Sexual experience, contraceptive usage, and source of contraception among never-married women: Albany (NY) Health Region.
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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.
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.
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.
In general, findings in studies on oral contraceptives (OCs) and breast cancer have not indicated prognosis to be worse among users of OCs. In few studies, however, has age at the start of OC usage been considered as a prognostic factor. In the present study, prognosis in breast cancer is compared with OC usage, particularly with age at the start of OC usage, among 193 consecutive patients at the Department of Oncology, University Hospital, Lund. An earlier series of 193 breast cancer patients at Malmö General Hospital is included for comparisons. In the Lund series, five-year survival was 62% among women who started to use OCs before the age of 20.78% among those who started to use OCs between the ages of 20 and 25, and 86% among non-users and those who started to use OCs after the age of 25 (p = 0.009, test for homogeneity). Although age was found to be a prognostic factor in the Lund series (RR = 0.90, p = 0.001), this was not so in the earlier (older) Malmö series. The relationship with age differed significantly between the two series (p = 0.003), suggesting the apparent effect of age at diagnosis to be a cohort effect due to the introduction of OCs during the 'sixties. The age-specific relationship between survival and OC usage would seem to indicate the presence of a biological mechanism in which OCs may participate during precancerous and early stages of breast cancer.
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Zinc and copper concentration in serum and hair were determined in 12 women before the initiation of oral contraceptive therapy and after a period of 3 months and 6 months. A significant elevation in serum copper occured after the usage of oral contraceptive for 3 months. The taking of oral contraceptive agent (OCA) for a subsequent 3 month period caused no further significant increase in serum copper concentration. No significant effect of OCA on serum zinc and on hair concentration of these trace elements was noted. Further study is indicated to establish the significance of these on overall metabolism and on clinical consequences.
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Adoption of family planning practices involves two decisions--acceptance or rejection of, firstly, the concept of voluntary fertility control, and secondly, of the use of contraceptives. Modern contraceptives are a medical innovation. The diffusion process is influenced by social, economic and political factors in the country.
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This report describes a pilot study conducted to determine the attitudes of men toward contraception. A questionnaire elicited responses from 436 males regarding: Personal data; contraceptive responsibility; contraceptive knowledge; use of contraception and preference for future methods. Results include attitudes toward contraceptive responsibility, assistance to pregnant partners and knowledge regarding eight common contraceptives. Usage of contraceptives in general and condoms and withdrawal specifically is reported. Preference for eight common contraceptive methods is also presented, along with data on delay of intercourse due to lack of contraceptives, partners' requests for male use of condoms/withdrawal and attitudes toward dissemination of contraceptive material to the public. Also reported are attitudes toward development of new contraceptives, use of male sterility shots or pills and the prices that men would pay for newly developed male contraceptives. The most preferred male contraceptive for future development is reported. It was concluded that the survey form and methodology were valid; that men desired to participate in family regulation; that the majority of men placed a low economic value on male contraceptives and finally that the overwhelming majority of men wanted contraceptive information to be widely disseminated in the public.
Users of the six major methods of contraception are compared across a broad range of variables using data from a community sample. Differences between the groups were apparent for a range of socioeconomic and reproductive variables, and current users of the various methods also differed in their past use of contraception. Users of barrier methods fared particularly well. Few differences were observed for current health status or for the sociocultural variables examined, although users of natural methods differed from all others in their religious affiliation and commitment. Discriminant analysis showed that the most predictive variables distinguishing women who had opted for permanent methods of contraception (female sterilization and vasectomy) were the woman's stated reason for using her current method and her past contraceptive patterns; the inclusion of social, health and reproductive indicators did little to improve the prediction. It is argued that heightened expectations for contraceptive efficacy in the face of increasing concerns about long-term health consequences have contributed to the increased use of permanent methods.
To investigate the merits of using psychometric testing as a predictive adjunct to counseling patients in the choice of a contraceptive method, 134 family-planning patients using an oral contraceptive for one year or longer completed the Neuroticism Scale Questionnaire. Clinic records of these patients were examined to determine consistency of contraceptive usage. Patients who were inconsistent in contraceptive usage scored significantly higher on the anxiety and emotional immaturity for inconsistent users. Results of this study provided support for the findings of two similar studies but failed to provide support for others. However, the over-all predictive ability of the questionnaire scores proved to be low. Further study is recommended.
With the objective of identifying whether hypospadias in infants is associated with maternal use of oral contraceptives before pregnancy or in early pregnancy, 846 case-control pairs were collected from eight different malformation monitoring programs around the world and mothers were interviewed using structured questionnaires administered after the birth of the infants. There was no difference in the preconceptional use of oral contraceptives between cases and controls, neither with respect to the number of years of oral contraceptive usage nor the time between stopping oral contraceptives and the present pregnancy. To this material was added data on oral contraceptive usage in early pregnancy from two other sources: an ongoing case-control study in Spain (725 infants with hypospadias) and a population-based study in Sweden (631 infants with hypospadias). There was no statistically significant difference in oral contraceptive exposure in early pregnancy between cases and controls. There is no demonstrable association between oral contraceptive use and infant hypospadias.
This study examined the relationship of conservatism to reports of contraceptive usage, reasons for nonusage of a particular birth control method, and knowledge of birth control information. The never married high conservative subjects who were sexually experienced revealed that they had (a) a lower frequency of usage as well as a lower variety of contraceptive methods; (b) endorsed the beliefs that it was morally wrong and that it was unnatural to use a given birth control method significantly more often as reasons for not using contraceptive techniques; and (c) less knowledge of birth control methods than did low conservative subjects who were sexually experienced. Results were interpreted to support the notion that the fear of loss of control of one's impulses and hence the basis for conservative attitudes are determinants of contraceptive usage.
Histories of the usage of oral contraceptives and other estrogens were obtained from 320 women 20-49 years of age who had pathologically confirmed diagnoses of benign breast disease made at Washington County Hospital in Hagerstown, Maryland, during the period 1968 through 1972. Similar histories were obtained from 320 controls matched for race, sex, age, residence in county, and willingness to participate in a health survey. No association could be found between oral contraceptive usage and benign breast tumor. The use of other estrogens, notably diethylstilbestrol, was significantly related to the presence of benign breast disease.