Sample records for contraceptive vaginal ring

  1. The contraceptive vaginal ring. (United States)

    Edwardson, Jill; Jamshidi, Roxanne


    The contraceptive vaginal ring offers effective contraception that is self-administered, requires less frequent dosing than many other forms of contraception, and provides low doses of hormones. NuvaRing (Organon, Oss, The Netherlands), the only contraceptive vaginal ring approved for use in the United States, contains etonogestrel and ethinyl estradiol. It is inserted into the vagina for 3 weeks, followed by a 1-week ring-free period, and works by inhibiting ovulation. Most women note a beneficial effect on bleeding profiles and are satisfied with NuvaRing. Commonly reported adverse events include vaginitis, leukorrhea, headaches, and device-related events such as discomfort. Serious adverse events are rare. In Chile and Peru, progesterone-only vaginal contraceptive rings are available for nursing women. Studies are ongoing examining new formulations of vaginal contraceptive rings.

  2. Steroidal contraceptive vaginal rings. (United States)

    Sarkar, N N


    The development of steroid-releasing vaginal rings over the past three decades is reviewed to illustrate the role of this device as an effective hormonal contraceptive for women. Vaginal rings are made of polysiloxane rubber or ethylene-vinyl-acetate copolymer with an outer diameter of 54-60 mm and a cross-sectional diameter of 4-9.5 mm and contain progestogen only or a combination of progestogen and oestrogen. The soft flexible combined ring is inserted in the vagina for three weeks and removed for seven days to allow withdrawal bleeding. Progesterone/progestogen-only rings are kept in for varying periods and replaced without a ring-free period. Rings are in various stages of research and development but a few, such as NuvaRing, have reached the market in some countries. Women find this method easy to use, effective, well tolerated and acceptable with no serious side-effects. Though the contraceptive efficacy of these vaginal rings is high, acceptability is yet to be established.

  3. Contraceptive vaginal rings: a review. (United States)

    Brache, Vivian; Faundes, Anibal


    Development efforts on contraceptive vaginal rings were initiated over 40 years ago based on two principles: the capacity of the vaginal epithelium to absorb steroids and the capacity of elastomers to release these hormones at a nearly constant rate. Numerous models of contraceptive vaginal rings (CVRs) have been studied, but only two have reached the market: NuvaRing, a combined ring that releases etonogestrel (ENG) and ethinylestradiol (EE), and Progering, a progesterone-releasing ring for use in lactating women. The main advantages of CVRs are their effectiveness (similar to or slightly better than the pill), ease of use without the need of remembering a daily routine, user's ability to control initiation and discontinuation, nearly constant release rate allowing for lower doses, greater bioavailability and good cycle control with the combined ring. The main disadvantages are related to the mode of delivery; CVRs may cause vaginal discharge and complaints, ring expulsion is not uncommon, the ring may be felt during coitus and vaginal insertion may be unpleasant for some women. The studies reviewed in this article provide evidence that CVRs are safe, effective and highly acceptable to women. There is no doubt that CVRs offer a new, effective contraceptive option to women, expanding their available choices of hormonal contraception.

  4. Contraceptive vaginal ring (NuvaRing)-a novel, convenient and effective contraceptive option

    Institute of Scientific and Technical Information of China (English)

    Chen Wei-lin; Fan Guang-sheng


    Contraceptive vaginal ring (NuvaRing) is a new combined hormonal contraceptive method.Each ring contains 2.7mg ethinyl estradiol (EE) and 11.7mg etonogestrel.The ring is characteristic with its ease of use,lower EE systemic exposure and excellent cycle control.Studies have demonstrated that the efficacy and safety of the ring are equivalent to combined oral contraceptive (COC).The side effects of the ring are fewer and the biocompatibility is good.Recent studies have proved that the NuvaRing is a new,effective hormonal contraceptive option for women.


    Institute of Scientific and Technical Information of China (English)

    ZHANGHai-Wei; ZHENGHuai-Mei


    A new contraceptive vaginal ring was jointly produced by the Shanghai Medical University and the Shanghai Rubber Products Research Institute. It has an outer silicone elastomer shell and a tilling of 35 mg levonorgestrel gel in inner core. Amount of LNG release is

  6. Acute Mesenteric Venous Thrombosis with a Vaginal Contraceptive Ring

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    Wesley Eilbert


    Full Text Available Mesenteric venous thrombosis is a rare cause of abdominal pain, which if left untreated may result in bowel infarction, peritonitis and death. The majority of patients with this illness have a recognizable, predisposing prothrombotic condition. Oral contraceptives have been identified as a predisposing factor for mesenteric venous thrombosis in reproductive-aged women. In the last fifteen years new methods of hormonal birth control have been introduced, including a transdermal patch and an intravaginal ring. In this report, we describe a case of mesenteric venous thrombosis in a young woman caused by a vaginal contraceptive ring. [West J Emerg Med. 2014;15(4:395-397.

  7. Vaginal contraceptive rings: option for the new millennium. (United States)


    Vaginal contraceptive rings, currently in advanced clinical trials, offer a simple, long-acting, woman-controlled method of fertility control. A ring developed by the Population Council's Center for Biomedical Research, with continual release of 20 mcg of ethinyl estradiol and 1 mg of norethindrone acetate, has been accepted by a commercial partner for further studies leading to market introduction. Another Population Council-developed ring combines an even lower dose of estrogen (15 mcg) with its own patented progestin, NESTORONE. Organon is in phase III trials of a ring combining 15 mcg of ethinyl estradiol and the progestin etonogestrel and expects to complete its research by mid-1999. Of particular interest is the potential for vaginal irritation. The one-size ring is smaller than most diaphragms and does not require fitting. Once a woman has received instructions, she can insert and remove the ring herself. The ring's regimen of 3 weeks of use and 1 week of rest is similar to the schedule for oral contraceptives (OCs), but provides better cycle control than a combined OC that delivers one-third more of the same progestin and estrogen. Finally, a progestin-only vaginal ring for lactating women has been licensed for manufacture and distribution in Latin America.

  8. Association of vaginal dysbiosis and biofilm with contraceptive vaginal ring biomass in African women. (United States)

    Hardy, Liselotte; Jespers, Vicky; De Baetselier, Irith; Buyze, Jozefien; Mwambarangwe, Lambert; Musengamana, Viateur; van de Wijgert, Janneke; Crucitti, Tania


    We investigated the presence, density and bacterial composition of contraceptive vaginal ring biomass and its association with the vaginal microbiome. Of 415 rings worn by 120 Rwandese women for three weeks, the biomass density was assessed with crystal violet and the bacterial composition of biomass eluates was assessed with quantitative polymerase chain reaction (qPCR). The biomass was visualised after fluorescence in situ hybridisation (FISH) and with scanning electron microscopy (SEM). The vaginal microbiome was assessed with Nugent scoring and vaginal biofilm was visualised after FISH. All vaginal rings were covered with biomass (mean optical density (OD) of 3.36; standard deviation (SD) 0.64). Lactobacilli were present on 93% of the rings, Gardnerella vaginalis on 57%, and Atopobium vaginae on 37%. The ring biomass density was associated with the concentration of A. vaginae (OD +0.03; 95% confidence interval (CI) 0.01-0.05 for one log increase; p = 0.002) and of G. vaginalis (OD +0.03; (95% CI 0.01-0.05; p = 0.013). The density also correlated with Nugent score: rings worn by women with a BV Nugent score (mean OD +0.26), and intermediate score (mean OD +0.09) had a denser biomass compared to rings worn by participants with a normal score (p = 0.002). Furthermore, presence of vaginal biofilm containing G. vaginalis (p = 0.001) and A. vaginae (p = 0.005) correlated with a denser ring biomass (mean OD +0.24 and +0.22 respectively). With SEM we observed either a loose network of elongated bacteria or a dense biofilm. We found a correlation between vaginal dysbiosis and the density and composition of the ring biomass, and further research is needed to determine if these relationships are causal. As multipurpose vaginal rings to prevent pregnancy, HIV, and other sexually transmitted diseases are being developed, the potential impact of ring biomass on the vaginal microbiota and the release of active pharmaceutical ingredients should be researched in depth.

  9. Weight gain, body image and sexual function in young patients treated with contraceptive vaginal ring. A prospective pilot study. (United States)

    Morotti, Elena; Casadio, Paolo; Guasina, Francesca; Battaglia, Bruno; Mattioli, Mara; Battaglia, Cesare


    Oral contraceptives could induce mood changes. As far as our knowledge, there are no studies in literature that have examined the role of vaginal contraception in self-perceived body image. To evaluate the effects of intravaginal contraception on weight gain and perceived body image in relation with the Beck's Depression Inventory questionnaire (BDI) and the McCoy Female Sexuality Questionnaire (MFSQ). Twenty-one adult (18-35 years old) eumenorrheic (menstrual cycle of 25-35 days), lean (body mass index - BMI - of 19-25 kg/m(2)) women who were referred for hormonal contraception were administered the Stunkard Figure Rating Scale (FRS), BDI and MFSQ. Subjects were studied in basal condition and after 6 months of therapy with vaginal contraception (NuvaRing®; Organon-Schering-Plough Italia, Milan, Italy). BMI, FRS, MFSQ and BDI. After 6 months of therapy with NuvaRing®, both body weight (60.0 ± 8.3; p = 0.050) and BMI (22.1 ± 3.1; p = 0.028) slightly, but statistically, increased. FRS and BDI showed no differences after the vaginal contraception. Hormonal contraception was associated with a significant decrease in the two-factor Italian MFSQ score. Vaginal ring seems a good alternative to other hormonal contraceptive not significantly altering the female sexuality and not influencing the FRS and BDI.


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    Full Text Available OBJECTIVES: To study the efficacy , and acceptability and reasons for discontinuity of CCVRs in Indian women along with cycle control , safety aspects , local and systemic adverse effects , chances of spontaneous expulsion and partner compliance . METHODS: This interventional longitudinal study included 45 married women aged between 18 - 45 years seeking reversible means of contraception but wi th no history of usage of any form of hormonal contraceptives in the previous 6 months . The outcome variables were measured in terms of contraceptive efficacy , cycle regularity , systemic effects on blood pressure , liver function , body weight , lipid paramet ers and blood sugar along with local effect on cervix and vagina . Patient compliance , acceptability and spouse compliance was also measured by questionnaires . RESULTS: In this study there were no unwanted pregnanc ies in women amongst 117 exposed cycles . T he incidence of intended bleeding pattern was 95% , the effect of CCVR on liver function , blood pressure , etc . w as not clinically relevant . I t was not associated with an increased risk of cervical or vaginal abnormalities , 9 6 % women were satisfied with the ring usage and 9 7 % would recommend it to others , 70 % of women and 82 % of their partners never/ rarely felt the ring during intercourse . CONCLUSION: From the present study , it can be concluded that CCVR is an effective contraceptive with good cycle control , minimal systemic or local adverse effects along with low incidence of spontaneous expulsion and higher level of user and partner acceptability .

  11. 复方阴道避孕环NuvaRing:一种新型的方便有效的避孕选择%Contraceptive vaginal ring(NuvaRing): a novel,convenient and effective contraceptive option

    Institute of Scientific and Technical Information of China (English)

    陈蔚琳; 范光升


    Contraceptive vaginal ring (NuvaRing) is a new contraceptive method. The ring is used every month. Studies have demonstrated that the efficacy and safety of the ring are equivalent to oral contraceptives (OCs). Patients reported being highly satisfied with the vaginal ring and reported fewer systemic side effects than using OC users. NuvaRing offers a new, effective hormonal contraceptive option for women.%复方阴道避孕环NuvaRing是一种新型的避孕药物,每月阴道用药一次,使用方便,避孕效果及安全性与口服避孕药相当,而且可以提供更好的周期控制,生物利用率高,全身副作用低,耐受性好,是一种安全有效的避孕选择.

  12. Effects of a One Year Reusable Contraceptive Vaginal Ring on Vaginal Microflora and the Risk of Vaginal Infection: An Open-Label Prospective Evaluation.

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    Yongmei Huang

    Full Text Available A contraceptive vaginal ring (CVR containing Nestorone® (NES and ethinyl estradiol (EE that is reusable for 1- year (13 cycles is under development. This study assessed effects of this investigational CVR on the incidence of vaginal infections and change in vaginal microflora.There were 120 women enrolled into a NES/EE CVR Phase III trial and a microbiology sub-study for up to 1- year of cyclic product use. Gynecological examinations were conducted at baseline, the first week of cycle 6 and last week of cycle 13 (or during early discontinuation visits. Vaginal swabs were obtained for wet mount microscopy, Gram stain and culture. The CVR was removed from the vagina at the last study visit and cultured. Semi-quantitative cultures for Lactobacillus, Gardnerella vaginalis, Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, anaerobic gram negative rods (GNRs, Candida albicans and other yeasts were performed on vaginal and CVR samples. Vaginal infections were documented throughout the study.Over 1- year of use, 3.3% of subjects were clinically diagnosed with bacterial vaginosis, 15.0% with vulvovaginal candidiasis, and 0.8% with trichomoniasis. The detection rate of these three infections did not change significantly from baseline to either Cycle 6 or 13. Nugent scores remained stable. H2O2-positive Lactobacillus dominated vaginal flora with a non-significant prevalence increase from 76.7% at baseline to 82.7% at cycle 6 and 90.2% at cycle 13, and a median concentration of 107 colony forming units (cfu per gram. Although anaerobic GNRs prevalence increased significantly, the median concentration decreased slightly (104 to 103cfu per gram. There were no significant changes in frequency or concentrations of other pathogens. High levels of agreement between vaginal and ring surface microbiota were observed.Sustained use of the NES/EE CVR did not increase the risk of vaginal infection and was not disruptive to the vaginal ecosystem

  13. The combined contraceptive vaginal ring (NuvaRing) and endometrial histology.

    NARCIS (Netherlands)

    Bulten, J.; Grefte, J.M.M.; Siebers, A.G.; Dieben, T.


    We investigated the effects of NuvaRing on endometrial histology in a 2-year open-label, multicenter trial in 103 premenopausal women aged 18-35 years. Subjects received 26 cycles of treatment, each comprising 3 weeks of ring use followed by a 1-week ring-free period. Endometrial biopsies were taken

  14. A Comparative Study on the Contraception Efficacy and Safety of the Progesterone Releasing Contraceptive Vaginal Ring and the Copper T 380A IUD Inserted during the Lactation Period

    Institute of Scientific and Technical Information of China (English)

    杜明昆; 郑怀美; 郑苏华; 陈帼君


    A comparative study was made on the contraception efficacy and safety of the vaginal ring releasing 10 mg/day of progesterone in 160 cases and an intrauterine device, the copper T 380A in 100 cases during lactation. It was found that the contraceptive method is acceptable from 42 to 60 days postpartum. No pregnancy occurred in the copper T 380A IUD users during lactation. Those methods are worth to be recommended because of their contraceptive efficacy and no adverse effects on breast feeding children. Prenatal care and Family Planning Programe are administered together to raise lactation performance rate, and to decrease induced abortion rate, the health of mothers and children were protected.

  15. Nonbarrier contraceptives and vaginitis and vaginosis. (United States)

    Roy, S


    Within the limitations of the available data, it has been reported that oral contraceptive use versus other contraceptive methods is associated with a greater or similar frequency of candidiasis, increased numbers of anaerobic microorganisms, an increased or similar frequency of chlamydia trachomatis, and a reduced frequency of bacterial vaginosis and trichomoniasis. The impact of contraceptive steroids on cellular and humoral immunologic factors may explain these observations. Intrauterine contraceptive device use is reported to be associated with an increased rate of bacterial vaginosis and anaerobic organism recovery from the vagina regardless of symptoms. Patients having a contraceptive vaginal ring were found to have the same number and types of vaginal organisms as oral contraceptive users. Levonorgestrel-releasing subdermal implant (Norplant, Wyeth-Ayerst, Philadelphia, Pa.) users have been reported to have approximately half the rate of vaginitis and vaginosis compared with that of Copper T-200 intrauterine device users.

  16. Vaginal contraceptives still evolving. (United States)

    Pearson, R M


    The effort to develop vaginal contraceptives began in the distant past and is still underway today. 1000 years ago, South American Indians inserted into the vagina bark strips impregnated with quinine. In medieval times women used vaginal inserts of cloth soaked in honey or vinegar. Quinine pessaries were introduced into Europe in the late 1800s, and in the early 1900s investigators began to study the effects of various chemicals on sperm motility. Following World War II, surfactant spermicides which disrupt the sperm membrane were developed and marketed. Many of these preparations contained nonoxynol-9. Currently, the D-isomer of propranolol is being examined as a spermicidal contraceptive, and several bacteriocides, e.g., benzalkonium and chlorhexidine, are being developed as spermicides which reduce the penetrability of cervical mucus. Other chemicals being investigated act by inhibiting the acrosome reaction. Advantages of vaginal contraceptives are that they are inexpensive, reversible, and relatively safe and easy to use. Generally they require no medical intervention or supervision. In addition, spermicides may kill or inhibit the growth of organisms responsible for sexually transmitted diseases. Disadvantages of spermicides are that they are generally less effective than many other methods, some interfere with sexual spontaneity, they may cause local irritations, and some women find them messy to use. Recently, concerns were expressed about the possible teratogenic effects of sperimicides. Most of these concerns proved to be unfounded. Given the many new avenues of research, the major disadvantage of sperimicides, i.e., their high failure rates, may be minimized in the near future.

  17. The vaginal contraceptive sponge. (United States)

    Edelman, D A


    The vaginal contraceptive sponge, approved on April 1, 1983 by the US Food Administration (FDA) for sale in the US as a single use, disposable, over-the-counter contraceptive, is made of polyurethane and designed to be biocompatible with the vaginal environment. The sponge is available in a single size, is round, and about 5.5 cm in diameter and 2.5 cm thick. An indentation on 1 side helps to ensure the sponge's correct placement against the cervix. A polyester retrieval loop attached to the sponge facilitates removal. Postcoital tests of the sponge without the spermicide indicated that it was ineffective in preventing sperm from entering the cervical canal. Before insertion, the contraceptive sponge is moistened with tap water to activate the spermicide and is inserted into the vagina with the indentation placed against the cervis. The sponge has been designed to provide continuous protection against pregnancy for at least 24 hours after insertion. Following a successful phase ii clinical trail of the sponge, in 1979 comparative phase iii clinical trials were initiated by Family Health International. The following trials were conducted: sponge versus the diaphragm (arcing-spring) used with a spermicide (nonoxynol-9) at 13 clinics in the US (1439 subjects) and at 2 clinics in Canada and the UK (502 subjects); sponge versus a foaming spermicidal (menfegol) suppository at 5 clinics in Yugoslavia, Taiwan, and Bangladesh (1386) subjects); and sponge versus spermicidal (nonoxynol-9) foam at 2 clinics in Israel and Thailand (366 subjects). In all trials the contraceptive methods were raondomly assigned. Clinics were required to follow up subjects for 1 year. Only the US study has been completed. In the comparative trials of the sponge and diaphragm (both US based and overseas) the pregnancy rates were significantly higher for the sponge. In the comparative trials of the sponge and foaming suppositories or spermicidal foam there were no significant differences between the

  18. Changes of vaginal microenvironment in 20 women after NuvaRing contraceptive ring placement%20例阴道内放置 NuvaRing 避孕环后微环境的改变

    Institute of Scientific and Technical Information of China (English)

    杨淑娟; 苏士利; 董白桦


    Objective To study the changes of vaginal microenvironment after NuvaRing contraceptive ring placement. Methods For 20 women who received vaginal contraceptive ring placement,vaginal discharge of different cycles were examined with five joint inspections of vaginitis and microscopy.Concentrations of IL-2 and IL-8 in vaginal lavage of all subjects were determined with radioimmunoassay (RIA).Results After the ring was placed for a cycle,the con-centrations of IL-2 and IL-8 were risen (P 0.05).Five joint inspections of vaginitis and microscopy showed that pH value,quantification of leukocytes,lactobacilli,bacterial vaginosis (BV),vulvovaginal candidiasis (VVC),and trichomonal vaginitis (TV)of vaginal discharge had no significant difference compared with the indexes before the ring was placed.Conclusion Vaginal contraceptive ring increases the concentrations of IL-2 and IL-8 ini-tially,which will return normal after vagina adaptes to the ring.Vaginal ring has no obvious effects on vaginal acid cir-cumstances and couldnt lead to the growth of other bacteria.%目的:探讨20例阴道内放置 NuvaRing 避孕环后微环境的变化。方法对20例使用过避孕环的妇女(自身对照),利用阴道炎五联检法和显微镜观察法处理带环前后不同周期的阴道分泌物,并用放射免疫法检测阴道灌洗液中炎性因子 IL-2和 IL-8在带环前后不同浓度的变化。结果与放置阴道避孕环前比较,炎性因子 IL-2和IL-8带环1个周期后浓度呈上升趋势(P <0.05);带环3、6个周期后 IL-2、IL-8浓度逐渐下降并趋于正常(P >0.05)。经阴道五联检及显微镜下检测,阴道分泌物的 pH 值、白细胞、乳酸杆菌、细菌性阴道病(BV)、霉菌性阴道炎(VVC)、滴虫性阴道炎(TV)各项与带环前无明显变化。结论阴道放置避孕环后对炎性因子 IL-2、IL-8初期有所影响,但随着阴道对环的适应及机体自身的调节会使 IL-2

  19. Enhancing contraceptive choice for postpartum women in sub-Saharan Africa with the progesterone vaginal ring: a review of the evidence

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    RamaRao S


    Full Text Available Saumya RamaRao,1 Salisu Ishaku,2 Wilson Liambila,3 Babacar Mane41Population Council, Reproductive Health Program, New York, NY, USA; 2Population Council, Reproductive Health Program, Abuja, Nigeria; 3Population Council, Reproductive Health Program, Nairobi, Kenya; 4Population Council, Reproductive Health Program, Dakar, SenegalAbstract: It is increasingly recognized that women who have just given birth have a high unmet need and require contraceptive protection in the first year postpartum. A majority of women in developing countries do breastfeed exclusively but for short durations, hence they may be sometimes unknowingly exposed to the risk of pregnancy if they are relying on nursing for contraceptive protection. The WHO’s Medical Eligibility Criteria for Contraceptive Use recommends the use of different contraceptives in the first year postpartum depending on whether the woman is nursing or not and the time since delivery. Some of the options available for breastfeeding women include implants, IUDs and injectables, which can be obtained only from a trained family planning provider. Since 2013, Population Council has been carrying out a study in Senegal, Nigeria, and Kenya to assess the acceptability of progesterone vaginal ring (PVR as a new contraceptive option designed specifically for use by breastfeeding women to extend the period of lactational amenorrhea and promote birth spacing. Breastfeeding in sub-Saharan Africa is near universal with fairly long durations, a situation that increases the effectiveness of PVR. Each ring delivers a daily dose of 10 mg of progesterone and can be used continuously up to 3 months with a woman being able to continue with its use up to 1 year (four rings used consecutively. Preliminary results indicate that many women who had used the method found it acceptable and their partners supported its use. Activities aimed at having PVR registered and made available in focal countries are ongoing. Integration of

  20. Counseling on vaginal delivery of contraceptive hormones: implications for women's body knowledge and sexual health. (United States)

    Nappi, Rossella E


    Healthcare providers (HCPs) have an important role in helping women select the contraceptive method that best matches their needs and lifestyle. Recent surveys outline the need of women to be informed about all available choices, including the newest methods (particularly those not requiring daily administration), such as vaginal contraception. The most relevant publications on combined contraceptive vaginal ring are revised in the context of counseling as an opportunity to empower women in term of vaginal health and sexual functioning. HCPs should explain the main characteristics of the combined contraceptive vaginal ring including the anatomical and physiological implications that make the vagina an ideal route of hormonal administration and the basic notions about functional modifications of the vagina during reproductive life. Clinical data on the vaginal ring should be summarized with regard to efficacy, tolerability, pharmacokinetics, cycle control and user acceptability, including recent findings on extra-contraceptive benefits (also compared to other hormonal contraceptives) on the vaginal flora and on sexual function. Vaginal contraception offers various benefits and should always be discussed during contraceptive counseling. An open dialogue about vaginal contraception will also help enhance body knowledge and sexual health.

  1. [Morrhuic acid vaginal contraceptive suppository]. (United States)

    Xie, W Y


    Sodium morrhuate started to be used as spermicide in 1982. A follow-up study was conducted in China in 1984 to investigate its effectiveness. Several different tests was conducted using sodium morrhuate solutions of 0.5, 0.25 and 0.123 concentration on semen samples. Ames tests, born marrow chromosome tests, deformation tests, and local toxicological tests were conducted on rats, and rabbits. In addition a post coital and a two-stage clinical study were conducted on humans. 34 women was recruited for the first stage of the study in November 1984; 1746 women aged 20-40, including 1581 parous and 165 newly-married women, were recruited from the second stage clinical study. Semen tests found that a solution of 0.25% concentration could immobilize sperm instantaneously. No deformation or toxic effect was found, and no abnormality was found in post coital tests. The sperm immobilization was statistically significant between the cases and the placebo group, and sperm immobilization was most effective with 20 mg/pill concentration in post-coital tests. Among those who participated in the clinical study, 16073 months of use were observed. The 12 months cumulative method failure rate calculated using the life table method was 4.8% and the use failure rate was 10.1%. The discontinuation rate was 27.3%. The major cause of failure was inconsistent and incorrect use of method. The effectiveness of sodium morrhuate as a spermicide was not significantly different from Neo Sampoon, but it has a higher effectiveness than the contraceptive sponge or the stainless steel single ring which is commonly used in China. Gynecological examination was conducted every 6 months for 2 years on the women who participated in the study. No negative reaction was found in the examinations. It is recommended that this method be used by women of all ages, especially breast-feeding women who can not use other methods of contraception.

  2. The Effectiveness of Vaginal Contraceptive Sponge

    Institute of Scientific and Technical Information of China (English)

    金毓翠; 丁家佩; 董吟秋; 董炳麟; 许雪芬


    The vaginal contraceptive sponge is made of polyurethane containing 1 g of nonoxynot-9, The gross cumulative twelve month life table pregnancy rate of 352 cases using vaginal contraceptive sponge was 5.7/ 100 women and the method pregnancy rate was 2. 3/ 100 women. The gross cumulative continuation rate per 100 women was 74. Only 2 patients (1,0/ 100 women) suffering from vaginitis and itching of vulva no longer wished to continue in the stud). Over the course of the study no significant changes were observed in any of the laboratory parameters such as vagina & cervix smear etc. that had been monitored. This modality associated with few side effects and its effectiveness rate and also indicated a protection from the risk of acquring of sex-transmitted diseases.

  3. Comparison of the impact of vaginal and oral administration of combined hormonal contraceptives on hepatic proteins sensitive to estrogen

    NARCIS (Netherlands)

    Sitruk-Ware, R.L.; Menard, J.; Rad, M.; Burggraaf, J.; Kam,; Tokay, B.A.; Sivin, I.; Kluft, C.


    Objective: We evaluated the effects of a new combined hormonal contraceptive vaginal ring (CVR) delivering the nonandrogenic progestin Nestorone® (NES) and ethinyl estradiol (EE) on several key estrogen-sensitive hepatic proteins that may be markers for the risk of arterial or venous disease events

  4. Comparison of the impact of vaginal and oral administration of combined hormonal contraceptives on hepatic proteins sensitive to estrogen

    NARCIS (Netherlands)

    Sitruk-Ware, R.L.; Menard, J.; Rad, M.; Burggraaf, J.; Kam,; Tokay, B.A.; Sivin, I.; Kluft, C.


    Objective: We evaluated the effects of a new combined hormonal contraceptive vaginal ring (CVR) delivering the nonandrogenic progestin Nestorone® (NES) and ethinyl estradiol (EE) on several key estrogen-sensitive hepatic proteins that may be markers for the risk of arterial or venous disease events

  5. Effects of oral contraceptives in vaginal cytology. (United States)

    Montes, M B; Ferreira, A C; Fenólio, J C; Franceschini, S A; Toloi, M R


    Many literature studies have shown that long-term use of oral contraceptives (OC) is associated with lack of protection of the epithelium of the uterine cervix. Forty-five patients, from 18 to 35 years old, users of two contraceptive formulations, of different estrogenic concentration, took part in this study as volunteers to evaluate the predisposition of the cervix to pathologies. The results found before OC use were 11% of Chlamydia trachomatis infection and 13% of HPV infection. These pathologies were correctly treated and after 5 months of OC use we found total remission of Chlamydia trachomatis infection and 4% of persistent HPV infection. These data lead us to conclude that the OC studied here interfered very little with the presented pathologic results. The risk factors that we considered relevant were: 1) age group (the patients that presented HPV and C. trachomatis infections were young university students); 2) lifestyle (most patients certified that they did not combine the use of barrier contraceptives with the use of OC); 3) multiple sexual partners; 4) low socioeconomic condition.

  6. Efficacy, safety, and patient acceptability of the etonogestrel and ethinyl estradiol vaginal ring

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    Lete I


    Full Text Available Iñaki Lete, Maialen Pérez de Arrilucea, María Rodríguez, Eskerne BelloDepartment of Gynecology, University Hospital Araba, Vitoria, Spain Abstract: The contraceptive vaginal ring (CVR is a combined hormonal contraceptive method, containing ethinyl estradiol and etonogestrel, that works by inhibiting ovulation. It differs from combined oral contraceptives (COCs in the route of administration, which is vaginal, and the frequency of administration, which is monthly. The efficacy of the CVR is similar to that of COCs but compliance appears to be better in typical users. The CVR enables appropriate control of the menstrual cycle, with a similar side effect profile to COCs, while achieving good user acceptance. Different studies have established noncontraceptive beneficial effects of the CVR; for example, it can be useful for treating dysmenorrhea or excess menstrual bleeding. Recent epidemiological studies have confirmed that the risk of venous thromboembolism with the CVR is similar to that of COCs, including COCs that contain levonorgestrel. Keywords: contraceptive vaginal ring, efficacy, cycle control, acceptability, safety

  7. Aetiology & risk factors of recurrent vaginitis & its association with various contraceptive methods. (United States)

    Thulkar, Jyoti; Kriplani, Alka; Agarwal, Nutan; Vishnubhatla, Sreenivas


    Women who do not seek treatment for recurrent vaginitis have risk to acquire other sexually transmitted infections. Besides proper antibiotic treatment, male condom acts as a barrier to various infections. Present study was done to assess type of vaginitis, its association with various contraceptive methods and need of male condom in prevention of recurrent vaginitis. Prospective hospital based cohort study with a total of 400 women with recurrent vaginitis was done. Wet mount and Gram's staining examination were done to diagnose type of vaginitis. After treatment, proper counselling about good hygiene and use of male condom for 4 months in addition to their contraceptive method was advised. Patients were called after four months or when they developed symptoms of vaginitis. Tubal ligation (38.8%) and non contraceptives (34.0%) were the most common methods used by recurrent vaginitis patients. Bacterial vaginosis (BV, 53.8%) and mixed infection (36.8%) were commonly seen infections. BV was not observed in OC pill users. Overall post-treatment cure was 89.1 per cent. INTERPRETATION CONCLUSIONS: Our findings showed that male condom use provided protection against recurrent vaginitis and its use should be promoted with other contraceptive methods in high risk cases. Female condom may be another option.

  8. Matrix and reservoir-type multipurpose vaginal rings for controlled release of dapivirine and levonorgestrel. (United States)

    Boyd, Peter; Fetherston, Susan M; McCoy, Clare F; Major, Ian; Murphy, Diarmaid J; Kumar, Sandeep; Holt, Jonathon; Brimer, Andrew; Blanda, Wendy; Devlin, Brid; Malcolm, R Karl


    A matrix-type silicone elastomer vaginal ring providing 28-day continuous release of dapivirine (DPV) - a lead candidate human immunodeficiency virus type 1 (HIV-1) microbicide compound - has recently demonstrated moderate levels of protection in two Phase III clinical studies. Here, next-generation matrix and reservoir-type silicone elastomer vaginal rings are reported for the first time offering simultaneous and continuous in vitro release of DPV and the contraceptive progestin levonorgestrel (LNG) over a period of between 60 and 180days. For matrix-type vaginal rings comprising initial drug loadings of 100, 150 or 200mg DPV and 0, 16 or 32mg LNG, Day 1 daily DPV release values were between 4132 and 6113μg while Day 60 values ranged from 284 to 454μg. Daily LNG release ranged from 129 to 684μg on Day 1 and 2-91μg on Day 60. Core-type rings comprising one or two drug-loaded cores provided extended duration of in vitro release out to 180days, and maintained daily drug release rates within much narrower windows (either 75-131μg/day or 37-66μg/day for DPV, and either 96-150μg/day or 37-57μg/day for LNG, depending on core ring configuration and ignoring initial lag release effect for LNG) compared with matrix-type rings. The data support the continued development of these devices as multi-purpose prevention technologies (MPTs) for HIV prevention and long-acting contraception. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Multicenter comparison of the contraceptive ring and patch: a randomized controlled trial

    National Research Council Canada - National Science Library

    Creinin, Mitchell D; Meyn, Leslie A; Borgatta, Lynn; Barnhart, Kurt; Jensen, Jeff; Burke, Anne E; Westhoff, Carolyn; Gilliam, Melissa; Dutton, Caryn; Ballagh, Susan A


    To understand if the contraceptive ring or patch was more acceptable, as measured primarily by continuation, to women using an oral contraceptive and interested in a nondaily, combined hormonal contraceptive...

  10. Controlling levonorgestrel binding and release in a multi-purpose prevention technology vaginal ring device. (United States)

    Murphy, Diarmaid J; Boyd, Peter; McCoy, Clare F; Kumar, Sandeep; Holt, Jonathon D S; Blanda, Wendy; Brimer, Andrew N; Malcolm, R Karl


    Despite a long history of incorporating steroids into silicone elastomers for drug delivery applications, little is presently known about the propensity for irreversible drug binding in these systems. In this study, the ability of the contraceptive progestin levonorgestrel to bind chemically with hydrosilane groups in addition-cure silicone elastomers has been thoroughly investigated. Cure time, cure temperature, levonorgestrel particle size, initial levonorgestrel loading and silicone elastomer type were demonstrated to be key parameters impacting the extent of levonorgestrel binding, each through their influence on the solubility of levonorgestrel in the silicone elastomer. Understanding and overcoming this levonorgestrel binding phenomenon is critical for the ongoing development of a number of drug delivery products, including a multi-purpose technology vaginal ring device offering simultaneous release of levonorgestrel and dapivirine - a lead candidate antiretroviral microbicide - for combination HIV prevention and hormonal contraception.

  11. Unscheduled vaginal bleeding with progestin-only contraceptive use. (United States)

    Zigler, Rachel E; McNicholas, Colleen


    Nearly 20% of women using contraception are using progestin-only contraception, including progestin-only pills, depot-medroxyprogesterone acetate, subdermal etonogestrel implants, and levonorgestrel intrauterine devices. This number will continue to grow with the increased provision of long-acting reversible contraception. Although overall satisfaction among women using progestin-only contraception is high, dissatisfaction and discontinuation may be associated with unscheduled bleeding and spotting. The exact etiology of irregular bleeding associated with progestin-containing contraceptives is not completely understood, yet several mechanisms have been suggested. Several therapies targeting these mechanisms have been evaluated with mixed results. This paper will review the physiology and management of unscheduled bleeding with progestin-containing contraceptives. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. 21 CFR 201.325 - Over-the-counter drugs for vaginal contraceptive and spermicide use containing nonoxynol 9 as the... (United States)


    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Over-the-counter drugs for vaginal contraceptive... Products § 201.325 Over-the-counter drugs for vaginal contraceptive and spermicide use containing nonoxynol... use of vaginal contraceptive drug products containing nonoxynol 9 does not protect against...

  13. Women Report Vaginal Ring for Preventing HIV had Little Effect on Sexual Intercourse (United States)

    ... News Releases News Release Tuesday, October 18, 2016 Women report vaginal ring for preventing HIV had little ... social harm were associated with low adherence. Most women who used an experimental vaginal ring for HIV ...

  14. 76 FR 17444 - In the Matter of Certain Vaginal Ring Birth Control Devices; Notice of Investigation (United States)


    ... COMMISSION In the Matter of Certain Vaginal Ring Birth Control Devices; Notice of Investigation AGENCY: U.S... certain vaginal ring birth control devices by reason of infringement of claim 1 of U.S. Patent No. 6,086... importation, or the sale within the United States after importation of certain vaginal ring birth control...

  15. Candida vaginitis during contraceptive use: the influence of methods, antifungal susceptibility and virulence patterns. (United States)

    Güzel, A B; Küçükgöz-Güleç, U; Aydin, M; Gümral, R; Kalkanci, A; Ilkit, M


    No consensus exists about whether contraceptives cause an increased risk of vaginitis, including vulvovaginal candidosis (VVC). We investigated 495 women (252 who used contraceptives; 243 who did not) for the presence of VVC. Antifungal susceptibility testing was performed for five antifungal agents and for boric acid, and three virulence factors were also examined. We recovered 129 (26.1%) monofungal populations from vaginal samples of women with acute VVC (AVVC, n = 18), symptomatic recurrent VVC (RVVC, n = 22) and asymptomatic RVVC (n = 28), as well as of other contraceptive users who carried Candida in their vaginas (n = 61). It is important to note that the women who had VVC used the same contraceptive methods (p > 0.05). Candida albicans was the most common species isolated (45%), followed by C. glabrata (40.3%). Most of the vaginal yeast isolates exhibited low minimum inhibitory concentration levels for the five antifungals tested. However, this was not the case for boric acid. In addition, the yeast fungi that was derived from the AVVC and RVVC patients showed higher amounts of haemolytic activity than the yeast fungi found among the controls (p contraception does not predispose women to VVC (p > 0.05). Also, both host- and organism-related factors were required to achieve optimal clinical treatment for VVC.

  16. Vaginitis (United States)

    ... vaginal cream, ring, or tablet. A water-soluble lubricant also may be helpful during intercourse. Glossary Antibiotics: ... Resources & Publications Committee Opinions Practice Bulletins Patient Education Green Journal Clinical Updates Practice Management Coding Health Info ...

  17. Bioavailability of the Yuzpe and levonorgestrel regimens of emergency contraception: vaginal vs. oral administration. (United States)

    Kives, Sari; Hahn, Philip M; White, Emily; Stanczyk, Frank Z; Reid, Robert L


    Separate crossover studies compared the bioavailability of oral vs. vaginal routes of administration for the Yuzpe (n=5) and levonorgestrel regimens (n=4) of emergency contraception. Twice the standard dose of the Yuzpe regimen (200 microg of ethinyl estradiol, 1000 microg of levonorgestrel) or the levonorgestrel regimen (1500 microg of levonorgestrel) was self-administered vaginally. One week later, each subject received orally the standard dose of the assigned medication. Serial blood samples were collected over 24 h and assayed for levonorgestrel and ethinyl estradiol (for the Yuzpe regimen only). Paired t tests were used to compare oral vs. vaginal administration for maximum concentration (Cmax), time to maximum concentration (Tmax) and area under the curve over 24 h (AUC0-24). Relative bioavailability (vaginal/oral) was derived from AUC0-24. Vaginal administration of double the standard dose of the Yuzpe regimen resulted in a lower Cmax (vaginal=5.4 vs. oral=14.6 ng/mL, p=.038) and a later Tmax (5.9 vs. 2.0 h, p=.066) for levonorgestrel, compared to oral administration. Corresponding ethinyl estradiol concentrations were higher (786 vs. 391 pg/mL, p=.039) and peaked later (4.0 vs. 1.9 hr, p=.154) with vaginal administration. Relative bioavailabilities for levonorgestrel and ethinyl estradiol were 58% and 175%, respectively. Similarly, vaginal administration of the levonorgestrel regimen resulted in a lower Cmax (vaginal=5.4 vs. oral=15.2 ng/mL, p=.006) and a later Tmax (7.4 vs. 1.3 h, p=.037) for levonorgestel, compared to oral administration. The relative bioavailability was 62%. Our preliminary data suggest that vaginal administration of these emergency contraception regimens appears to require at least three times the standard oral dose to achieve equivalent systemic levonorgestrel concentrations.

