage among female emergency department patients.
OBJECTIVES: For female emergency department (ED) patients, we sought to assess the prevalence of contraceptive usage as well as the extent of contraceptive knowledge and to determine if demographic and sexual health history factors, comprehension of contraceptive methods and moral/religious opinions on contraception were associated with current usage of birth control pills (BCPs), prior usage of emergency contraception (EC) and frequency of condom usage. METHODS: English-speaking female ED patients aged between 18 and 55 years at a northeastern United States urban ED were surveyed on their usage, comprehension and opinions regarding BCPs, EC and condoms. RESULTS: Of the 539 respondents (64.6% were aged </=35 years), most were White (63.1%), single (42.5%), Catholic (48.4%) and privately insured (55.3%). Among the 223 women at pregnancy risk [not currently pregnant, not using any form of nonsurgical birth control (except condoms) and with no prior tubal ligation or hysterectomy], about 25% were using BCPs, fewer than 10% had used EC and almost 40% never used condoms. Most women displayed good knowledge about BCPs and condoms but poor understanding about EC. In multivariate logistic regression analyses, current BCP usage among women at risk of pregnancy was associated with younger age [odds ratio (OR)=0.54; 95% confidence interval (CI)=0.37-0.79], private insurance (OR=2.52; 95% CI=1.30-4.86) and recent intercourse (OR=1.61; 95% CI=1.19-2.18). Among women at risk of pregnancy, those who had an abortion (OR=2.56; 95% CI=1.17-5.61) and those who displayed greater EC knowledge (OR=3.23; 95% CI=1.50-6.95) had greater odds of having used EC. Among all women, more frequent condom usage was associated with being younger (OR=0.57; 95% CI=0.46-0.70), having never been married (OR=0.44; 95% CI=0.28-0.68) and not having intercourse recently (OR=0.79; 95% CI=0.64-0.98). CONCLUSIONS: A high percentage of female ED patients (41.4%) were at risk of pregnancy. Demographic and sexual history factors can help identify women who might benefit from receiving referrals or education on contraceptive measures.
Adolescent↗
Absence of correlation between oral contraceptive usage and cardiovascular mortality.
Oral contraceptive (OC) usage and cardiovascular mortality rates for all women (and men) of reproductive age, but specifically for those aged 35-44 years, were examined in the United Kingdom. These data show: OC-usage increased from 14.1 million packs in 1968, to 45.1 million in 1976, decreasing to 37.1 million in 1980. Ischaemic heart disease (IHD) mortality rates for the years 1968-1980 for women of reproductive age of 15-34 years were stable: for those aged 35-44 years the rates fell gradually by 19%. Mortality rates for all types of cerebrovascular disease (CVD) for 1969-1978 remained stable for women of 15-34 years, but for women of 35-44 years rates for subarachnoid haemorrhage and cerebral haemorrhage (the two largest groups) declined by 11% and 34% respectively. The absence of a positive correlation between OC usage and cardiovascular mortality rates is difficult to explain if OCs are the cause of fatalities, as claimed by some epidemiological studies. Possible counteracting variables--such as decreased ascertainment or decreased usage by women of 35-44 years, or decreased relative risk over the time period--which might account for this paradoxical result, were examined but discarded as being unlikely. Evidence from other data--e.g. the similarity of male and female mortality rates for each group, the increased mortality rates for women of 45-54 years (who do not take OCs), and the similarity of mortality rates in women in years when OC-usage was widely different--all suggest that a counteracting variable does not exist. The data on cardiovascular mortality rates in the UK, showing an absence of positive correlation with OC-usage, are thus opposed to the conclusions of epidemiological studies claiming an increased risk of cardiovascular mortality due to OCs, and specifically contradict the claim that such increased risk is found in 35-44 year-old OC-users.
Adolescent↗
Contraceptive usage among abortion seekers in Nigeria.
A study on contraceptive usage among abortion seekers in 150 randomly selected health institutions in the most and the least urbanized states of the health zone B representing the South Western states of Nigeria was conducted over a period of 2 months. There were 1839 abortion seekers during the period. About 30.4% (559) of the respondents admitted to ever used any form of contraceptive methods. Most of the respondents who admitted to ever used any form of contraceptives i.e. 81.2% (454/559) were not using the contraceptive methods regularly and this cut across all the methods. Oral contraceptive pill was the commonest method used, though not on regular basis. The most frequent reason for not ever used contraceptive methods was ignorance. There is a need for intensification of strategies for promotion of use of family planning methods, which can be achieved through good counselling, sexuality education, and availability of cheap, and affordable contraceptive methods and services.
Abortion Applicants↗
Predictors of adolescent female decision making regarding contraceptive usage.
The relationship of cognitive capacity, cognitive egocentrism, and experience factors to decision making in a contraceptive usage problem was examined. Fifty sexually active, unmarried females, ages 14-19, served as subjects. Using correlational, regression, and canonical correlational analyses, cognitive capacity and cognitive egocentrism variables, not experience with contraceptives, were found to be significantly related to, and predictive of, five of seven decision-making variables. Forty-one percent of the variance was accounted for in predicting the canonical decision-making variable. The implications of these results for future research are discussed.
Adolescent↗
Survey of oral contraceptive usage.
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Age Factors↗
Steroid receptor expression in vaginal epithelium of healthy fertile women and influences of hormonal contraceptive usage.