  18. Estradiol-progesterone interaction during the preparation of vaginal rings. (United States)

    Saleh, Saleh I; Khidr, Sayed H; Ahmed, Sayed M; Jackanicz, Theodore M; Nash, Harold A


    An unexpected enhanced release, in vitro, of estradiol (E2) was observed on the preparation of vaginal rings containing E2 and progesterone (P) in a silicone elastomer. The present work deals with exploring the reason(s) behind this enhanced E2 release. The effect of the ring design (i.e., putting P and E2 in the same compartment or in adjacent or separate compartments) was studied. The effects of the curing temperature as well as the curing time were also investigated. The possible interaction(s) between P and E2 on simple heating of their mixtures was investigated using infrared (IR), differential scanning calorimetry (DSC), and nuclear magnetic resonance (NMR) techniques. Also, the dissolution behavior of P, E2, and their mixture before and after heating was studied. The ring design, with respect to the position of the steroid layer(s), affected the release of P and E2 from the vaginal rings. Curing the rings at higher temperatures (>/=140 degrees C) for >/=30 min resulted in an enhanced release of the steroids, especially E2. The IR, DSC, phase diagram, and NMR results indicate that an interaction between P and E2, leading to the formation of a molecular complex, took place. It was concluded that putting P and E2 in the same compartment and curing by heating at a high temperature and for an extended time promoted this kind of interaction. The greater hydrophobicity of the interaction product, relative to that of E2, was considered the main reason behind the enhanced in vitro release of E2 from the vaginal rings.

  19. Investigation of vaginal microbiota in sexually active women using hormonal contraceptives in Pakistan

    Directory of Open Access Journals (Sweden)

    Kazi Yasmeen


    Full Text Available Abstract Background Previous studies report association of contraceptives with moderate increase in urinary tract infection among sexually active premenopausal women. The aim of our study was to find out whether the use of hormonal contraceptives has any effect on microbiota of the vagina in the contraceptives users in Khairpur Sindh Pakistan. Methods A prospective study in woman population of Khairpur Sindh Pakistan aged 20–30 years and 31–40 years, using Hormonal contraceptives was carried out. High vaginal swab samples (n = 100 were collected from the test populations as well as control group (n = 100 and investigated for vaginal microbial flora using standard microbiological and biochemical techniques. Results Vaginal swabs culturing from hormonal contraceptives users in the age group 20–30 years showed statistically insignificant Candida sp (10% samples, and statistically significant (p Staphylococcus saprophyticus. (18% samples, Streptococcus agalactiae (23% samples, Escherichia coli (28% samples and Lactobacillus fermentum (32% samples. In the age group 31–40 years, statistically significant percentage of samples (p Lactobacillus fermentum (28%, Candida sp (24%, and E. coli, (24% where statistically insignificant samples showed Staphylococcus saprophyticus (13% and Streptococcus agalactiae (11%. Conclusions The use of hormonal contraceptives alters the normal microbiota of vagina in women according to the age. Lactobacillus fermentum appeared as the predominant species followed by E. coli among the age group of 20–30 years and, Lactobacillus fermentum, Candida sp and E. coli as predominant among women of age group 31–40 years when compared to corresponding control groups. An inverse relationship between E. coli and Lactobacillus fermentum was observed in the women aged 20–30 years.

  20. Determinants of resumption of vaginal intercourse in puerperium period in Ogbomoso: consideration for early use of contraceptives

    Directory of Open Access Journals (Sweden)

    Kola M. Owonikoko


    Full Text Available Background: Early postpartum period for mothers is characterized with high demand for neonatal care, adjusting to sudden withdrawal of hormones of pregnancy and dealing with sexual desires of the husband. The study aimed at determines the timing, factors influencing postpartum resumption of vaginal intercourse and the contraceptive usage. Methods: Women in puerperium were interviewed with structured questionnaire on their socio-demographic status, obstetric history, sexual activities, contraception usage and reason for sexual abstinence. Results: About 40% (143 of participants had resumed vaginal intercourse within puerperium with mean resumption period of 3.2 +/- 1.8 weeks. Only 12% (48 of them used modern contraceptive. Educational status (P <0.001; occupation (P <0.001; educational status of the husband (P <0.001; occupation of the husband (P <0.001; parity (P <0.05; husband's income (P <0.05 and use of modern contraception (P <0.001 showed significant statistical difference between the women who had resumed vaginal sexual intercourse and those who have not. Logistic regression showed that educational status of the participants (OR = 0.48, CI = 0.246-0.938; P = 0.032 and parity (OR = 0.34, CI = 0.196-0.591; P = 0.001 were the most significant factors associated with early resumption of vaginal intercourse. One hundred and eighty-five (72% of women who were yet to resume coitus, did so because of fear of pregnancy. Conclusions: Significant number of women resumed vaginal intercourse during the puerperium despite low contraception usage. There is need to initiate a contraception method before discharge home following delivery. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 1061-1066

  1. Efficacy and tolerability of a novel estradiol vaginal ring for relief of menopausal symptoms. (United States)

    Speroff, Leon


    To assess the efficacy, tolerability, and acceptance of a vaginal ring delivering the equivalent of 50 or 100 microg per day of estradiol (E2), compared with placebo, for relief of moderate to severe vasomotor symptoms and urogenital symptoms in postmenopausal women. Women with moderate to severe vasomotor symptoms (seven or more per day or 56 per week average) received 13 weeks of treatment with a vaginal ring delivering 50 microg per day E2 (n = 113) or 100 microg per day E2 (n = 112), or a placebo vaginal ring (n = 108). Severity of vasomotor symptoms was assessed by a daily diary card and the Greene Climacteric Scale. Urogenital signs and symptoms were evaluated via patient and physician assessment and vaginal cytology. Participant satisfaction with the vaginal ring was evaluated via questionnaire. Vasomotor symptoms significantly improved in both treatment groups, compared with placebo (P <.05). There was a trend toward greater improvement in patient assessment of urogenital signs with active rings compared with placebo. For women with vaginal atrophy at baseline (n = 60), the maturation index improved significantly in both treatment groups compared with placebo. Total Greene Climacteric Scale scores significantly improved for both E2 vaginal ring groups (P <.05) compared with placebo. The vaginal rings were well tolerated. Most adverse events were mild or moderate and consistent with estrogen therapy. A novel vaginal ring delivering the equivalent of 50 or 100 microg per day of E2 significantly reduced the number and severity of vasomotor symptoms and improved urogenital symptoms, compared with placebo. The E2 vaginal ring was well tolerated.

  2. Vaginal Testosterone Cream vs Estradiol Vaginal Ring for Vaginal Dryness or Decreased Libido in Women Receiving Aromatase Inhibitors for Early-Stage Breast Cancer: A Randomized Clinical Trial. (United States)

    Melisko, Michelle E; Goldman, Mindy E; Hwang, Jimmy; De Luca, Amy; Fang, Sally; Esserman, Laura J; Chien, Amy J; Park, John W; Rugo, Hope S


    Aromatase inhibitors (AI) are associated with significant urogenital atrophy, affecting quality of life and drug compliance. To evaluate safety of intravaginal testosterone cream (IVT) or an estradiol-releasing vaginal ring (7.5 μg/d) in patients with early-stage breast cancer (BC) receiving an AI. Intervention was considered unsafe if more than 25% of patients had persistent elevation in estradiol (E2), defined as E2 greater than 10 pg/mL (to convert to pmol/L, multiply by 3.671) and at least 10 pg/mL above baseline after treatment initiation on 2 consecutive tests at least 2 weeks apart. Postmenopausal (PM) women with hormone receptor (HR)-positive stage I to III BC taking AIs with self-reported vaginal dryness, dyspareunia, or decreased libido were randomized to 12 weeks of IVT or an estradiol vaginal ring. Estradiol was measured at baseline and weeks 4 and 12 using a commercially available liquid chromatography and tandem mass spectrometry assay; follicle-stimulating hormone levels were measured at baseline and week 4. Gynecologic examinations and sexual quality-of-life questionnaires were completed at baseline and week 12. This randomized noncomparative design allowed safety evaluation of 2 interventions concurrently in the same population of patients, reducing the possibility of E2 assay variability over time and between the 2 interventions. The primary objective of this trial was to evaluate safety of IVT or an estradiol vaginal ring in patients with early-stage BC receiving an AI; secondary objectives included evaluation of adverse events, changes in sexual quality of life using the Cancer Rehabilitation Evaluation System sexuality subscales, changes in vaginal atrophy using a validated 4-point scale, and comparison of E2 levels. Overall, 76 women signed consent (mean [range] age, 56 [37-78] years), 75 started treatment, and 69 completed 12 weeks of treatment. Mean (range) baseline E2 was 20 (10 pg/mL) in 28 of 76 women (37%). Persistent E2 elevation was

  3. Phase I randomized safety study of twice daily dosing of acidform vaginal gel: candidate antimicrobial contraceptive.

    Directory of Open Access Journals (Sweden)

    Marla J Keller

    Full Text Available BACKGROUND: Acidform gel, an acid-buffering product that inactivates spermatozoa, may be an effective topical non-hormonal contraceptive. This study was designed to evaluate the safety of vaginal dosing and effects of Acidform on mucosal immune mediators, antimicrobial properties of genital secretions, and vaginal microbiota. METHODS: Thirty-six sexually abstinent U.S. women were randomized to apply Acidform or hydroxyethylcellulose (HEC placebo gel twice daily for 14 consecutive days. Safety was assessed by symptoms and pelvic examination. The impact of gel on mucosal immunity was assessed by quantifying cytokines, chemokines, antimicrobial proteins and antimicrobial activity of genital secretions collected by cervicovaginal lavage (CVL at screening, 2 hours after gel application, and on days 7, 14 and 21. Vaginal microbiota was characterized at enrollment and day 14 using species-specific quantitative PCR assays. RESULTS: The median vaginal and cervical pH was significantly lower 2 hours after application of Acidform and was associated with an increase in the bactericidal activity of CVL against E. coli. However, 65% of women who received Acidform had at least one local adverse event compared with 11% who received placebo (p = 0.002. While there was no increase in inflammatory cytokines or chemokines, CVL concentrations of lactoferrin and interleukin-1 receptor antagonist (IL-1ra, an anti-inflammatory protein, were significantly lower following Acidform compared to HEC placebo gel application. There were no significant changes in Lactobacillus crispatus or Lactobacillus jensenii in either group but there was a decrease in Gardnerella vaginalis in the Acidform group (p = 0.08. CONCLUSIONS: Acidform gel may augment mucosal defense as evidenced by an increase in bactericidal activity of genital secretions against E. coli and a decrease in Gardnerella vaginalis colonization. However, Acidform was associated with more irritation than

  4. Phase I Randomized Safety Study of Twice Daily Dosing of Acidform Vaginal Gel: Candidate Antimicrobial Contraceptive (United States)

    Keller, Marla J.; Carpenter, Colleen A.; Lo, Yungtai; Einstein, Mark H.; Liu, Congzhou; Fredricks, David N.; Herold, Betsy C.


    Background Acidform gel, an acid-buffering product that inactivates spermatozoa, may be an effective topical non-hormonal contraceptive. This study was designed to evaluate the safety of vaginal dosing and effects of Acidform on mucosal immune mediators, antimicrobial properties of genital secretions, and vaginal microbiota. Methods Thirty-six sexually abstinent U.S. women were randomized to apply Acidform or hydroxyethylcellulose (HEC) placebo gel twice daily for 14 consecutive days. Safety was assessed by symptoms and pelvic examination. The impact of gel on mucosal immunity was assessed by quantifying cytokines, chemokines, antimicrobial proteins and antimicrobial activity of genital secretions collected by cervicovaginal lavage (CVL) at screening, 2 hours after gel application, and on days 7, 14 and 21. Vaginal microbiota was characterized at enrollment and day 14 using species-specific quantitative PCR assays. Results The median vaginal and cervical pH was significantly lower 2 hours after application of Acidform and was associated with an increase in the bactericidal activity of CVL against E. coli. However, 65% of women who received Acidform had at least one local adverse event compared with 11% who received placebo (p = 0.002). While there was no increase in inflammatory cytokines or chemokines, CVL concentrations of lactoferrin and interleukin-1 receptor antagonist (IL-1ra), an anti-inflammatory protein, were significantly lower following Acidform compared to HEC placebo gel application. There were no significant changes in Lactobacillus crispatus or Lactobacillus jensenii in either group but there was a decrease in Gardnerella vaginalis in the Acidform group (p = 0.08). Conclusions Acidform gel may augment mucosal defense as evidenced by an increase in bactericidal activity of genital secretions against E. coli and a decrease in Gardnerella vaginalis colonization. However, Acidform was associated with more irritation than placebo and lower levels

  5. 77 FR 8900 - Certain Vaginal Ring Birth Control Devices; Termination of the Investigation Based on Withdrawal... (United States)


    ... From the Federal Register Online via the Government Publishing Office INTERNATIONAL TRADE COMMISSION Certain Vaginal Ring Birth Control Devices; Termination of the Investigation Based on Withdrawal... within the United States after importation of certain vaginal birth control devices by reason of...

  6. 绝经后取环的临床体会%Clinical experience of contraceptive ring taking post-menopause

    Institute of Scientific and Technical Information of China (English)



    目的:总结绝经期后妇女取环的临床经验。方法:回顾性分析绝经期后妇女取环的临床资料。结果:绝经期越长,困难取环率越高。结论:妇女绝经后应及时取环,未及时取环应做好困难取环的准备。%Objective:To summarize the clinical experience of contraceptive ring taking post-menopause.Methods:The clinical data of women post-menopause accepting contraceptive ring taking was analyzed retrospectively.Results:The longer the menopause,the higher the difficult rate of contraceptive ring taking.Conclusions:The postmenopausal women should take contraceptive ring timely,who fails to take contraceptive ring timely should be prepared for the difficult contraceptive ring taking.

  7. Contraception-related venous thromboembolism in adolescents. (United States)

    O'Brien, Sarah H


    Venous thromboembolism (VTE) is a rare but serious complication of combined hormonal contraception. While the absolute risk of VTE is low in adolescents, thrombotic events in contraception users younger than the age of 20 years account for 5 to 10% of total contraception-related VTE events in population studies, because of the high frequency of contraception use in adolescents. An increased risk of VTE exists not only with oral contraceptives, but also the contraceptive patch and vaginal ring. Most adolescents who experience contraception-related VTE have additional transient or inherited thrombotic risk factors at the time of VTE. Although the presence of inherited thrombophilia impacts the risk of contraception-related VTE, thrombophilia screening before contraception prescribing should be targeted only to high-risk populations. Pediatric institutions, caregivers, and young women need to be aware of the risk of VTE with estrogen-containing contraception, and maintain a high index of suspicion for this complication in women using these agents.

  8. Immediate Postpartum Intrauterine Contraceptive Device Insertions in Caesarean and Vaginal Deliveries: A Comparative Study of Follow-Up Outcomes (United States)

    Nanda, Smiti; Gupta, Anjali; More, Hemant


    Background. Immediate postpartum intrauterine contraceptive device (IPPIUCD) is a lucrative postpartum family planning method which provides effective reversible contraception to women in the delivery setting. Our aim was to study the clinical outcomes of IPPIUCD insertions and compare them as a factor of route of insertion (vaginal versus caesarean). Methods. This is a retrospective analytical study done in a tertiary care teaching institute. A Cohort of 593 vaginal and caesarean deliveries with IPPIUCD insertions, over a two-year period, was studied and compared for follow-up results. Outcome measures were safety (perforation, irregular bleeding, unusual vaginal discharge, and infection), efficacy (pregnancy, expulsions, and discontinuations), and incidence of undescended IUCD strings. Descriptives were calculated for various outcomes and chi square tests were used for comparison in between categorical variables. Results. Overall complication rates were low. No case of perforation or pregnancy was reported. Spontaneous expulsions were present in 5.3% cases and were significantly higher in vaginal insertions (p = 0.042). The incidence of undescended strings was high (38%), with highly significant difference between both groups (p = 0.000). Conclusion. IPPIUCD is a strong weapon in the family planning armoury and should be encouraged in both vaginal and caesarean deliveries. Early follow-up should be encouraged to detect expulsions and tackle common problems. PMID:27631023

  9. Effects of combined oral contraceptives, depot medroxyprogesterone acetate and the levonorgestrel-releasing intrauterine system on the vaginal microbiome. (United States)

    Brooks, J Paul; Edwards, David J; Blithe, Diana L; Fettweis, Jennifer M; Serrano, Myrna G; Sheth, Nihar U; Strauss, Jerome F; Buck, Gregory A; Jefferson, Kimberly K


    Prior studies suggest that the composition of the vaginal microbiome may positively or negatively affect susceptibility to sexually transmitted infections (STIs) and bacterial vaginosis (BV). Some female hormonal contraceptive methods also appear to positively or negatively influence STI transmission and BV. Therefore, changes in the vaginal microbiome that are associated with different contraceptive methods may explain, in part, effects on STI transmission and BV. We performed a retrospective study of 16S rRNA gene survey data of vaginal samples from a subset of participants from the Human Vaginal Microbiome Project at Virginia Commonwealth University. The subset included 682 women who reported using a single form of birth control that was condoms, combined oral contraceptives (COCs), depot medroxyprogesterone acetate (DMPA) or the levonorgestrel-releasing intrauterine system (LNG-IUS). Women using COCs [adjusted odds ratio (aOR) 0.29, 95% confidence interval (CI) 0.13-0.64] and DMPA (aOR 0.34, 95% CI 0.13-0.89), but not LNG-IUS (aOR 1.55, 95% CI 0.72-3.35), were less likely to be colonized by BV-associated bacteria relative to women who used condoms. Women using COCs (aOR 1.94, 95% CI 1.25-3.02) were more likely to be colonized by beneficial H2O2-producing Lactobacillus species compared with women using condoms, while women using DMPA (aOR 1.09, 95% CI 0.63-1.86) and LNG-IUS (aOR 0.74, 95% CI 0.48-1.15) were not. Use of COCs is significantly associated with increased vaginal colonization by healthy lactobacilli and reduced BV-associated taxa. COC use may positively influence gynecologic health through an increase in healthy lactobacilli and a decrease in BV-associated bacterial taxa. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Biomarkers and biometric measures of adherence to use of ARV-based vaginal rings

    Directory of Open Access Journals (Sweden)

    Randy M Stalter


    Full Text Available Introduction: Poor adherence to product use has been observed in recent trials of antiretroviral (ARV-based oral and vaginal gel HIV prevention products, resulting in an inability to determine product efficacy. The delivery of microbicides through vaginal rings is widely perceived as a way to achieve better adherence but vaginal rings do not eliminate the adherence challenges exhibited in clinical trials. Improved objective measures of adherence are needed as new ARV-based vaginal ring products enter the clinical trial stage. Methods: To identify technologies that have potential future application for vaginal ring adherence measurement, a comprehensive literature search was conducted that covered a number of biomedical and public health databases, including PubMed, Embase, POPLINE and the Web of Science. Published patents and patent applications were also searched. Technical experts were also consulted to gather more information and help evaluate identified technologies. Approaches were evaluated as to feasibility of development and clinical trial implementation, cost and technical strength. Results: Numerous approaches were identified through our landscape analysis and classified as either point measures or cumulative measures of vaginal ring adherence. Point measurements are those that give a measure of adherence at a particular point in time. Cumulative measures attempt to measure ring adherence over a period of time. Discussion: Approaches that require modifications to an existing ring product are at a significant disadvantage, as this will likely introduce additional regulatory barriers to the development process and increase manufacturing costs. From the point of view of clinical trial implementation, desirable attributes would be high acceptance by trial participants, and little or no additional time or training requirements on the part of participants or clinic staff. We have identified four promising approaches as being high priority

  11. Safety studies of sperm agglutinating factor produced by Staphylococcus aureus as a vaginal contraceptive: in vivo studies. (United States)

    Kaur, Siftjit; Prabha, Vijay; Kaur, Kiranjeet


    Sperm agglutinating factor (SAF) isolated from Staphylococcus aureus when applied at concentration 10 μg before mating completely prevented conception in the mouse. The objective of the present study was to evaluate its safety, as safety is an important concern to be addressed before a compound is selected for contraceptive use. Our results showed that SAF has a very high safety profile. Vaginal application of SAF at 10 μg to the mouse for 14 consecutive days caused no systemic toxicity and vaginal irritation as indicated by lack of effect on organ weights and histology. Moreover, no adverse effect was observed on the subsequent reproductive capability, perinatal outcome and growth and development of the offspring. SAF (10 μg) did not irritate the skin or penile mucosa. Oral administration of 2 mg/kg body weight of SAF did not show any toxicity to reproductive and non-reproductive organs. Therefore, SAF with spermicidal activity and lack of toxicity may have the potential to become the active ingredient of a vaginal contraceptive.

  12. Contraception - Update and Trends

    Directory of Open Access Journals (Sweden)

    Rabe T


    Full Text Available In the future, fertility control will focus on the improvement of existing methods (efficacy, side effects, easy use, duration of action, manufacturing process, costs, on new approaches (mode of action and on new targets for contraception. Counselling of women in view of contraceptive choices based on individual risks (e. g. cardiovascular disease, thrombophilia, family risk of breast cancer, sexually transmitted diseases will gain more and more importance. Only a few companies can afford research in contraception such as Bayer-Schering-Pharma, Wyeth-Ayerst, Ortho-McNeil and Organon. Female contraception: Ovulation inhibition: In the future, a focus will be placed on the preselection of patients to minimize their individual risk, new oral contraceptive (OC regimen, OC with new progestins, OC with estradiol or estradiolesters, new ovulation inhibitors with new progestins and new regimens including long cycles and continuous steroidal contraceptives, new contraceptive patches, vaginal rings, spray-on contraceptives, recently identified genes involved in the ovulation process as new targets for ovulation inhibitors. Fertilisation inhibition: New intrauterine systems will comprise: a smaller Mirena intrauterine system releasing levonorgestrel (LNG and new frameless progestin-releasing intrauterine systems (IUS. Various new contraceptive barriers have been introduced. Research is ongoing on substances acting both as spermicides and as microbicides, reducing the risk of sexually transmitted diseases. New implantables and injectables will feature an improved pharmacokinetic profile, decreased side effects and a safer delivery system. Additionally, there are various new approaches in female sterilisation. Immunocontraception for the female will not be available in the near future. Implantation inhibition: Selective progesterone receptor modulators (SPRMs are tested for postcoital contraception. New targets are analysed for immunocontraceptives. Male

  13. A Novel Microbicide/Contraceptive Intravaginal Ring Protects Macaque Genital Mucosa against SHIV-RT Infection Ex Vivo.

    Directory of Open Access Journals (Sweden)

    Guillermo Villegas

    Full Text Available Women need multipurpose prevention products (MPTs that protect against sexually transmitted infections (STIs and provide contraception. The Population Council has developed a prototype intravaginal ring (IVR releasing the non-nucleoside reverse transcriptase inhibitor (NNRTI MIV-150 (M, zinc acetate (ZA, carrageenan (CG and levonorgestrel (LNG (MZCL IVR to protect against HIV, HSV-2, HPV and unintended pregnancy. Our objective was to evaluate the anti-SHIV-RT activity of MZCL IVR in genital mucosa. First, macaque vaginal tissues were challenged with SHIV-RT in the presence of (i MIV-150 ± LNG or (ii vaginal fluids (VF; available from studies completed earlier collected at various time points post insertion of MZCL and MZC IVRs. Then, (iii MZCL IVRs (vs. LNG IVRs were inserted in non-Depo Provera-treated macaques for 24h and VF, genital biopsies, and blood were collected and tissues were challenged with SHIV-RT. Infection was monitored with one step SIV gag qRT-PCR or p27 ELISA. MIV-150 (LCMS/MS, RIA, LNG (RIA and CG (ELISA were measured in different compartments. Log-normal generalized mixed linear models were used for analysis. LNG did not affect the anti-SHIV-RT activity of MIV-150 in vitro. MIV-150 in VF from MZC/MZCL IVR-treated macaques inhibited SHIV-RT in vaginal mucosa in a dose-dependent manner (p<0.05. MIV-150 in vaginal tissue from MZCL IVR-treated animals inhibited ex vivo infection relative to baseline (96%; p<0.0001 and post LNG IVR group (90%, p<0.001. No MIV-150 dose-dependent protection was observed, likely because of high MIV-150 concentrations in all vaginal tissue samples. In cervical tissue, MIV-150 inhibited infection vs. baseline (99%; p<0.05. No cervical tissue was available for MIV-150 measurement. Exposure to LNG IVR did not change tissue infection level. These observations support further development of MZCL IVR as a multipurpose prevention technology to improve women's sexual and reproductive health.

  14. [Contraception and adolescence]. (United States)

    Amate, P; Luton, D; Davitian, C


    The mean age of first sexual intercourse is still around 17 in France, but a lot of teenagers are concerned by contraception before, with approximately 25% of sexually active 15-year-old girls. The contraceptive method must take into consideration some typical features of this population, as sporadic and non-planned sexual activity, with several sexual partners in a short period of time. In 2004, the "Haute Autorité de santé" has recommended, as first-line method, combined oral contraceptive (COC) pills, in association with male condoms. Copper-containing intrauterine contraceptive devices (IUCD) and etonogestrel-containing subcutaneous implant have been suggested but not recommended. However, oral contraceptive pill, as a user-based method, carries an important typical-use failure rate, because remembering taking a daily pill, and dealing with stop periods, may be challenging. Some easier-to-use method should be kept in mind, as 28-day COC packs, transdermal contraceptive patches, and vaginal contraceptive rings. Moreover, American studies have shown that long-acting reversible contraceptives (LARC), i.e. IUCD and implant, have many advantages for teenagers: very effective, safe, invisible. They seem well-fitted for this population, with high satisfaction and continuation rates, as long as side effects are well explained. Thus, LARC methods should be proposed more widely to teenagers. Anyway, before prescribing a contraceptive method, it is important to determine the specific situation of every teenager, to let them choose the method that they consider as appropriate in their own case, and to think about the availability of the chosen method. It is necessary to explain how to handle mistakes or misses with user-based contraceptive methods, and emergency contraception can be anticipated and prescribed in advanced provision. The use of male condoms should be encouraged for adolescents, with another effective contraceptive method, in order to reduce the high risk

  15. Development of disulfiram-loaded vaginal rings for the localised treatment of cervical cancer. (United States)

    Boyd, Peter; Major, Ian; Wang, Weiguang; McConville, Christopher


    Cervical cancer is the third most prevalent cancer in women and disproportionately affects those in low resource settings due to limited programs for screening and prevention. In the developed world treatment for the disease in the non-metastasised state usually takes the form of surgical intervention and/or radiotherapy. In the developing world such techniques are less widely available. This paper describes the development of an intravaginal ring for the localised delivery of a chemotherapeutic drug to the cervix that has the potential to reduce the need for surgical intervention and will also provide a novel anti-cancer therapy for women in low resource settings. Disulfiram has demonstrated antineoplastic action against prostate, breast and lung cancer. Both PEVA and silicone elastomer were investigated for suitability as materials in the manufacture of DSF eluting intravaginal rings. DSF inhibited the curing process of the silicone elastomer, therefore PEVA was chosen as the material to manufacture the DSF-loaded vaginal rings. The vaginal rings had an excellent content uniformity while the DSF remained stable throughout the manufacturing process. Furthermore, the rings provided diffusion controlled release of DSF at levels well in excess of the IC50 value for the HeLa cervical cancer cell line.

  16. [Contraception and obesity]. (United States)

    Lobert, M; Pigeyre, M; Gronier, H; Catteau-Jonard, S; Robin, G


    The prevalence of obesity is increasing massively over several decades in industrialized countries. Obese women are sexually active but they use fewer contraceptive methods and are at high risk of unintended pregnancy. In addition, obesity is an important risk factor for venous thromboembolism events and arterial thrombosis (myocardial infarction and ischemic stroke). All of these data are to be considered in choosing a contraceptive method for obese women. Except depot medroxyprogesterone acetate injection, the progestin-only contraceptives (progestin only pills and etonogestrel subdermal implant) and the intra-uterine devices are the preferred contraceptive methods in obese women. The combined estrogen-progestin contraceptives (pill, patch and vaginal ring) may be proposed in very strict conditions (no other associated vascular risk factor). Obesity does not increase the risk of failure of most contraceptive methods. Bariatric surgery is a complex situation. It requires to program a possible pregnancy and contraception is needed for several months. Some bariatric surgical techniques such as by-pass can induce gastrointestinal malabsorption. In this situation, all oral contraceptives are not recommended because of a higher risk of failure.

  17. Vaginitis (United States)

    ... are the symptoms of a yeast infection? What treatments are available for vaginal yeast infection? Should I use an over-the-counter medication to treat a yeast infection? What is bacterial vaginosis? What are the symptoms of bacterial vaginosis? How ...

  18. 国产天然孕酮阴道环的抗生育作用药效学和动物体内血药浓度变化研究%Study on Pharmacodynamics and Plasma Concentration of Progesterone Vaginal Ring

    Institute of Scientific and Technical Information of China (English)

    桂幼伦; 郭湘洁; 谢淑武; 邵海浩; 曹霖; 朱焰


    Objective: To study on long-term contraceptive effectiveness and plasma concentration and release duration of natural progesterone vaginal ring. Methods: 1) Twenty-four fertility New Zealand rabbits were randomly divided into 4 groups: high-dose progesterone vaginal ring (840 mg/ring), mid-dose progesterone vaginal ring (420 mg / ring), tings low-dose progesterone vaginal ring (210 mg/ring), blank vaginal ting. After recovering to be mating, the long-term contraceptive effects of progesterone vaginal ring on rabbit were observed. 2) Twelve castred goats were randomly divided into 2 groups and given the domestic ring and Chile ting, respectively. Blood samples were taken before and after inserting tings at different time points via jugular vein. Magnetic enzymelinked immunosorbent system was applied to assay the concentration of progesterone. Results: 1) There was no significant effect on the general condition of the animals, the contraceptive effect in high-dose group and mid-dose group was good, long performance could maintain 3 months, while the low-dose contraceptive was less effective. 2) Plasma concentration of domestic and Chilean progesterone vaginal ring except 20 d, 27 d, 90 d was not significantly different outside (P>0.05). Conclusion: Natural progesterone vaginal rings and high-dose and mid-dose groups had long-term contraceptive effect. The domestic vaginal ring of progesterone can be as a substitute of imported vaginal ring of progesterone.%目的:研究和观察天然孕酮阴道环的长效避孕效果,及其在山羊体内的血药浓度和持续释放时间.方法:①将24只具有生育能力的新西兰雌兔随机分为4组,分别阴道置入空白环、天然孕酮阴道环低剂量(210 mg/环)、中剂量(420 mg/环)和高剂量((840 mg/环).手术15 d后进行交配,观察天然孕酮阴道环对家兔的长效避孕效果.②将12只去卵巢山羊随机分为2组,分别给予国产和智利产天然孕酮阴道环,并于置入阴道环

  19. Clinical significance of oral contraceptive in treating vaginal bleeding in 114 cases%口服避孕药止血114例的临床疗效观察

    Institute of Scientific and Technical Information of China (English)



    Objective To investigate the related factors and curative effect of oral contraceptive in treating vaginal bleeding after birth control operation. Methods In our hospital from April 2011 to June 2012, 114 cases of patients in taking oral contraceptive after induced abortion or Sheung Wan or ring extraction and vaginal bleeding last more than two weeks with clinical data were retrospectively analyzed and observed the curative effect . Results The bleeding time of 63 cases lasted for 14-20 days, 30 cases lasted for 21-35 days, 20 cases lasted for over 35 days. The related factors of oral contraceptive in treating vaginal bleeding were including infection, adverse birth history, repeated abortion history, intrauterine residue, female endocrine disorders. Conclusion Taking oral contraceptive after birth control operation can reduce the amount of bleeding and shorten the bleeding time and return to normal menstrual cycle with avoiding pregnancy.%目的:探讨患者接受计划生育节育手术后口服避孕药止血的相关影响因素和疗效。方法回顾性分析人工流产、上环、取环术后阴道出血时间超过2周的患者114例,给予口服避孕药止血,观察临床疗效。结果①出血时间在14~20 d的患者63例,出血时间在21~35 d的患者31例,出血时间长于35 d的患者20例。②口服避孕药止血与受术者的感染、不良分娩史、多次人工流产史、宫内残留及内分泌紊乱等因素有关。结论计划生育节育手术后口服避孕药,能减少出血量、缩短出血时间,达到止血的效果,可帮助患者恢复正常月经周期,避免再孕。

  20. Meaning-making matters in product design: users' sensory perceptions and experience evaluations of long-acting vaginal gels and intravaginal rings. (United States)

    Rosen, Rochelle K; van den Berg, Jacob J; Vargas, Sara E; Senocak, Natali; Shaw, Julia G; Buckheit, Robert W; Smith, Kelley Alison; Guthrie, Kate Morrow


    Users' sensory perceptions and experiences of intravaginal products can inform acceptability and adherence. Focusing on the meanings women derive from formulation/device characteristics facilitates developers' design iterations toward optimizing user experience. We investigated how users of long-acting gels and intravaginal rings (IVRs) impute meaning to characteristics that may affect future product use. Focus groups were conducted with contraceptive IVR and vaginal lubricant users. Current perceptibility science and historical theory on the cultural acceptability of fertility regulating methods informed the analysis. A total of 21 IVR users and 29 lubricant users attended focus groups in which they manipulated products in their hands and discussed reactions to product characteristics. Participants used prior product experiences and sensory perceptions of prototype manipulations to inform meanings about product properties and performance for pregnancy, disease prevention, comfort, and perceived efficacy. The meanings derived from product characteristics depended on why the product would be used; a characteristic deemed problematic in one risk context may be considered preferable in another. Intravaginal product users create narratives that ascribe influence or causality to product characteristics. These meanings, whether correct or incorrect biologically, will shape vaginal product acceptability, use, and effectiveness. Long-acting and sustained-release drug delivery systems will be part of the multipurpose prevention continuum. Developers must consider how sensory experiences and culturally salient assumptions shape the meanings users make of product design characteristics. Those meanings will ultimately impact use and effectiveness. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Contraception - Update and Trends

    Directory of Open Access Journals (Sweden)

    Rabe T


    Full Text Available Fertility control in the future will focus on the improvement of existing methods (efficacy, side effects, easy use, duration of action, manufacturing process, costs, on new approaches (mode of action bringing additional health benefits, and on new targets for nonhormonal contraception. Counselling of women in view to contraceptive choices based on the individual risk (e. g. cardiovascular disease, thrombophilia, family risk of breast cancer, sexually transmitted diseases will gain more and more importance. Only a few companies can afford research in contraception such as Bayer-Schering-Pharma, and MSD. Female contraception: Ovulation inhibition: preselection of patients to minimize the individual risk. New oral contraceptive (OC regimen, OC with new progestins, OC with estradiol or estradiol esters, new ovulation inhibitors with new progestins and new regimen including long cycles and continuous delivery of steroidal contraceptives, new contraceptive patches, vaginal rings andsprayon contraceptives. Recently identified genes involved in the ovulation process as new targets for ovulation inhibitors. Fertilisation inhibition: new intrauterine systems have been developed: a smaller Mirena intrauterine system releasing levonorgestrel (LNG and a new frameless progestinreleasing intrauterine systems (IUS. Various new contraceptive barriers have been introduced. Research is ongoing on substances acting both as spermicide and as microbicides as a dualprotection method reducing both the risk of unwanted pregnancy and the risk of sexually transmitted diseases. New implantable systems and improved injectables (with improved pharmacokinetic profile, decreased side effects and a safer delivery system have been made available recently. Various new approaches in female sterilisation include non invasive method of tubal occlusion Immunocontraception for the female will not be available in the near future. Implantation inhibition: selective progesterone

  2. (Copper-curcumin) β-cyclodextrin vaginal gel: delivering a novel metal-herbal approach for the development of topical contraception prophylaxis. (United States)

    Gaurav, Chauhan; Goutam, Rath; Rohan, Kesarkar N; Sweta, Kothari T; Abhay, Chowdhary S; Amit, Goyal K


    Delivering a safe and effective topical vaginal contraceptive is the need of present era. We explored the potential of a metal (copper) and herbal moiety (curcumin) for this topical contraceptive prophylaxis. Complex of copper and curcumin (Cu-Cur) was synthesized and the concerns regarding its aqueous solubility was resolved by including it into the hydrophobic cavity of β-cyclodextrin (β-CD) as (Cu-Cur)CD inclusion complex. Dose assessment was made on the basis of in-vitro spermicidal assays and cell cytotoxicity studies. Finally the (Cu-Cur)CD loaded vaginal gel was prepared, characterized and evaluated for in-vitro spermicidal activity and preclinical toxicity studies. Spectral and morphological characterizations confirmed the synthesis of (Cu-Cur) and (Cu-Cur)CD inclusion complex. Spermicidal assays and Hela cell cytotoxic data revealed an optimized 1.5% (Cu-Cur)CD for further studies. 1.5% w/w (Cu-Cur)CD loaded carbopol 974p gel provided 100% motility even at 2-fold dilution and preclinical toxicity studies in Rats and Rabbits revealed its highly safe profile. The hypothesis of considering metal-herbal complex and its cyclodextrin complex has worked and the well planned strategy of including it in (β-CD) cavity provided a preeminent platform for vaginal delivery. In-vitro assays and preclinical toxicity analysis confirmed its potential to be used as highly safe and effective prophylaxis.

  3. Immediate start of hormonal contraceptives for contraception. (United States)

    Lopez, Laureen M; Newmann, Sara J; Grimes, David A; Nanda, Kavita; Schulz, Kenneth F


    ' method (OR 1.99; 95% CI 1.05 to 3.77). A trial of two immediate-start methods showed the vaginal ring group had less prolonged bleeding (OR 0.42; 95% CI 0.20 to 0.89) and less frequent bleeding (OR 0.23; 95% CI 0.05 to 1.03) than COC users. The ring group also reported fewer side effects. Also, more immediate ring users were very satisfied than immediate COC users (OR 2.88; 95% CI 1.59 to 5.22). We found limited evidence that immediate start of hormonal contraception reduces unintended pregnancies or increases method continuation. However, the pregnancy rate was lower with immediate start of DMPA versus another method. Some differences were associated with contraceptive type rather than initiation method, i.e., immediate ring versus immediate COC. More studies are needed of immediate versus conventional start of the same hormonal contraceptive.

  4. New and emerging contraceptives: a state-of-the-art review

    Directory of Open Access Journals (Sweden)

    Bahamondes L


    Full Text Available Luis Bahamondes, M Valeria Bahamondes Human Reproduction Unit, Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Campinas and National Institute of Hormones and Women's Health, Campinas, SP, Brazil Background: The first hormonal contraceptive was introduced onto the market in several countries 50 years ago; however, the portfolio of contraceptive methods remains restricted with regards to their steroid composition, their cost, and their ability to satisfy the requirements of millions of women/couples in accordance with their different reproductive intentions, behaviors, cultures, and settings. Methods: A literature review was conducted using Medline, Embase, and Current Contents databases, up to September 1, 2013 to identify publications reporting new contraceptives in development using combinations of the search terms: contraception, contraceptives, oral contraceptives, patch, vaginal ring, implants, intrauterine contraceptives, and emergency contraception (EC. Also, several experts in the field were also consulted to document ongoing projects on contraception development. Additionally, the website was searched for ongoing studies on existing contraceptive methods and new and emerging female contraceptives developed over the past 5 years. Information was also obtained from the pharmaceutical industry. Results: Early sexual debut and late menopause means that women may require contraception for up to 30 years. Although oral, injectable, vaginal, transdermal, subdermal, and intrauterine contraceptives are already available, new contraceptives have been developed in an attempt to reduce side effects and avoid early discontinuation, and to fulfill women's different requirements. Research efforts are focused on replacing ethinyl-estradiol with natural estradiol to reduce thrombotic events. In addition, new, less androgenic progestins are being introduced and selective progesterone receptor

  5. Neglected vaginal pessary

    Directory of Open Access Journals (Sweden)

    Meenu Jain


    Full Text Available Vaginal pessary may be opted for management of uterine prolapse as a safe option, but to avoid complications regular follow-up is a must. We are reporting a case of neglected vaginal pessary in a 72 year old female which got embedded in vaginal mucosa and required excision of vaginal band for its removal. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 291-292

  6. Sexual Desire and Hormonal Contraception (United States)

    Boozalis, Amanda; Tutlam, Nhial T.; Robbins, Camaryn Chrisman; Peipert, Jeffrey F.


    Objective To examine the effect of hormonal contraception on sexual desire. Materials and Methods We performed a cross-sectional analysis of 1,938 of the 9,256 participants enrolled in the Contraceptive CHOICE Project. This subset included participants enrolled between April and September 2011 who completed a baseline and six-month telephone survey. Multivariable logistic regression was used to assess the association between contraceptive method and report of lacking interest in sex, controlling for potential confounding variables. Results More than one in five participants (23.9%) reported lacking interest in sex at 6 months after initiating a new contraceptive method. Of 262 copper IUD users (referent group), 18.3% reported lacking interest in sex. Our primary outcome was more prevalent in women who are young (copper IUD users, participants using depot medroxyprogesterone (ORadj=2.61, 95% confidence interval (CI)=1.47-4.61), the vaginal ring (ORadj=2.53, 95% CI=1.37-4.69), and the implant (ORadj=1.60, 95% CI=1.03-2.49) more commonly reported lack of interest in sex. We found no association between use of the hormonal IUD, oral contraceptive pill, and patch and lack of interest in sex. Conclusion CHOICE participants using depot medroxyprogesterone acetate, the contraceptive ring, and implant were more likely to report a lack of interest in sex compared to copper IUD users. Future research should confirm these findings and their possible physiological basis. Clinicians should be reassured that most women do not experience reduced sex drive with the use of most contraceptive methods. PMID:26855094

  7. Meldingen bij het Nederlands Bijwerkingen Centrum Lareb van expulsie van een vaginale-anticonceptie-ring (NuvaRing) en van zwangerschap tijdens het gebruik ervan

    NARCIS (Netherlands)

    Passier, J L M; van Puijenbroek, E P; van Grootheest, A C


    Netherlands Pharmacovigilance Foundation Lareb expulsion of the vaginal contraceptive ring NuvaRing was reported 8 times between February 2003 and April 2004. Moreover, in two of these reports pregnancy was reported. In that same period, Lareb received 10 more reports of pregnancy during the use of

  8. Modified uterine manipulator and vaginal rings for total laparoscopic radical hysterectomy. (United States)

    Ramirez, P T; Frumovitz, M; Dos Reis, R; Milam, M R; Bevers, M W; Levenback, C F; Coleman, R L


    At present, there is no standard technique that allows surgeons performing total laparoscopic radical hysterectomy to complete the colpotomy and remove an adequate (2-cm) margin of upper vaginal tissue while maintaining adequate pneumoperitoneum. We evaluated the feasibility and safety of using a modified uterine manipulator for total laparoscopic radical hysterectomy in patients with cervical or endometrial cancer. A retrospective review was performed in all patients who underwent total laparoscopic radical hysterectomy using a modified uterine manipulator at our institution during the period April 2004 to December 2006. This analysis included 30 patients who underwent surgery with the modified uterine manipulator. There were no reports of difficulty with placement of the instrument, multiple attempts at placement, difficulty with uterine manipulation, or uterine perforation. In no patient was a vaginal incision or episiotomy required to fit the instrument through the introitus. In no case was there loss of pneumoperitoneum during colpotomy. Additional upper vaginal tissue had to be removed after intraoperative assessment of the adequacy of the surgical specimen in five (16.7%) of 30 patients. Use of the modified uterine manipulator according to our technique is safe and feasible, allowing for adequate vaginal resection and maintenance of pneumoperitoneum.

  9. An interdisciplinary framework for measuring and supporting adherence in HIV prevention trials of ARV-based vaginal rings

    Directory of Open Access Journals (Sweden)

    Kathleen M MacQueen


    Full Text Available Introduction: Product adherence and its measurement have emerged as a critical challenge in the evaluation of new HIV prevention technologies. Long-acting ARV-based vaginal rings may simplify use instructions and require less user behaviour, thereby facilitating adherence. One ARV-based ring is in efficacy trials and others, including multipurpose rings, are in the pipeline. Participant motivations, counselling support and measurement challenges during ring trials must still be addressed. In previous HIV prevention trials, this has been done largely using descriptive and post-hoc methods that are highly variable and minimally evaluated. We outline an interdisciplinary framework for systematically investigating promising strategies to support product uptake and adherence, and to measure adherence in the context of randomized, blinded clinical trials. Discussion: The interdisciplinary framework highlights the dual use of adherence measurement (i.e. to provide feedback during trial implementation and to inform interpretation of trial findings and underscores the complex pathways that connect measurement, adherence support and enacted adherence behaviour. Three inter-related approaches are highlighted: 1 adherence support – sequential efforts to define motivators of study product adherence and to develop, test, refine and evaluate adherence support messages; 2 self-reported psychometric measures – creation of valid and generalizable measures based in easily administered scales that capture vaginal ring use with improved predictive ability at screening, baseline and follow-up that better engage participants in reporting adherence; and 3 more objective measurement of adherence – real-time adherence monitoring and cumulative measurement to correlate adherence with overall product effectiveness through innovative designs, models and prototypes using electronic and biometric technologies to detect ring insertion and/or removal or expulsion

  10. Women’s perceptions and reasons for choosing the pill, patch, or ring in the CHOICE study: a cross-sectional survey of contraceptive method selection after counseling (United States)


    Background The European CHOICE study was a cross-sectional survey that evaluated women’s combined hormonal contraceptive choices before and after contraceptive counseling in Austria, Belgium, Czech Republic and Slovakia, the Netherlands, Poland, Sweden, Switzerland, Israel, Russia, and Ukraine. The changes in method selection before and after counseling were reported previously. In this paper we present the reasons given by the 18,787 participating women for selecting their contraceptive method of choice, as well as their perceptions about the contraceptive pill, patch, and ring after counseling. Methods Women with an interest in a combined hormonal contraceptive method (pill, patch, or ring) were counseled using a standardized counseling leaflet. The women completed questionnaires, which included questions on why they had selected a particular method of contraception, and the extent to which they agreed with statements about the attributes of the pill, patch, and ring. The results for each country were compared with the percentages for all countries combined by using a binomial regression model. Multiple logistic regression models were used to investigate the extent to which the probability of choosing a method was related to prespecified aspects (i.e. perceptions) of each contraceptive method. Results ‘Easy to use’, ‘convenience’, and ‘regular menstrual bleeding’ were important selection criteria. ‘Nondaily administration’ was one of the main reasons women selected the patch or ring. ‘Daily use’ and ‘will forget to take it’ were the primary reasons for not selecting the pill, while the main reasons for not choosing the patch included ‘not discrete, visible’ and ‘can fall off’. In a small number of instances, the ring was rejected because some women don’t like to use a ‘foreign body’. Women’s perceptions influenced their contraceptive decisions: positive perceptions about a method increased the likelihood that a woman

  11. Benefits and risks of hormonal contraception for women

    Directory of Open Access Journals (Sweden)

    Hagen, Anja


    Full Text Available Scientific background: A large proportion of women of reproductive age in Germany use various methods of pregnancy prevention (contraception, among them various hormone-based methods. Hormonal contraceptives may be divided into combined estrogen-progestogen contraceptives (pills, skin patches, vaginal rings, progestogen-only contraceptives (pills, injections, implants, hormone spirals and emergency contraceptives. Research questions: The evaluation addressed the question of benefits and risks of hormonal contraceptives, their economic effects as well as their ethical-social and legal implications.MethodsA systematic literature search was conducted in April 2006 starting from 2000. The evaluation is primarily based on systematic reviews. Results: In perfect use, all hormonal contraceptives excluding emergency contraceptives proved to be the most effective reversible contraceptive methods (rate of unintended pregnancies 0.05% to 0.3%. However, the typical use of oral contraceptives, injections, skin patches, and vaginal rings, which also considers possible application errors, showed a lower contraceptive efficacy (rate of unintended pregnancies 3% to 8%. It was lower than that of copper spirals. The risk of venous thromboembolism increased three to six times in users of hormonal contraceptives, the risks of stroke and myocardial infarction two to three times. The risk declined after discontinuation of use. The effects were estrogen-dose and progestogen-type dependent. The use of hormonal contraceptives showed a relative risk of ovarian and endometrial carcinomas of approximately 0.5 or 0.7, of breast and cervical cancer of approximately 1.2 or 1.6. The effect remained several years after discontinuation of use. The results concerning hepatocellular carcinoma suggested a carcinogenic effect. In women with acne, an improvement due to use of hormonal contraceptives was proven. Cervical chlamydial infections were more frequent in users of hormonal

  12. Ovarian Reserve Assessment in Users of Oral Contraception Seeking Fertility Advice on their Reproductive Lifespan

    DEFF Research Database (Denmark)

    Petersen, K. Birch; Hvidman, H. W.; Forman, J. L.;


    STUDY QUESTION: To what extent does oral contraception (OC) impair ovarian reserve parameters in women who seek fertility assessment and counselling to get advice on whether their remaining reproductive lifespan is reduced? SUMMARY ANSWER: Ovarian reserve parameters defined by anti...... and the contraceptive vaginal ring). Non-users included women with an intrauterine device (IUD) or no hormonal contraception. MAIN RESULTS AND THE ROLE OF CHANCE: Of the 887 women, 244 (27.5%) used OC. In a linear regression analyses adjusted for age, ovarian volume was 50% lower (95% CI 45.1-53.7%), AMH was 19% lower...

  13. Ovarian reserve assessment in users of oral contraception seeking fertility advice on their reproductive lifespan

    DEFF Research Database (Denmark)

    Birch Petersen, K; Hvidman, H W; Forman, J L;


    STUDY QUESTION: To what extent does oral contraception (OC) impair ovarian reserve parameters in women who seek fertility assessment and counselling to get advice on whether their remaining reproductive lifespan is reduced? SUMMARY ANSWER: Ovarian reserve parameters defined by anti...... and the contraceptive vaginal ring). Non-users included women with an intrauterine device (IUD) or no hormonal contraception. MAIN RESULTS AND THE ROLE OF CHANCE: Of the 887 women, 244 (27.5%) used OC. In a linear regression analyses adjusted for age, ovarian volume was 50% lower (95% CI 45.1-53.7%), AMH was 19% lower...

  14. [Combined hormonal contraception in cycles artificially extended]. (United States)

    Bustillos-Alamilla, Edgardo; Zepeda-Zaragoza, J; Hernández-Ruiz, M A; Briones-Landa, Carlos Humberto


    To compare the bleeding patterns, satisfaction and tolerability of 3 different contraceptive in an extended regimens in the service of Family Planning of the North Central Hospital of PEMEX. Healthy, adult women with desire of contraception for one year (N 120) were randomly assigned to receive oral contraceptive drospirenone/ethinyl E2 (group1), the norelgestromin/ethinyl E2 transdermal patch (group 2) and vaginal ring etonogestrel/ ethinyl E2 (group 3) in an extended regimen (42 consecutive days, 1 hormone-free week). Study assessments were conducted at scheduled visits at the time of initial screening, at baseline after 1, 3, 6, and 12 months. Subjects recorded menstrual associated symptoms bleeding data and completed satisfaction questionnaires. Subjects and investigators provided overall assessments of the regimens. Extended use of 3 different contraceptive resulted in fewer bleeding days in every group (66.6%, 55% and 58.3% P 0.0024), and less mastalgia and menstrual pain. Subjects were highly satisfied with three regimens (93.3%, 96.6% and 91.6% P 0.00421). Although not mayor adverse events were reported with this regimen, there was an increase in spotting days; it decreased with each successive cycle of therapy. Efficacy and safety were similar to those reported for traditional cycle. Extended-contraceptive regimen delays menses and reduces bleeding, a profile that may be preferred by women who seek flexibility with their contraceptive method.

  15. Clinical efficacy and safety of megestrol acetate vaginal ring%醋酸甲地孕酮硅阴道环有效性和安全性的临床研究

    Institute of Scientific and Technical Information of China (English)

    钱金凤; 朱心怡; 沈意文; 黄紫蓉


    Objective To explore the efficacy and safety of megestrol acetate silicone vaginal ring.Methods A total of 165 healthy child-bearing age women were recruited to examine the efficacy,safety and satisfaction rate of megestrol acetate silicone vaginal ring.Results The cumulative pregnancy rate of megestrol acetate silicone vaginal ring was 3.93%.And its discontinuation rate was 2.54%,the incidence of adverse events 11.52% and the incidence of adverse effects 1.81% while the symptoms were all slight.The bleeding pattern was similar to that of normal menstruation.Compared with baseline,the elevated level of triglycerides and the reduced level of low-density lipoprotein (LDL) were significantly different while no significant difference existed in high-density lipoprotein (HDL),cholesterol and hemoglobin,etc.The satisfaction rate of megestrol acetate silicone vaginal ring was 94.6% and increased with time.Conclusion Megestrol acetate silicone vaginal ring is an effective and safe option of contraceptives.%目的 观察醋酸甲地孕酮(甲地孕酮乙酸盐)硅阴道环的避孕效果和安全性.方法 纳入165例健康育龄期女性志愿者使用醋酸甲地孕酮硅阴道环避孕12个月,分析避孕有效性、安全性及满意度等.结果 随访12个月累积妊娠率为3.93%,停用率2.54%,不良事件发生率为11.52%(19例),不良反应1.81%(3例),症状均较轻微,不需要治疗;使用中阴道环脱落率18.2%(27例).出血模式和正常月经周期相似;使用前后血生化指标均在正常范围内,甘油三酯上升、低密度脂蛋白下降,差异均有统计学意义,其他化验指标(如高密度脂蛋白、胆固醇等)差异均无统计学意义;阴道环使用12个月后的受试者满意度为94.6%,随着使用时间的延长满意度逐渐提高.结论 醋酸甲地孕酮硅阴道环临床使用安全、有效,可能成为避孕新选择.


    Sitruk-Ware, Regine; Nath, Anita; Mishell, Daniel R.


    Steady progress in contraception research has been achieved over the past 50 years. Hormonal and non-hormonal modern contraceptives have improved women’s lives by reducing different health conditions that contributed to considerable morbidity. However the contraceptives available today are not suitable to all users and the need to expand contraceptive choices still exists. Novel products such as new implants, contraceptive vaginal rings, transdermal patches and newer combinations of oral contraceptives have recently been introduced in family planning programs and hormonal contraception is widely used for spacing and limiting births. Concerns over the adverse effects of hormonal contraceptives have led to research and development of new combinations with improved metabolic profile. Recent developments include use of natural compounds such as estradiol (E2) and estradiol valerate (E2V) with the hope to decrease thrombotic risk, in combination with newer progestins derived from the progesterone structure or from spirolactone, in order to avoid the androgenic effects. Progesterone antagonists and progesterone receptor modulators are highly effective in blocking ovulation and preventing follicular rupture and are undergoing investigations in the form of oral pills and in semi long-acting delivery systems. Future developments also include the combination of a contraceptive with an antiretroviral agent for dual contraception and protection against sexually transmitted diseases, to be used before intercourse or on demand, as well as for continuous use in dual-protection rings. Alhough clinical trials of male contraception have reflected promising results, limited involvement of industry in that area of research has decreased the likelihood of having a male method available in the current decade. Development of non-hormonal methods are still at an early stage of research, with the identification of specific targets within the reproductive system in ovaries and testes, as

  17. Vaginal dryness (United States)

    ... Vaginitis due to reduced estrogen; Atrophic vaginitis; Menopause vaginal dryness ... sexual intercourse more comfortable. It also helps decrease vaginal dryness. If estrogen levels drop off, the vaginal tissue ...

  18. Detection of the Human 70-kD and 60-kD Heat Shock Proteins in the Vagina: Relation to Microbial Flora, Vaginal pH, and Method of Contraception

    Directory of Open Access Journals (Sweden)

    P. Giraldo


    Full Text Available The expression of the 60-kD and 70-kD heat shock proteins (hsp60 and hsp70 in the vaginas of 43 asymptomatic women of reproductive age with or without a history of recurrent vulvovaginitis (RVV were compared. Vaginal wash samples were obtained and assayed by enzyme-linked immunosorbent assay (ELISA for human hsp60 and hsp70. Heat shock protein 70 was not detected in any of the 19 women with no history of RVV, and hsp60 was present in only one woman in this group. In contrast, in the RVV group, 11 (45.8% were hsp60-positive and eight (33.3% were hsp70-positive. The presence of either heat shock protein in the vagina was associated with an elevated vaginal pH (>4.5. Bacterial vaginosis or Candida was identified in some of the asymptomatic subjects; their occurrence was significantly higher in women with vaginal hsp70 than in women with no heat shock proteins. Oral contraceptives were used by 35.7% of subjects who were negative for vaginal heat shock proteins, as opposed to only 12.5% of women who were positive for hsp70 and 8.3% who were positive for hsp60. Expression of heat shock proteins in the vagina may indicate an altered vaginal environment and a susceptibility to vulvovaginal symptoms. Infect. Dis. Obstet. Gynecol. 7:23–25, 1999.

  19. The oestrogenic effects of gestodene, a potent contraceptive progestin, are mediated by its A-ring reduced metabolites. (United States)

    Lemus, A E; Zaga, V; Santillán, R; García, G A; Grillasca, I; Damián-Matsumura, P; Jackson, K J; Cooney, A J; Larrea, F; Pérez-Palacios, G


    Gestodene (17 alpha-ethynyl-13 beta-ethyl-17 beta-hydroxy-4, 15-gonadien-3-one) is the most potent synthetic progestin currently available and it is widely used as a fertility regulating agent in a number of contraceptive formulations because of its high effectiveness, safety and acceptability. The observation that contraceptive synthetic progestins exert hormone-like effects other than their progestational activities, prompted us to investigate whether gestodene (GSD) administration may induce oestrogenic effects, even though the GSD molecule does not interact with intracellular oestrogen receptors (ER). To assess whether GSD may exert oestrogenic effects through some of its neutral metabolites, a series of experimental studies were undertaken using GSD and three of its A-ring reduced metabolites. Receptor binding studies by displacement analysis confirmed that indeed GSD does not bind to the ER, whereas its 3 beta,5 alpha-tetrahydro reduced derivative (3 beta GSD) interacts with a relative high affinity with the ER. The 3 alpha,5 alpha GSD isomer (3 alpha GSD) also binds to the ER, though to a lesser extent. The ability of the A-ring reduced GSD derivatives to induce oestrogenic actions was evaluated by the use of two different molecular bioassays: (a) transactivation of a yeast system co-transfected with the human ER alpha (hER alpha) gene and oestrogen responsive elements fused to the beta-galactosidase reporter vector and (b) transactivation of the hER alpha-mediated transcription of the chloramphenicol acetyl transferase (CAT) reporter gene in a HeLa cells expression system. The oestrogenic potency of 3 beta GSD was also assessed by its capability to induce oestrogen-dependent progestin receptors (PR) in the anterior pituitary of castrated female rats. The results demonstrated that 3 beta GSD and 3 alpha GSD were able to activate, in a dose-dependent manner, the hER alpha-mediated transcription of both the beta-galactosidase and the CAT reporter genes in the

  20. Effects of Oral, Vaginal, and Transdermal Hormonal Contraception on Serum Levels of Coenzyme Q10, Vitamin E, and Total Antioxidant Activity

    Directory of Open Access Journals (Sweden)

    Prabhudas R. Palan


    coenzyme Q10 levels compared with normal subjects. Serum TAOC levels were significantly lower (P<.05 among the contraceptive user groups. Alterations in coenzyme Q10 and α-tocopherol induced by hormonal contraception and the potential effect(s of exogenous ovarian hormones should be taken into consideration in future antioxidant research.

  1. Vaginal Atrophy (United States)

    Vaginal atrophy Overview Vaginal atrophy (atrophic vaginitis) is thinning, drying and inflammation of the vaginal walls due to your body having less estrogen. Vaginal atrophy occurs most often after ...

  2. [Choosing contraception]. (United States)

    Gonzalez Velez, A C


    The development of contraception has allowed women to think about and experience motherhood not as their destiny but as an option. Humans have always been interested in controlling their fertility. Writings unearthed in the 18th century demonstrated the interest of the ancient Egyptians and Greeks in fertility control. The oral contraceptive (OC) pill, developed in the 1950s by Pincus and Rock, has allowed millions of women to avoid unwanted pregnancy. Since 1960, when the oral contraceptive Enovid was first marketed in the US, over 200 million women throughout the world have used OCs. Modern formulations have low hormone doses, which has minimized side effects. OCs now have an effectiveness of 98%. The method is controlled by the woman, permitting autonomous decisions about pregnancy. Currently, in Colombia, 12.9% of women in union use OCs, 25.7% are sterilized, 11.1% each use IUDs and traditional methods, 4.3% use condoms, 2.5% use injectables, 1.4% use vaginal tablets, 0.7% each use Norplant and vasectomy, and 1.8% use other methods. 27.8% use no method. OCs can be used as an emergency method in case of rape, an unexpected sexual encounter, or failure of another method. When used as a postcoital method, OCs must be taken within 72 hours of unprotected sexual intercourse.

  3. Current issues in contraception

    Directory of Open Access Journals (Sweden)

    Drača Petar D.


    Full Text Available Introduction. The authors analyze contemporary methods of contraception. Regarding oral contraception, they point to agents which decrease the efficacy of oral contraception. They also deal with agents which increase the level of estrogen, thus increasing side effects (paracetamol, vitamin C. Oral contraceptives Oral contraceptives may also have an impact on the efficacy of some medications (anticonvulsants, antidepressants. Health risks of oral contraceptives are also mentioned, as well as WHO's, guidelines for women using contraceptives based on risks and benefits. Other methods of contraception The authors also offer criteria for use of bioactive intrauterine devices (IUD, with recommendations of WHO. Besides men's, there are women's condoms, which are very reliable protection against infections, but their negative side is that they are rather expensive. Bad sides of vaginal wash are also emphasized, although this method is rather widespread in the world. Conclusion. At the end, the authors quote the International Family Planning Fund (IFPF which considers IUD to be the most reliable method of contraception nowadays. .

  4. Knowledge of contraceptive effectiveness. (United States)

    Eisenberg, David L; Secura, Gina M; Madden, Tessa E; Allsworth, Jenifer E; Zhao, Qiuhong; Peipert, Jeffrey F


    The purpose of this study was to determine women's knowledge of contraceptive effectiveness. We performed a cross-sectional analysis of a contraceptive knowledge questionnaire that had been completed by 4144 women who were enrolled in the Contraceptive CHOICE Project before they received comprehensive contraceptive counseling and chose their method. For each contraceptive method, women were asked "what percentage would get pregnant in a year: 10%, don't know." Overall, 86% of subjects knew that the annual risk of pregnancy is >10% if no contraception is used. More than 45% of women overestimate the effectiveness of depo-medroxyprogesterone acetate, pills, the patch, the ring, and condoms. After adjustment for age, education, and contraceptive history, the data showed that women who chose the intrauterine device (adjusted relative risk, 6.9; 95% confidence interval, 5.6-8.5) or implant (adjusted relative risk, 5.9; 95% confidence interval, 4.7-7.3) were significantly more likely to identify the effectiveness of their method accurately compared with women who chose either the pill, patch, or ring. This cohort demonstrated significant knowledge gaps regarding contraceptive effectiveness and over-estimated the effectiveness of pills, the patch, the ring, depo-medroxyprogesterone acetate, and condoms. Copyright © 2012 Mosby, Inc. All rights reserved.

  5. Vaginal Atrophy (United States)

    ... Body in Balance › Vaginal Atrophy Fact Sheet Vaginal Atrophy November, 2011 Download PDFs English Espanol Editors JoAnn ... MD Richard J. Santen, MD What is vaginal atrophy? Vaginal atrophy is a condition in which the ...

  6. The sexuological impact of hormonal contraceptives based on their route of administration. (United States)

    Guida, Maurizio; Di Carlo, Costantino; Troisi, Jacopo; Gallo, Alessandra; Cibarelli, Francesca; Martini, Ellis; Tiranini, Lara; Nappi, Rossella E


    Evidence on the effects of hormonal contraceptives on female sexuality is conflicting. We enrolled 556 women, divided into six groups: two composed of subjects using a combined hormonal contraceptive (COC) containing 0.020 ("COC20") and 0.030 ("COC30") mg of ethynyl estradiol (EE), "natural", using COC containing 1.5 mg of estradiol (E2), "ring", using a vaginal ring releasing each day 0.015 mg of EE + 0.120 of etonogestrel, "subcutaneous", using a progestin only subcutaneous contraceptive implant releasing etonogestrel and "controls", using no hormonal contraceptive methods. The subjects were required to answer to the McCoy female sexuality questionnaire and were subjected to a blood test for hormonal evaluation. An ultrasound evaluation of the dorsal clitoral artery was also performed. The higher McCoy sexological value were recorded in the subdermal group; significant differences were recorded among the groups in terms of hormone distribution, with the higher levels of androstenedione in subdermal and control groups. The ultrasound evaluation of dorsal clitoral artery shows a significative correlation between pulsatility and resistance indices and orgasm parameters of McCoy questionnaire. The recorded difference in the sexual and hormonal parameters among the studied hormonal contraceptives may guide toward the personalization of contraceptive choice.

  7. Emergency Contraception

    Directory of Open Access Journals (Sweden)

    Gemzell-Danielsson K


    Full Text Available There have been numerous attempts to control fertility after unprotected sexual intercourse. From very bizarre methods like the vaginal application of Coca Cola to the more serious attempts using calcium antagonists influencing fertility parameters in sperm to hormonal methods or intrauterine devices. So far, hormonal methods preventing or delaying ovulation have proved to be the most popular starting with the combination of ethinyl estradiol and levonorgestrel, known as the Yuzpe regimen. The first dose had to be taken within 72 hours of unprotected intercourse, a second one 12 hours later. Later on, levonorgestrel alone, at first in a regimen similar to the Yuzpe method (2 × 0.75 mg 12 hours apart showed to be more successful, eventually resulting in the development of a 1.5 mg levonorgestrel pill that combined good efficacy with a high ease of use. It has become the standard method used up to this day in most countries. Since the mid 1970s copper IUDs have been used for emergency contraception, which show a high efficacy. Their disadvantages lie in the fact that emergency contraception is considered an off label use and that they might not be acceptable for every patient. Mifepristone in doses of 10 or 25 mg is being used successfully as an emergency contraceptive in China, but has never received any significant consideration in Western countries. The most recent development is the approval of the selective progesterone receptor modulator ulipristal acetate in the dosage of 30 mg for emergency contraception up to 5 days after unprotected intercourse, combining the safe and easy application of the single dose levonorgestrel pill with an even higher efficacy. Several efficacious and easy to use methods for emergency contraception are available on the market today with the most widely spread being levonorgestrel in a single dose of 1.5 mg (given as one tablet of 1.5 mg or 2 tablets of 0.75 mg each for administration up to 3 days after

  8. vaginal histological changes of the baboon

    African Journals Online (AJOL)


    Apr 4, 2009 ... baboon is a good model for investigating possible effects of hormonal contraceptives on vaginal epithelium .... folding. The placard and rosette arrangement of cells remained high. .... A randomized, double-blind trial. Mauritas.

  9. Budget impact analysis of 8 hormonal contraceptive options. (United States)

    Crespi, Simone; Kerrigan, Matthew; Sood, Vipan


    To develop a model comparing costs of 8 hormonal contraceptives and determine whether acquisition costs for implants and intrauterine devices (IUDs) were offset by decreased pregnancy-related costs over a 3-year time horizon from a managed care perspective. A model was developed to assess the budget impact of branded or generic oral contraceptives (OCs), quarterly intramuscular depot medroxyprogesterone, etonogestrel/ethinyl estradiol vaginal ring, etonogestrel implant, levonorgestrel IUD, norelgestromin/ethinyl estradiol transdermal contraceptive, and ethinyl estradiol/levonorgestrel extended-cycle OC. Major variables included drug costs, typical use failure rates, discontinuation rates, and pregnancy costs. The base case assessed costs for 1000 women initiating each of the hormonal contraceptives. The etonogestrel implant and levonorgestrel IUD resulted in the fewest pregnancies, 63 and 85, respectively, and the least cost, $1.75 million and $2.0 million, respectively. In comparison, generic OC users accounted for a total of 243 pregnancies and $3.4 million in costs. At the end of year 1, costs for the etonogestrel implant ($800,471) and levonorgestrel IUD ($949,721) were already lower than those for generic OCs ($1,146,890). Sensitivity analysis showed that the cost of pregnancies, not product acquisition cost, was the primary cost driver. Higher initial acquisition costs for the etonogestrel implant and levonorgestrel IUD were offset within 1 year by lower contraceptive failure rates and consequent pregnancy costs. Thus, after accounting for typical use failure rates of contraceptive products, the etonogestrel implant and levonorgestrel IUD emerged as the least expensive hormonal contraceptives.

  10. The effect of adverse information and positive promotion on women's preferences for prescribed contraceptive products. (United States)

    Knox, Stephanie A; Viney, Rosalie C; Gu, Yuanyuan; Hole, Arne R; Fiebig, Denzil G; Street, Deborah J; Haas, Marion R; Weisberg, Edith; Bateson, Deborah


    Recent rapid growth in the range of contraceptive products has given women more choice, but also adds complexity to the resultant decision of which product to choose. This paper uses a discrete choice experiment (DCE) to investigate the effect of adverse information and positive promotion on women's stated preferences for prescribed contraceptive products. In November 2007, 527 Australian women aged 18-49 years were recruited from an online panel. Each was randomly allocated to one of three information conditions. The control group only received basic information on contraceptive products. One treatment group also received adverse information on the risks of the combined oral pill. The other group received basic information and promotional material on the vaginal ring, newly introduced into Australia and on the transdermal patch, which is unavailable in Australia. Respondents completed 32 choice sets with 3 product options where each option was described by a product label: either combined pill, minipill, injection, implant, hormonal IUD, hormonal vaginal ring, hormonal transdermal patch or copper IUD; and by the attributes: effect on acne, effect on weight, frequency of administration, contraceptive effectiveness, doctor's recommendation, effect on periods and cost. Women's choices were analysed using a generalized multinomial logit model (G-MNL) and model estimates were used to predict product shares for each information condition. The predictions indicated that adverse information did not affect women's preferences for products relative to only receiving basic information. The promotional material increased women's preferences for the transdermal patch. Women in all groups had a low preference for the vaginal ring which was not improved by promotion. The findings highlight the need for researchers to pay attention to setting the context when conducting DCEs as this can significantly affect results.

  11. Influence of hormonal contraceptives and the occurrence of stroke: integrative review. (United States)

    Lima, Adman Câmara Soares; Martins, Larissa Castelo Guedes; Lopes, Marcos Venícios de Oliveira; Araújo, Thelma Leite de; Lima, Francisca Elisângela Teixeira; Aquino, Priscila de Souza; Moura, Escolástica Rejane Ferreira


    To identify scientific evidence regarding the influence of hormonal contraceptive use and the occurrence of stroke. Integrative review of the literature, through database search using the descriptors "contraceptive agents", "contraceptive devices", "contraceptives, Oral" and "Stroke". Original studies in Portuguese, Spanish and English, published in full and available online were included. Studies that did not answer our guiding questions and duplicated studies were excluded. Women using combined oral contraceptives have higher risk of stroke, even with a lower hormonal dosage and different types of progestogen, regardless of the duration of use. The use of contraceptives associated with smoking, hypertension, migraine, hypercholesterolemia, obesity and sedentary lifestyle increases the chance of stroke. Contraceptive patch and vaginal ring are associated to increased risk. Use of combined hormonal contraceptives, except for the injectable and the transdermal ones, increases the chance of occurrence of the event. Progestogen-only contraceptives were considered safe. Identificar evidências científicas acerca da influência do uso de anticoncepcionais hormonais na ocorrência do acidente vascular cerebral (AVC). Revisão integrativa da literatura, com pesquisa em bases de dados, utilizando os descritores "contraceptive agents", "contraceptive devices", "contraceptives, Oral" e "stroke". Foram incluídos artigos originais nos idiomas português, espanhol e inglês, publicados na íntegra e disponíveis eletronicamente. Foram excluídos artigos que não respondiam às questões norteadoras e repetidos. Usuárias de anticoncepcional oral combinado apresentam risco maior de AVC, mesmo com dosagem hormonal menor e diferentes tipos de progestágeno, independente do tempo de uso. A presença associada de tabagismo, hipertensão arterial, enxaqueca, hipercolesterolemia, obesidade e sedentarismo aumenta a chance desse desfecho. Adesivo anticoncepcional e anel vaginal s

  12. Vaginal Diseases (United States)

    Vaginal problems are some of the most common reasons women go to the doctor. They may have ... that affect the vagina include sexually transmitted diseases, vaginal cancer, and vulvar cancer. Treatment of vaginal problems ...

  13. Vaginal Fistula (United States)

    Vaginal fistula Overview By Mayo Clinic Staff A vaginal fistula is an abnormal opening that connects your vagina to ... or urine to pass through your vagina. Vaginal fistulas can develop as a result of an injury, ...

  14. Association of Hormonal Contraception With Depression. (United States)

    Skovlund, Charlotte Wessel; Mørch, Lina Steinrud; Kessing, Lars Vedel; Lidegaard, Øjvind


    Millions of women worldwide use hormonal contraception. Despite the clinical evidence of an influence of hormonal contraception on some women's mood, associations between the use of hormonal contraception and mood disturbances remain inadequately addressed. To investigate whether the use of hormonal contraception is positively associated with subsequent use of antidepressants and a diagnosis of depression at a psychiatric hospital. This nationwide prospective cohort study combined data from the National Prescription Register and the Psychiatric Central Research Register in Denmark. All women and adolescents aged 15 to 34 years who were living in Denmark were followed up from January 1, 2000, to December 2013, if they had no prior depression diagnosis, redeemed prescription for antidepressants, other major psychiatric diagnosis, cancer, venous thrombosis, or infertility treatment. Data were collected from January 1, 1995, to December 31, 2013, and analyzed from January 1, 2015, through April 1, 2016. Use of different types of hormonal contraception. With time-varying covariates, adjusted incidence rate ratios (RRs) were calculated for first use of an antidepressant and first diagnosis of depression at a psychiatric hospital. A total of 1 061 997 women (mean [SD] age, 24.4 [0.001] years; mean [SD] follow-up, 6.4 [0.004] years) were included in the analysis. Compared with nonusers, users of combined oral contraceptives had an RR of first use of an antidepressant of 1.23 (95% CI, 1.22-1.25). Users of progestogen-only pills had an RR for first use of an antidepressant of 1.34 (95% CI, 1.27-1.40); users of a patch (norgestrolmin), 2.0 (95% CI, 1.76-2.18); users of a vaginal ring (etonogestrel), 1.6 (95% CI, 1.55-1.69); and users of a levonorgestrel intrauterine system, 1.4 (95% CI, 1.31-1.42). For depression diagnoses, similar or slightly lower estimates were found. The relative risks generally decreased with increasing age. Adolescents (age range, 15-19 years) using

  15. Forgettable contraception. (United States)

    Grimes, David A


    The term "forgettable contraception" has received less attention in family planning than has "long-acting reversible contraception." Defined here as a method requiring attention no more often than every 3 years, forgettable contraception includes sterilization (female or male), intrauterine devices, and implants. Five principal factors determine contraceptive effectiveness: efficacy, compliance, continuation, fecundity, and the timing of coitus. Of these, compliance and continuation dominate; the key determinants of contraceptive effectiveness are human, not pharmacological. Human nature undermines methods with high theoretical efficacy, such as oral contraceptives and injectable contraceptives. By obviating the need to think about contraception for long intervals, forgettable contraception can help overcome our human fallibility. As a result, all forgettable contraception methods provide first-tier effectiveness (contraceptives today with exclusively first-tier effectiveness is the one that can be started -- and then forgotten for years.

  16. Women's perceptions and reasons for choosing the pill, patch, or ring in the CHOICE study: a cross-sectional survey of contraceptive method selection after counseling

    National Research Council Canada - National Science Library

    Egarter, Christian; Frey Tirri, Brigitte; Bitzer, Johannes; Kaminskyy, Vyacheslav; Oddens, Björn J; Prilepskaya, Vera; Yeshaya, Arie; Marintcheva-Petrova, Maya; Weyers, Steven


    .... In this paper we present the reasons given by the 18,787 participating women for selecting their contraceptive method of choice, as well as their perceptions about the contraceptive pill, patch...

  17. [Contraception in perimenopause]. (United States)

    Merki-Feld, G S


    Perimenopausal women are still potentially fertile and pregnancy is attended with increased maternal and perinatal mortality. Several contraceptive methods can be used therapeutic for the treatment of climacteric symptoms like menstrual irregularities, flushes and vaginal dryness. Low-dose oral contraceptives (OC) prevent climacteric symptoms and additionally protect from perimenopausal bone loss. However, the individual cardiovascular risk increases with age and is even higher in perimenopausal women using OCs. Therefore for women with cardiovascular risk factors sterilization, barrier methods, progestin-only methods and intrauterine devices (IUD) are the better choice. Prolonged and heavy menses can be treated with the levonorgestrel-releasing IUD or injectable progestogens. If estrogen replacement is necessary, a low-dose treatment with natural estrogens can be combined with barrier methods, the levonorgestrel-releasing IUD and injectable progestogens. The variety of contraceptive options available to perimenopausal women allows individual counseling and thus may enhance compliance.

  18. [Barrier methods of contraception]. (United States)

    Goldsmith, A; Edelman, D A


    Vaginal methods of contraception were the earliest types used and some references to them date back to antiquity. Most of the vaginal contraceptive agents identified by the ancient Greeks, Indians, Japanese, and Chinese have been found in modern laboratory tests to have spermicidal properties, but it is doubtful that the methods were fully reliable or were used by many people. During the 19th century the condom, vaginal spermicides, and diaphragm became available. The development of nonoxynol-9 and other nonirritating but effective spermicidal agents improved vaginal contraceptives greatly by the 1950s, but starting in the 1960s newer methods began to replace the vaginal methods. Interest in barrier methods has been reawakened somewhat by concern about the health effects of hormonal methods. At present all barrier methods leave something to be desired. Failure rates of 3-30% for barrier methods in general have been estimated, but the higher rates are believed due to incorrect or inconsistent use. Theoretical failure rates of condoms and diaphragms have been estimated at 3/100 women-years, but in actual use failure rates may reach 15 for condoms and 13 for diaphragms used with spermicides. Use-effectiveness rates are greatly influenced by motivation. For a variety of reasons, the acceptability of barrier methods is low, especially in developing countries. New developments in spermicidal agents include sperm inhibitors, which impede the fertilizing capacity of sperm rather than attempting a spermicidal effect; a number of such agents have been studied and have proven more effective in animal tests than conventional spermicides. Neosampoon, a new spermicidal foam, has attracted an increasing number of users, especially in developing countries. A new condom, made of thin polymers and containing a standard dose of nonoxynol-9, has been designed to dissolve in the vaginal fluid. Further studies are needed of its acceptability, efficacy, and side effects before it becomes

  19. Progress on contraception methods of perimenopausal women%围绝经期妇女避孕方法的研究进展

    Institute of Scientific and Technical Information of China (English)

    柳韦华; 孙彦玲; 高丹凤


    This article introduced the progress on perimenopause contraception. Various contraceptive options may be offered to perimenopausal women, including oral contraceptives, tubal ligation, intrauterine devices, barrier methods, hormonal injectables and implants. Recently, new methods of contraception have been introduced presenting high efficacy rates and minor side - effect, such as the monthly injectable system, the contraceptive vaginal ring and the transderimal contraceptive system. The use of the various contraceptive methods during perimenopause holds special benefits and risks that should be carefully balanced, after a thorough consultation and according to each women(s) contraception needs.%本文综述了围绝经期妇女避孕方法 的研究进展,围绝经期妇女可采用多种避孕方法 ,包括口服避孕药、输卵管结扎、宫内节育器,屏障避孕、避孕针和皮下埋植.最近一些新的避孕方法 高效、副作用小,如每月注射的长效避孕针、阴道环和透皮贴剂等.围绝经期采用不同的方法 避孕各有利弊,根据个体需要选择恰当的避孕措施.