BACKGROUND: The objective of this study was to evaluate whether long-term usage of hormonal contraceptives modifies the steroid receptor expression in the human vaginal epithelium of healthy young women. METHODS: In a cross-sectional study, three groups of hormonal contraceptive users [combined oral contraceptives (COCs), levonorgestrel implants (LNG) and depot medroxyprogesterone acetate injections (DMPAs)] were compared to controls. Fifteen subjects (20-34 years) were enrolled to each group. Vaginal biopsies were collected at two occasions from each subject, and serum concentrations of E(2) and progesterone were measured. Monoclonal antibodies directed against progesterone receptors (PRs) and estrogen receptors (ERs) were used in immunohistochemistry on formalin-fixed tissue sections of vaginal mucosa. A program for immunohistomorphometric quantification was devised to estimate frequency of epithelial steroid receptor-expressing cells. RESULTS: Progesterone receptor expression was markedly down-regulated and significantly reduced in DMPA users compared to controls, COC and LNG users. In DMPA users, the ER expression was significantly elevated in the first compared to the second sample, and significantly elevated compared to LNG users. Estradiol concentration in serum was significantly reduced in hormonal contraceptive users compared to controls. CONCLUSIONS: Steroid receptor expression in human vaginal epithelium is altered by long-term use of DMPA compared to controls.
Adult↗
Emergency hormonal contraception usage in genitourinary medicine clinic attenders.
OBJECTIVE: To assess the indications for usage of emergency hormonal contraception amongst a population of London genitourinary medicine clinic attenders. METHODS: In a prospective study, 150 consecutive women receiving emergency hormonal contraception (EHC) were enrolled. The attending doctor completed a questionnaire of patient details and prescribed EHC with prophylactic prochlorperazine. Follow-up was arranged three weeks later, at which time outcomes and side-effects of therapy were recorded. For those women who did not reattended as planned case notes were reviewed at three months. RESULTS: Of 150 women surveyed, 100 (66%) reported contraceptive method failure, 48 (32%) had used no contraception at the time of last sexual intercourse and two requested EHC after sexual assault. Ninety three (62%) reported condom failure, 7 (5%) oral contraceptive pill failure. Seventy five (50%) had used EHC before (range 1-10 times). Seventy one (47%) women reattended within three months. Five (3.3%) of the 150 women were pregnant; none of these cases had experienced nausea or vomiting whilst taking EHC. Side-effects were reported by 22 (31%) of the 71 patients who reattended. Nine (6%) women had been followed-up in the family planning advisory clinic. Of the 71 women who reattended, 39 (55%) reported that their preferred future method of contraception would be condoms. Of the 150 women 19 (13%) underwent tests for sexually transmissible infections within one month of presentation. CONCLUSIONS: EHC usage in this population was associated with a failure rate of at least 3.3% and an overall side effect rate of 31%. Despite requests for emergency contraception because of condom failure many elected to continue using condoms as their preferred method of contraception. The majority of women (53%) did not return for follow-up or family planning advice, and so we believe that future contraceptive plans must be addressed at the time EHC is prescribed.
Adolescent↗
Apoplectic leiomyomas of the uterus. A clinicopathologic study of five distinctive hemorrhagic leiomyomas associated with oral contraceptive usage.
Five histologically distinctive uterine smooth muscle neoplasms with multifocal hemorrhages termed apoplectic leiomyomas were studied. All patients were found to have been taking a combination-type oral contraceptive hormonal medication containing the progestin norethindrone for 2-4 years. Abdominal pain was the most frequent presenting symptom. The tumors ranged in size from about 1.1 to 4 cm and had multiple gross hemorrhages. Microscopically, they were characterized by stellate zones of recent hemorrhage within nodules of hypercellular smooth muscle. Coagulative necrosis, as seen in "red degeneration," was inconspicuous. Mitotic figures were sparse, not exceeding 2/10 HPF, and were mostly located in the perihemorrhagic areas. Abnormal blood vessels of various sizes were frequent and may have led to the hemorrhages. No recurrences developed up to 12 years after operation. A causal relationship between apoplectic leiomyomas and oral contraceptive usage is strongly suggested. Recognition of their distinctive pathologic features will prevent misdiagnosis as leiomyosarcoma.
Adult↗
In-vivo measurement of spin lattice relaxation time (T1) of liver in healthy volunteers: the effects of age, sex and oral contraceptive usage.
Magnetic resonance imaging of 81 healthy adult volunteers has been undertaken to establish the normal range of liver spin lattice relaxation time (T1) at 0.08 tesla. The influence of age, sex and oral contraceptive usage has been assessed. Liver T1 decreased with age. The mean liver T1 of subjects under 40 years of age was significantly longer than that of older subjects. A wider range of T1 values was observed in the younger age group. No difference in T1 was found between males and females who were not oral contraceptive users. The mean liver T1 of females who were taking the pill was significantly longer than that of females of similar age who were not oral contraceptive users. Serial examinations of eight oral contraceptive users showed that mean liver T1 values were significantly longer in the 3 weeks during which they were taking the pill than during the week off the pill.
Adult↗
Sociological aspects of contraceptive usage.
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Contraception↗
[Principal decisional factors relating to contraceptive usage in adolescents].
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Adolescent↗
[3-phase-usage contraceptives].
The main trends of improving methods of usage of oral steroidal contraceptives are reviewed. The data characterizing the features of the pharmacodynamics of three-phase usage steroidal agents, their side effects are presented.
Contraceptives, Oral↗