  20. Combined hormonal contraception use in reproductive-age women with contraindications to estrogen use. (United States)

    Lauring, Julianne R; Lehman, Erik B; Deimling, Timothy A; Legro, Richard S; Chuang, Cynthia H


    The Centers for Disease Control and Prevention's US Medical Eligibility Criteria for Contraceptive Use recommends that combined hormonal contraceptives (ie, birth control pills, contraceptive patch, vaginal ring) should be avoided in women with specific medical conditions because of the increased risk of cardiovascular events associated with estrogen use. Whether women with category 3 (theoretical or proven risk usually outweigh the advantages) or category 4 (unacceptable health risk) contraindications are appropriately avoiding estrogen-containing combined hormonal contraceptives is unknown. We describe the prevalence of combined hormonal contraceptive use among a sample of reproductive-age women with medical contraindications to estrogen use. Our hypothesis was that women with categories 3 and 4 contraindications would use estrogen-containing contraception less often than women without medical contraindications. We also explored whether inappropriate estrogen-containing contraceptive use is related to contraceptive provider characteristics. Data are from the baseline survey of the MyNewOptions study, which included privately insured women residing in Pennsylvania aged 18-40 years, who were sexually active and not intending pregnancy in the next year. Women were surveyed about their medical conditions, contraceptive use, and characteristics of their contraceptive provider. Women were considered to have a contraindication to combined hormonal contraceptives if they reported a category 3 or category 4 contraindication: hypertension, smokers older than age 35 years, a history of venous thromboembolism, diabetes with complications, coronary artery disease, systemic lupus erythematosus with antiphospholipid antibodies, breast cancer, or migraine headaches with aura. χ(2) tests for general association were used to compare combined hormonal contraceptives use, contraceptive health provider characteristics, and sociodemographic data in women with and without

  1. Impact of a women's counselling programme on combined hormonal contraception in Portugal--the IMAGINE Study. (United States)

    Costa, Ana Rosa R; Palma, Fátima; Sá, José Luís; Vicente, Lisa; Bombas, Teresa; Nogueira, Ana Maria; Rocha, Pedro


    The aim of this health education project was to measure the impact of counselling about combined hormonal contraceptive (CHC) methods on the subsequent choice of method by Portuguese women. This was a multi-centre study with a representative population, at the national and regional levels, of 2951 Portuguese women≥16 years of age visiting the gynaecologist. Counselling on available CHC methods was provided using a single leaflet, and their CHC choice was assessed before and after counselling. A combined oral contraceptive (COC) was the method preferred by the majority of the women prior to counselling. After counselling, 35% of women who initially had chosen the pill, switched to either the vaginal ring or the transdermal patch, and the difference was statistically significant. Ease of use was the major reason for choosing the COC, while a lower probability of omission was the reason for choosing the vaginal ring and the patch. The implementation of a counselling programme significantly affected contraceptive choices leading in a number of cases to the selection of alternatives better suited to women's lifestyle. Age and educational level are socio-demographic factors which play an important role.

  2. [Contraception in the future]. (United States)

    Hamzaoui, R; Boukhris, M


    In the last decade, global use of contraceptive methods has increased. About 50% of couples of childbearing age use a modern contraceptive method. This evolution and a positive change in attitude towards male contraception has encouraged research in fertility regulation to enlarge and to improve acceptance of the contraceptive mix. Current injectable contraceptives interfere with the menstrual cycle. Research is exploring ways to minimize such secondary effects by reducing the total hormone dose and by changing the way the active product is delivered (e.g., microspheres). An injectable prototype is an analogue of levonorgestrel (HRP 002). A new IUD is made of leather suspended by a nylon suture which has been inserted into the uterine muscle. RU-486, often used to interrupt early pregnancy, is being tested as an oral contraceptive (OC). It inhibits secretion of gonadotropins and ovulation. It holds promise as an OC with no estrogen component. Since it also inhibits endometrial development and thus prevents implantation, it may someday be used for emergency contraception (i.e., postcoital contraception). New contraceptive implants under study include Norplant RII (2 rods of levonorgestrel lasting for 3 years), Implanon (desogestrel), and Capranor (biodegradable implant lasting 2 years). The female condom consists of a flexible polyurethane sheath with a flexible ring at each end. It has the potential to protect against sexually transmitted diseases since it covers the labial lips and is impermeable to HIV. France and Switzerland have both approved its use. It will enter the UK market at the end of the year. Approval for marketing has been sought in the US.

  3. Drug interactions between non-rifamycin antibiotics and hormonal contraception: a systematic review. (United States)

    Simmons, Katharine B; Haddad, Lisa B; Nanda, Kavita; Curtis, Kathryn M


    The purpose of this study was to determine whether interactions between non-rifamycin antibiotics and hormonal contraceptives result in decreased effectiveness or increased toxicity of either therapy. We searched MEDLINE, Embase,, and Cochrane libraries from database inception through June 2016. We included trials, cohort, case-control, and pharmacokinetic studies in any language that addressed pregnancy rates, pharmacodynamics, or pharmacokinetic outcomes when any hormonal contraceptive and non-rifamycin antibiotic were administered together vs apart. Of 7291 original records that were identified, 29 met criteria for inclusion. Two authors independently assessed study quality and risk of bias using the United States Preventive Services Task Force evidence grading system. Findings were tabulated by drug class. Study quality ranged from good to poor and addressed only oral contraceptive pills, emergency contraception pills, and the combined vaginal ring. Two studies demonstrated no difference in pregnancy rates in women who used oral contraceptives with and without non-rifamycin antibiotics. No differences in ovulation suppression or breakthrough bleeding were observed in any study that combined hormonal contraceptives with any antibiotic. No significant decreases in any progestin pharmacokinetic parameter occurred during co-administration with any antibiotic. Ethinyl estradiol area under the curve decreased when administered with dirithromycin, but no other drug. Evidence from clinical and pharmacokinetic outcomes studies does not support the existence of drug interactions between hormonal contraception and non-rifamycin antibiotics. Data are limited by low quantity and quality for some drug classes. Most women can expect no reduction in hormonal contraceptive effect with the concurrent use of non-rifamycin antibiotics. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Emergency contraception (United States)

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B; Family planning - emergency contraception ... prevents pregnancy in the same way as regular birth control pills: By preventing or delaying the release of an ...

  5. Knowledge-attitude-practice survey among Portuguese gynaecologists regarding combined hormonal contraceptives methods. (United States)

    Bombas, Teresa; Costa, Ana Rosa; Palma, Fátima; Vicente, Lisa; Sá, José Luís; Nogueira, Ana Maria; Andrade, Sofia


    ABSTRACT Objectives To evaluate knowledge, attitude and practices of Portuguese gynaecologists regarding combined hormonal contraceptives. Methods A cross-sectional survey was conducted among 303 gynaecologists. Results Ninety percent of the gynaecologists considered that deciding on contraceptive methods is a process wherein the woman has her say. Efficacy, safety and the woman's preference were the major factors influencing gynaecologists, while efficacy, tolerability and ease of use were the major factors perceived by the specialists to influence the women's choice. Gynaecologists believed that only 2% of women taking the pill were 100% compliant compared to 48% of those using the patch and 75% of those using the ring. The lower risk of omission was the strong point for the latter methods. Side effects were the main reason to change to another method. Vaginal manipulation was the most difficult topic to discuss. Conclusions Most gynaecologists decided with the woman on the contraceptive method. The main reasons for the gynaecologist's recommendation of a given contraceptive method and the women's choice were different. Counselling implies an open discussion and topics related to sexuality were considered difficult to discuss. Improving communication skills and understanding women's requirements are critical for contraceptive counselling.

  6. Contraceptive Development. (United States)

    Troen, Philip; And Others

    This report provides an overview of research activities and needs in the area of contraceptive development. In a review of the present state, discussions are offered on the effectiveness and drawbacks of oral contraceptives, intrauterine devices, barrier methods, natural family planning, and sterilization. Methods of contraception that are in the…

  7. [Adolescent contraception. Current trends]. (United States)

    Anthuber, Sabine


    Despite easy availability of contraception, Germany is confronted with the problem of increasing rates of pregnancies and abortions in minors. Prescription of contraceptives that do not rely on compliance and are acceptable to adolescents is required in addition to improved counseling. For that purpose, adherence to the guidelines for the use of contraceptives in minors written by the consortium for legislation in medicine (AG Medizinrecht) is essential. Oral contraceptives are the most commonly prescribed form of birth control, advantages include reversibility as well as a good tolerance and safety profile. New developments are low-dose compounds, novel progestins, prevention of ovulation by pure gestagen pills and the long-term use of low-dose monophasic micro pills. Long-term contraceptives like subdermally implantable depot compounds or hormone-releasing pessaries in utero have been used on a regular basis and seem a convenient alternative for birth control for longer periods, also in adolescents. The easy-to-use intravaginal ring and the birth control patch have expanded the spectrum of hormone-releasing contraceptive systems. Studies show improved compliance and a possible reduction of unintentional pregnancies due to application errors. Amelioration of the range of highly effective birth control products different modes of application will hopefully lead to drop in the rate of unplanned pregnancies, especially in adolescents.

  8. Complete vaginal outlet stenosis in a patient with Sheehan's syndrome. (United States)

    Choo, Minji; Park, Hana; Yi, Kyong Wook


    We present a case of complete vaginal stenosis in a woman diagnosed with Sheehan's syndrome. The patient delivered at full-term 5 months prior, and experienced massive postpartum bleeding at that time. During evaluation of persistent amenorrhea, we found that her vaginal orifice was completely adhesive and obstructed. Prior to corrective surgery, we managed the patient with an oral contraceptive to induce uterine bleeding into the vaginal outflow tract. After three cycles of an oral contraceptive, we could confirm that there was no stenotic lesion in the vaginal cavity as a hematocolpos was created. Adhesiolysis with scar revision for the vaginal stenosis was successfully performed; it was found that the lesion was limited to only the distal part of the vaginal outlet. Complete vaginal stenosis in reproductive age women with hypopituitarism has not been reported. The artificial induction of hematometrocolpos before surgery was useful in determining the extent of the stenotic lesion, and assured safety.

  9. Atrophic vaginitis. (United States)

    Stika, Catherine S


    With the loss of estrogen that occurs with menopause, physiologic and structural changes occur within the vulvovaginal mucosa that lead to a condition commonly called atrophic vaginitis. Although mild genital changes occur in most women, 10-47% of postmenopausal women will develop one or more debilitating symptoms that include vulvovaginal dryness, dyspareunia, vulvar itching or pain, recurrent urinary tract infections, as well as abnormal vaginal discharge. Topical estrogen replacement therapies reverse these mucosal changes and are effective treatments for the symptoms of atrophic vaginitis. Vaginal moisturizers and lubricants also provide symptomatic relief for vaginal dryness and dyspareunia, respectively. © 2010 Wiley Periodicals, Inc.

  10. Knowledge and attitudes of Latin American obstetricians and gynecologists regarding intrauterine contraceptives (United States)

    Bahamondes, Luis; Makuch, Maria Y; Monteiro, Ilza; Marin, Victor; Lynen, Richard


    Background Intrauterine contraceptives (IUCs), including the copper intrauterine device and the levonorgestrel-releasing intrauterine system (LNG-IUS), are among the reversible contraceptive methods with high effectiveness. However, use is low in many settings, including some Latin American countries, mainly due to the influences of myths, fears, and negative attitudes, not only of users and potential users, but also of different cadres of health care professionals. The purpose of this study was to assess the knowledge and attitudes of a group of Latin American obstetricians and gynecologists regarding IUCs. Methods A survey was conducted during a scientific meeting organized in Chile in 2014 to present and discuss updated information about contraception. Obstetricians and gynecologists from 12 Latin American countries, who reported that they provide daily contraception services in both the public and private sectors, participated in the meeting. Participants who agreed to take part in the survey responded to a multiple-choice questionnaire on issues regarding knowledge, use, and attitudes about IUCs. Results Of the 210 obstetricians and gynecologists participating in the meeting, the respondents to each question varied from 168 (80.0%) to 205 (97.6%). Almost 50% recognized that the failure rate of combined oral contraceptives, patches, and vaginal rings is 8%–10%. Furthermore, 10% of the participants did not recognize the high contraceptive effectiveness of long-acting reversible contraceptive methods. Additionally, almost 80% of the respondents answered that they did not offer IUCs to nulligravidas and almost 10% did not offer IUCs to adolescents, albeit almost 90% of the respondents reported that nulligravidas are candidates for an LNG-IUS. Conclusion Some deficiencies and contradictions in terms of knowledge and attitudes were identified from the answers of the Latin American obstetricians and gynecologists who participated in the survey. The knowledge and

  11. Birth Control Ring (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Birth Control Ring KidsHealth > For Teens > Birth Control Ring A A A What's in this article? ... español Anillo vaginal anticonceptivo What Is It? The birth control ring is a soft, flexible, doughnut-shaped ring ...

  12. Contraceptive Methods. (United States)

    Colquitt, Charlie W; Martin, Tonya S


    The prevention of pregnancy remains an important part of the practice of medicine. Contraception can occur at a number of points in the basic reproductive biological process and through a number of contraceptive product options. Pharmacists are health care providers appropriately positioned to assist patients in suitable contraceptive product selection based on their personal situations and lifestyles. This article provides an overview of available products for prevention of pregnancy and associated risks and benefits. Contraceptive products are categorized by their hormonal content and method of action. Hormonal options include oral contraceptive pills, contraceptive patch, implants, injection, intravaginal, and intrauterine devices. Barrier products prevent pregnancy by creating a physical obstacle to the successful fertilization of an egg by sperm. All products and methods are associated with benefits and potential complications that must be considered as patients, and health care providers select the most satisfactory option.

  13. Emergency contraception. (United States)

    Van Look, P F; von Hertzen, H


    The term 'emergency contraception', as employed in this paper, refers to methods that are used as emergency procedures to prevent pregnancy following unprotected intercourse. Alternative, less appropriate, terms are postcoital and 'morning-after' contraception. References to postcoital preparations can be found as far back as 1500 BC in Egyptian papyri, but it was not until fairly recently that contraceptive research has been able to at least partially fulfill that need. The development of hormonal methods of emergency contraception goes back to the 1960s when the first human trials of postcoitally administered high-dose oestrogens were undertaken. Combined oestrogen- progestogen combination therapy (the so-called Yuzpe regimen) was introduced in the early 1970s, while the postcoital insertion of an intrauterine contraceptive device (IUD) for emergency contraception was first reported in 1976. Other compounds that have been tested more recently include levonorgestrel, the antiprogestogen mifepristone, and danazol. Although there is some debate about the magnitude of the protective effect, few people question the important role that emergency contraception can play in preventing unwanted pregnancy and hence maternal mortality and morbidity resulting from unsafe abortion. Given that the most often used methods of emergency contraception, namely the Yuzpe regimen and postcoital insertion of an IUD, rely on technology that has been available for some 30 years, family planning programmes that claim to be concerned with improving women's reproductive health, cannot really be excused if they do not provide emergency contraception as part of their routine services.

  14. Post-placental postpartum intrauterine contraceptive devices insertion: our scenario

    Directory of Open Access Journals (Sweden)

    Monica Soni


    Conclusions: PPIUCD, a long-acting reversible method of contraception, is a safe option with high retention rate and very few expulsions and side effects. There was higher rate of acceptance, no expulsion and high continuation rate in post-cesarean cases as compared to vaginally delivered cases. [Int J Reprod Contracept Obstet Gynecol 2016; 5(3.000: 766-769

  15. Contraceptive sales in the setting of the Zika virus epidemic (United States)

    Bahamondes, Luis; Ali, Moazzam; Monteiro, Ilza; Fernandes, Arlete


    STUDY QUESTION Has there been any influence of the Zika virus (ZIKV) outbreak on the sales of contraceptive methods in Brazil? SUMMARY ANSWER Contraceptive sales in the 24 months of evaluation showed little variation and no significant change has been observed since the ZIKV outbreak. WHAT IS KNOWN ALREADY Transmission of ZIKV is primarily by Aedes aegypti mosquitoes; however, sexual transmission has also been described. The association of several birth defects and the ZIKV infection during pregnancy has been established, and it was estimated in Bahia, Brazil that the infection rate could range from 10% to 80%. The World Health Organisation (WHO) declared the cluster of microcephaly cases and other neurological disorders a health emergency on 1 February 2016. The Brazilian government also made recommendations for women who were planning to become pregnant and who reside in ZIKV-affected areas to reconsider or postpone pregnancy. STUDY DESIGN, SIZE, DURATION The objective of this study was to assess the sales of contraceptive methods in Brazil, tracking it from before and through the ZIKV outbreak. We obtained information from all pharmaceutical companies based in Brazil and from the manufacturers of long-acting reversible contraceptives (LARCs), including the copper-intrauterine device (IUD), the levonorgestrel-releasing intrauterine system (LNG-IUS) and implants, about contraceptives sales in the public and private sectors between September 2014 and August 2016. PARTICIPANTS/MATERIALS, SETTING, METHODS We analyzed the data for: (i) oral contraceptives, i.e. combined oral contraceptives (COC) and progestin-only pills (POP), and vaginal and transdermal contraceptives, (ii) injectable contraceptives, i.e. once-a-month and depot-medroxyprogesterone acetate, (iii) LARCs and (iv) emergency contraceptive (EC) pills. MAIN RESULTS AND THE ROLE OF CHANCE Monthly sales of COC, POP, patches and vaginal rings represent the major sales segment of the market, i.e. 12.7–13

  16. Vaginal Cancer (United States)

    Vaginal cancer is a rare type of cancer. It is more common in women 60 and older. You are also more likely to get it if you have had a human ... test can find abnormal cells that may be cancer. Vaginal cancer can often be cured in its ...

  17. Vaginal cysts (United States)

    ... cysts URL of this page: // Vaginal cysts To use the sharing ... may need a biopsy to rule out vaginal cancer, especially if the mass appears to be solid. If the cyst is located under the bladder or urethra, x-rays may be needed to see if ...

  18. Adolescent contraception. (United States)

    Nelson, A L


    By age 19, the average North American man has had sex with 5.11 people. Almost two thirds of high-school senior-aged women have had sex. While the rates of sexual activity among teens in the US are not substantially different from rates in other developed western countries, adolescent pregnancy rates in the US are several times higher than in most other countries. These high rates of adolescent pregnancy are partly due to the collective reluctance among adults in the US to discuss sexuality issues with adolescents and provide them with contraception. Effective communication is the key to providing contraception to teens. Studies have clearly shown that teens are interested in sexuality and would like to discuss the issue with their physicians. The author notes that any successful program to reduce unwanted pregnancies among teens will understand that teens are often concrete thinkers focused upon their physical appearance and dedicated to taking risks. Oral contraception, long-acting progestin methods, condoms, and other options are discussed. However, emergency contraception with birth control pills is the one most important contraceptive option which can be provided to teens. The approach has recently been approved by the FDA Advisory Board for both safety and efficacy. Recent studies, however, show that less than 10% of US clinicians informed their patients of the availability of emergency contraception. Information on providers of emergency contraception can be obtained by dialing Princeton University's Office of Population Research's toll-free emergency contraception hotline at (800) 584-9911.

  19. Emphysematous vaginitis. (United States)

    Lima-Silva, Joana; Vieira-Baptista, Pedro; Cavaco-Gomes, João; Maia, Tiago; Beires, Jorge


    Emphysematous vaginitis is a rare condition, characterized by the presence of multiple gas-filled cysts in the vaginal and/or exocervical mucosa. Although its etiology is not completely understood, it is self-limited, with a benign clinical course. Vaginal discharge, sometimes bloody, and pruritus are the most common symptoms. Chronic and acute inflammation can be found, and diseases that impair the immune system and pregnancy have been associated with this condition. A 48-year-old postmenopausal woman, with a history of hysterectomy with several comorbidities, presented with a 4-month history of bloody discharge and vulvar pruritus. Examination showed multiple cystic lesions, 1 to 5 mm, occupying the posterior and right lateral vaginal walls. Speculum examination produced crepitus. Vaginal wet mount was normal, except for diminished lactobacilli; results of Trichomonas vaginalis DNA test and vaginal cultures were negative. Lugol's iodine applied to the vagina was taken up by the intact lesions. Biopsy result showed typical features of emphysematous vaginitis. This is an unusual entity, presenting with common gynecological complaints, and both physicians and pathologists should be aware to prevent misdiagnosis and overtreatment.

  20. Oral contraception following abortion (United States)

    Che, Yan; Liu, Xiaoting; Zhang, Bin; Cheng, Linan


    Abstract Oral contraceptives (OCs) following induced abortion offer a reliable method to avoid repeated abortion. However, limited data exist supporting the effective use of OCs postabortion. We conducted this systematic review and meta-analysis in the present study reported immediate administration of OCs or combined OCs postabortion may reduce vaginal bleeding time and amount, shorten the menstruation recovery period, increase endometrial thickness 2 to 3 weeks after abortion, and reduce the risk of complications and unintended pregnancies. A total of 8 major authorized Chinese and English databases were screened from January 1960 to November 2014. Randomized controlled trials in which patients had undergone medical or surgical abortions were included. Chinese studies that met the inclusion criteria were divided into 3 groups: administration of OC postmedical abortion (group I; n = 1712), administration of OC postsurgical abortion (group II; n = 8788), and administration of OC in combination with traditional Chinese medicine postsurgical abortion (group III; n = 19,707). In total, 119 of 6160 publications were included in this analysis. Significant difference was observed in group I for vaginal bleeding time (P = 0.0001), the amount of vaginal bleeding (P = 0.03), and menstruation recovery period (P abortion (P abortion, and reduce the risk of complications and unintended pregnancies. PMID:27399060

  1. Contraceptive implants. (United States)

    McDonald-Mosley, Raegan; Burke, Anne E


    Implantable contraception has been extensively used worldwide. Implants are one of the most effective and reversible methods of contraception available. These devices may be particularly appropriate for certain populations of women, including women who cannot use estrogen-containing contraception. Implants are safe for use by women with many chronic medical problems. The newest implant, Implanon (Organon International, Oss, The Netherlands), is the only device currently available in the United States and was approved in 2006. It is registered for 3 years of pregnancy prevention. Contraceptive implants have failure rates similar to tubal ligation, and yet they are readily reversible with a return to fertility within days of removal. Moreover, these contraceptive devices can be safely placed in the immediate postpartum period, ensuring good contraceptive coverage for women who may be at risk for an unintended pregnancy. Irregular bleeding is a common side effect for all progestin-only contraceptive implants. Preinsertion counseling should address possible side effects, and treatment may be offered to women who experience prolonged or frequent bleeding. Thieme Medical Publishers.

  2. Vaginal cancer (United States)

    Hacker NF. Vulvar and vaginal cancer. In: Hacker NF, Gambone JC, Hobel CJ, eds. Hacker and Moore's Essentials of Obstetrics and Gynecology . 6th ed. Philadelphia, PA: Elsevier; 2016:chap 40. Jhingran ...

  3. Clindamycin Vaginal (United States)

    ... be used to treat vaginal irritation caused by yeast infections or by sexually transmitted diseases such as ... the lining of all or part of the intestine is swollen, irritated, or has sores) or severe ...

  4. Vaginal Bleeding (United States)

    Menstruation, or period, is a woman's monthly bleeding.Abnormal vaginal bleeding is different from normal menstrual periods. It could be bleeding that is between periods, is very heavy, or lasts much ...

  5. Vaginal Microbiota. (United States)

    Mendling, Werner


    The knowledge about the normal and abnormal vaginal microbiome has changed over the last years. Culturing techniques are not suitable any more for determination of a normal or abnormal vaginal microbiota. Non culture-based modern technologies revealed a complex and dynamic system mainly dominated by lactobacilli.The normal and the abnormal vaginal microbiota are complex ecosystems of more than 200 bacterial species influenced by genes, ethnic background and environmental and behavioral factors. Several species of lactobacilli per individuum dominate the healthy vagina. They support a defense system together with antibacterial substances, cytokines, defensins and others against dysbiosis, infections and care for an normal pregnancy without preterm birth.The numbers of Lactobacillus (L.) iners increase in the case of dysbiosis.Bacterial vaginosis (BV) - associated bacteria (BVAB), Atopobium vaginae and Clostridiales and one or two of four Gardnerella vaginalis - strains develop in different mixtures and numbers polymicrobial biofilms on the vaginal epithelium, which are not dissolved by antibiotic therapies according to guidelines and, thus, provoke recurrences.Aerobic vaginitis seems to be an immunological disorder of the vagina with influence on the microbiota, which is here dominated by aerobic bacteria (Streptococcus agalactiae, Escherichia coli). Their role in AV is unknown.Vaginal or oral application of lactobacilli is obviously able to improve therapeutic results of BV and dysbiosis.

  6. Emergency Contraception (United States)

    ... the pill that contains ulipristal acetate reduces the risk of pregnancy more effectively than pills that contain levonorgestrel.It is important to remember that emergency contraceptive pills will not prevent pregnancy if you have ...

  7. Birth Control Ring (United States)

    ... Right Sport for You Healthy School Lunch Planner Birth Control Ring KidsHealth > For Teens > Birth Control Ring Print A A A What's in ... español Anillo vaginal anticonceptivo What Is It? The birth control ring is a soft, flexible, doughnut-shaped ...

  8. Knowledge and attitudes of Latin American obstetricians and gynecologists regarding intrauterine contraceptives

    Directory of Open Access Journals (Sweden)

    Bahamondes L


    Full Text Available Luis Bahamondes,1 Maria Y Makuch,1 Ilza Monteiro,1 Victor Marin,2 Richard Lynen3 1Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil; 2Department of Obstetrics and Gynecology, Hospital Central, Petróleos Mexicanos, México City, Mexico; 3Bayer HealthCare, Newark, NJ, USA Background: Intrauterine contraceptives (IUCs, including the copper intrauterine device and the levonorgestrel-releasing intrauterine system (LNG-IUS, are among the reversible contraceptive methods with high effectiveness. However, use is low in many settings, including some Latin American countries, mainly due to the influences of myths, fears, and negative attitudes, not only of users and potential users, but also of different cadres of health care professionals. The purpose of this study was to assess the knowledge and attitudes of a group of Latin American obstetricians and gynecologists regarding IUCs.Methods: A survey was conducted during a scientific meeting organized in Chile in 2014 to present and discuss updated information about contraception. Obstetricians and gynecologists from 12 Latin American countries, who reported that they provide daily contraception services in both the public and private sectors, participated in the meeting. Participants who agreed to take part in the survey responded to a multiple-choice questionnaire on issues regarding knowledge, use, and attitudes about IUCs.Results: Of the 210 obstetricians and gynecologists participating in the meeting, the respondents to each question varied from 168 (80.0% to 205 (97.6%. Almost 50% recognized that the failure rate of combined oral contraceptives, patches, and vaginal rings is 8%–10%. Furthermore, 10% of the participants did not recognize the high contraceptive effectiveness of long-acting reversible contraceptive methods. Additionally, almost 80% of the respondents answered that they did not offer IUCs to nulligravidas and almost 10% did

  9. Application of Compound Short-Acting Oral Contraceptive in the Continued Vaginal Bleeding After Drug Abortion%复方短效口服避孕药在药物性流产后持续阴道出血中的应用

    Institute of Scientific and Technical Information of China (English)



    目的:探讨复方短效口服避孕药治疗药流后持续少量阴道出血的疗效。方法收集2014年10月至2015年3月因早孕(≤49天)予米非司酮及米索前列醇行药物流产的健康妇女60例,药流后少量阴道流血持续≥2周,其中30例要求保守治疗、予口服复方短效避孕药者为观察组,30例行清宫术者为对照组,比较两组的治疗效果。结果观察组和对照组的阴道流血停止率分别为93.3%及96.7%,无统计学差异(P>0.05);观察组和对照组的经后(撤退性出血后)复查B超宫内组织消失率分别为90.0%及96.7%,无统计学差异(P>0.05)。两组患者经后复查尿妊娠试验均为阴性。结论复方短效口服避孕药治疗药流后持续少量阴道出血具有与清宫术相当的效果。%Objective To explore the efficacy of compound short-acting oral contraceptive for the treatment of continued small amount of vaginal bleeding after drug abortion. Methods A total of 60 cases of early pregnancy (≤49 d) admitted to our hospital from October 2014 to March 2015 were selected. All cases had continued small amount of vaginal bleeding after drug abortion with mifepristone and misoprostol. 30 cases who required conservative treatment and received compound short-acting oral contraceptive were set as the observation group, and 30 cases who received uterine curettage were set as the control group. The curative effects of two groups were compared. Results The rates of stopped vaginal bleeding of observation group and control group were 93.3%and 96.7%respectively, with no statistical difference (P>0.05). The rate of intrauterine tissue disappeared of observation group and control group were 90.0%and 96.7%respectively, with no statistical difference (P>0.05). The urine pregnant tests of two groups after withdrawal vaginal bleeding were negative. Conclusions Compound short-acting oral contraceptive has similar effect to uterine curettage for the treatment

  10. Complete vaginal outlet stenosis in a patient with Sheehan’s syndrome (United States)

    Choo, Minji; Park, Hana


    We present a case of complete vaginal stenosis in a woman diagnosed with Sheehan’s syndrome. The patient delivered at full-term 5 months prior, and experienced massive postpartum bleeding at that time. During evaluation of persistent amenorrhea, we found that her vaginal orifice was completely adhesive and obstructed. Prior to corrective surgery, we managed the patient with an oral contraceptive to induce uterine bleeding into the vaginal outflow tract. After three cycles of an oral contraceptive, we could confirm that there was no stenotic lesion in the vaginal cavity as a hematocolpos was created. Adhesiolysis with scar revision for the vaginal stenosis was successfully performed; it was found that the lesion was limited to only the distal part of the vaginal outlet. Complete vaginal stenosis in reproductive age women with hypopituitarism has not been reported. The artificial induction of hematometrocolpos before surgery was useful in determining the extent of the stenotic lesion, and assured safety. PMID:27896263

  11. Contraceptive procedures. (United States)

    Beasley, Anitra; Schutt-Ainé, Ann


    Although most women desire to control the size and spacing of their family, the rate of unintended pregnancy in the United States remains high, with approximately half of all pregnancies being unintended. Reducing unintended pregnancy is a national public health goal, and the increased use of long-acting reversible contraceptives (LARCs) (intrauterine devices and implants) can help meet this goal. LARCs are among the most effective forms of contraception available. There are few contraindications to their use, and insertion and removal are straightforward procedures that are well tolerated in the outpatient office setting. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Hormonal contraception decreases bacterial vaginosis but oral contraception may increase candidiasis: implications for HIV transmission. (United States)

    van de Wijgert, Janneke H H M; Verwijs, Marijn C; Turner, Abigail Norris; Morrison, Charles S


    A 2012 WHO consultation concluded that combined oral contraception (COC) does not increase HIV acquisition in women, but the evidence for depot medroxyprogesterone acetate (DMPA) is conflicting. We evaluated the effect of COC and DMPA use on the vaginal microbiome because current evidence suggests that any deviation from a 'healthy' vaginal microbiome increases women's susceptibility to HIV. We conducted a systematic review and reanalysed the Hormonal Contraception and HIV Acquisition (HC-HIV) study. Vaginal microbiome outcomes included bacterial vaginosis by Nugent scoring, vaginal candidiasis by culture or KOH wet mount and microbiome compositions as characterized by molecular techniques. Our review of 36 eligible studies found that COC and DMPA use reduce bacterial vaginosis by 10-20 and 18-30%, respectively. The HC-HIV data showed that COC and DMPA use also reduce intermediate microbiota (Nugent score of 4-6) by 11% each. In contrast, COC use (but not DMPA use) may increase vaginal candidiasis. Molecular vaginal microbiome studies (n=4) confirm that high oestrogen levels favour a vaginal microbiome composition dominated by 'healthy' Lactobacillus species; the effects of progesterone are less clear and not well studied. DMPA use does not increase HIV risk by increasing bacterial vaginosis or vaginal candidiasis. COC use may predispose for vaginal candidiasis, but is not believed to be associated with increased HIV acquisition. However, the potential role of Candida species, and vaginal microbiome imbalances other than bacterial vaginosis or Candida species, in HIV transmission cannot yet be ruled out. Further in-depth molecular studies are needed.

  13. Sublingual versus vaginal misoprostol for medical termination of pregnancy: a comparative study

    Directory of Open Access Journals (Sweden)

    Ayswary Shanmugam


    Conclusions: There is no significant difference in efficacy and side effects between sublingual and vaginal route of misoprostol for termination of pregnancy. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3398-3403

  14. Emergency Contraception (United States)

    ... It works because the copper prevents sperm from swimming or functioning well. While more expensive than ECPs, an IUD is the most effective type of emergency contraception. It also can prevent future pregnancies for up to 12 years after insertion. How ...

  15. Effects of switching from oral to transdermal or transvaginal contraception on markers of thrombosis (United States)

    Jensen, Jeffrey T.; Burke, Anne E.; Barnhart, Kurt T.; Tillotson, Carrie; Messerle-Forbes, Marci; Peters, Dawn


    Background The study was conducted to determine the impact of switching from oral to transdermal patch or vaginal ring contraception on biomarkers of thrombosis. Study Design Current healthy oral contraceptive (OC) users were randomized to switch to either a contraceptive ring (CR) or patch (CP) and underwent phlebotomy to measure surrogate biomarkers of thrombosis (sex hormone binding globulin (SHBG), free protein S, and activated protein C-resistance (APC-r)) before switching, and during the 4th cycle of use of the new method. Results Of 142 reproductive age women enrolled, 120 sample pairs were available for analysis. SHBG increased significantly from baseline in CP users (mean change (95% CI) +29.9 nM (9.6, 50) but not in CR users −1.6 (−16.6, 13.5). Protein S decreased significantly from baseline in CP users (mean change −7.1% (−12.1, −2.1), but increased significantly in CR users +5.3% (1.1, 9.6). The APC-r ratio did not undergo a significant change from baseline in either group [CP +0.06 (−0.06, 0.18), CR +0.02 (−0.10, 0.14)] Compared to CR users, subjects using the CP had significantly higher SHBG (187.5 (167.0, 208), 146 (132.6,159.4), p = 0.012), significantly lower protein S (81.8 (76.8, 86.8), 93.6 (89.1, 98.1), p = 0.001), and similar APC-r ratios (2.99 (2.85,3.14), 3.09 (2.96, 3.22), p = 0.3) at the cycle 4 visit. Conclusion OC users who switch to the ring exhibit beneficial changes in biomarkers of thrombosis while those switching to the patch display a shift favoring clot formation. PMID:19014790

  16. [Hormonal contraception]. (United States)

    Prilepskaia, V N


    Effective contraceptives contribute to the regulation of births, protect the health of women, reduce maternal and perinatal mortality and gynecological diseases, and prevent abortion-related complications. Complications after abortion average 30%, and among primigravidas the rate reaches 45%. Abortion can result in sterility and in the inability to carry out the pregnancy. Oral contraceptives (OCs) are used by 150 million globally. In new preparations ethinyl estradiol (EE) and levonorgestrel (LNG) are the most common components. In the 2-phase and 3-phase preparations Sequilar, Anteovin, and lipid profile safe Triquilar the gestagen component was reduced 40%. Continuin and Famulen are minipills, and Postinor is a postcoital contraceptive. Absolute contraindications of OCs include thromboembolytic diseases, severe cardiovascular system diseases, liver disorders, cirrhosis, cerebral vascular diseases, grave diabetes, jaundice, and malignant tumors of the mammae and sexual organs. Rigevidon, Triquilar, and Trisiston have high steroid content with minimal side effects. The protective effect of OCs are: 2-3 times lower risk of inflammation of the small pelvis, lower risk of malignant and benign ovarian tumors that lasts even after discontinuation, uterine cancer prevention (antiproliferation effect on the endometrium and inhibition of mitotic activity of the myometrium), and reduced risk of benign breast neoplasms. The finding that estrogen-induced risk of breast cancer increases with longterm contraceptive use in young nulliparas has not been persuasively proven. The optimal duration of uninterrupted OC use is 1-1.5 years. Monophasic estrogen-gestagen preparations include Bisecurin, Non-Ovlon, Ovidon, Rigevidon, Minisiston, and Demulen with low dosages of EE, LNG, norethisterone acetate, and diacetate ethonodiol. Norplant is a subdermal silastic capsule with effectiveness for up to 5 years.

  17. Contraceptive practices. (United States)

    Morgenthau, J E; Rao, P S


    A family life education program (FLEP) providing contraceptive services within a comprehensive health care organization for low-income, inner-city adolescents is described. Each female patient attending in the July 1-September 30, 1974, period was included in a study undertaken to identify and serve the unmet needs of the teen-age population in the community of East Harlem. Of the 334 females interviewed, almost 1/2 were black, 37% were Hispanic, 12% were white, and 2% were Oriental, totals representative of the surrounding community. The questionnaire included information on demographic and social background, sexual history, reproductive history, and contraceptive experience. Comparisons are made on the answers between groups. Personal contacts and school outreach were the 2 main sources of referral to the clinic. Sexual history was found to be associated with social background rather than physiological factors. More than 1/2 the teen-agers had never used contraception prior to their 1st clinic visit and another 1/4 of the girls were using unreliable methods. The study indicated that teen-agers will use good programs which are designed to meet their needs. For teen-agers, a free-standing clinic offering comprehensive health care is the ideal situation.

  18. Understanding contraceptive failure


    Trussell, James


    Contraceptive failure is a major source of unintended pregnancy. This chapter will review sources of data and measurement of contraceptive failure, summarize results from the literature on the risks of contraceptive failure during typical and perfect use for available methods of contraception, provide a tool for communicating risks of contraceptive failure to clients, examine determinants of contraceptive failure, and identify methodological pitfalls in the published literature.

  19. Influence of Exogenous Reproductive Hormones on Specific Antibody Production in Genital Secretions after Vaginal Vaccination with Recombinant Cholera Toxin B Subunit in Humans


    Wassen, Lotta; Jertborn, Marianne


    The objective of this study was to investigate the influence of exogenous reproductive hormones on the local and systemic production of specific immunoglobulin A (IgA) and IgG antibodies after vaginal vaccination with recombinant cholera toxin subunit B (CTB). Three groups of women using either progesterone-containing intrauterine devices (n = 9), oral contraceptives (n = 8), or no hormonal contraceptive methods (n = 9) were vaginally immunized twice, 2 weeks apart. Cervical secretions, vagin...

  20. Comparative study of vaginal hysterectomy and abdominal hysterectomy for enlarged uterus

    Directory of Open Access Journals (Sweden)

    Chandrika S.


    Conclusions: Bulk reducing techniques were used to remove the moderately enlarged uterus through vaginal route. Vaginal hysterectomy is invasive route, safe and feasible in cases with enlarged uteri up to 14 weeks due to benign causes. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3116-3120

  1. Vaginal dryness alternative treatments (United States)

    Alternative treatments for vaginal dryness ... Question: Is there a drug-free treatment for vaginal dryness? Answer: There are many causes of vaginal dryness . It may be caused by reduced estrogen level, infection, medicines, and ...

  2. [Male contraception]. (United States)

    Demoulin, A


    Among the reasons why male hormonal contraception has lagged behind female methods are the necessity of preserving virility, the fact that spermatogenesis is a continuous process, the need to control secondary effects and toxicity, and the requirement that modes of administration be acceptable to both partners. Among currently available reversible mehtods, withdrawal is undoubtedly the most ancient. It is still widespread but cannot be recommended because of its limited effectiveness. The condom is used by about 10% of couples worldwide as a principal or temporary method, but its inter-ference with sensation has limited its acceptance. Condoms are nevertheless highly effective when used with a spermicide. Various androgens are currently under investigation. High doses of testosterone can induce azoospermia without affecting libido but their side effects may be serious. The use of combinations of steroids permits doses to be reduced and offers promise for the future. The combination of oral medroxyprogesterone acetate and percutaneous testosterone is one of the better approaches; the combination is effective and nontoxic but has the disadvantage of percutaneous administration. Gossypol, a pigment extracted from the cotton plant, has been used as a contraceptive in China with a reported efficacy of 99.89%, recovery of fertility within 3 months, and no effect on future fertility. However, its toxicity appears to be significant in the animal and its reversibility is uncertain. A search is on for analogs which would preserve the contraceptive effects while eliminating toxic effects. Several gonadotropin releasing hormone (GnRH) analogs under investigation for their interference with spermatogenesis have given promising results. Several chemicals tested for contraceptive effects have had unacceptably high toxicity. Chinese investigators have reported good results with various physical methods of interfering with sperm production, but their reversibility and innocuity

  3. Oral contraceptives. (United States)

    Maclennan, A H


    Over 60 million women use highly efficient and safe modern combined oral contraceptives (OCs) every day. A women who takes the oral contraceptive for 5 years before the age of 30 will actually live 12 days longer, although a woman taking the pill for the 1st time for 5 years after the age of 30 will have her life span reduced on the average by 80 days. OC related morbidity and mortality mostly occur in women over 35 who smoke. Combined low dose OCs are safe for women who do not smoke, at least to 45 years of age and probably to the menopause. The prescription of OCs is also safe to the young adolescent. The pill does not interfere with maturation of the hypothalamic-pituitary ovarian axis and does not increase the incidence of amenorrhoea, oligomenorrhoea or infertility in later life. Patients with contraindications to estrogen therapy are excluded from OC use (history of thromboembolism, major heart disease, liver disease, breast cancer). Low-dose (30-35 mcg estrogen-containing monophasic or triphasic) pills are recommended. Combined oral contraceptives contain either ethinyl estradiol (1.7 to 2 times more potent) or mestranol. After absorption the progestagens, norethisterone acetate, ethynodiol diacetate and lynoestrenol are all metabolized to norethisterone. The progestagen-only pill has about a 2% failure rate and poorer cycle control than the combined pill, but it lacks estrogenic, progestagenic and androgenic side effects. This pill is suitable for the lactating mother, for smokers over 35, for hypertensive patients, and for those with a history of thrombosis. The efficacy of the progestagen-only pill is restored in 3 days of pill taking. Postcoital contraception is an alternative: treatment can be given for at least 72 hours after intercourse. The Yuzpe method calls for the patient to take 2 combined oral contraceptive tablets containing levonorgestrel and ethinyl estradiol (Eugynon or Ovral) followed by a further 2 tablets 12 hours later. This regimen

  4. Foreign body in vagina: a cause of persistent vaginal discharge in children

    Directory of Open Access Journals (Sweden)

    P. Pallavee


    Full Text Available Vulvovaginitis and vaginal discharge in pediatric patients, while not uncommon, is commonly believed to be due to such causes as absence of the protective effect on the vaginal mucosa. However, other causes need also to be kept in mind. We report a case of chronic vaginal discharge in a 5 yr old, who had retained a foreign body in her vagina for 6-7 months. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 224-225

  5. Immediate versus delayed postpartum insertion of contraceptive implant for contraception. (United States)

    Sothornwit, Jen; Werawatakul, Yuthapong; Kaewrudee, Srinaree; Lumbiganon, Pisake; Laopaiboon, Malinee


    inclusion criteria of the review. We did not identify any ongoing trials. Two included studies were at low risk of selection, attrition, and reporting biases, but were at high risk of performance and detection biases due to the inability to blind participants to the intervention. One included study was at high risk of attrition bias. The overall quality of the evidence for each comparison ranged from very low to moderate; the main limitations were risk of bias and imprecision.Initiation rate of contraceptive implants at the first postpartum check-up visit was significantly higher in the immediate insertion group than in the delayed insertion group (RR 1.41, 95% CI 1.28 to 1.55; three studies, 410 participants; moderate quality evidence).There appeared to be little or no difference between the groups in the continuation rate of contraceptive implant used at six months after insertion (RR 1.02, 95% CI 0.93 to 1.11; two studies, 125 participants; low quality evidence) or at 12 months after insertion (RR 1.04; 95% CI 0.81 to 1.34; one study, 64 participants;very low quality evidence)Women who received an immediate postpartum contraceptive implant insertion had a higher mean number of days of abnormal vaginal bleeding within six weeks postpartum (MD 5.80 days, 95% CI 3.79 to 7.81; one study, 215 participants; low quality evidence) and a higher rate of other side effects in the first six weeks after birth (RR 2.06, 95% CI 1.38 to 3.06; one study, 215 participants; low quality evidence) than those who received a delayed postpartum insertion. There appeared to be little or no difference between the groups in heavy, irregular vaginal bleeding or associated severe cramping within 12 months (RR 1.01, 95% CI 0.72 to 1.44, one study, 64 participants;very low quality evidence).It was unclear whether there was any difference between the groups in scores for participant satisfaction on a 0-10 scale (MD -0.40, 95% CI -1.26 to 0.46, low quality evidence), or in rates of unintended pregnancy

  6. Contraception and Birth Control (United States)

    ... to the NICHD Staff Directory Skip sharing on social media links Rollup Image Home > Health & Research > A-Z Topics > Contraception and Birth Control > About Page Content ​About Contraception and Birth Control Contraception is the prevention of pregnancy. Contraception, or birth control, also allows couples to ...

  7. A randomized controlled trial of vaginal misoprostol tablet and intracervical dinoprostone gel in labor induction of women with prolonged pregnancies

    Directory of Open Access Journals (Sweden)

    Apurba Mandal


    Conclusions: Vaginal misoprostol tablet is a safe and more effective method of induction of labour when compared with intracervical dinoprostone gel in prolonged pregnancies. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 343-348

  8. Vaginal Cancer Overview (United States)

    ... are here Home > Types of Cancer > Vaginal Cancer Vaginal Cancer This is Cancer.Net’s Guide to Vaginal Cancer. Use the menu below to choose the Overview/ ... social workers, and patient advocates. Cancer.Net Guide Vaginal Cancer Introduction Statistics Medical Illustrations Risk Factors and Prevention ...

  9. Effects of Contraception on Cervical Cytology: Data from Mardin City

    Directory of Open Access Journals (Sweden)

    Işık İkbal BARIŞ


    Full Text Available Objective: Mardin is an area of low socioeconomic level with low rates of contraceptive method use. Our aim in this study was to evaluate the effects of the contraceptive methods used in the area on epithelial cell abnormalities and vaginal flora changes.Material and Method: Cervical smear samples received at the Pathology Department between 2010 and 2012 of 526 patients who had used a contraceptive method and 112 who had never used one were included in the study. The cases were divided into 3 groups as those using hormonal contraception (107, 20.3%, those using an intrauterine device (343, 65.2% and those using a barrier method (76, 14.4%. The evaluation was made using the Bethesda 2001 criteria for cervical epithelial abnormalities and specific cervicovaginal infections.Results: There was no significant difference between the groups for epithelial cell abnormalities while bacterial vaginitis (12%, p=0.03 and Trichomonas vaginalis (7.6% were more common in the IUD users. The Actinomyces rate in RIA users was 1.3%. There was only 1 case of bacterial vaginitis in the barrier group and none of the other patients had a specific infection.Discussion: We did not find a significant cytopathic effect of using a IUD or hormonal contraception in our study. There was a low rate of epithelial abnormality in the barrier method group. IUD was seen to increase the incidence of bacterial vaginitis, Trichomonas vaginalis and Actinomyces. We did not find a significant effect of hormone use on the vaginal flora.

  10. Desquamative inflammatory vaginitis. (United States)

    Reichman, Orna; Sobel, Jack


    Desquamative inflammatory vaginitis (DIV) is an uncommon form of chronic purulent vaginitis. It occurs mainly in Caucasians with a peak occurrence in the perimenopause. Symptoms and signs are nonspecific; DIV is a diagnosis of exclusion, and other causes of purulent vaginitis should be excluded. The main symptoms include purulent discharge, vestibulo-vaginal irritation, and dyspareunia. Examination of vaginal walls shows signs of inflammation with increased erythema and petechiae. Through microscopy (wet mount) of the vaginal secretions, DIV is defined by an increase in inflammatory cells and parabasal epithelial cells (immature squamous cells). Vaginal flora is abnormal and pH is always elevated above 4.5. Although etiology and pathogenesis remain unknown, the favorable response to anti-inflammatory agents suggests that the etiology is immune mediated. Either local vaginal clindamycin or vaginal corticosteroids are adequate treatment. As a chronic condition, maintenance treatment should be considered as relapse is common. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Oral steroid contraception. (United States)

    Sech, Laura A; Mishell, Daniel R


    Oral steroid contraception is a popular method of family planning worldwide. Over the past several decades, this method of contraception has changed significantly by decreasing the estrogen dose, changing the progestin component, and reducing the hormone free interval. Despite the popularity of oral steroid contraception, there has been much criticism regarding the associated risks of venous thromboembolism and stroke. Despite these established, yet uncommon risks, oral steroid contraception has many important health benefits. This review highlights the available formulations of oral contraceptives along with their evidence-based associated risks and benefits. Highlights regarding future directions for development of novel oral contraceptives are also addressed.

  12. Successful treatment of Depot Medroxyprogesterone acetate-related vaginal bleeding improves continuation rates in Adolescents

    Directory of Open Access Journals (Sweden)

    Kristin M. Rager


    Full Text Available High discontinuation rates for depot medroxyprogesterone acetate (DMPA in adolescents may contribute to the number of unintended pregnancies. Many cite vaginal bleeding as a reason for discontinuing DMPA use. In this study, we attempted to determine if treating DMPA-associated vaginal bleeding with monophasic oral contraceptive pills (OCP raised continuation rates. A total of 131 patients who reported vaginal bleeding while on DMPA were included in this study and 83 were treated with monophasic OCP. Of those who received OCP, 38.7% reported that vaginal bleeding stopped completely, 51.8% reported that vaginal bleeding stopped temporarily, and 6.0% reported no change. Overall, 94% of enrolled patients who received OCP as a treatment for DMPA-associated vaginal bleeding continued DMPA use. Our findings indicate that vaginal bleeding due to DMPA can be successfully treated, leading to improvement in continuation rates.

  13. 单纯孕激素长效避孕方法的出血模式改变及对策%Management of Irregular Vaginal Bleeding Induced by the Progestin only Contraceptives

    Institute of Scientific and Technical Information of China (English)



      单纯孕激素避孕方法主要分为肌内注射、皮下埋植剂及宫腔缓释系统。该类方法避孕安全、有效、可逆,几乎适合所有育龄妇女,特别是有血栓风险者。但有一定不良反应,主要为月经模式改变,表现为不规则出血或闭经,影响其长期使用。但发生机制尚不清楚,可能与子宫内膜炎症、血管充盈、管壁变薄、金属蛋白酶和环氧化酶活性增加等有关。治疗方法主要采用相应的对症止血,具有较好的效果。但在应用前做好咨询工作,对改善依从性具有重要临床意义。%Therearethreekindsofprogesteroneonlycontraceptives (POCs),intramuscularinjection, implants and levonorgestrel-intrauterine system(LNG-IUS). POCs offer the safe,effective and reversible contraceptive options,particulary for women with the risk of venous thromboembolism. Breakthrough or irregular bleeding (BTB) and amenorrhea are the main side-effects,which often lead to discontinuation. The exact pathophysiolog-ical mechanisms of BTB remain unclear,but they are likely to relate to the chronic endometritis,thin and dilated wall of vessels in subendometrium,high expression of COX-2 and MMP-9. Many effective methods are tried to stop bleeding. The most important thing is to consult the women carefully before their utilization of POCs.

  14. About Implantable Contraception (United States)

    ... a tube was inserted, and get a new contraceptive implant on schedule or switch to another method of ... continue Possible Side Effects Young women who get contraceptive implants might notice such side effects as: irregular or ...

  15. Contraception for the HIV-Positive Woman: A Review of Interactions between Hormonal Contraception and Antiretroviral Therapy

    Directory of Open Access Journals (Sweden)

    Jennifer A. Robinson


    Full Text Available Background. Preventing unintended pregnancy in HIV-positive women can significantly reduce maternal-to-child HIV transmission as well as improve the woman’s overall health. Hormonal contraceptives are safe and effective means to avoid unintended pregnancy, but there is concern that coadministration of antiretroviral drugs may alter contraceptive efficacy. Materials and Methods. We performed a literature search of PubMed and Ovid databases of articles published between January 1980 and February 2012 to identify English-language reports of drug-drug interactions between hormonal contraceptives (HCs and antiretroviral drugs (ARVs. We also reviewed the FDA prescribing information of contraceptive hormone preparations and antiretrovirals for additional data and recommendations. Results. Twenty peer-reviewed publications and 42 pharmaceutical package labels were reviewed. Several studies of combined oral contraceptive pills (COCs identified decreased serum estrogen and progestin levels when coadministered with certain ARVs. The contraceptive efficacy of injectable depot medroxyprogesterone acetate (DMPA and the levonorgestrel intrauterine system (LNG-IUS were largely unaffected by ARVs, while data on the contraceptive patch, ring, and implant were lacking. Conclusions. HIV-positive women should be offered a full range of hormonal contraceptive options, with conscientious counseling about possible reduced efficacy of COCs and the contraceptive implant when taken with ARVs. DMPA and the LNG-IUS maintain their contraceptive efficacy when taken with ARVs.

  16. Vaginal birth - slideshow (United States)

    ... page: // Vaginal birth - series—Normal anatomy To use the sharing features ... vaginal delivery. Please keep in mind that every birth is unique, and your labor and delivery may ...

  17. Assisted Vaginal Delivery (United States)

    ... be needed. What are the risks for my baby if I have assisted vaginal delivery? Although the overall rate of injury to the baby as a result of assisted vaginal delivery is low, there still is a risk of ...

  18. Vaginitis test - wet mount (United States)

    ... this page: // Vaginitis test - wet mount To use the sharing features on this page, please enable JavaScript. The vaginitis wet mount test is a test to detect ...

  19. Improved compliance and patient satisfaction with estradiol vaginal tablets in postmenopausal women previously treated with another local estrogen therapy

    Directory of Open Access Journals (Sweden)

    Minkin MJ


    Full Text Available Mary Jane Minkin,1 Ricardo Maamari,2 Suzanne Reiter31Obstetrics, Gynecology, and Menopause, Temple Medical Center, New Haven, CT, 2Hormone Therapy, Novo Nordisk Inc, Princeton, NJ, 3Mid-County Health Center, Largo, FL, USAAbstract: Up to half of all postmenopausal women will experience changes in the genitourinary tract induced by the hypoestrogenic state, collectively known as vaginal atrophy. Vaginally administered local estrogen therapy (LET is the standard of care for symptoms of vaginal atrophy that do not respond to nonhormonal interventions. Several LET formulations are available, and choice of therapy is based largely on patient needs and preferences. This online survey of postmenopausal LET users was conducted to investigate reasons for switching to vaginal estradiol tablets from other formulations and to evaluate factors associated with patient preference for and compliance with use of LET. Data was analyzed from 73 respondents currently using estradiol vaginal tablets who have previously used the estradiol vaginal ring, estradiol vaginal cream, and/or conjugated estrogen vaginal cream. Patients in this survey rated vaginal symptoms of vaginal atrophy as being more bothersome than urinary symptoms. Respondents preferred their current treatment with the vaginal tablet to their previous treatment with a cream or ring. The preference for tablets over creams was mainly related to formulation and application rather than to any perceived safety issues. Tablets were perceived as efficacious, convenient, and neat to apply. The study participants also reported a longer duration of tablet use compared with creams or rings, and greater compliance with vaginal tablets than with vaginal cream. This study provides new insights into reasons for patient noncompliance with estrogen cream or ring therapy that can be used to maximize patient adherence with LET.Keywords: vaginal atrophy, local estrogen therapy, estradiol, vaginal ring, vaginal tablet

  20. Searching for Ideal Contraceptives. (United States)

    Djerassi, Carl


    Discusses the problem of adolescent pregnancy and focuses on improving contraception as a practical solution. Describes the advantages and disadvantages of existing methods (the condom, the pill, and the contraceptive sponge). Predicts that the development of a fundamentally new contraceptive, such as a monthly menses-inducer pill, will not occur…

  1. Suspect online sellers and contraceptive access. (United States)

    Liang, Bryan A; Mackey, Tim K; Lovett, Kimberly M


    Issues surrounding contraception access have been a national focus. During this debate, adolescent and adult women may seek these products online. Due to safety concerns, including potential counterfeit forms, we wished to assess whether online "no prescription" contraceptives were available. We assessed online availability of reversible, prescription contraceptive methods resulting in contraceptives; NuvaRing; Ortho Evra patch; Paragard and Mirena IUDs; and Implanon/Nexplanon implants. Using Google search "buy ITEM no prescription," we reviewed the first five result pages for "no prescription" vendors. Searches were conducted 1/3/2012-2/20/2012. All contraceptives were available as "no prescription" products. Furthermore, IUDs were advertised as "over-the-counter" and YouTube videos provided "how to" videos, including a cartoon version. We also found that illicit online pharmacy marketing is shifting from direct search engine access to social media (Facebook, Twitter, Slidehare, flickr). Online contraceptive sales represent patient safety risks and a parallel system of high-risk product access absent professional guidance. Providers should educate patients, while policy makers employ legal strategies to address these systemic risks. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Vaginitis: diagnosis and management. (United States)

    Quan, Martin


    Vaginitis is one of the most common ambulatory problems to occur in women. It is a disorder responsible for > 10% of visits made to providers of women's health care. Although vaginal infections are the most common cause, other considerations include cervicitis, a normal vaginal discharge, foreign-body vaginitis, contact vaginitis, atrophic vaginitis, and desquamative inflammatory vaginitis. The medical history and examination are an important source of clues to the underlying diagnosis. However, making a definitive diagnosis requires skillful performance of office laboratory procedures, including the vaginal pool wet mount examination, determination of the vaginal pH, and the whiff test. Vaginal and cervical cultures, nucleic acid tests, and point-of-care tests are available and may be required in selected patients. Once a specific diagnosis is made, effective therapy can be prescribed. Candida vaginitis is generally treated with either the vaginal administration of an imidazole or triazole antifungal agent or the prescription of oral fluconazole. Oral nitroimidazole agents, metronidazole or tinidazole, are the only effective treatments for trichomoniasis in the United States. Bacterial vaginosis, which has been linked to important gynecologic and pregnancy complications, can be treated with an available oral or topical agent containing either a nitroimidazole or clindamycin.

  3. Ethinyl Estradiol and Etonogestrel Vaginal Ring (United States)

    ... works by preventing ovulation (the release of an egg from the ovaries). It also changes the lining ... as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant ...

  4. Hormonal contraception, thrombosis and age

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind


    risk of venous thromboembolism as compared with nonusers, and about twice the risk as compared with users of products with norethisterone, levonorgestrel or norgestimate (low-risk products). Transdermal patches and vaginal ring belong to high-risk products. The risk of thrombotic stroke and myocardial......: First choice in women below 35 years should be a combined low-risk pill, that is, with a second-generation progestin, with the lowest compliable dose of estrogen. Young women with risk factors of thrombosis such as age above 35 years, genetic predispositions, adiposity, polycystic ovary syndrome...

  5. Emergency contraception (post-coital Contraception). (United States)

    Pham, Angie


    Emergency Contraception is a post-coital contraceptive for women who have had unprotected intercourse or have reason to believe that their contraceptive method has failed. The article focuses mainly on Emergency Contraceptive Pills (ECPs) because they are the most frequently used form of post-coital contraception. In 1997 the FDA approved the "off-label" use of high dose of oral contraceptives for use as post-coital contraception. Since then, they have been approved for repackaging and marketed solely for use as post-coital emergency contraception. The first dose of ECPs must be administered within 72 hours of the act of unprotected intercourse. The second dose is taken 12 hours later. ECPs are believed to work in one of three ways depending on where the woman is in her menstrual cycle when she seeks treatment. It can delay or prevent ovulation, impair formation of the corpus luteum, or cause histological or biochemical changes within the endometrium, thus preventing implantation. Their effectiveness is approximately 75%, being most effective when administered as quickly as possible after the act of unprotected intercourse. The pills can cause nausea and vomiting, so the pre-administration of an anti-emetic may help alleviate these symptoms. A major issue concerning the ECPs is the lack of knowledge and availability. Very few health-care providers discuss ECPs with their patients. Most people cited the media as the primary source of information. The 72-hour window in which the ECPs must be administered makes it important for women to have easy access to these post-coital contraceptives. However, women who seek treatment will often find that their health-care provider will require a physical exam and/or a pregnancy test before writing a prescription. Yet, studies show that ECPs do not affect an implanted fetus, and there are no emergency contraceptive protocols that require pregnancy tests or physical exams prior to treatment. The AMA is encouraging physicians to

  6. Vaginal Atrophy following Long-Term Depot Medroxyprogesterone Acetate Use: A Case Report

    Directory of Open Access Journals (Sweden)

    Christie Walker


    Full Text Available Depot medroxyprogesterone acetate (DMPA is a commonly used form of contraception, with noncontraceptive benefits for the user. The mode of action is through the suppression of ovulation. It leads to hypoestrogenism which causes dryness of the vagina and dyspareunia. We present in this paper a patient that was very symptomatic with regard to vaginal atrophic changes determined by vaginal cytology. This side effect may become increasingly more common as we see more long-term use of DMPA.

  7. Clinical pharmacokinetics of contraceptive steroids. An update. (United States)

    Shenfield, G M; Griffin, J M


    The present article should be read in conjunction with the original review published in the Journal in 1983. There is no new information of major significance about the pharmacokinetics of levonorgestrel, norethisterone (norethindrone) or ethinylestradiol, although it has been shown that the concentrations of these hormones secreted in breast milk are small and mothers taking combined oral contraceptive steroids may breast-feed safely. Both levonorgestrel and ethinylestradiol can be successfully administered from appropriate vaginal formulations, but no clear advantages over oral administration have been demonstrated. Several new progestogens have been investigated. Desogestrel is a prodrug for its active metabolite 3-keto-desogestrel, gestodene is itself an active progestogen and norgestimate is a prodrug acting by conversion to norgestrel and its metabolites. All 3 compounds have good bioavailability with wide intersubject variation. The newer progestogens, like norethisterone and levonorgestrel, are bound to sex hormone binding globulin (SHBG). This causes their plasma concentrations to increase with time, since SHBG is induced by ethinylestradiol even in doses of 30 micrograms daily. The binding capacity and affinity of SHBG do not increase in direct proportion to its concentration. Further drug interactions with oral contraceptive steroids have been described. Contraceptive steroids may inhibit hepatic microsomal enzyme metabolism and increase the plasma concentration and effect of some tricyclic antidepressants, the hydroxylated benzodiazepines, some beta-blocking drugs, methylxanthines, prednisolone and cyclosporin. There are no significant effects on vitamins. Oral contraceptive steroids induce glucuronidation and hence decrease plasma concentrations of some benzodiazepines, clofibric acid, paracetamol (acetaminophen) and possibly morphine. The plasma concentration of ethinylestradiol may be increased by competitive sulphation with paracetamol. Plasma

  8. Combined oral contraceptives: health benefits beyond contraception. (United States)

    Caserta, D; Ralli, E; Matteucci, E; Bordi, G; Mallozzi, M; Moscarini, M


    It has been recognized for over 50 years that combined oral contraceptives (COCs) are also capable of offering health benefits beyond contraception through the treatment and prevention of several gynaecological and medical disorders. During the last years a constant attention was given to the adverse effects of COCs, whereas their non-contraceptive benefits were underestimated. To date, most women are still unaware of the therapeutic uses of hormonal contraceptives, while on the contrary there is an extensive and constantly increasing of these non-contraceptive health benefits. This review summarizes the conditions of special interest for physicians, including dysmenorrhoea, menorrhagia, hyperandrogenism (acne, hirsutism, polycystic ovary syndrome), functional ovarian cysts, endometriosis, premenstrual syndrome, myomas, pelvic inflammatory disease, bone mineral density, benign breast disease and endometrial/ovarian and colorectal cancer. The benefits of COCs in rheumatoid arthritis, multiple sclerosis, menstrual migraine and in perimenopause have also been treated for more comprehensive information. Using COCs specifically for non-contraceptive indications is still outside the product licence in the majority of cases. We strongly believe that these aspects are not of minor relevance and they deserve a special consideration by health providers and by the mass media, which have the main responsibility in the diffusion of scientific information. Thus, counseling and education are necessary to help women make well-informed health-care decisions and it is also crucial to increase awareness among general practitioners and gynaecologists.

  9. Contraceptive prevalence in Paraguay. (United States)

    Morris, L; Anderson, J E; Monteith, R S; Kriskovich, R; Schoemaker, J; Frutos, O


    Contraceptive use, source of contraception, history of abortion, current pregnancy intention, and fertility rates are evaluated for a national sample of women using data from the Paraguay Contraceptive Prevalence Survey, conducted in 1977. The survey found that 15.5 percent of all women aged 15--44 and 23.6 percent of ever-married women were using effective contraceptive methods. The urban/rural difference in contraceptive use paralleled fertility differentials: over 40 percent of ever-married women were using contraception in Greater Asuncion and other urban areas compared with 15 percent in rural areas. Overall, the data indicate that high-parity rural women have the greatest need for family planning services in Paraguay.

  10. Long-term contraceptives. (United States)

    Brown, Audrey


    To avoid unintended pregnancy, women in the UK need to consistently use reliable contraception for over 30 years. The long-acting reversible contraceptive methods compromise the progestogen-only implant, the progestogen-only injectable contraceptive, the copper-bearing intra-uterine device and the levonorgestrel-releasing intra-uterine system. These methods of contraception are highly reliable in pregnancy prevention, and are amongst the medically safest methods for users. Despite this, these long-acting methods are used by less than 10% of the UK population. National guidance has advised that increasing uptake of these long-acting methods will reduce the unplanned pregnancy rate. In addition, these methods are more cost effective than the oral contraceptive even at 1 year of use. Obstetricians and gynaecologists frequently come into contact with women requiring contraceptive advice, and should have a sound knowledge of the long-acting methods. Copyright 2010 Elsevier Ltd. All rights reserved.

  11. FastStats: Contraceptive Use (United States)

    ... this? Submit What's this? Submit Button NCHS Home Contraceptive Use Recommend on Facebook Tweet Share Compartir Data ... using long-acting reversible contraception (Intrauterine device or contraceptive implant) 7.2% Percent of women aged 15- ...

  12. Vaginal bleeding between periods (United States)

    ... may cause occasional spotting) Ectopic pregnancy Miscarriage Other pregnancy complications Vaginal dryness due to lack of estrogen after menopause Stress Stopping and starting birth control pills or estrogens ...

  13. Randomised controlled trial to compare safety and efficacy of vaginal versus oral route of misoprostol for induction of labour in term pregnancy with unfavourable cervix

    Directory of Open Access Journals (Sweden)

    Parminder Kaur


    Conclusions: Oral misoprostol has a better safety profile than vaginal route as the incidence of hyperstimulation and tachysystole was significantly more in vaginal group, although there were no significant differences in the maternal and neonatal outcomes. [Int J Reprod Contracept Obstet Gynecol 2015; 4(6.000: 1988-1992

  14. Efficacy of Amla (Emblica officinanis and Shibe yamani (potash alum in the management of Candida vaginitis: a randomized standard controlled trial

    Directory of Open Access Journals (Sweden)

    Masuma Zaki


    Conclusions: Test drugs provide statistically significant improvement in vulvovaginal pruritus, vaginal discharge and in wet mount test without any apparent side effects. It can serve as an alternative treatment for Candida vaginitis. [Int J Reprod Contracept Obstet Gynecol 2016; 5(5.000: 1601-1606

  15. Microbial biofilms on the surface of intravaginal rings worn in non-human primates. (United States)

    Gunawardana, Manjula; Moss, John A; Smith, Thomas J; Kennedy, Sean; Kopin, Etana; Nguyen, Cali; Malone, Amanda M; Rabe, Lorna; Schaudinn, Christoph; Webster, Paul; Srinivasan, Priya; Sweeney, Elizabeth D; Smith, James M; Baum, Marc M


    Millions of intravaginal rings (IVRs) are used by women worldwide for contraception and for the treatment of vaginal atrophy. These devices also are suitable for local and systemic sustained release drug delivery, notably for antiviral agents in human immunodeficiency virus pre-exposure prophylaxis. Despite the widespread use of IVRs, no studies have examined whether surface-attached bacterial biofilms develop in vivo, an important consideration when determining the safety of these devices. The present study used scanning electron microscopy, fluorescence in situ hybridization and confocal laser scanning microscopy to study biofilms that formed on the surface of IVRs worn for 28 days by six female pig-tailed macaques, an excellent model organism for the human vaginal microbiome. Four of the IVRs released the nucleotide analogue reverse transcriptase inhibitor tenofovir at a controlled rate and the remaining two were unmedicated. Large areas of the ring surfaces were covered with monolayers of epithelial cells. Two bacterial biofilm phenotypes were found to develop on these monolayers and both had a broad diversity of bacterial cells closely associated with the extracellular material. Phenotype I, the more common of the two, consisted of tightly packed bacterial mats approximately 5 µm in thickness. Phenotype II was much thicker, typically 40 µm, and had an open architecture containing interwoven networks of uniform fibres. There was no significant difference in biofilm thickness and appearance between medicated and unmedicated IVRs. These preliminary results suggest that bacterial biofilms could be common on intravaginal devices worn for extended periods of time.

  16. Vaginally administered PEGylated LIF antagonist blocked embryo implantation and eliminated non-target effects on bone in mice.

    Directory of Open Access Journals (Sweden)

    Ellen Menkhorst

    Full Text Available Female-controlled contraception/HIV prevention is critical to address health issues associated with gender inequality. Therefore, a contraceptive which can be administered in tandem with a microbicide to inhibit sexually transmitted infections, is desirable. Uterine leukemia inhibitory factor (LIF is obligatory for blastocyst implantation in mice and associated with infertility in women. We aimed to determine whether a PEGylated LIF inhibitor (PEGLA was an effective contraceptive following vaginal delivery and to identify non-uterine targets of PEGLA in mice.Vaginally-applied (125I-PEGLA accumulated in blood more slowly (30 min vs 10 min and showed reduced tissue and blood retention (24 h vs 96 h compared to intraperitoneal injection in mice. Vaginally-applied PEGLA blocked implantation. PEGLA administered by intraperitoneal injection inhibited bone remodelling whereas vaginally-applied PEGLA had no effect on bone. Further, PEGLA had no effect in an animal model of multiple sclerosis, experimental auto-immune encephalomyelitis, suggesting PEGLA cannot target the central nervous system.Vaginally-administered PEGLA is a promising non-hormonal contraceptive, one which could be delivered alone, or in tandem with a microbicide. Vaginal application reduced the total dose of PEGLA required to block implantation and eliminated the systemic effect on bone, showing the vagina is a promising site of administration for larger drugs which target organs within the reproductive tract.

  17. Desquamative Inflammatory Vaginitis: The Unknown

    National Research Council Canada - National Science Library

    María Trinidad Alumbreros Andújar; Ana González López; Celia Pérez Parra; Rafael López Pérez; Carmen Céspedes Casas; María Mercedes Ramírez Gómez; Castor Martin Francisco; Francisco Javier Haya Palazuelos


    Introduction: Desquamative inflammatory vaginitis (DIV) is a chronic inflammatory process of unknown etiology, characterized by genital pain and profuse vaginal discharge, mainly affecting perimenopausal women...


    African Journals Online (AJOL)


    Vaginal infection is one of the top 25 reasons for women to consult doctors in the. USA. The 3 most common ... VAGINAL DISCHARGE IN POSTMENOPAUSAL WOMEN. In this age group, the .... More than one host fac- tor may be involved and ...

  19. Vaginal infections update. (United States)

    Mashburn, Jane


    Vaginal symptoms are one of the leading reasons that women visit their health care providers. Women often self-diagnose and may treat themselves inappropriately. This article describes the etiology, risk factors, symptoms, diagnosis, and treatment of the 3 most common vaginal infections: bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis.

  20. Management of persistent vaginitis. (United States)

    Nyirjesy, Paul


    With vaginitis remaining a common condition that leads women to seek care, it is not surprising that some women develop chronic vulvovaginal problems that are difficult to diagnose and treat. With a differential diagnosis that encompasses vulvar disorders and infectious and noninfectious causes of vaginitis, accurate diagnosis is the cornerstone of choosing effective therapy. Evaluation should include a symptom-specific history, careful vulvar and vaginal examination, and office-based tests (vaginal pH, amine test, saline and 10% potassium hydroxide microscopy). Ancillary tests, especially yeast culture with speciation, are frequently crucial to obtaining a correct diagnosis. A heavy but normal physiologic discharge can be determined by excluding other causes. With vulvovaginal candidiasis, differentiating between Candida albicans and non-albicans Candida infection has important treatment ramifications. Most patients with C albicans infections can be successfully treated with maintenance antifungal therapy, usually with fluconazole. Although many non-albicans Candida, particularly Candida glabrata, may at times be innocent bystanders, vaginal boric acid therapy is an effective first choice for many true non-albicans Candida infections. Recurrent bacterial vaginosis, a difficult therapeutic challenge, can often be controlled with maintenance therapy. Multiple options, especially high-dose tinidazole, have been used for metronidazole-resistant trichomoniasis. With the aging of the U.S. population, atrophic vaginitis and desquamative inflammatory vaginitis, both associated with hypoestrogenism, are encountered frequently in women with persistent vaginitis.

  1. Contraception and cardiovascular disease

    NARCIS (Netherlands)

    Roos-Hesselink, JolienW.; Cornette, Jerome; Sliwa, Karen; Pieper, Petronella G.; Veldtman, Gruschen R.; Johnson, Mark R.


    Contraceptive counselling should begin early in females with heart disease, preferably directly after the start of menstruation. In coming to a decision about the method of contraception, the following issues should be considered: (i) the risk of pregnancy for the mother and the consequences of an

  2. Contraception and cardiovascular disease

    NARCIS (Netherlands)

    Roos-Hesselink, JolienW.; Cornette, Jerome; Sliwa, Karen; Pieper, Petronella G.; Veldtman, Gruschen R.; Johnson, Mark R.


    Contraceptive counselling should begin early in females with heart disease, preferably directly after the start of menstruation. In coming to a decision about the method of contraception, the following issues should be considered: (i) the risk of pregnancy for the mother and the consequences of an u

  3. Male Adolescent Contraceptive Utilization. (United States)

    Finkel, Madelon Lubin; Finkel, David J.


    The contraceptive utilization of a sample of sexually active, urban, high school males (Black, Hispanic, and White) was examined by anonymous questionnaire. Contraceptive use was haphazard, but White males tended to be more effective contraceptors than the other two groups. Reasons for nonuse were also studied. (Author/SJL)

  4. [Weariness of contraception]. (United States)

    Borg, V


    Mechanical methods of contraception tend nowadays to be considered as unsafe and the "modern" contraceptives are more popular. The advantage of the intrauterine device is that once it has been placed, one can forget about it. However it is necessary for the woman to undergo checkups and have the device replaced regularly. IUD's are not always very well tolerated psychologically. Women are influenced by information, the fear of the risks, the opinion of their friends and families and the media, and they end up getting tired of this method of contraception. Oral contraceptives are 100% safe but only provided one does not forget to take it: it imposes a daily routine which disturbs many women after a certain time. They then tend to relate all their problems to the pill. Women are aware of the risks contained in oral contraceptives, and they refuse to run these risks by themselves. Whichever method of contraception one chooses, it liberates the woman from the fear of unwanted pregnancy. A good contraception should do this, plus separate the idea of procreation from the sexual intercourse. This seems to be going well for a few years, but after a while a weariness appears. The answer may be to find a contraception suitable to both partners, so that they could make their own decision.

  5. Social marketing of contraceptives. (United States)

    Schellstede, W P; Derr, B B


    Application of commercial marketing techniques has not only increased awareness, acceptability, and use of modern contraceptives in developing countries, but also overcome logistic problems in service delivery. The ability of contraceptive social marketing to reach large numbers and to treat contraceptives as common consumer products has helped to diminish social and religious constraints associated with family planning. Each contraceptive social marketing program is built around a theme tailored to meet specific cultural, social, and management requirements. The primary target populations are those who cannot afford regular commercial products and those who are not adequately reached by government programs. In countries such as Sri Lanka and Jamaica, profit is not a primary sales objective and retail prices are highly subsidized to make products affordable to low-income people. In contrast, the Colombian and Thai programs use contraceptive social marketing to help offset the operating costs of rural community-based programs and seek profits. The most impressive contraceptive social marketing sales performances have been recorded in Bangladesh, Colombia, Egypt, and Jamaica. The main reason contraceptive social marketing is more cost-efficient than other modes of contraceptive distribution is that the cost of product delivery is assumed by the commercial system. Although there has been some interest in making these programs self-sufficient financially, this step has tended to undermine the purpose of serving lower income groups.

  6. Aetiology and management of non-specific vaginitis. (United States)

    Dattani, I M; Gerken, A; Evans, B A


    In a study of 100 women with non-specific vaginitis, characterised by a vaginal discharge which was malodorous and pruritic in most cases and caused dyspareunia and dysuria in some, Gardnerella vaginalis was isolated in 46% of patients. When present, G vaginalis was significantly associated with Mycoplasma hominis and Bacteroides species. Isolation of G vaginalis was unrelated to the presenting symptoms. Treatment with povidone-iodine pessaries for two weeks produced no pronounced benefit, either clinically or microbiologically, compared with a placebo. Nevertheless, 68% of all patients followed reported improvement four weeks after the start of treatment. The findings suggest that G vaginalis is one cause of non-specific vaginitis, which is more likely to be seen in women using oral contraceptives and is usually cured spontaneously. PMID:7034858

  7. Contraceptive failure in China. (United States)

    Wang, Duolao


    This study examines patterns and differentials of contraceptive failure rates by method and characteristics of users, using the Chinese Two-per-Thousand Fertility Survey data. The results show that contraceptive failure rates for modern methods including sterilization are some of the highest in the world. The first year failure rates are 4.2% for male sterilization, 0.7% for female sterilization, 10.3% for IUD, 14.5% for pill, and 19.0% for condom. There are also some differentials in contraceptive failure rates by users' sociodemographic and fertility characteristics. Contraceptive failure rate declines with women's age for all reversible methods. Rural women have higher sterilization, IUD, and condom contraceptive failure rates than urban women. Women with two or more children have a higher failure rate for sterilization methods but have lower failure rates for other methods.

  8. Management of Vaginal Cancer. (United States)

    Shrivastava, S B L; Agrawal, Gaurav; Mittal, Megha; Mishra, Priyanshi


    Vaginal cancer is a rare gynecologic cancer with very little documentation. Literature search to have useful information for the management of vaginal cancer and share. We have searched the PUBMED database, Google search engine and other database. A total of 26 references were taken into account. Once spread from primary other cancers or vulva is ruled out, vaginal cancer is designated to be primary in origin. It was revealed that majority of vaginal cancers reported are squamous cell carcinomas. The most common risk factors implicated are Human Papiloma Virus, age. Most common presenting symptoms were abnormal vaginal bleeding,. Diagnosis requires pathological confirmation. Management depends on staging work-up. Vaginal cancer is staged by FIGO system of staging and TNM staging. There are many prognostic factors influencing the choice of treatment. Lymph node metastasis is one of the important prognostic factors, others to mention are histology, size, age. In a recent SEER analysis of over 2000 patients, the 5 year disease specific survival was 84% for stage 1, 75% for stage II and 57% for advanced tumors. Early carcinomas are generally treated with either surgery or radiation therapy. Advanced cancers are treated with radiation therapy with simultaneous administration of combined chemotherapy. Preventive strategies include safe sex and HPV vaccination. Primary vaginal cancer is a rare entity, if there is no history of cancer cervix or vulva in past or absence of cervical squamous cell carcinoma or vulvar carcinoma within 5 years is usually considered as primary vaginal cancer. Though early stage vaginal cancers have better outcome treated with surgery or radiotherapy or surgery followed by radiotherapy, radiotherapy alone is preferred mode of treatment in vaginal cancers.

  9. The social marketing of contraceptives in Mexico. (United States)

    De La Macorra, L


    The success in social marketing of the PROFAM brand of subsidized contraceptives, by a nonprofit private institution that supports the Mexican government program, is related here. PROFAM began in 1978, when half of contraceptives were purchased commercially from drugstores: they were neither economical, consistently distributed, nor advertised. Comprehensive market research revealed that a great demand existed. It generated information for choice of items to market, package design, and instructions. In 1979, pills, condoms, foam, cream and vaginal suppositories, all locally produced were distributed. A serious problem initially was the impropriety of using the word "contraceptive" in the media. The first phase of advertising targeted newspapers. After 3 months, 40% of Mexico's drugstores carried PROFAM. The second phase of advertising, in radio, magazines and newspapers, approached consumers with information tailored to the specific socioeconomic group involved. The third phase, geared to rural areas and general stores, concentrates on advantages of each method. Other aggressive aspects of the campaign include house to house sampling and a mail-in question and answer service. Evidence of success in broadcasting the PROFAM message is the frequent reference to PROFAM in jokes in the media and even in graffiti. The government's goal is to reduce the growth rate form 2.9 percent annually to 1 percent by 2000.

  10. [Community marketing of contraceptives]. (United States)

    Urrutia, J M


    The 5-year-old community contraceptive distribution program developed by PROFAMILIA, Colombia's private family planning organization, has given excellent results, but several cost-effectiveness comparisons with social marketing programs have suggested that commercial distribution programs are superior. The community contraceptive distribution program has a high content of information and education activities, which produced significant increases in knowledge and use of contraception in the communities covered. It has been a fundamental support for the social marketing program, creating much of the demand for contraceptive products that the social marketing program has filled. The social marketing program has given good results in terms of volume of sales and in cost-effectiveness since 1976, prompting calls for replacement of the community contraceptive distribution program by the social marketing program in those sectors where knowledge and use of contraception have achieved acceptable levels. An experiment in the Department of Santander in 1984 and 1985 gave very favorable results, suggesting that community contraceptive distribution programs should be replaced by social marketing programs in all more developed markets. But economic problems in 1985 and the decision of manufacturers to decrease the profit margin for PROFAMILIA jeopardized the social marketing program. The community distribution program covered about 20% of the market. Reduced profits in the social marketing program threatened its continued expansion, at the same time that potential demand was growing because of increases in the fertile aged population and increased use of contraception. To meet the need, PROFAMILIA combined the community contraceptive distribution and social marketing programs into a new entity to be called community marketing. The strategy of the community marketing program will be to maintain PROFAMILIA's participation in the market and aid the growth of demand for

  11. Effect of mirena on contraception%曼月乐的避孕效果观察

    Institute of Scientific and Technical Information of China (English)

    秦柳平; 罗燕笑; 黄浩昭


    Objective To observe the effect of mirena on contraception. Methods To divide 100 women with intrauterine device into two groups, mirena group and copper intrauterine device group. The patients in the mirena group were treated with mirena. The patients in copper intrauterine device group were treated with copper intrauterine device. The contraception effect and complication in both groups were recorded. Results There was no difference in contraception effect between two groups. The incidence of menstrual quantity decrease in the mirena group was higher than it in copper intrauterine device group. The incidence of lower abdomenal pain in mirena group was lower than copper intrauterine device group. The incidence of amenorrhoea, irregular vaginal bleeding and ring drop were not significantly different between two groups. Conclusion Mirena is effective for contraception and its complication is few.%目的:观察曼月乐在我国妇女中的应用效果。方法100例放置节育环的妇女随机分为两组:曼月乐组和含铜节育环组。曼月乐组妇女放置曼月乐避孕,含铜节育环组则放置普通含铜节育环避孕。记录两组妇女的避孕效果和不良反应。结果两组妇女的避孕效果差异无统计学意义;曼月乐组月经量减少的妇女比含铜节育环组的多;曼月乐组发生下腹部疼痛的妇女则明显少于含铜节育环组的;两组妇女的闭经、阴道不规律出血、环脱落发生率差异无统计学意义。结论曼月乐避孕效果好,不良反应少。

  12. The 1998 Canadian Contraception Study. (United States)

    Fisher, William A.; Boroditsky, Richard; Bridges, Martha L.


    Describes the 1998 Canadian Contraception Study, a mailed survey which asked women about contraceptive practices past, present, and future (including use of oral contraceptives, condoms, and sterilization); familiarity with and opinion about different contraception methods; and general sexual and reproductive health. The paper also examines…

  13. Review of newer contraceptive agents. (United States)

    Qureshi, M; Attaran, M


    Advances in contraceptive technology have made birth control more effective, convenient, and safe. We review the newer products and some under development, including the latest oral contraceptives, injectable progesterone, subdermal progestin implants, progesterone-releasing IUDs, emergency contraception, and male contraception.

  14. Vaginal toxic shock reaction triggering desquamative inflammatory vaginitis. (United States)

    Pereira, Nigel; Edlind, Thomas D; Schlievert, Patrick M; Nyirjesy, Paul


    The study aimed to report 2 cases of desquamative inflammatory vaginitis associated with toxic shock syndrome toxin 1 (TSST-1)-producing Staphylococcus aureus strains. Case report of 2 patients, 1 with an acute and 1 with a chronic presentation, diagnosed with desquamative inflammatory vaginitis on the basis of clinical findings and wet mount microscopy. Pretreatment and posttreatment vaginal bacterial and yeast cultures were obtained. Pretreatment vaginal bacterial cultures from both patients grew TSST-1-producing S. aureus. Subsequent vaginal bacterial culture results after oral antibiotic therapy were negative. Desquamative inflammatory vaginitis may be triggered through TSST-1-mediated vaginal toxic shock reaction.

  15. Yeast Infection (Vaginal) (United States)

    ... caused by a type of candida other than Candida albicans You're pregnant You have uncontrolled diabetes Your ... contraceptives or hormone therapy, which increases estrogen levels Candida albicans is the most common type of fungus to ...

  16. Non-contraceptive benefits of oral contraceptives

    Directory of Open Access Journals (Sweden)

    Dhont M


    Full Text Available Marc Dhont Department of Obstetrics and Gynecology, Ghent University Hospital, Ghent, Belgium Abstract: The health benefits of the oral contraceptive (OC pill are numerous and outweigh the risks of OC use. There are unintended but useful preventive side effects and potential therapeutic uses of OCs apart from contraception itself. Unequivocal evidence for the protective influence of combined OCs against ovarian and endometrial cancers, and colon cancer to a lesser extent, has been found. The pill also reduces the incidence of benign breast disease, functional ovarian cysts, pelvic inflammatory disease requiring hospitalization, ectopic pregnancy, and iron-deficiency anemia. The pill can be used for the treatment of several gynecologic disorders such as dysmenorrhea, irregular or excessive bleeding, acne, hirsutism, and endometriosis-associated pain, whether prescribed solely to treat these symptoms or prescribed to treat them in addition to providing contraception. These health benefits are often underestimated, as they get too little attention from the mass media. Keywords: the pill, estrogens, progestogens, safety, contraception

  17. Can Vaginitis Be Prevented? (United States)

    ... the treatments? Are there complications? Does it affect pregnancy? How is it prevented? NICHD Research Information Clinical Trials Resources and Publications Can vaginitis be prevented? Skip sharing on social media links Share this: Page Content These steps can ...

  18. How Is Vaginitis Treated? (United States)

    ... to learn the specific type of vaginitis. 1 Bacterial Vaginosis Bacterial vaginosis (BV) is treated with an antibiotic that gets ... diagnosed? Are there complications? » Related A-Z Topics Bacterial Vaginosis Sexually Transmitted Diseases (STDs) NICHD News and Spotlights ...

  19. Anterior vaginal wall repair (United States)

    ... may have you: Learn pelvic floor muscle exercises ( Kegel exercises ) Use estrogen cream in your vagina Try ... Urinary incontinence - vaginal sling procedures Vagina Patient Instructions Kegel exercises - self-care Self catheterization - female Suprapubic catheter ...

  20. What Is Vaginal Cancer? (United States)

    ... or epithelial lining ) because it is formed by epithelial cells. The vaginal wall underneath the epithelium is made up of connective tissue, muscle tissue, lymph vessels, and nerves. The vagina ...

  1. Female contraception over 40

    DEFF Research Database (Denmark)


    of an unexpected pregnancy are potentially detrimental. No contraceptive method is contraindicated by advanced reproductive age alone; thus there is a need to discuss the effectiveness, risks and non-contraceptive benefits of all family planning methods for women in this age group. METHODS: MEDLINE searches were...... done by topic (epidemiology, age and reproduction, sexual function, delayed childbearing and specific contraceptive methods). The topic summaries were presented to the Workshop Group and omissions or disagreements were resolved by discussion. RESULTS: The decline in fecundity in the fifth decade...... is insufficient for contraceptive purposes. Thus a family planning method is needed. Sterilization is by far the most common method in several countries. Copper intrauterine devices and hormone intrauterine systems have similar effectiveness, with fewer than 1% failures in the first year of typical use. Special...

  2. Advertising of contraception. (United States)


    It is estimated that 1.7 million fertile and sexually active women in Great Britain do not use any reliable form of contraception. There is a need for better information regarding contraception, a need which could be filled by commercial advertising of family planning in general and specific contraceptive products in particular. Mass media and public advertising of family planning services is permitted in Britain. Funds available for such purposes are inadequate for continued advertising. The law should be changed to allow advertising for specific brands of condoms, spermicides, and pills. IUDs and diaphragms are used in too small numbers to make advertising worthwhile. The objection to contraceptive advertising is that it would be offensive to the public. However, public opinion research confounds this theory.

  3. Post abortion contraception. (United States)

    Gemzell-Danielsson, Kristina; Kopp, Helena Kallner


    A safe induced abortion has no impact on future fertility. Ovulation may resume as early as 8 days after the abortion. There is no difference in return to fertility after medical or surgical abortion. Most women resume sexual activity soon after an abortion. Contraceptive counseling and provision should therefore be an integrated part of the abortion services to help women avoid another unintended pregnancy and risk, in many cases an unsafe, abortion. Long-acting reversible contraceptive methods that includes implants and intrauterine contraception have been shown to be the most effective contraceptive methods to help women prevent unintended pregnancy following an abortion. However, starting any method is better than starting no method at all. This Special Report will give a short guide to available methods and when they can be started after an induced abortion.

  4. Contraception during lactation. (United States)

    Badraoui, M H; Hefnawi, F; Bahgat, R; Fawzi, G; El Gaali, O; Ismail, H; Hegab, M


    Seven hundred and seventy-two lactating mothers were studied from delivery for 1 year to select the best contraceptive method (oral drug, injected drug, or IUD) which did not affect lactation. Ten groups of mothers were studied, including 234 control subjects. The injectable progestational contraceptives caused an improvement in the amount of milk and its protein concentration, whereas the IUCDs did not influence the lactation pattern. Sulpiride was an ineffective contraceptive but a potent lactation stimulant. The side effects of each method (effects on milk yield, protein content and prolactin concentrations) were also noted; it was concluded that IUCDs are the ideal contraceptive method during lactation, with the use of a lactation stimulant when indicated.

  5. [Post-abortion contraception]. (United States)

    Ohannessian, A; Jamin, C


    To establish guidelines of the French National College of Gynecologists and Obstetricians about post-abortion contraception. A systematic review of the literature about post-abortion contraception was performed on Medline and Cochrane Database between 1978 and March 2016. The guidelines of the French and foreign scientific societies were also consulted. After an abortion, if the woman wishes to use a contraception, it should be started as soon as possible because of the very early ovulation resumption. The contraception choice must be done in accordance with the woman's expectations and lifestyle. The contraindications of each contraception must be respected. The long-acting reversible contraception, intra-uterine device (IUD) and implant, could be preferred (grade C) as the efficacy is not dependent on compliance. Thus, they could better prevent repeat abortion (LE3). In case of surgical abortion, IUD should be proposed and inserted immediately after the procedure (grade A), as well as the implant (grade B). In case of medical abortion, the implant can be inserted from the day of mifépristone, the IUD after an ultrasound examination confirming the success of the abortion (no continuing pregnancy or retained sac) (grade C). Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  6. History of oral contraception. (United States)

    Dhont, Marc


    On the 50th birthday of the pill, it is appropriate to recall the milestones which have led to its development and evolution during the last five decades. The main contraceptive effect of the pill being inhibition of ovulation, it may be called a small miracle that this drug was developed long before the complex regulation of ovulation and the menstrual cycle was elucidated. Another stumbling block on its way was the hostile climate with regard to contraception that prevailed at the time. Animal experiments on the effect of sex steroids on ovulation, and the synthesis of sex steroids and orally active analogues were the necessary preliminaries. We owe the development of oral contraceptives to a handful of persons: two determined feminists, Margaret Sanger and Katherine McCormick; a biologist, Gregory Pincus; and a gynaecologist, John Rock. Soon after the introduction of the first pills, some nasty and life-threatening side effects emerged, which were due to the high doses of sex steroids. This led to the development of new preparations with reduced oestrogen content, progestins with more specific action, and alternative administration routes. Almost every decade we have witnessed a breakthrough in oral contraception. Social and moral objections to birth control have gradually disappeared and, notwithstanding some pill scares, oral contraceptives are now one of the most used methods of contraception. Finally, all's well that ends well: recent reports have substantiated the multiple noncontraceptive health benefits paving the way for a bright future for this 50-year-old product.

  7. Contraceptive implants: current perspectives

    Directory of Open Access Journals (Sweden)

    Rowlands S


    Full Text Available Sam Rowlands,1,2 Stephen Searle3 1Centre of Postgraduate Medical Research and Education, School of Health and Social Care, Bournemouth University, Bournemouth, United Kingdom; 2Dorset HealthCare, Bournemouth, United Kingdom; 3Sexual Health Services, Chesterfield, United KingdomAbstract: Progestin-only contraceptive implants are a highly cost-effective form of long-acting reversible contraception. They are the most effective reversible contraceptives and are of a similar effectiveness to sterilization. Pregnancies are rare in women using this method of contraception, and those that do occur must be fully investigated, with an ultrasound scan of the arm and serum etonogestrel level if the implant cannot be located. There are very few contraindications to use of implants, and they have an excellent safety profile. Both acceptability and continuation with the method are high. Noncontraceptive benefits include improvements in dysmenorrhea, ovulatory pain, and endometriosis. Problematic bleeding is a relatively common adverse effect that must be covered in preinsertion information-giving and supported adequately if it occurs. Recognized training for both insertion and removal should be undertaken. Care needs to be taken at both insertion and removal to avoid neurovascular injury. Implants should always be palpable; if they are not, noninsertion should be assumed until disproven. Etonogestrel implants are now radiopaque, which aids localization. Anticipated difficult removals should be performed by specially trained experts. Keywords: contraceptive, subdermal implant, etonogestrel, levonorgestrel, progestin-only, long-acting reversible contraception

  8. Menopause and the vaginal microbiome. (United States)

    Muhleisen, Alicia L; Herbst-Kralovetz, Melissa M


    For over a century it has been well documented that bacteria in the vagina maintain vaginal homeostasis, and that an imbalance or dysbiosis may be associated with poor reproductive and gynecologic health outcomes. Vaginal microbiota are of particular significance to postmenopausal women and may have a profound effect on vulvovaginal atrophy, vaginal dryness, sexual health and overall quality of life. As molecular-based techniques have evolved, our understanding of the diversity and complexity of this bacterial community has expanded. The objective of this review is to compare the changes that have been identified in the vaginal microbiota of menopausal women, outline alterations in the microbiome associated with specific menopausal symptoms, and define how hormone replacement therapy impacts the vaginal microbiome and menopausal symptoms; it concludes by considering the potential of probiotics to reinstate vaginal homeostasis following menopause. This review details the studies that support the role of Lactobacillus species in maintaining vaginal homeostasis and how the vaginal microbiome structure in postmenopausal women changes with decreasing levels of circulating estrogen. In addition, the associated transformations in the microanatomical features of the vaginal epithelium that can lead to vaginal symptoms associated with menopause are described. Furthermore, hormone replacement therapy directly influences the dominance of Lactobacillus in the microbiota and can resolve vaginal symptoms. Oral and vaginal probiotics hold great promise and initial studies complement the findings of previous research efforts concerning menopause and the vaginal microbiome; however, additional trials are required to determine the efficacy of bacterial therapeutics to modulate or restore vaginal homeostasis.

  9. Contraceptive needs of the adolescent. (United States)

    Steyn, Petrus S; Goldstuck, Norman D


    The provision of contraception to adolescents requires specific attention. Adolescents require contraceptive methods which are safe, effective and simple to use. While long-acting reversible contraceptive methods are preferable, they should have a choice and not be forced or mandated especially in situations where this may compromise safety. After counselling they should have the ability to choose any method of contraception. Under the appropriate circumstances, each method of contraception may have a place. This chapter will be devoted to evaluating the most current scientific rationale for the indication for use of each method of contraception in adolescents.

  10. Recasting image of contraceptives. (United States)

    Rimon Jg; Kiragu, K


    Even though contraceptives are linked to sex which, along with sensuality and peer acceptance, is used to market consumer goods, contraceptives are promoted in a hygienic, clinical way. Glamorous images which divert from adverse health effects are used to sell unhealthy goods, e.g., alcohol and cigarettes, but technical and intimidating promotion techniques centering on risks are used to promote family planning (FP) products and services which actually save the lives of mothers and children and improve their health. Until recently, only the medical system provided FP products and services so consumers identified them with illness and a help-seeking behavior. The image of contraceptives must be remolded to gain people's attention. To avoid instilling mistrust of a method in consumers, even those who believe in birth spacing, it is important for images to be positive and to reflect accurate information. In Indonesia, the Dualima condom has been linked to responsible fatherhood thereby creating a positive image and removing the negative image of a condom being linked to illicit sex. In the US, condom adds show the user in control, especially in reference to AIDS. Prior to promotion of any contraceptive, complete, clear communication and marketing plans are needed to identify and to focus on consumers' perceived needs. A survey in Egypt shows that the most important attributes of a contraceptive are ease of use, healthiness, and effectiveness and that Egyptians considered IUDs to best fit these attributes. Images of contraceptive users often determine whether potential users do choose to use contraceptives. For example, in Cameroon and the Philippines, female users are considered to be smart, rich, educated, confident and in control of their lives. In the Philippines, male users are perceived to be loving, caring, and considerate husbands. The mass medias can improve providers' public image as was the case in Turkey and Egypt.

  11. Designed Chemical Intervention with Thiols for Prophylactic Contraception.

    Directory of Open Access Journals (Sweden)

    Monika Sharma

    Full Text Available Unlike somatic cells, sperm have several-fold more available-thiols that are susceptible to redox-active agents. The present study explains the mechanism behind the instant sperm-immobilizing and trichomonacidal activities of pyrrolidinium pyrrolidine-1-carbodithioate (PPC, a novel thiol agent rationally created for prophylactic contraception by minor chemical modifications of some known thiol drugs. PPC, and its three derivatives (with potential active-site blocked by alkylation, were synthesized and evaluated against live human sperm and metronidazole-susceptible and resistant Trichomonas vaginalis, in vitro. Sperm hexokinase activity was evaluated by coupled enzyme assay. PPC irreversibly immobilized 100% human sperm in ∼30 seconds and totally eliminated Trichomonas vaginalis more efficiently than nonoxynol-9 and metronidazole. It significantly inhibited (P<0.001 thiol-sensitive sperm hexokinase. However, the molecule completely lost all its biological activities once its thiol group was blocked by alkylation. PPC was subsequently formulated into a mucoadhesive vaginal film using GRaS excipients and evaluated for spermicidal and microbicidal activities (in vitro, and contraceptive efficacy in rabbits. PPC remained fully active in quick-dissolving, mucoadhesive vaginal-film formulation, and these PPC-films significantly reduced pregnancy and fertility rates in rabbits. The films released ∼90% of PPC in simulated vaginal fluid (pH 4.2 at 37°C in 5 minutes, in vitro. We have thus discovered a common target (reactive thiols on chiefly-anaerobic, redox-sensitive cells like sperm and Trichomonas, which is susceptible to designed chemical interference for prophylactic contraception. The active thiol in PPC inactivates sperm and Trichomonas via interference with crucial sulfhydryl-disulfide based reactions, e.g. hexokinase activation in human sperm. In comparison to non-specific surfactant action of OTC spermicide nonoxynol-9, the action of

  12. Combined Hormonal Birth Control: Pill, Patch, and Ring (United States)

    ... AQ FREQUENTLY ASKED QUESTIONS FAQ185 CONTRACEPTION Combined Hormonal Birth Control: Pill, Patch, and Ring • What are combined hormonal birth control methods? • How do combined hormonal methods prevent pregnancy? • ...

  13. Severe atrophic vaginitis causing vaginal synechiae and hematocolpos at menopause. (United States)

    Segal, Saya; Harvie, Heidi S; Siegelman, Evan; Arya, Lily A


    Vaginal atrophy caused by decreased levels of ovarian estrogen production is common at menopause. Atrophic vaginitis severe enough to result in vaginal stricture of the upper two thirds of the vagina and subsequent hematocolpos is unusual. A 53-year-old woman presented with nonvisualization of the cervix at the time of her annual examination. Pelvic ultrasound reported a "vaginal cyst," and the final diagnosis of hematocolpos was made by magnetic resonance imaging. The woman was managed with surgical excision of vaginal synechiae followed by local vaginal estrogen therapy and dilators, with satisfactory results. Untreated severe atrophic vaginitis at menopause can result in a shortened vagina and hematocolpos. Magnetic resonance imaging is useful to characterize vaginal pathology in postmenopausal women.

  14. European Society of Contraception Statement on Contraception in Obese Women

    DEFF Research Database (Denmark)

    Merki-Feld, Gabriele S; Skouby, Sven; Serfaty, David;


    and to use contraceptives with a positive ratio of benefits versus risks. The Expert Group on hormonal and molecular contraception of the European Society of Contraception convened to review the existing evidence and propose recommendations to the prescribers in line with most recent studies...

  15. Hormonal contraception and venous thromboembolism

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Milsom, Ian; Geirsson, Reynir Tomas;


    New studies about the influence of hormonal contraception on the risk of venous thromboembolism (VTE) have been published.......New studies about the influence of hormonal contraception on the risk of venous thromboembolism (VTE) have been published....

  16. How Effective Is Male Contraception? (United States)

    ... Clinical Trials Resources and Publications How effective is male contraception? Skip sharing on social media links Share this: Page Content Not all contraceptive methods are appropriate for all situations, and individuals ...

  17. [Disease and contraception. Recent aspects]. (United States)

    Rozenbaum, H


    This article reviews several different articles which have contributed to an understanding of the harmful or beneficial effects of oral contraceptives (OCs) on various diseases. The Royal College of General Practitioners study found that current OC users compared to women who had never used OCs had relative risks of .52 for menorrhagia, .37 for dysmenorrhea, .65 for irregular cycles, .72 for intermenstrual bleeding, and .71 for premenstrual syndrome. Several studies found combined OCs to offer protection against ovarian cysts. Microdose progestin only pills did not ameliorate most menstrual problems and aggravated ovarian cysts. Despite some theoretical grounds for suspecting an association between pituitary prolactinomas and OC use, recent studies have failed to find an increased relative risk for prolactinomas in women using OCs for contraceptive purposes, although 1 study found an increased risk in women using OCs for cycle control. 1 study reported 11 pregnancies in 30 diabetic women in 15 months of IUD use; the high rate was attributed to abnormal patterns of mineral deposit on the IUD surface. The 11 pregnancies occurred with 5 Gravigardes, 5 Saf-T-Coils, and 1 Dalkon Shield. Other studies on the contrary have noted no difference in pregnancy rates among 103 diabetic women using Copper Ts or 118 diabetic women using Lippes loops. Combined OCs appear to reduce the incidence of rheumatoid arthritis by 1/2 among current OC users and to protect former users as well. Combined OCs aggravate lupus erythmatous but synthetic progestins alone are effective without aggravating the condition. It has recently been argued that low dose OCs are not contraindicated in cases of sickle cell disease and may even offer protection against thromboembolic vascular accidents for women with sickle cell anemia. Estimates of relative risk of pelvic infection among IUD users vary from 1.5 to 6.5, with the risk apparently greatest for women under 25. Recent studies have indicated that

  18. Contraception in perimenopause. (United States)

    Taneepanichskul, Surasak; Dusitsin, Nikorn


    Women in their forties are still potentially fertile, and pregnancy in this age group is attended with increased maternal mortality, spontaneous abortion, fetal anomalies and perinatal mortality. Contraception for women in this age group has special risks and benefits; both should be balanced to choose between the different options available. Recent epidemiological and clinical pharmacology studies have indicated the safety of extending the use of combined oral contraceptives (COCs) beyond the age of 35 years and up to menopause. Women who have reasons for avoiding COCs can use progestogen-only contraceptives like pills, depot injectables and implants. Implant combines high efficacy and long-term effect. Both copper-releasing and levonorgestrel-releasing intrauterine contraceptive device (LNG-IUD) combine the advantages of high efficacy and long-term effect. The reduced fecundity above the age of forty can allow extending the use beyond the accepted term, and up to one or two years beyond the menopause without the need for replacement. The levonorgestrel IUD has the advantage of reducing the amount of menstrual bleeding. The condom has the added benefit of protection against sexual transmitted diseases (STDs). Male or female sterilization is an excellent contraceptive option, provided that this approach is culturally acceptable and available at reasonable cost and low risk.

  19. Vaginal dose de-escalation in image guided adaptive brachytherapy for locally advanced cervical cancer. (United States)

    Mohamed, Sandy; Lindegaard, Jacob Christian; de Leeuw, Astrid A C; Jürgenliemk-Schulz, Ina; Kirchheiner, Kathrin; Kirisits, Christian; Pötter, Richard; Tanderup, Kari


    Vaginal stenosis is a major problem following radiotherapy in cervical cancer. We investigated a new dose planning strategy for vaginal dose de-escalation (VDD). Fifty consecutive locally advanced cervical cancer patients without lower or middle vaginal involvement at diagnosis from 3 institutions were analysed. External beam radiotherapy was combined with MRI-guided brachytherapy. VDD was obtained by decreasing dwell times in ovoid/ring and increasing dwell times in tandem/needles. The aim was to maintain the target dose (D90 of HR-CTV⩾85Gy EQD2) while reducing the dose to the surface of the vagina to vaginal loading (ovoid/ring) was reduced from 51% to 33% of the total loading with VDD, which significantly reduced the dose to the vaginal dose points (pvaginal point was reduced by a mean of 4±4Gy EQD2 (pvaginal stenosis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Vaginal itching and discharge - child (United States)

    ... vulvae; Itching - vaginal area; Vulvar itching; Yeast infection - child ... To prevent and treat vaginal irritation, your child should: Avoid colored or perfumed toilet tissue and bubble bath. Use plain, unscented soap. Limit bath time to 15 minutes or less. Ask ...

  1. General Information about Vaginal Cancer (United States)

    ... Treatment Research Vaginal Cancer Treatment (PDQ®)–Patient Version General Information About Vaginal Cancer Go to Health Professional ... the vagina (also called the birth canal). Enlarge Anatomy of the female reproductive system. The organs in ...

  2. Hormonal contraceptives and venous thrombosis

    NARCIS (Netherlands)

    Stegeman, Berendina Hendrika (Bernardine)


    Oral contraceptive use is associated with venous thrombosis. However, the mechanism behind this remains unclear. The aim of this thesis was to evaluate genetic variation in the first-pass metabolism of contraceptives, to identify the clinical implications of hormonal contraceptive use after a

  3. Hormonal contraceptives and venous thrombosis

    NARCIS (Netherlands)

    Stegeman, Berendina Hendrika (Bernardine)


    Oral contraceptive use is associated with venous thrombosis. However, the mechanism behind this remains unclear. The aim of this thesis was to evaluate genetic variation in the first-pass metabolism of contraceptives, to identify the clinical implications of hormonal contraceptive use after a thromb

  4. Adolescent Religiosity and Contraceptive Usage. (United States)

    Studer, Marlena; Thornton, Arland


    Examined contraceptive use by never married, sexually experienced female adolescents (N=224). Found birth control pills to be the single most popular method of contraception. Subjects who reported regularly attending religious services were less likely to have used an effective, medical method of contraception than those who rarely attended…

  5. Repeated administration of high-dose depot medroxyprogesterone acetate does not alter SHIVSF162p3 viral kinetics and tenofovir pharmacokinetics when delivered via intravaginal rings. (United States)

    Srinivasan, Priya; Zhang, Jining; Dinh, Chuong T; Teller, Ryan S; McNicholl, Janet M; Kiser, Patrick F; Herold, Betsy C; Smith, James M


    Intravaginal rings (IVR) for HIV prevention will likely be used by women on depot medroxyprogesterone acetate (DMPA) hormonal contraception. We used pigtailed macaques to evaluate the effects of DMPA on tenofovir disoproxil fumarate (TDF) IVR pharmacokinetics and viral shedding. Mucosal tenofovir (TFV) levels were compared in SHIVSF162p3 -negative DMPA-treated (n=4) and normally cycling (n=6) macaques receiving TDF IVRs. Plasma viremia and vaginal shedding were determined in groups of SHIVSF162p3 -positive DMPA-treated (n=6) and normally cycling (n=5) macaques. Similar median vaginal fluid TFV concentrations were observed in the DMPA-treated and cycling macaques over 4 weeks (1.2×10(5) and 1.1.×10(5)  ng/mL, respectively). Median plasma viremia and vaginal shedding AUC of the DMPA-treated (2.73×10(7) and 8.15×10(4) copies/mL, respectively) and cycling macaques (3.98×10(7) and 1.47×10(3) copies/mL, respectively) were statistically similar. DMPA does not affect TDF IVR pharmacokinetics or SHIV shedding. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. [Contraception during the perimenopause: indications, security, and non contraceptive benefits]. (United States)

    Cantero Pérez, P; Klingemann, J; Yaron, M; Irion, N Fournet; Streuli, I


    Although patients' fertility is diminished in the period of perimenopause, they still need efficient contraception. Thorough knowledge of the physiological changes occuring during this period of transition is essential in order to provide optimal care. Until the age of 50, no contraceptive method is specifically considered unsuitable due to age alone. The choice of contraceptive needs to be adapted to the patient, assessing the individual risk factors and favouring the potential non-contraceptive advantages of the method selected. Long-term contraceptive methods (e.g., the copper intrauterine device (IUD), the Mirena IUD or a subcutaneous implant) offer an excellent solution on both levels.

  7. Vaginal metastasis of pancreatic cancer. (United States)

    Benhayoune, Khadija; El Fatemi, Hinde; El Ghaouti, Meryem; Bannani, Abdelaziz; Melhouf, Abdelilah; Harmouch, Taoufik


    Vaginal metastasis from pancreatic cancer is an extreme case and often indicates a poor prognosis. We present a case of pancreatic carcinoma with metastasis to the vagina that was discovered by vaginal bleeding. To our knowledge, this is the third case in the world of a primary pancreatic adenocarcinoma discovered of symptoms from a vaginal metastasis.

  8. Role of the community pharmacist in emergency contraception counseling and delivery in the United States: current trends and future prospects

    Directory of Open Access Journals (Sweden)

    Rafie S


    Full Text Available Sally Rafie,1 Rebecca H Stone,2 Tracey A Wilkinson,3 Laura M Borgelt,4,5 Shareen Y El-Ibiary,6 Denise Ragland7 1Department of Pharmacy, UC San Diego Health, San Diego, CA, 2Department of Clinical and Administrative Pharmacy, University of Georgia, College of Pharmacy, Athens, GA, 3Children’s Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, 4Department of Clinical Pharmacy, 5Department of Family Medicine, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, 6Department of Pharmacy Practice, College of Pharmacy, Midwestern University, Glendale, AZ, 7Department of Pharmacy Practice, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR, USA Abstract: Women and couples continue to experience unintended pregnancies at high rates. In the US, 45% of all pregnancies are either mistimed or unwanted. Mishaps with contraceptives, such as condom breakage, missed pills, incorrect timing of patch or vaginal ring application, contraceptive nonuse, forced intercourse, and other circumstances, place women at risk of unintended pregnancy. There is a critical role for emergency contraception (EC in preventing those pregnancies. There are currently three methods of EC available in the US. Levonorgestrel EC pills have been available with a prescription for over 15 years and over-the-counter since 2013. In 2010, ulipristal acetate EC pills became available with a prescription. Finally, the copper intrauterine device remains the most effective form of EC. Use of EC is increasing over time, due to wider availability and accessibility of EC methods. One strategy to expand access for both prescription and nonprescription EC products is to include pharmacies as a point of access and allow pharmacist prescribing. In eight states, pharmacists are able to prescribe and provide EC directly to women: levonorgestrel EC in eight states and ulipristal

  9. Trends in contraceptive use among women with human immunodeficiency virus. (United States)

    Sun, Mengyang; Peipert, Jeffrey F; Zhao, Qiuhong; Wilson, Tracey E; Weber, Kathleen M; Sanchez-Keeland, Lorraine; DʼSouza, Gypsyamber; Young, Mary; Watts, D Heather; Keller, Marla J; Cohan, Deborah; Massad, L Stewart


    To estimate trends in contraceptive use, especially long-acting reversible contraceptives (LARCs) and condoms, among human immunodeficiency virus (HIV)-seropositive and HIV-seronegative women. Human immunodeficiency virus-seropositive and HIV-seronegative women in a multicenter longitudinal cohort were interviewed semiannually between 1998 and 2010 about sexual behaviors and contraceptive use. Trends in contraceptive use by women aged 18-45 years who were at risk for unintended pregnancy but not trying to conceive were analyzed using generalized estimating equations. Condoms were the dominant form of contraception for HIV-seropositive women and showed little change across time. Less than 15% of these women used no contraception. Between 1998 and 2010, LARC use increased among HIV-seronegative women from 4.8% (6 of 126) to 13.5% (19 of 141, P=.02), but not significantly among seropositive women (0.9% [4 of 438] to 2.8% [6 of 213], P=.09). Use of highly effective contraceptives, including pills, patches, rings, injectable progestin, implants, and intrauterine devices, ranged from 15.2% (53 of 348) in 1998 to 17.4% (37 of 213) in 2010 (P=.55). Human immunodeficiency virus-seronegative but not HIV-seropositive LARC users were less likely than nonusers to use condoms consistently (hazard ratio 0.51, 95% confidence interval [CI] 0.32-0.81, P=.004 for seronegative women; hazard ratio 1.09, 95% CI 0.96-1.23 for seropositive women). Although most HIV-seropositive women use contraception, they rely primarily on condoms and have not experienced the increase in LARC use seen among seronegative women. Strategies to improve simultaneous use of condoms and LARC are needed to minimize risk of unintended pregnancy as well as HIV transmission and acquisition of sexually transmitted infections. II.

  10. Posterior vaginal wall cyst of Mullerian origin: a case report

    Directory of Open Access Journals (Sweden)

    Sunita Samal


    Full Text Available Cystic lesions of vagina are relatively uncommon and an incidental finding during routine gynaecological examination. Mullerian cysts are congenital cysts of vagina, usually reported during childbearing age group. These cysts mostly arise at the level of cervix and extend anteriorly in relation to bladder, but very rarely they may also extend posteriorly. This is a rare case of posterior vaginal wall cyst of Mullerian origin. A 36-year-old multi para (P2L2 both SVD, presented with a mass descending through vagina since 2-3 months. Pelvic examination revealed a 5x5 cm cystic mass arising from the posterior vaginal wall. Complete excision of the cyst was done. The cyst was filled with chocolate coloured material and histopathology confirmed a Mullerian cyst. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 245-246

  11. Vaginal and Vulvar Cancer (United States)

    ... is passed from one person to another during sex. There is a vaccine that protects against the types of HPV that most often cause cervical, vaginal, and vulvar cancers. It is recommended for preteens (both boys and girls) aged 11 to 12 ...

  12. Staging for vaginal cancer. (United States)

    Rajaram, Shalini; Maheshwari, Amita; Srivastava, Astha


    Vaginal cancer is a rare cancer comprising about 3% of all gynecologic cancers. Primary vaginal cancer should be carefully assigned as spread from cervix, vulva, and other metastatic tumors to vagina can occur. Although vaginal cancer traditionally occurs in older postmenopausal women, the incidence of high-risk human papillomavirus (HPV)-induced cancers is increasing in younger women. Squamous cell carcinoma is still the most common histopathologic type followed by adenocarcinoma. With decreasing use of diethylstilbestrol in pregnancy, non-diethylstilbestrol-associated cancers are described. The Federation Internationale de Gynecologie et d'Obstetrique (FIGO) staging of vaginal cancer (2009) follows the same rules as cervical cancer; it is clinically staged and allows the use of routine investigative modalities for staging. Although FIGO encourages the use of advanced imaging modalities, such as computed tomography, magnetic resonance imaging (MRI), and positron emission tomography (PET), to guide therapy, the imaging findings may not be used to change or reassign the stage. TNM staging is the pathologic staging system proposed by the American Joint Committee on Cancer, and information available from examination of the resected specimen, including pelvic and inguinal lymph nodes, may be used for staging. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Is vaginal hyaluronic acid as effective as vaginal estriol for vaginal dryness relief? (United States)

    Stute, Petra


    In a multicenter, randomized, controlled, open-label, parallel- group trial hyaluronic acid vaginal gel (Hyalofemme) was compared to estriol vaginal cream (Ovestin) in women with vaginal dryness due to various causes. A total of 144 supposedly postmenopausal women below age 70 years were randomized in a 1:1 ratio to either receive hyaluronic acid vaginal gel (5 g per application) or estriol vaginal cream (0.5 g cream per application = 0.5 mg estriol) every 3 days for a total of ten applications, respectively. Exclusion criteria included vaginal infections, conventional contraindications to estrogens, use of vaginal products other than the investigational compounds, being unmarried, pregnant, or breastfeeding. The aim of the study was to test for non-inferiority of hyaluronic acid vaginal gel compared to estriol vaginal cream. The primary efficacy end point was the percentage (%) improvement in vaginal dryness, with the secondary end points being the percentage (%) improvements in vaginal itching, burning, and dyspareunia. Efficacy was assessed by using a visual analog scale (VAS) (0-10; 0 = absent, 10 = intolerable) at baseline (V0), during telephone contact after the third administration (V1), and at the final visit after the tenth administration (V2). Safety parameters included vaginal pH, endometrial thickness, and a vaginal smear for vaginal microecosystem assessment. Adverse events were recorded according to international guidelines. 133 women completed the study. At baseline, participants' characteristics did not differ significantly. Mean age was 54 years, time since menopause was 5 years on average, and cause of menopause was mostly natural. However, mean menstrual cycle days were also reported, although according to inclusion criteria only postmenopausal women were eligible for the study. At V1, an improvement in vaginal dryness was reported by about 49 % of women using hyaluronic acid vaginal gel, and by 53 % of women using estriol vaginal cream (p = 0

  14. Post placental copper-T 380A insertion after normal vaginal delivery and cesarean section and its clinical outcome

    Directory of Open Access Journals (Sweden)

    Jyoti Malik


    Conclusions: Although there was high incidence of missing IUCD threads (due to coiling of thread, actual expulsion rate was far lesser. Removal rate due to menorrhagia, pain abdomen and vaginal discharge was low and 6 months continuation rate was considerably good. [Int J Reprod Contracept Obstet Gynecol 2016; 5(7.000: 2254-2256

  15. Role of vaginal progesterone in reducing the rate of preterm labour in women with a sonographic short cervix

    Directory of Open Access Journals (Sweden)

    Kirtirekha Mohapatra


    Conclusions: Vaginal progesterone started from midtrimester in pregnant ladies with short cervix with previous history of midtrimester abortion or preterm labour is effective in reducing the rate of preterm birth. [Int J Reprod Contracept Obstet Gynecol 2015; 4(6.000: 1793-1797

  16. Randomised comparison of oral and vaginal misoprostol when combined with mifepristone for termination of second trimester pregnancy

    Directory of Open Access Journals (Sweden)

    Madhuri N.


    Conclusion: 200 and micro;g misoprostol inserted vaginally is better than 400 and micro;g of oral misoprostol, 36 hours after administration of tab. Mifepristone 200 mg for termination of second trimester pregnancy. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 509-513

  17. Obesity and hormonal contraceptive efficacy. (United States)

    Robinson, Jennifer A; Burke, Anne E


    Obesity is a major public health concern affecting an increasing proportion of reproductive-aged women. Avoiding unintended pregnancy is of major importance, given the increased risks associated with pregnancy, but obesity may affect the efficacy of hormonal contraceptives by altering how these drugs are absorbed, distributed, metabolized or eliminated. Limited data suggest that long-acting, reversible contraceptives maintain excellent efficacy in obese women. Some studies demonstrating altered pharmacokinetic parameters and increased failure rates with combined oral contraceptives, the contraceptive patch and emergency contraceptive pills suggest decreased efficacy of these methods. It is unclear whether bariatric surgery affects hormonal contraceptive efficacy. Obese women should be offered the full range of contraceptive options, with counseling that balances the risks and benefits of each method, including the risk of unintended pregnancy.

  18. Ectopic Pregnancy After Plan B Emergency Contraceptive Use. (United States)

    Steele, Brianne Jo; Layman, Kerri


    Pregnancy outcomes after emergency contraceptive use has been debated over time, but review of the literature includes mechanisms by which these medications may increase the chance of an ectopic pregnancy. Such cases are infrequently reported, and many emergency providers may not readily consider this possibility when treating patients. This is a case presentation of ectopic pregnancy in a patient who had recently used Plan B (levonorgestrel) emergency contraceptive. She presented with abdominal pain and vaginal spotting, and was evaluated by serum testing and pelvic ultrasound. She was discovered to have a right adnexal pregnancy. She was treated initially with methotrexate, though she ultimately required surgery for definitive treatment. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case report aims to bring a unique clinical case to the attention of emergency providers. The goal is to review research on the topic of levonorgestrel use and the incidence of ectopic pregnancies. The mechanism of action of this emergency contraceptive is addressed, and though no definite causal relationship is known between levonorgestrel and ectopic pregnancies, there is a pharmacologic explanation for how this event may occur after use of this medication. Ultimately, the emergency provider will be reminded of the importance of educating the patient on the possible outcomes after its use, including failure of an emergency contraceptive and the potential of ectopic pregnancy. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Optimized Benzalkonium Chloride Gel: A Potential Vaginal Microbicides

    Institute of Scientific and Technical Information of China (English)

    Xun-cheng DING; Wei-hua LI; Jie-fei LI; Qiang-yi WANG


    Objective To develop an optimized BZK gel with good pharmaceutical effect and less toxicity to vaginal mucosa.Methods Four methods as below were used to research the spermicidal activity of BZK gel: 1)in vitro spermicidal test; 2) in vivo spermicidal test in rabbits; 3) anti-fertility test in rabbits; 4)contraceptive test in rabbits. Mucosal irritation test was used in rats to evaluate the safety of optimized BZK gel. Microbiological assessments were used to research anti-STI pathogens (including treponema pallidum, neisseria gonorrhoeae, trichomona vaginalis, candida albicans,ureaplama urealyticum, herpes simplex virus type-2, chlamydiae trachomatis) effect of optimized BZK gel.Results In vitro spermicidal test, EC50 of BZK gel was 0.029 mg/ml, a little higher than that of N-9 (0.019 mg/ml). The MIC of BZK gel was 0.25 mg/ml, similar to that of N-9 (0.20 mg/ml).The vaginal mucosal irritation test in rats showed that 0.429% BZK gel showed only minimal vaginal irritation, and did not damage the vaginal epithelium or cause local inflammation in rats. Microbiological assessments showed that optimized BZK gel could inhibit or inactivate common STI pathogens even after 3-fold or 5-fold dilution.Conclusion Optimized BZK gel was an effective microbicides.

  20. Vaginal Practices of HIV-Negative Zimbabwean Women

    Directory of Open Access Journals (Sweden)

    Abigail Norris Turner


    Full Text Available Background. Vaginal practices (VPs may increase HIV risk by injuring vaginal epithelium or by increasing risk of bacterial vaginosis, an established risk factor for HIV. Methods. HIV-negative Zimbabwean women (n=2,185 participating in a prospective study on hormonal contraception and HIV risk completed an ancillary questionnaire capturing detailed VP data at quarterly followup visits for two years. Results. Most participants (84% reported ever cleansing inside the vagina, and at 40% of visits women reported drying the vagina using cloth or paper. Vaginal tightening using cloth/cotton wool, lemon juice, traditional herbs/powders, or other products was reported at 4% of visits. Women with ≥15 unprotected sex acts monthly had higher odds of cleansing (adjusted odds ratio (aOR: 1.17, 95% CI: 1.04–1.32. Women with sexually transmitted infections had higher odds of tightening (aOR: 1.42, 95% CI: 1.08–1.86. Conclusion. Because certain vaginal practices were associated with other HIV risk factors, synergism between VPs and other risk factors should be explored.

  1. Vaginal Practices of HIV-Negative Zimbabwean Women (United States)

    Turner, Abigail Norris; Morrison, Charles S.; Munjoma, Marshall W.; Moyo, Precious; Chipato, Tsungai; van de Wijgert, Janneke H.


    Background. Vaginal practices (VPs) may increase HIV risk by injuring vaginal epithelium or by increasing risk of bacterial vaginosis, an established risk factor for HIV. Methods. HIV-negative Zimbabwean women (n = 2,185) participating in a prospective study on hormonal contraception and HIV risk completed an ancillary questionnaire capturing detailed VP data at quarterly followup visits for two years. Results. Most participants (84%) reported ever cleansing inside the vagina, and at 40% of visits women reported drying the vagina using cloth or paper. Vaginal tightening using cloth/cotton wool, lemon juice, traditional herbs/powders, or other products was reported at 4% of visits. Women with ≥15 unprotected sex acts monthly had higher odds of cleansing (adjusted odds ratio (aOR): 1.17, 95% CI: 1.04–1.32). Women with sexually transmitted infections had higher odds of tightening (aOR: 1.42, 95% CI: 1.08–1.86). Conclusion. Because certain vaginal practices were associated with other HIV risk factors, synergism between VPs and other risk factors should be explored. PMID:20871844

  2. Impedance pattern of vaginal and vestibular mucosa in cyclic goats

    Directory of Open Access Journals (Sweden)

    Ivo Křivánek


    Full Text Available The changes of vaginal and vestibular impedance during the oestrous cycle in goats were examined. The onset of oestrus was teased with a buck once a day during the experiment. Impedance was mea­sured by a four-terminal method. The vaginal impedance was recorded under slight pressure of electrodes to the vaginal dorsal wall at the cervix. The vestibular impedance was recorded under slight pressure of electrodes to the vestibular dorsal wall 5 cm from the vulva and at the vulva. The im­pe­dan­ce was measured once a day from 4 days before the expected oestrus to 6 days after onset of oestrus. The vaginal impedance at the cervix decreased during pro-oestrus (P < 0.01 and increased du­ring oestrus (P < 0.01. The vestibular impedance 5 cm from the vulva decreased during pro-oestrus (P < 0.01 and increased after oestrus (P < 0.01. The decrease of vaginal impedance during peri-oestrus was nearly twofold in comparison with the vestibular impedance 5 cm from the vulva. No sig­ni­fi­cant decrease of the vestibular impedance at the vulva was found during the oestrous cycle. The results indicate that the vaginal impedance at the cervix and vestibular impedance 5 cm from the vulva measured by means of a four-terminal method during the oestrous cycle display cyclic changes that are closely related to the oestrous behaviour of goats.

  3. Trends and Recent Estimates: Contraceptive Use among U.S. Teens. Child Trends Research Brief. Publication #2006-04 (United States)

    Franzetta, Kerry; Terry-Humen, Elizabeth; Manlove, Jennifer; Ikramullah, Erum


    This Research Brief draws on recently released nationally representative data to provide information on teenagers' patterns of contraceptive use during heterosexual, vaginal intercourse. In this brief, the authors examine these patterns for males and females, for members of racial and ethnic groups, and for younger and older teenagers. Among the…

  4. Newly developed vaginal atrophy symptoms II and vaginal pH: a better correlation in vaginal atrophy? (United States)

    Tuntiviriyapun, P; Panyakhamlerd, K; Triratanachat, S; Chatsuwan, T; Chaikittisilpa, S; Jaisamrarn, U; Taechakraichana, N


    The primary objective of this study was to evaluate the correlation among symptoms, signs, and the number of lactobacilli in postmenopausal vaginal atrophy. The secondary objective was to develop a new parameter to improve the correlation. A cross-sectional descriptive study. Naturally postmenopausal women aged 45-70 years with at least one clinical symptom of vaginal atrophy of moderate to severe intensity were included in this study. All of the objective parameters (vaginal atrophy score, vaginal pH, the number of lactobacilli, vaginal maturation index, and vaginal maturation value) were evaluated and correlated with vaginal atrophy symptoms. A new parameter of vaginal atrophy, vaginal atrophy symptoms II, was developed and consists of the two most bothersome symptoms (vaginal dryness and dyspareunia). Vaginal atrophy symptoms II was analyzed for correlation with the objective parameters. A total of 132 naturally postmenopausal women were recruited for analysis. Vaginal pH was the only objective parameter found to have a weak correlation with vaginal atrophy symptoms (r = 0.273, p = 0.002). The newly developed vaginal atrophy symptoms II parameter showed moderate correlation with vaginal pH (r = 0.356, p atrophy score (r = 0.230, p atrophy symptoms and the objective parameters. Vaginal pH was significantly correlated with vaginal atrophy symptoms. The newly developed vaginal atrophy symptoms II was associated with a better correlation. The vaginal atrophy symptoms II and vaginal pH may be better tools for clinical evaluation and future study of the vaginal ecosystem.

  5. Inappropriate use of combined hormonal contraceptives for birth control among women of reproductive age in the United States. (United States)

    Yu, Jingbo; Hu, X Henry


    To describe the extent of inappropriate use of combined hormonal contraceptives (CHC) according to the United States Medical Eligibility Criteria (U.S. MEC). We analyzed Kantar Health's 2010 U.S. National Health and Wellness Survey data, which is an annual population-based survey of 75,000 U.S. adults via internet. A stratified random sampling framework was used to construct a sample that reflects the U.S. census by age, gender, and ethnicity. The analysis included nonpregnant females aged 18-44 years who used CHC, including oral, patch, or vaginal rings in the past 6 months. Women classified into category 3 (theoretical or proven risks usually outweigh the advantages of using the method) or 4 (unacceptable health risk) according to the U.S. MEC were defined as having high-risk conditions, or inappropriate CHC use. The proportions of women who had inappropriate CHC use were then projected to the U.S. population by diseases/conditions and demographic characteristics incorporating sampling weights. We identified 2963 adult females of reproductive age (mean 29.3±6.0) (i.e., 20.4% of all adult females of reproductive age in the database) as being CHC users. Among them, 23.7% (95% CI: 22.8%-24.5%) had at least one high-risk condition and 9.3% (95% CI: 9.2%-9.4%) had at least one condition of unacceptable risk. The three most common high-risk conditions were migraine (12.7%), multiple risk factors for arterial cardiovascular disease (9.3%), and hypertension (6.1%). Women with relatively higher proportions of inappropriate CHC use were age ≥35, not finished college, and Medicaid recipients. A large portion of women used CHC inappropriately. Hormone-free and progestin-only contraceptives are available options with potentially less risk for them.

  6. Contraception: traditional and religious attitudes. (United States)

    Schenker, J G; Rabenou, V


    Humans have tried to control fertility for centuries. Primitive, preliterate societies practiced infanticide and abortion. When primitive women understood the advantages of conception control, they tried, when possible, to use contraception. In the 4th century B.C., Plato and Aristotle advocated a one-child family. Greek medical literature reported a hollow tube inserted through the cervix into the uterus and a potion as contraceptives. Islamic physicians had much knowledge about conception control. The attitudes toward contraception. In the 5th century B.C., Saint Augustine condemned contraception, even among married couples. The condom emerged in the early modern period. Yet, they were usually worn to protect against disease, e.g., bilharzia in Egypt and syphilis in Europe. The cervical cap and the diaphragm are examples of occlusive pessaries. By 1880, contraceptives and spermicides were advertised. In 1928, the IUD joined the existing contraceptives. Today we have combined oral contraceptives. Judaic law requires husbands to fulfill their wives sexual needs, separate from their duty to procreate. It also calls men, not women, to procreate and forbids men from masturbating, thus Judaic law does not forbid women from practicing contraception. The Roman Catholic church forbids contraceptive use because it is a sin against nature. Some Protestant denominations have allowed contraceptive use. Islamic law states that children are gifts from Allah. Some Moslems believe that they must have many children, but Allah and the Prophet state that children have rights to education and future security. These rights allow couples to prevent pregnancy. Neither Hinduism nor Buddhism prohibit contraceptive use. Differences in husband-wife communication, sex roles, access to contraceptives, and traditional family values will have more of an effect on contraceptive use and fertility than theological barriers or the social class of religious groups.

  7. Vaginal leiomyoma in pregnancy presenting as a prolapsed vaginal mass. (United States)

    Dane, Cem; Rustemoglu, Yaprak; Kiray, Murat; Ozkuvanci, Unsal; Tatar, Zeynep; Dane, Banu


    Vaginal leiomyomas are rare benign solid tumours of the vagina. They can cause mechanical dystocia, which is a common problem in obstetrics leading to serious maternal and perinatal complications. Here we describe a patient with a vaginal leiomyoma diagnosed during the mid-trimester that could have caused dystocia. This 22-year-old woman presented with a vaginal mass and leaking vaginal fluid during pregnancy. On examination, a prolapsed, pedunculated mass, measuring 5 × 3 × 4 cm was detected in the anterior vaginal wall. Via a midline incision, the mass was easily enucleated and removed. Transvaginal surgical enucleation of the vaginal leiomyoma is usually curative and recommended as the initial treatment of choice to prevent for dystocia. Such treatment is indicated when the tumour is a potential obstacle to normal labour.

  8. Pyomyositis after vaginal delivery.

    LENUS (Irish Health Repository)

    Gaughan, Eve


    Pyomyositis is a purulent infection of skeletal muscle that arises from haematogenous spread, usually with abscess formation. It can develop after a transient bacteraemia of any cause. This type of infection has never been reported before in the literature after vaginal delivery. A 34-year-old woman had progressive severe pain in the left buttock and thigh and weakness in the left lower limb day 1 post spontaneous vaginal delivery. MRI showed severe oedema of the left gluteus, iliacus, piriformis and adductor muscles of the left thigh and a small fluid collection at the left hip joint. She was diagnosed with pyomyositis. She had fever of 37.9°C immediately postpartum and her risk factors for bacteraemia were a mild IV cannula-associated cellulitis and labour itself. She required prolonged treatment with antibiotics before significant clinical improvement was noted.

  9. Actinomyces in the vaginas of women with and without intrauterine contraceptive devices. (United States)

    Curtis, E M; Pine, L


    Either Actinomyces israeli, A. naeslundii, or Arachnia propionica was found, by immunofluorescence studies, in cervicovaginal mucus from 36% of 50 women. One or more of these organisms were found in a surprising 27% of those with neither intrauterine contraceptive devices (IUDs) nor intravaginal foreign bodies. The only common finding was abundant vaginal mucus, and no clinical features were more serious than vaginal itching, odor, or vague discomfort. Among those women who harbored actinomycetes, the average duration of continuous IUD use was 5.3 years; the comparable figure for those with no infection was 2.1 years.

  10. Adolescents and oral contraceptives. (United States)

    Sanfilippo, J S


    Oral contraceptive (OC) options for adolescents are provides. Clarification for those desiring a birth control method is necessary and the benefits of decreased acne and dysmenorrhea with low dose OCs should be stressed along with the importance of compliance. A community effort is suggested to communicate the sexual and contraceptive alternatives, including abstinence and outercourse (sexual stimulation to orgasm without intercourse). Attention is given to concerns associated with teenage sexual activity, prevention of adolescent pregnancy, contraceptive options for the adolescent patient, adolescent attitudes toward birth control OCs, management of the adolescent OC user, manipulation of steroid components of OCs to respond to adolescent concerns, and other hormonal contraceptive options such as minipills or abstinence. The text is supplemented with tables: the % of US women by single years of age for 1971, 1976, 1979, and 1982; comparative pregnancy and abortion rates for the US and 5 other countries; federal cost for teen childbearing; adolescent nonhormonal contraceptive methods (advantages, disadvantages, and retail cost); checklist to identify those at risk for noncompliance with OCs; hormonal side effects of OCs; risks from OCs to adolescents; and benefits of OCs. Concern about adolescent pregnancy dates back to Aristotle. A modern profile shows girls form single-parent families are sexually active at an earlier age, adolescent mothers produce offspring who repeat the cycle, victims of sexual abuse are more likely to be sexually active, and teenagers in foster care are 4 times more likely to be sexually active and 8 times more likely to become pregnant. Prevention involves a multifaceted approach. OCs are the most appropriate contraceptive choice for adolescents. Frequency of intercourse is closely associated with OC use after approximately 15 months of unprotected sexual activity. At risk for noncompliance variables are scales of personality development

  11. A natural contraceptive. (United States)

    Shirkie, R


    Breastfeeding is a natural contraceptive against another pregnancy. The longer the mother nurses, the longer she delays the return of fertility. A natural mechanism triggered by breastfeeding interrupted Ms. El-Hady's monthly cycle of ovulation and menstruation. Depending on how long and how often she suckles her child, this infertility, termed lactational amenorrhea, could last as long as 2 years. This traditional method of spacing births offers protection against pregnancy to more women than all other methods of contraception combined, according to family planning researchers. With growing trends away from breastfeeding, the traditional practice is losing its impact on fertility. Not many women in Egypt use modern contraceptives. There is little understanding of lactational amenorrhea, but researchers are giving it more attention as they continue to search for effective family planning methods appropriate to the needs and circumstances of the rural population. They know that the effect is only temporary and varies from woman to woman. Ms. El-Hady has been amenorrheic for 15 months, but other women experience much shorter periods of amenorrhea, and some none at all. The secretion of milk is promoted by a hormone called prolactin that the anterior pituitary gland produces in large quantities during pregnancy. The frequency and duration of breastfeeding appear to determine the length of amenorrhea, although the mother's nutrition and any other type of contraceptive used may also play a role. Each month for 2 years, Dr. Olfat Darwish, professor of nutrition at the University of Alexandria's High Institute of Public Health, has visited 260 rural mothers and 290 urban mothers to gather data on diet, breastfeeding practices, state of amenorrhea, and use of contraception. The length of the breastfeeding period was found to affect the duration of amenorrhea. Early weaning brought an earlier return of ovulation and menstruation, and thus of fertility. The nutritional

  12. [Contraception: yes, but at what cost?]. (United States)

    Grenon-Plante, D


    This article, arguing that consumers have a right to be informed about the dangers of health care measures, discusses the health risks of oral contraceptives (OCs) and IUDs. In a brief review of the history of contraceptive development and use, it is stated that the 1st OC was tested on only 132 women in Puerto Rico before being approved for commercial use. OCs, which inhibit ovulation, sperm penetration, and implantation of the egg, represent the surest and most convenient contraceptive yet developed. Despite their advantages, pills may cause various secondary effects such as spotting, water retention, irritability, nervousness, nausea, vaginitis, migraine headaches, hypertension, and others, whose alleviation is responsible for large additional profits to the pharmaceutical industry. Although results are difficult to interpret and the passage of time may not have been sufficient, disquieting indications of a possible carcinogenic effect of OCs have been noted. The pill has been implicated in an elevated incidence of thromboembolism and is known to influence the metabolism of some substances, and the list of contraindications for pill use is long. Women wishing to use pills should consult a conscientious physician who will take a complete medical history, perform a thorough physical, and furnish complete information on the risks of pill use. IUD mode of action is incompletely understood. Fewer than 2/3 of women accepting IUDS are able to tolerate them for more than 1 year, from 7 to 20% of IUDs are spontaneously expelled, and from 3-35% are removed at the request of the client for pelvic pain and bleeding. Another 4-15% are removed each year for other medical reasons. IUD related mortality is less than that related to OCs, but a series of secondary effects and contraindications are associated with their use. If a woman chooses to use an IUD despite everything, she should choose a physician experienced in IUD insertion who is not experimenting with a new type of

  13. [The CHOICE study (Contraceptive Health Research Of Informed Choice Experience)--an educational research program for Polish women planning combined hormonal contraceptives use]. (United States)

    Tomaszewski, Jacek; Paszkowski, Tomasz; Debski, Romuald; Kotarski, Jan; Skrzypulec-Plinta, Violetta; Spaczyński, Robert Z; Pawelczyk, Leszek


    The aim of the study was to develop an optimal educational model for contraceptive counseling, to analyze conditions influencing choice of hormonal contraception, to study patients' opinions on present, planned and proposed contraceptive methods and to link these data with socioeconomic and demographic conditions. One thousand eight hundred fifty women (mean age 26.8 +/- 5.9 yrs) willing to use hormonal contraception were presented with essential information on combined hormonal contraception and asked to fill the anonymous questionnaire investigating factors influencing contraceptive choice and patients' opinion on alternative forms of birth regulation. The study was conducted in selected 185 centers in Poland and was a part of a larger survey (CHOICE) conducted on 11 216 women in Europe and Israel. Majority of the studied women were in stable relationship (85,5%), had higher or incomplete higher education (54.8%) and permanent job (54%). The purpose of the visit was to start/change contraception (64.2%), a routine gynecologic check-up (36.7%) or the need for a prescription for the continued contraceptive medication (18.7%). The most commonly used contraceptive methods were oral contraceptive pills (OCP 38.7%) and condom (24.9%). Majority of women highly valued contraceptive counseling and more than 90% were eager to get familiarized with information leaflets. Before the counseling majority of subjects stated that were convinced to use OCP (52.7%; major advantages named: easy to use, favorable bleeding profile, amelioration of menstrual discomfort, comfortable, discrete) and contraceptive patch (22%; major advantages named: applied once a week, comfortable, simple, low risk for noncompliance, favorable bleeding profile). After the counseling there was an increase in proportion of women interested in contraceptive hormonal ring (by 19%; major advantages named: applied once a month, comfortable, very low risk for noncompliance, high efficacy and positive

  14. Vaginal pressure during daily activities before and after vaginal repair

    DEFF Research Database (Denmark)

    Mouritsen, L; Hulbaek, M; Brostrøm, S


    The objective of the study was to measure vaginal pressure during various daily activities in patients before and after vaginal surgery for pelvic organ prolapse, searching data for evidence-based activity guidelines. Vaginal pressure (VP) was studied in 23 patients during activities such as rest......, pelvic floor contraction (PFC), coughing, Valsalva, rising from sitting to standing and lifting 2 and 5 kg with four different lifting techniques. VP was measured before, 1-5 days and 4-6 weeks after vaginal repair. Mean VP was four to five times higher during coughing and Valsalva compared to PFC...

  15. Vaginal pressure during daily activities before and after vaginal repair

    DEFF Research Database (Denmark)

    Mouritsen, L; Hulbaek, M; Brostrøm, S


    , pelvic floor contraction (PFC), coughing, Valsalva, rising from sitting to standing and lifting 2 and 5 kg with four different lifting techniques. VP was measured before, 1-5 days and 4-6 weeks after vaginal repair. Mean VP was four to five times higher during coughing and Valsalva compared to PFC......The objective of the study was to measure vaginal pressure during various daily activities in patients before and after vaginal surgery for pelvic organ prolapse, searching data for evidence-based activity guidelines. Vaginal pressure (VP) was studied in 23 patients during activities such as rest...

  16. Condom practices of urban teens using Norplant contraceptive implants, oral contraceptives, and condoms for contraception. (United States)

    Darney, P D; Callegari, L S; Swift, A; Atkinson, E S; Robert, A M


    The availability of long-acting hormonal birth control methods has created new contraceptive options for adolescents. The purpose of this study was to determine whether teens initiating these methods use condoms less frequently than teens using oral contraceptive pills or condoms alone and may therefore be at an increased risk of acquiring sexually transmitted infections. To investigate ongoing condom behavior in teens using levonorgestrel (Norplant) contraceptive implants, oral contraceptives, and condoms alone, we examined data from a 2-year prospective cohort study of 399 urban teens. The study consisted of 3 clinic-based cohorts of adolescent female contraceptive users: Norplant contraceptive implants (n = 200), oral contraceptives (n = 100), and condoms alone (n = 99). Data were collected at an admission interview and at 1- and 2-year follow-up from method continuers. Norplant contraceptive implant users were less likely than oral contraceptive or condom users to report condom use at last sex or consistent condom use at 1- and 2-year follow-up. The implant group showed a significant decrease in condom use from admission to 2 years after method initiation. The proportion of implant users self-reporting new sexually transmitted infections at 2-year follow-up, however, was not significantly greater than that of oral contraceptive or condom users. Our findings indicate that teen users of Norplant contraceptive implants are less likely to use condoms than teens who choose oral contraceptives but, probably because of differences in sexual behavior, are no more likely to self-report sexually transmitted infections. Our findings also indicate that teens who choose oral contraceptives and condoms do not use them consistently enough to avoid pregnancies or sexually transmitted infections.

  17. Contraceptive care for the adolescent. (United States)

    Feldman, Elizabeth


    Despite recent improvements in rates of teen pregnancy, abortion, birth,and contraceptive use, effective contraceptive counseling for adolescents should be a high priority for the primary care provider in the office setting. Adolescent psychosocial risk screening and appropriate counseling about sexual decision-making is necessary. Contraceptive services visits include, relevant history, limited physical examination, provision of information, anticipatory guidance about sexual behaviors, and the provision of contraceptive methods. Teens should always be encouraged to use a male condom during sex to reduce STI risk. A variety of barrier and hormonal contraceptive methods are available for the adolescent population. Education about and provision of EC is effective in reducing the rate of unintended pregnancy and abortion in the United States. Contraceptive care for adolescents is a rewarding experience for primary care providers.

  18. Awareness and Practice of Emergency Contraception Among ...

    African Journals Online (AJOL)

    Alasia Datonye

    most common form is the Emergency contraceptive pill. (ECP) sometimes called ... due to their undue advantage and access to contraception education. A pre- ... contraception to adolescents would increase sexual promiscuity among them ...

  19. Blood pressure and contraceptive use


    Khaw, Kay-Tee; Peart, W S


    In a survey of 461 women routinely attending family planning clinics those taking oral contraceptives had significantly higher mean systolic and diastolic blood pressures than those using non-hormonal contraception. There appeared to be a dose-response relation of blood pressure to the progestogen component of two oral contraceptives with an identical 30 μg ethinyloestradiol component. This supports the idea that the progestogen as well as the oestrogen component has an aetiological role in t...


    Directory of Open Access Journals (Sweden)



    Full Text Available INTRODUCTION: The development of sub dermal contraceptive implant has been an important improvement in current contraceptive technology and to a good alternative to offer well established contraceptive method. Hormonal implant must show high efficacy, high acceptabilit y and rapid return of fertility after removal by maintaining a sustained release of progesterone, the contraceptive effect of the implant can be obtained with a much smaller daily dose than when administering the same steroid by an oral or intramuscular ro ute. Sub dermal implant s are also independent of user compliance which remains a determinant factor in the efficacy of most contraceptive methods. In addition after removal of the hormonal implant, fertility returns almost immediately. They contain only pr ogestogen, these implant may also be used by women who cannot tolerate oestrogen or by women for whom oestrogen is contraindicated. The availability of new innovative contraceptive implant system such as implanon is very important to offer couples alternat ive methods to plan size of their family more efficiently. OBJECTIVES: To study efficacy and safety profile of single rod sub dermal contraceptive device implant implanon. To evaluate the vaginal bleeding patterns observed during the use of implanon. To as sess the acceptability of the contraceptive device as indicated by discontinuation rates. MATERIAL AND METHODS: S tudy was carried in OBG department of RMC Kanpur on healthy female volunteers having regular menstruation & at least one living child. RESULT: The result of this study was excellent in terms of contraception with pearl index of 0, almost one third cases were having in frequent bleeding episode. CONCLUSION: The study was conducted on 110 women of age 20 - 35 years with at least one living child and having regular menstrual period, in present study half of cases discontinued implant due to no fix pattern of bleeding and failure was o%, efficacy of this implant

  1. Vaginal delivery for breech presentation should be an option: experience in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Isha Gutgutia


    Conclusions: Neonatal outcome did not depend on mode of delivery though maternal morbidity and cost of care is increased following Caesarean Section. Proper selection of cases and by improving skill and confidence in new generation obstetrician, vaginal delivery of singleton fetuses in breech presentation at term remains a safe option that can be offered to a woman in a tertiary care centre. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 562-565

  2. Vascular ring (United States)

    ... subclavian and left ligamentum ateriosus; Congenital heart defect - vascular ring; Birth defect heart - vascular ring ... Vascular ring is rare. It accounts for less than 1% of all congenital heart problems. The condition ...

  3. Advances in male hormonal contraception

    Directory of Open Access Journals (Sweden)

    Costantino Antonietta


    Full Text Available Contraception is a basic human right for its role on health, quality of life and wellbeing of the woman and of the society as a whole. Since the introduction of female hormonal contraception the responsibility of family planning has always been with women. Currently there are only a few contraceptive methods available for men, but recently, men have become more interested in supporting their partners actively. Over the last few decades different trials have been performed providing important advances in the development of a safe and effective hormonal contraceptive for men. This paper summarizes some of the most recent trials.

  4. Contraceptive Methods and Factors Associated with Modern Contraceptive In Use

    Directory of Open Access Journals (Sweden)

    Hammad Ali Qazi


    Full Text Available Objective: The world population will likely increase by 2.5 billion over the next 43 years, passing from the current 6.7 billion to 9.2 billion in 2050. Only limited information about the contraceptive practices especially modern contraceptive use is available. The aim of this study is to determine the prevalence of contraceptive methods and factors associated with modern contraceptive in useMaterials and Methods: A cross sectional study of 288 females selected through consecutive sampling was conducted in Jinnah Post graduate Medical Center family reproductive health care center Karachi, Pakistan from November 2008 to January 2009. Females of reproductive age 16-50 years using any contraceptive measures and giving informed consent were included. Those who with severe debilitating disease, having any physical and mental disability were excluded. Two trained co researchers interviewed the participants for socio demographic reasons. The main outcome variables of the study were comparing modern and traditional contraceptive methods and factors associated with modern contraceptive in use.Results: The results showed mean age of contraceptive users was 29.49 (±6.42 years. Modern contraceptive method was used by 216 (75% and traditional method by 72 (25%. Final multiple logistic regression showed that a few factors have influence on usage rate including: age>30 years [AOR, 0.426 95% CI0.209-0.865], addiction [AOR, 0.381 95% CI0.173-0.839], and means of information like family planning worker (FPW [AOR, 6.315 95% CI 3.057-13.046], Television (TV [AOR, 0.402 95% CI 0.165-0.979] and billboard (BB [AOR, 0.207 95% CI 0.066-0.447].Conclusion: Modern contraceptive method use is very common in our region (75%. The important means of information for modern contraceptive in use were GPs and family planning workers.

  5. Association of amoebae and actinomyces in an intrauterine contraceptive device user. (United States)

    Arroyo, G; Quinn, J A


    A patient wearing an intrauterine contraceptive device (IUD) was diagnosed as being colonized by Actinomyces and amoebae by examination of a routine Papanicolaou smear. The patient received vaginal treatment with metronidazole, which temporarily eliminated the protozoa; however, it was necessary to remove the IUD to definitively eradicate the microorganisms. Follow-up Papanicolaou smears taken after removal of the IUD have been normal and free of both microorganisms.

  6. Linking Changes in Contraceptive Use to Declines in Teen Pregnancy Rates

    Directory of Open Access Journals (Sweden)

    Jennifer Manlove


    Full Text Available Using a unique microsimulation tool, Teen FamilyScape, the present study explores how changes in the mix of contraceptive methods used by teens contributed to the decline in the U.S. teen pregnancy rate between 2002 and 2010. Results indicate that changes in contraceptive use contributed to approximately half of the decline in the teen pregnancy rate during this time period (48% and that a little more than half of this “contraceptive effect” was due to an increase in teen condom use (58%. The remaining share of the contraceptive effect can be attributed to an increase in the use of more effective hormonal (pill, patch, ring and long-acting reversible contraceptive (LARC/injectable methods (Intrauterine Devices (IUD, implant and injectable. Results from an additional counterfactual analysis suggest that the contraceptive effect was driven by the fact that the percentage of teens using no birth control fell during the study time period, rather than by the fact that some teens switched from less effective methods (condoms to more effective hormonal and LARC/injectable methods. However, very high typical use failure rates for teen condom users suggest the need for a two-pronged approach for continuing reductions in teen pregnancy for sexually active teens: first, targeting the youth most at risk of not using contraception and helping them choose contraception, and second, increasing the effectiveness of method use among existing contraceptors.

  7. Treatment Options by Stage (Vaginal Cancer) (United States)

    ... Health Professional Vaginal Cancer Treatment Research Vaginal Cancer Treatment (PDQ®)–Patient Version General Information About Vaginal Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on ...

  8. [Contraceptive compliance - why is contraceptive failure still so frequent?]. (United States)

    Bitzer, Johannes


    Contraceptive compliance is defined as the correct use (according to the method specific prescriptions given by a medical professional and/or in written form as patient information leaflet) of a contraceptive method. Non-compliance describes a mismatch between the real behaviour of a user and the correct or ideal behaviour. There are various indicators that in general contraceptive compliance is far from ideal. Many studies report a rate of unintended pregnancies of 50%, half of them terminating in abortion. The abortion rate remains high even in countries with availability of advanced contraceptive technology. Especially with hormonal contraception and barrier methods the gap between correct and real use is large. Discontinuation rates per year reach up to 50%. Reasons for Non Compliance are (a) Lack of motivation to prevent a pregnancy due to ambivalence regarding the wish for a child as well as sexual and relationship issues (b) Cognitive factors (False information, misconceptions, irrational fears) (c) Difficult or lacking access to contraceptive methods (d) Behavioral errors and mistakes (Forgetting, loosing etc.) and (e) Side effects of the methods used. Three strategies to improve compliance can be distinguished: (a) Improving counselling; (b) Developing contraceptive methods which demand a low level of compliant behaviour by the user; (c) Improving quality of life of users by minimizing the negative side effects and maximizing the non contraceptive health benefits.

  9. Objective Measurement of Inaccurate Condom Use Reporting Among Women Using Depot Medroxyprogesterone Acetate for Contraception. (United States)

    Heffron, Renee; Parikh, Urvi M; Penrose, Kerri J; Mugo, Nelly; Donnell, Deborah; Celum, Connie; Mellors, John W; Baeten, Jared M


    Observational analyses have suggested that women using the injectable contraceptive depot medroxyprogesterone acetate (DMPA) may have heightened risk of acquiring HIV. However, those analyses were potentially confounded by sexual behavior, with possible differential condom use and reporting by women using DMPA versus no contraception. In a cross-sectional study, we measured the presence of a biomarker of recent condomless sex (Y chromosomal [Yc] DNA) in vaginal swabs from HIV-uninfected African women who had an HIV-infected partner and reported 100 % condom use. Half of the samples tested were from women reporting DMPA and half were from women using no contraception. Among 428 specimens tested (213 from DMPA users and 215 from women using no contraception), 32.0 % had Yc DNA detected, with a mean of 193 copies/10,000 human cells (range 0.1-8201). The frequency of detection did not differ by contraceptive use: 34.2 % of DMPA users versus 29.8 % of women using no contraception, adjusted odds ratio 1.3 (95 % confidence interval 0.9-2.0). These results suggest that inaccurate reporting of condom use by DMPA users may not account for the heightened risk of HIV acquisition among DMPA users in some observational studies.

  10. Barrier versus oral contraceptive use: a study of female college students. (United States)

    Radius, S M; Joffe, A; Gall, M J


    Although they provide birth control and are easier to use, oral contraceptives (OCPs) are not the preferred approach to preventing sexually transmitted disease (STD). Do the knowledge, attitudes, and experiences of oral contraceptive users place them at greater risk for STDs than those who employ barrier methods? This study examined differences between sexually active female college students (ie, those who reported ever having had vaginal intercourse) who used OCPs and those who employed barrier methods of contraception at the time of their most recent intercourse. The authors analyzed HIV- and other STD-related knowledge, attitudes, and behaviors from three consecutive annual health surveys of young women about to begin their first year of college. Findings showed barrier and OCP users to be comparable in knowledge about the effectiveness of various contraceptive methods in protecting them against STDs, perceived personal susceptibility to HIV, and experiences with alcohol before sexual intercourse. Oral contraceptive users, compared with those in the group who used barrier methods, reported a greater number of recent partners (p less than .03) and greater perceived vulnerability to STDs (p less than .03). Student healthcare providers must develop creative educational strategies to encourage simultaneous use of both oral contraceptives and barrier methods to protect students against STDs and pregnancy.

  11. The Effects of Hormones and Vaginal Microflora on the Glycome of the Female Genital Tract: Cervical-Vaginal Fluid (United States)

    Moncla, Bernard J.; Chappell, Catherine A.; Debo, Brian M.; Meyn, Leslie A.


    In this study, we characterized the glycome of cervical-vaginal fluid, collected with a Catamenial cup. We quantified: glycosidase levels; sialic acid and high mannose specific lectin binding; mucins, MUC1, MUC4, MUC5AC, MUC7; and albumin in the samples collected. These data were analyzed in the context of hormonal status (day of menstrual cycle, hormonal contraception use) and role, if any, of the type of the vaginal microflora present. When the Nugent score was used to stratify the subjects by microflora as normal, intermediate, or bacterial vaginosis, several important differences were observed. The activities of four of six glycosidases in the samples from women with bacterial vaginosis were significantly increased when compared to normal or intermediate women: sialidase, P = IUDs (P = 0.02). The number of sialic acid binding sites was lower in the postmenopausal group (P = 0.04), but the number of high mannose binding sites, measured with Griffithsin, was not significantly different among the 6 hormonal groups. The glycosidase levels in the cervical-vaginal mucus were rather low in the groups, with exception of α-glucosidase activity that was much lower in the postmenopausal group (Pmicroorganisms. These effects were so influential that it required us to remove subjects with BV for data interpretation of the impact of hormones. We also suggest that certain changes occurring in vaginal/cervical proteins are due to bacteria or their products. Therefore, the quantitation of vaginal mucins and lectin binding offers a new method to monitor bacteria-host interactions in the female reproductive tract. The data suggest that some of the changes in these components are the result of host processing, such as the increases in mucin content, while the microflora is responsible for the increases in glycosidases and the decreases in lectin binding. The methods should be considered a valid marker for insult to the female genital tract. PMID:27437931

  12. Vaginal pressure during daily activities before and after vaginal repair

    DEFF Research Database (Denmark)

    Mouritsen, L; Hulbaek, M; Brostrøm, S


    The objective of the study was to measure vaginal pressure during various daily activities in patients before and after vaginal surgery for pelvic organ prolapse, searching data for evidence-based activity guidelines. Vaginal pressure (VP) was studied in 23 patients during activities such as rest......, pelvic floor contraction (PFC), coughing, Valsalva, rising from sitting to standing and lifting 2 and 5 kg with four different lifting techniques. VP was measured before, 1-5 days and 4-6 weeks after vaginal repair. Mean VP was four to five times higher during coughing and Valsalva compared to PFC...... was not related to the type of vaginal repair. The results imply that post-operative counselling should concentrate more on treating chronic cough and constipation than restrictions of moderate physical activities....

  13. Neoplasia vaginal intraepitelial


    Baquedano M.,Laura; Lamarca B,Marta; José G,Yasmina; Rubio C,Patricia; Ruiz C,Miguel Ángel


    Objetivo: Actualizar los conocimientos disponibles sobre la neoplasia vaginal intraepitelial (VAIN) especialmente en el diagnóstico y tratamiento. Métodos: Revisión de la literatura en Pubmed de los últimos 20 años, especialmente de los publicados desde 2005 hasta la actualidad y considerando sobre todo los ensayos clínicos aleatorizados. Resultados: Su prevalencia real es desconocida, aunque es una patología rara generalmente en mujeres posmenopaúsicas. Su fisiopatología es similar a la neop...

  14. IMAP statement on contraceptive efficacy. (United States)


    Unwanted pregnancy may have serious negative effects upon the health and well-being of individuals and families. The use of effective contraception is therefore important. Efficacy, however, is not the only factor considered by clients when choosing a contraceptive method, so counsellors and service providers should not promote methods on the sole basis of their efficacy, irrespective of client preference. With regard to method efficacy, important considerations which may affect the choice of a method are the availability of emergency contraception and access to safe abortion services in the event of method failure. Biological factors such as age, parity, and whether a woman is breast feeding may affect contraceptive efficacy and should be a consideration when choosing a method. Contraceptive efficacy is usually measured in terms of failure rates calculated from the number of pregnancies which occur during a specified period of contraceptive use. Method failure is that attributable to the method, while user failure is that attributable to incorrect use of the method in addition to method failure. The failure rates for specific methods of contraception reported in the literature vary, sometimes substantially. The article briefly considers the measurement of efficacy and human factors affecting contraceptive efficacy with regard to clients, providers, and managers.

  15. Vaginal wind: A literature review. (United States)

    Neels, Hedwig; Mortiers, Xavier; de Graaf, Sybrich; Tjalma, Wiebren A A; De Wachter, Stefan; Vermandel, Alexandra


    In the medical literature, there is little known about vaginal wind, though from clinical expertise, it turns out to be a consistent and underreported problem. The aim of this review was to collect the available literature about the different aspects of vaginal wind. A systematic literature search was conducted using three databases until December 2015. The search strategy was built using relevant synonyms of vaginal wind. Study characteristics were extracted. Risk of bias, the quality of the relevant studies and the level of evidence was judged. Eleven studies met the inclusion criteria. Vaginal wind occurs on random movements and during or after coitus. The prevalence ranges from one to 69%. The pathophysiology is unclear and the incidence unknown. Known risk factors are vaginal delivery and urinary incontinence. Provoking factors are coitus, digital stimulation, cunnilingus and exercising. Female sexual function is decreased. The sexual function of male partners with vaginal wind is not influenced. Overall vaginal wind leads to a decrease in the quality of live and can have cause social isolation. The treatment is related to the cause and mainly not successful. Tampons can be used for treatment as well as prevention. Vaginal wind is an underestimated health issue with a severe impact on sexual functioning. Adequate research is needed regarding the influence of sexual activity, weight, age, parity, the underlying pathophysiological mechanisms, prevention and treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Normal breast physiology: the reasons hormonal contraceptives and induced abortion increase breast-cancer risk. (United States)

    Lanfranchi, Angela


    A woman gains protection from breast cancer by completing a full-term pregnancy. In utero, her offspring produce hormones that mature 85 percent of the mother's breast tissue into cancer-resistant breast tissue. If the pregnancy ends through an induced abortion or a premature birth before thirty-two weeks, the mother's breasts will have only partially matured, retaining even more cancer-susceptible breast tissue than when the pregnancy began. This increased amount of immature breast tissue will leave the mother with more sites for cancer initiation, thereby increasing her risk of breast cancer. Hormonal contraceptives increase breast-cancer risk by their proliferative effect on breast tissue and their direct carcinogenic effects on DNA. Hormonal contraceptives include estrogen-progestin combination drugs prescribed in any manner of delivery: orally, transdermally, vaginally, or intrauterine. This article provides the detailed physiology and data that elucidate the mechanisms through which induced abortion and hormonal contraceptives increase breast-cancer risk.

  17. Expanding contraceptive options. (United States)


    The goals of Family Health International (FHI) have been to introduce a variety of birth control options to people in developing countries, and to provide information to the user on the advantages and disadvantages of each method. FHI has worked with many developing countries in clinical trials of established as well as new contraceptive methods. These trials played an important part in making 2 sterilization procedures, laparoscopy and minilaparotomy popular for women. Further research improved the methods and have made them the most popular in the world, chosen by 130 million users. FHI is doing clinical trials on a new IUD, that is a copper bearing T-shaped device called the TCu380A. they have collected data on over 10,000 women using IUD's and early analysis indicates TCu380A is more effective than others. FHI is also evaluating devices such as Norplant that will prevent pregnancy up to 5 years by implanting the capsules in the arm. More than 8,000 women are being tested to determine the acceptability of implants in different geographical locations. Other research groups are doing work in 10 additional countries: Bangladesh will expand its program to 24,000 women and Nepal to 8,000 women. Trials are also being conducted on progestogen pills, since they do not lesson the volume of milk in breast feeding. FHI has also worked to introduce creative community-based distribution channels. In one case, specially trained health workers delivered contraceptives door-to-door in over 150,000 households. They found that 2 of 3 women accepted the pills and in a follow up survey 90% were still using them. FHI is now focusing on ways to improve moving new contraceptives from clinical testing on everyday use. They will coordinate training programs, educational material, media campaigns, and efforts with other international organizations, government agencies, and family planning groups.

  18. Gestodene-containing contraceptives. (United States)

    Kuhl, H; Jung-Hoffmann, C; Wiegratz, I


    As GSD is the most potent progestogen used in oral contraceptives, the doses of GSD can be lower than those of other progestogen components. The monophasic (30 micrograms EE + 75 micrograms GSD) and the triphasic formulation (30 micrograms EE + 50 micrograms GSD/40 micrograms EE + 70 micrograms GSD/30 micrograms EE + 100 micrograms GSD) suppress gonadotropin release and ovarian function profoundly and inhibit ovulation reliably. The strong anti-estrogenic and progestogenic effectiveness of GSD is based on the high GSD serum concentrations achieved during daily intake. Because of the weak androgenic properties of GSD, both formulations can be characterized as estrogen-dominant with respect to their hepatic effects. Except for the first cycles, both formulations afford good cycle control, and the rate of side effects is similar to that with comparable low-dose oral contraceptives. The levels of total and free androgens and androgen precursors, as well as of peripheral androgen activity, are significantly reduced, resulting in a reduced incidence of acne. The concentrations of SHBG and other serum-binding globulins are elevated considerably, and thyroid function is almost unaffected. The estrogen-dominant effect on hepatic metabolism of both formulations also is reflected by a significant increase in the levels of triglycerides and VLDL, HDL, and some apolipoproteins, while LDL-CH and total CH remain unchanged. Similar to other low-dose oral contraceptives, the GSD-containing preparations cause a slight impairment of glucose tolerance that does not appear to be of clinical relevance. However, a significant increase exists in pro-coagulatory and fibrinolytic activity that leads to a considerable stimulation of fibrin turnover. In predisposed women, this may contribute to an elevated risk of venous and arterial thromboembolic diseases.

  19. Potencies of oral contraceptives. (United States)

    Edgren, R A; Sturtevant, F M


    Oral contraceptives are combinations of estrogens and progestogens or, in the case of the mini-pills, progestogens alone. With specific test procedures in laboratory animals or human subjects, it is possible to assign potency evaluations to the components relative to the progestational, estrogenic, or antiestrogenic activities of the progestogen or to the estrogenic potencies of the estrogenic component. It might even be possible to quantify the synergistic effects of the estrogen on the progestational agent. Unfortunately, however, it is impossible now to amalgamate such assay results into single estimates of the potencies of the combinations (either the combination products per se or the combination tablets of sequential products). For example, an over-all estrogenic potency of a combination preparation would involve the integration of contributions form the estrogen itself plus the estrogenic products of metabolism of the progestogen minus the antagonistic effect of the progestational agent, if any. These factors cannot now be quantified independently, much less merged into a single figure of clinical significance. Further, even if it were possible to produce such an estimate, it is unlikely that the evaluation would be meaningful in relation to any putative side effect or adverse reaction, i.e., the alleged thrombogenic effects of oral contraceptives cannot currently be related directly to any measure of potency that will allow prediction of these clinical conditions from laboratory models. Any evaluation of the potential of a given contraceptive to produce a specific side effect will depend upon data generated with specific regard to that adverse reaction and the individual product in question.

  20. Vaginal Vault Prolapse

    Directory of Open Access Journals (Sweden)

    Azubuike Uzoma


    Vault prolapse repair rely on either the use of patient's tissue or synthetic materials and can be carried out abdominally or vaginally. Sacrospinous fixation and abdominal sacrocolpopexy are the commonly performed procedures, with literature in favour of abdominal sacrocolpopexy over sacrospinous fixation due to its reported higher success rate of about 90%. Other less commonly performed procedures include uterosacral ligament suspension and illiococcygeal fixation, both of which are equally effective, with the former having a high risk of ureteric injury. Colpoclesis will play a greater role in the future as the aging population increases. Mesh procedures are gaining in popularity, and preliminary data from vaginal mesh procedures is encouraging. Laparoscopic techniques require a high level of skill and experience. There are many controversies on the mechanism of prolapse and management techniques, which we have tried to address in this article. Conclusion. As the aging population increases, the incidence of prolapse will also rise, older techniques using native tissue will continue, while new techniques using the mesh needs to be studied further. The later may well be the way forward in future.

  1. Emergency contraception: different bioethical perspectives

    Directory of Open Access Journals (Sweden)

    Marco Bo


    Full Text Available Emergency contraceptives, in this case post-morning pills, are contraceptive methods used to avoid an unwanted pregnancy after an unprotected sexual intercourse. Their use is feeding a strong ethical debate between subjects for and against their prescription and leading some health professionals to conscientious objection. Among people contrary to prescription some oppose to it because of a general refuse of all contraceptive methods, others considering post-morning pills as abortive. Among people supporting prescription, some consider emergency contraception necessary to assure fundamental women’s rights, in particular the right to sexual auto-determination, while others prescribe emergency contraception only to avoid a greater demand for abortion. It is up to the Italian National Health Service warranting a correct balance between the two opposite positions, that can protect women’s right of access to health services.

  2. [Abortion or contraception (author's transl)]. (United States)

    Goldsmith, A; Edelman, D A


    The period immediately following an abortion, spontaneous or induced, has been considered favourable to the initiation of high efficicy contraception: sterilization, oral contraceptives, or intrauterine devices. The rate of post-abortal complications associated with these contraceptive methods was evaluated using data drawn from published and unpublished studies. The following conclusions were reached: sterilization is advisable only for women who do not desire additional children, and is obviously not recommended for young nulliparous women. The effective use of oral contraceptives requires a high motivational level and is therefore advisable only in cases where such motivation exists. The insertion of an intrauterine device seems to be the most adequate contraceptive method for women with low motivational level.

  3. Vaginal haemangioendothelioma: an unusual tumour.

    LENUS (Irish Health Repository)

    Mohan, H


    Vaginal tumours are uncommon and this is a particularly rare case of a vaginal haemangioendothelioma in a 38-year-old woman. Initial presentation consisted of symptoms similar to uterovaginal prolapse with "something coming down". Examination under anaesthesia demonstrated a necrotic anterior vaginal wall tumour. Histology of the lesion revealed a haemangioendothelioma which had some features of haemangiopericytoma. While the natural history of vaginal haemangioendothelioma is uncertain, as a group, they have a propensity for local recurrence. To our knowledge this is the third reported case of a vaginal haemangioendothelioma. Management of this tumour is challenging given the paucity of literature on this tumour. There is a need to add rare tumours to our "knowledge bank" to guide management of these unusual tumours.

  4. [Morality and contraception]. (United States)

    Gakwaya, D


    The conflict of morality and natural law come into focus when contraception and procreation are examined despite the religious pronouncements of Charles de Koninck. Man, having mastered nature, confronts interminable new problems in the pursuit of physical, economic, moral, and material happiness. The population explosion in Rwanda make it indispensable that the prevention of undesired pregnancy is the right of a man and a women choosing the appropriate method. Man's morality allows the violation of natural law in order to pursue one's own goal of survival using counterbalancing means whenever under- or overpopulation may threaten its existence or portend extinction. Natural law could be the guiding principle in man's moral development.

  5. Adolescent pregnancy and contraception. (United States)

    Dalby, Jessica; Hayon, Ronni; Carlson, Jensena


    7% of US teen women became pregnant in 2008, totaling 750,000 pregnancies nationwide. For women ages 15 to 19, 82% of pregnancies are unintended. Adolescents have a disproportionate risk of medical complications in pregnancy. Furthermore, adolescent parents and their infants both tend to suffer poor psychosocial outcomes. Preventing unintended and adolescent pregnancies are key public health objectives for Healthy People 2020. Screening for sexual activity and pregnancy risk should be a routine part of all adolescent visits. Proven reductions in unintended pregnancy in teens are attained by providing access to contraception at no cost and promoting the most-effective methods.

  6. Ring blowers. Ring blower

    Energy Technology Data Exchange (ETDEWEB)

    Nakahara, Y.; Okamura, T.; Takahashi, M. (Fuji Electric Co. Ltd., Tokyo (Japan))


    Features, structures and several products of ring blowers were outlined. The ring blower is featured by its medium characteristics because it is higher in air pressure than a turboblower and larger in airflow than a vane blower, and it is applicable flexibly to not only air blasting but various industrial fields such as suction transfer. As several products corresponding to various fields, the followings were outlined: the low noise type with optimum shapes of inlet, outlet and casing cover for reducing noises by 10 dB or more, the heat resistant, water-tight and explosion-proof types suitable for severe environmental conditions, the multi-voltage type for every country served at different voltages, the high air pressure type with two pressure rise stages, and the large airflow type with a wide impeller. In addition, as special use products, the glass fiber reinforced unsatulated polyester ring blower for respiration apparatus, and the variable speed blushless DC motor-driven one for medical beds were outlined. 2 refs., 9 figs., 1 tab.

  7. Sexual and Contraceptive Behaviors among Adolescents Requesting Emergency Contraception. (United States)

    Cwiak, Carrie; Howard, Brandon; Hsieh, Jennifer; Ricciotti, Nancy; Sucato, Gina S


    Unintended pregnancy rates in the United States remain high among adolescents. Emergency contraception (EC) provides the only option for pregnancy prevention after unprotected sex. To better define the population of adolescents who request and use EC pills, we performed a post hoc analysis of an over-the-counter simulation study of EC pills. Teen reproductive health clinics in 5 cities. Adolescents between the ages of 13 and 17 years who requested EC. Single-tablet levonorgestrel 1.5 mg. We calculated the correlations between age and baseline sexual and contraceptive behaviors. χ(2) Tests were used to compare behaviors of first-time and repeat EC users. Overall, the most commonly reported contraceptive methods ever used were condoms, oral contraceptives, none, and withdrawal; the most common method ever used in each age group was no method for 13- to 14-year-olds and condom for 15-, 16-, and 17-year-olds. The percentage of participants who had never used contraception before requesting EC decreased with age (53% [20/28] of 13- to 14-year-olds vs 15% [10/65] of 17-year-olds). First-time EC users were more likely to report no previous contraceptive use compared with repeat EC users (42% [88/208] vs 10% [13/135]; P < .001). Regardless of age, the most commonly reported reason for requesting EC was nonuse of any contraceptive method (ie, "unprotected sex"). Adolescents who requested EC most commonly reported ever-use of contraceptive methods that rely on user adherence or no method at all, with younger adolescents more likely than older adolescents to have used no previous method. The provision of EC presents an opportunity to provide education and access to highly effective, long-term contraceptive methods. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  8. Oral contraception in Denmark 1998-2010

    DEFF Research Database (Denmark)

    Wilson, Nadia M; Laursen, Maja; Lidegaard, Øjvind


    Oral contraceptives (OC) are the most popular contraception in Denmark. Overall figures on use are well described, but more detailed use patterns according to type and age need to be updated.......Oral contraceptives (OC) are the most popular contraception in Denmark. Overall figures on use are well described, but more detailed use patterns according to type and age need to be updated....

  9. Abortion and contraceptive failure. (United States)


    Persona, marketed by Unipath, is a new method of natural family planning which has been on the market since 1996. It works by measuring the hormone levels in a woman's urine and letting her know when she is not fertile and may have sex without using a barrier method of contraception. The British Pregnancy Advisory Service (BPAS) found that their surveyed clients who reported using Persona had 188 abortions in 3 months and concluded that there was a need for better information and more advice for couples who plan to use the method. The other major non-NHS abortion provider, Marie Stopes International, reported similar findings, with about 60 women per month visiting their clinics for abortions after having used the method. The BPAS survey also showed that 43% of the women who had an abortion after using Persona were aged 24 years or younger even though Persona is intended for use by women aged 25-40 years in stable relationships. A similar proportion also reported having sex on days when the method told them that they were most fertile. These latter women were not asked if they used another method of contraception on fertile days. An additional 13% reported ignoring the instructions to wait for 3 natural periods after terminating pill use before beginning to use Persona.

  10. Contraception in Obese Women

    Directory of Open Access Journals (Sweden)

    Merki Feld G


    Full Text Available Today obesity is an epidemic. Within Europe the prevalence of obesity is 20–30% with a tendency to increase further. Obesity is associated with severe complications like diabetes mellitus, cardiovascular disease increased risk for venous thromboembolism (VTE and metabolic syndrome. Especially availability of efficient methods which do not further enhance the cardiovascular and thromboembolic risk in obese women is an important point. Using contraception to prevent unwanted pregnancies is recommended to all women whatever their weight, as it reduces the risks of unplanned pregnancy, which is higher in women with overweight. Progestin-only contraceptives and IUDs have no or minimal metabolic effects and are first choices options, also it has to be taken in account that oral progestins and the implant might have lower efficacy in very obese women. CHC are associated with a higher risk for VTE in obese women,but should be used if other methods are not acceptable. A long-cycle or use of preparations with 30 mcg EE can contribute to improve efficacy.

  11. New and emerging contraceptive options: a focus on transdermal contraception

    Directory of Open Access Journals (Sweden)

    Böttcher B


    Full Text Available Bettina Böttcher, Ludwig WildtDepartment of Gynecologic Endocrinology and Reproductive Medicine, Innsbruck Medical University, Innsbruck, AustriaAbstract: Transdermal contraception is a convenient way of hormonal contraception that allows weekly application of a patch for 3 consecutive weeks followed by a patch-free week. Efficacy, side effects, advantages, and disadvantages as well as patient satisfaction with this formulation are discussed in this short review. The first patch, introduced in 2002, contained ethinylestradiol and norelgestromin. Recently, a new patch containing gestodene as the gestagen component has been developed. Early data for this formulation are presented.Keywords: transdermal contraception, skin patch

  12. Contraception and unwanted pregnancy. (United States)

    Adler, N E


    An overview of research findings in the US on the psychological and social variables associated with unwanted pregnancy and on the consequences of unwanted pregnancy was provided. Studies which examined personality differences between women and adolescent females who practicaed effective contraception and thesse who experienced unwanted pregnancy consistently found that the latter group, compared to the former group, had lower self-esteem, were more passive, tended to engage in more risk taking behavior, and were less achievement and future oriented. Several studies found that those who experienced unwanted pregnancies were often poorly informed about sex and contraception. Sex education, however, did not always lead to an increase in the knowledge and use of contraception. Sex education was unable to overcome the effects of male and female sexual socialization processes in which adolescents were inculcated with a double sex standard and females with a sense of guilt concerning the use of contraception. Numerous studies showed that unperceived or denied motives played a role in the occurence of unwanted pregnancies. Unwanted pregnancies were associated with loss, and these pregnancies probably represented an attempt to replace the loss of a loved person. Women who were in conflict about their work and mothering roles, and women who did not want to work but felt pressured to do so, frequently had inappropriate pregnancies. Teenagers who were not interested in school or in future careers often had unwanted pregnancies. These pregnancies probably represented an attempt to establish a social identity. W.B. Miller identified 8 stages in the reproductive life span when unwanted pregnancies were most likely to occur. These stages were 1) the initial stage of adolescence when the individual may not be fully aware of her fertility, 2) the 1st 6 months following the initiation of sexual activity, 3) at the beginning of a new relationship, 4) during the initial stage of

  13. [Contraception and pelvic infection in women]. (United States)

    Keith, L; Berger, G S; Brown, E R


    Although sexually transmitted diseases are a major public health problem at the international level, the relationship between contraception and pelvic infection is seldom examined. Numerous STDs are more difficult to diagnose, more frequent, and more serious in women than in men. Differential diagnosis between pelvic infection and other intraabdominal syndromes has been a concern for practitioners for years, and many pelvic infections are probably never diagnosed. Lower abdominal pain and sensitivity as well as fever, leucocytosis, accelerated sedimentation rate, inflammatory annexial mass evident on sonography, and microorganisms in the pouch of Douglass and presence of leucocytes in the peritoneal fluid are diagnostic criteria. Apart from errors in treatment resulting from errors in diagnosis, pelvic infections are often inadequately treated, especially in the initial phase before symptoms are confirmed. The exact incidence of pelvic infections in the US is unknown, but pelvic inflammatory disease (PID) accounted for over 200,000 hospitalizations per year between 1970-75. PID carries grave risks of subsequent ectopic pregnancy, chronic pelvic pain, and infertility which is more likely as the number of acute episodes increases. The female genital tract has diverse microenvironments propitious for growth of microorganisms of different types, aerobic and anaerobic. Each anatomic site has specific features conditioning bacterial growth. Histological modifications during the menstrual cycle and pregnancy affect the microbial flora. Except in the case of gonorrhea, it is not known how many female lower genital tract infections spread to the upper tract. Since 1970, several studies have domonstrated a growing diversity of cervical and vaginal flora in asymptomatic subjects. The principal risk factors for PID have been well described in the literature. All contraceptive methods except the IUD provide some degree of protection against PID. Even among IUD users the risk of

  14. A study to compare the clinical outcome of sublingual and vaginal misoprostol in the medical management of missed miscarriage in first trimester

    Directory of Open Access Journals (Sweden)

    Akanksha Lamba


    Conclusions: The effectiveness of Sublingual misoprostol is comparable to that of vaginal misoprostol for medical management of missed miscarriage but is associated with an increased risk of side effects especially diarrhoea. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 491-494

  15. Perceived racial, socioeconomic and gender discrimination and its impact on contraceptive choice. (United States)

    Kossler, Karla; Kuroki, Lindsay M; Allsworth, Jenifer E; Secura, Gina M; Roehl, Kimberly A; Peipert, Jeffrey F


    The study was conducted to determine whether perceived racial, economic and gender discrimination has an impact on contraception use and choice of method. We analyzed the first 2,500 women aged 14-45 years enrolled in the Contraceptive CHOICE Project, a prospective cohort study aimed to reduce barriers to obtaining long-acting reversible contraception. Items from the "Experiences of Discrimination" (EOD) scale measured experienced race-, gender- and economic-based discrimination. Overall, 57% of women reported a history of discrimination. Thirty-three percent reported gender- or race-based discrimination, and 24% reported discrimination attributed to socioeconomic status (SES). Prior to study enrollment, women reporting discrimination were more likely to report any contraception use (61% vs. 52%, pdiscrimination were associated with increased current use of less effective methods [adjusted risk ratio (aRR) 1.22, 95% confidence interval (CI) 1.06-1.41; aRR 1.25, CI 1.08-1.45; aRR 1.23, CI 1.06-1.43, respectively]. After enrollment, 66% of women with a history of experience of discrimination chose a long-acting reversible contraceptive method (intrauterine device or implantable) and 35% chose a depo-medroxyprogesterone acetate or contraceptive pill, patch or ring. Discrimination negatively impacts a woman's use of contraception. However, after financial and structural barriers to contraceptive use were eliminated, women with EOD overwhelmingly selected effective methods of contraception. Future interventions to improve access and utilization of contraception should focus on eliminating barriers and targeting interventions that encompass race-, gender- and economic-based discrimination. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Contraception and Thrombophilia - A statement from the German Society of Gynecological Endocrinology and Reproductive Medicine (DGGEF e. V. and the Professional Association of the German Gynaecologists (BVF e. V.

    Directory of Open Access Journals (Sweden)

    Rabe T


    healthy women without known risk factors as follows (VTE cases per 10,000 woman-years: – No method-related increased risk (3–4: Non-hormonal contraceptives (e.g. tubal sterilisation, condoms, spermicides, behavioral methods, copper IUDs – No or only slightly increased risk (3–4: Levonorgestrel IUS, progestogen-only pill, estrogen-free oral contraceptives – Moderately increased risk (3–10: Combined OCs (COCs with 50 µg EE containing norethisterone, norethisterone acetate, levonorgestrel, norgestimate, chlormadinone acetate, dienogest; COCs with estradiol valerate and dienogest; vaginal combined estrogen/progestogen ring, depot injectables – Moderately increased risk (6–14: COCs with 50 µg EE containing desogestrel, gestodene, cyproterone acetate or drospirenone; combined estrogen/ progestogen contraceptive patch Detection of women at risk for VTE via family and personal history is absolutely required before any hormonal therapy (e.g. contraception, hormonal replacement. General screening for thrombophilia is not recommended. Additional individual risk factors must be considered. Each patient should be advised about early symptoms of vascular occlusion. For patients with an increased risk of VTE a risk-benefit analysis must be done regarding nonhormonal choices and non-contraceptive benefits of individual hormonal treatment (e.g. for COCs: regular menstrual cycles, less dysmenorrhoea, improvement of acne vulgaris. Shared decision-making and informed consent are strongly recommended.

  17. Vaginal microbicides: An overview

    Directory of Open Access Journals (Sweden)

    Hany Abdel-Aleem


    Full Text Available It is estimated that more than 340 million new cases of curable sexually transmitted infections occur every year throughout the world in men and women age (15–49years. Women bear an increasing burden of the epidemic as both caregivers for the ill and because of their heightened risk of infection due to biological, economic and social vulnerabilities. There is an urgent need for new prevention strategies that women can use themselves and initiate. A vaginal microbicide defined as substances intended to reduce or prevent transmission of HIV and/or other sexually transmitted infections (STIs when applied topically to genital mucosal surfaces, provides a woman-controlled method applied before sex that could kill, neutralize, or block HIV and other sexually transmitted diseases.

  18. Vaginal dose de-escalation in image guided adaptive brachytherapy for locally advanced cervical cancer

    DEFF Research Database (Denmark)

    Mohamed, Sandy; Lindegaard, Jacob Christian; de Leeuw, Astrid A C;


    at diagnosis from 3 institutions were analysed. External beam radiotherapy was combined with MRI-guided brachytherapy. VDD was obtained by decreasing dwell times in ovoid/ring and increasing dwell times in tandem/needles. The aim was to maintain the target dose (D90 of HR-CTV ⩾ 85 Gy EQD2) while reducing...... the dose to the surface of the vagina to mean vaginal loading (ovoid/ring) was reduced from 51% to 33% of the total loading with VDD, which significantly reduced the dose to the vaginal dose points (p...... mean of 4 ± 4 Gy EQD2 (p

  19. Saturn's Rings (United States)

    Cuzzi, J. N.


    The rings are changing before our eyes; structure varies on all timescales and unexpected things have been discovered. Many questions have been answered, but some answers remain elusive (see Cuzzi et al 2010 for a review). Here we highlight the major ring science progress over the mission to date, and describe new observations planned for Cassini's final three years. Ring Composition and particle sizes: The rings are nearly all water ice with no other ices - so why are they reddish? The C Ring and Cassini Division are "dirtier" than the more massive B and A Rings, as shown by near-IR and, recently, microwave observations. Particle sizes, from stellar and radio occultations, vary from place to place. Ring structure, micro and macro: numerous spiral density waves and ubiquitous "self-gravity wakes" reveal processes which fostered planet formation in the solar system and elsewhere. However, big puzzles remain regarding the main ring divisions, the C Ring plateau structures, and the B Ring irregular structure. Moonlets, inside and out, seen and unseen: Two gaps contain sizeable moonlets, but more gaps seem to contain none; even smaller embedded "propeller" objects wander, systematically or randomly, through the A ring. Rubble pile ringmoons just outside the rings may escaped from the rings, and the recently discovered "Peggy" may be trying this as we watch. Impact bombardment of the rings: Comet fragments set the rings to rippling on century-timescales, and boulders crash through hourly; meanwhile, the constant hail of infalling Kuiper belt material has a lower mass flux than previously thought. Origin and Age of the Rings: The ring mass and bombardment play key roles. The ring mass is well known everywhere but in the B Ring (where most of it is). New models suggest how tidal breakup of evolving moons may have formed massive ancient rings, of which the current ring is just a shadow. During its last three years, the Cassini tour profile will allow entirely new


    Directory of Open Access Journals (Sweden)

    Asha Rani


    Full Text Available Post-partum period is one of the critical times when both woman and new-born need a special and integrated package of health services as morbidity and mortality rates are quite high during this period and also the women are vulnerable to unintended pregnancy. Studies show that pregnancies taking place within 24 months of a previous birth have a higher risk of adverse outcomes like abortions, premature labor, post-partum haemorrhage, low birth weight babies, fetal loss and maternal death. In India, 65 percent of women in the first year post-partum have an unmet need for family planning. Hence, contraception needs to be practiced in this critical period.1 Intrauterine contraceptive device is the most commonly used reversible method of contraception worldwide with about 127 million current users.2 Insertion of an IUD immediately after delivery is appealing for several reasons. The woman is not pregnant and is motivated for contraception and the setting is convenient for both woman and provider. For women with limited access to medical care, the delivery affords a unique opportunity to address the need for contraception. The evidence for post-partum IUD insertion was weak when this study was undertaken. Therefore, the present study was planned to evaluate the safety and efficacy (In terms of pain, expulsion, excessive bleeding, foul smelling vaginal discharge of insertion of immediate post-partum IUD in women delivering vaginally or by caesarean section.

  1. Molecular approaches to contraceptive development

    Indian Academy of Sciences (India)

    Usha Natraj


    The next generation of contraceptives will be based on the identification of novel molecules essential for reproductive processes and will rely on the refinement of older as well as newer technologies. Functional analysis of naturally occurring reproductive genetic disorders and creation of mice null for specific genes would greatly assist in the choice of genetic targets for contraceptive development. Structure-based design of drugs as exemplified by the preparation of an orally active non-peptide gonadotropin releasing hormone (GnRH) would revolutionize drug formulation and delivery for a peptide analogue. This review examines some of the molecular targets that may change contraceptive choices in the future.

  2. [Mercilon - the optimal oral contraceptive]. (United States)

    Rachev, E; Damianov, L; Kolarov, G; Novachkov, V; Ivanov, S


    The authors review the effect of the oral contraceptive Mercilon on menstrual cycle, contraceptive efficacy, lipid profile, safety profile and adverse effects in a group of 32 women, included in the survey. The results of the trial show excellent contraceptive effect with Pearl Index of 0.00 and good control over the menstrual cycle. No negative or unfavorable effects were seen on the lipid profile as well as on the liver kidney and coangulant system function. Minor side effects were seen in only 5% of the patients.

  3. Contraceptive counselling and self-prescription of contraceptives of German gynaecologists : Results of a nationwide survey

    NARCIS (Netherlands)

    Buhling, Kai J.; Klovekorn, Lisa; Daniels, Benita; Studnitz, Friederike S. G.; Eulenburg, Christine; Mueck, Alfred O.


    Objective To evaluate the attitude toward contraceptive methods of gynaecologists who, in Germany, are the sole prescribers of contraceptives. Methods An anonymous questionnaire was sent to 9545 gynaecologists inquiring about factors involved in their prescription of contraceptives, the contraceptiv

  4. Contraceptive counselling and self-prescription of contraceptives of German gynaecologists : Results of a nationwide survey

    NARCIS (Netherlands)

    Buhling, Kai J.; Klovekorn, Lisa; Daniels, Benita; Studnitz, Friederike S. G.; Eulenburg, Christine; Mueck, Alfred O.


    Objective To evaluate the attitude toward contraceptive methods of gynaecologists who, in Germany, are the sole prescribers of contraceptives. Methods An anonymous questionnaire was sent to 9545 gynaecologists inquiring about factors involved in their prescription of contraceptives, the contraceptiv

  5. Intravaginal hormonal contraception for women of reproductive age with excessive body mass

    Directory of Open Access Journals (Sweden)

    I. B. Gridina


    Full Text Available There are a number of disadvantages inherent in all oral hormonal contraceptives: need for daily administration, fluctuations of hormone levels throughout the day, metabolism in the gastrointestinal tract, the effect of the first passage through the liver. All this became a prerequisite to the creation of prolonged oral hormonal methods of contraception, which would be devoid of these shortcomings. One of such method of hormonal contraception is intravaginal hormonal system. The aim was to determine the safety and efficacy of its use in women of reproductive age with overweight. 43 women were included. State of lipid metabolism, changes of the hemostatic system, blood pressure and weight fluctuations in the past 6 months of using intravaginal hormonal contraceptive system were studied. Results. It is established that hormonal intravaginal contraceptive ring gives minimal metabolic effects. Conclusion. This suggests that this ring can be used successfully in patients with excessive body mass, because there is no effect of the ring on hemostasis, lipid metabolism and body weight.

  6. Levonorgestrel, not etonogestrel, provides contraception in free-ranging koalas. (United States)

    Hynes, E F; Handasyde, K A; Shaw, Geoff; Renfree, Marilyn B


    Management of high-density koala (Phascolarctos cinereus) populations is essential because of the browsing damage they inflict on their habitat. We have tested two types of gestagen implant, namely levonorgestrel and etonogestrel, as contraceptives for koalas. Free-ranging female koalas were given either a control, levonorgestrel (70 mg) or etonogestrel (34 or 68 mg) implant before the breeding season. Koalas were monitored every 4-12 weeks for births. Plasma progesterone was measured and a cytological smear of the urogenital sinus was taken. Fertility was high in the control group and the two etonogestrel-treated groups, with approximately 90% of females giving birth. In contrast, no levonorgestrel-treated female produced young during the study. Removal of levonorgestrel implants from six females reversed the contraceptive effect in the next breeding season, whereas the eight females in which the levonorgestrel implants were left in remained infertile for six breeding seasons. Vaginal cytology showed evidence of oestrous cycles during the breeding season in all females from all groups and there was no difference seen in the prevalence of cornified epithelial cells in the oestrous smears. This indirectly suggests that levonorgestrel does not prevent follicular development and oestrous cycling. Plasma progesterone in levonorgestrel-treated females remained low all year, but rose in controls concurrent with the onset of the breeding season. This suggests that levonorgestrel prevents pregnancy by blocking ovulation. Etonogestrel had absolutely no contraceptive effect at the two doses delivered and so is not suitable for controlling koala populations. In contrast, levonorgestrel was effective as a long-term, reversible contraceptive in wild koalas.

  7. Vortex rings

    Energy Technology Data Exchange (ETDEWEB)

    Akhmetov, D.G. [Lavrentiev Institute of Hydrodynamics, Novosibirsk (Russian Federation)


    This book presents a comprehensive coverage of the wide field of vortex rings. The book presents the results of systematic experimental investigations, theoretical foundation, as well as the practical applications of vortex rings, such as the extinction of fires at gushing gas and oil wells. All the basic properties of vortex rings as well as their hydrodynamic structures are presented. Special attention is paid to the formation and motion of turbulent vortex rings. (orig.)

  8. Vaginal or uterine bleeding - overview (United States)

    There are many causes of abnormal vaginal bleeding. HORMONES Most often, abnormal uterine bleeding is caused by a hormone imbalance. When hormones are the cause, doctors call the problem dysfunctional uterine bleeding (DUB) . DUB is more ...

  9. How Is Vaginal Cancer Diagnosed? (United States)

    ... light is inserted into the bladder through the urethra. If suspicious areas or growths are seen, a biopsy will be done. Cystoscopy may be recommended if a vaginal cancer is large and/or located in the front ...

  10. Drugs Approved for Vaginal Cancer (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) to prevent vaginal cancer. The list includes generic names and brand names. The drug names link to NCI’s Cancer Drug Information summaries.

  11. Vaginal bleeding in late pregnancy (United States)

    ... page: // Vaginal bleeding in late pregnancy To use the sharing features ... the blood from soaking your clothes. What Causes Bleeding Later in Pregnancy? When labor begins, the cervix ...

  12. The role of emergency contraception. (United States)

    Trussell, James; Ellertson, Charlotte; Stewart, Felicia; Raymond, Elizabeth G; Shochet, Tara


    Emergency contraception is an underused therapeutic option for women in the event of unprotected sexual intercourse. Available postcoital contraceptives include emergency contraceptive pills (ECPs) both with and without estrogen, and copper-bearing intrauterine devices. Each method has its individual efficacy, safety, and side effect profile. Most patients will experience prevention of pregnancy, providing they follow the treatment regimen carefully. There are concerns that women who use ECPs may become lax with their regular birth control methods; however, reported evidence indicates that making ECPs more readily available would ultimately reduce the incidence of unintended pregnancies. In addition, it is typically conscientious contraceptive users who are most likely to seek emergency treatment. Patient education is paramount in the reduction of unintended pregnancies and there are numerous medical resources available to women to assist them in this endeavor. Finally, ECPs are associated with financial and psychologic advantages that benefit both the individual patient and society at large.

  13. Contraception for adolescents with lupus

    Directory of Open Access Journals (Sweden)

    Wagner-Weiner Linda


    Full Text Available Abstract Sexually active adolescents, including young women with lupus, are at high risk for unplanned pregnancy. Unplanned pregnancy among teens with lupus is associated with an elevated risk of poor maternal and fetal outcomes. The provision of effective contraception is a crucial element of care for a sexually-active young woman with lupus. Unfortunately, providers may be hesitant to prescribe contraception to this group due to concerns about increasing the risk of lupus complications. This article reviews the risks and benefits of currently-available contraceptives for young women with lupus. Providers are encouraged to consider long-term, highly-effective contraception, such as implantables and intrauterine devices, for appropriately selected adolescents with lupus.

  14. Ring theory

    CERN Document Server

    Rowen, Louis H


    This is an abridged edition of the author's previous two-volume work, Ring Theory, which concentrates on essential material for a general ring theory course while ommitting much of the material intended for ring theory specialists. It has been praised by reviewers:**""As a textbook for graduate students, Ring Theory joins the best....The experts will find several attractive and pleasant features in Ring Theory. The most noteworthy is the inclusion, usually in supplements and appendices, of many useful constructions which are hard to locate outside of the original sources....The audience of non

  15. Contraceptive considerations in overweight teens. (United States)

    Kaneshiro, Bliss; Edelman, Alison


    The purpose of this review is to explore the efficacy and safety of contraceptives in overweight adolescents. There are few studies exploring hormonal contraceptive efficacy and safety in overweight and obese adults and almost none addressing these issues in adolescents. Luckily for teens, in terms of safety, many of the comorbidities associated with obesity are yet to transpire and their options for contraception remain relatively unrestricted. Studies of the combined oral contraceptive pill and patch in adults suggest that efficacy may be decreased in overweight adolescents. There is no evidence to suggest that the efficacy of the contraceptive implant or intrauterine device (IUD) is decreased in overweight adolescents. Indeed, these long-acting reversible methods will be the best choice for many adolescents because of their high efficacy. Although the literature is not definitive, there is probably a subset of adolescents who are susceptible to weight gain with use of depot medroxyprogesterone acetate. Although there is little research regarding contraceptive efficacy in overweight adolescents, IUDs and implants will be the best methods for many adolescents because of their high efficacy, reversibility, and safety. (C) 2011 Lippincott Williams & Wilkins, Inc.

  16. A universal combination treatment for vaginitis. (United States)

    Bornstein, Jacob; Zarfati, Doron


    We compared a novel vaginal tablet consisting of 100 mg of clotrimazole and 100 mg of metronidazole ('Clo-Met') to a 100-mg clotrimazole tablet in the treatment of vaginitis. A multicenter, double-blind, randomized controlled study. Women with vaginal discharge and diagnosed as suffering from vaginitis caused by Trichomonas vaginalis, bacterial vaginosis or Candida albicans, or any combination of the three, and who had not received treatment for vaginitis during the previous month, were studied. 165 patients were enrolled into the study--84 into the combined therapy group, and 81 into the clotrimazole group. In women with Candida vaginitis, Clo-Met was more effective than clotrimazole treatment (p vaginal tablet consisting of clotrimazole and metronidazole is therapeutically effective in candidal vaginitis. The effectiveness of Clo-Met on bacterial vaginosis, T. vaginalis infection as well as on vaginal infections due to a combination of these microorganisms should be studied further.

  17. Strategies for communicating contraceptive effectiveness. (United States)

    Lopez, Laureen M; Steiner, Markus; Grimes, David A; Hilgenberg, Deborah; Schulz, Kenneth F


    Knowledge of contraceptive effectiveness is crucial to making an informed choice. The consumer has to comprehend the pros and cons of the contraceptive methods being considered. Choice may be influenced by understanding the likelihood of pregnancy with each method and factors that influence effectiveness. To review all randomized controlled trials comparing strategies for communicating to consumers the effectiveness of contraceptives in preventing pregnancy. Through February 2013, we searched the computerized databases of MEDLINE, POPLINE, CENTRAL, PsycINFO and CINAHL,, and ICTRP. Previous searches also included EMBASE. We also examined references lists of relevant articles. For the initial review, we wrote to known investigators for information about other published or unpublished trials. We included randomized controlled trials that compared methods for communicating contraceptive effectiveness to consumers. The comparison could be usual practice or an alternative to the experimental intervention.Outcome measures were knowledge of contraceptive effectiveness, attitude about contraception or toward any particular contraceptive, and choice or use of contraceptive method. For the initial review, two authors independently extracted the data. One author entered the data into RevMan, and a second author verified accuracy. For the update, an author and a research associate extracted, entered, and checked the data.For dichotomous variables, we calculated the Mantel-Haenszel odds ratio with 95% confidence intervals (CI). For continuous variables, we computed the mean difference (MD) with 95% CI. Seven trials met the inclusion criteria and had a total of 4526 women. Five were multi-site studies. Four trials were conducted in the USA, while Nigeria and Zambia were represented by one study each, and one trial was done in both Jamaica and India.Two trials provided multiple sessions for participants. In one study that examined contraceptive choice, women in

  18. Planetary Rings

    CERN Document Server

    Tiscareno, Matthew S


    Planetary rings are the only nearby astrophysical disks, and the only disks that have been investigated by spacecraft. Although there are significant differences between rings and other disks, chiefly the large planet/ring mass ratio that greatly enhances the flatness of rings (aspect ratios as small as 1e-7), understanding of disks in general can be enhanced by understanding the dynamical processes observed at close-range and in real-time in planetary rings. We review the known ring systems of the four giant planets, as well as the prospects for ring systems yet to be discovered. We then review planetary rings by type. The main rings of Saturn comprise our system's only dense broad disk and host many phenomena of general application to disks including spiral waves, gap formation, self-gravity wakes, viscous overstability and normal modes, impact clouds, and orbital evolution of embedded moons. Dense narrow rings are the primary natural laboratory for understanding shepherding and self-stability. Narrow dusty...


    Directory of Open Access Journals (Sweden)



    Full Text Available ABSTRACT: BACKGROUND/OBJECTIVES: Bacterial vaginosis (BV, an alteration of vaginal flora involving a decrease in Lactobacilli and predo minance of anaerobic bacteria, is the most common cause of vaginal complaints for women of chil dbearing age .Causative agents include Gardnerella vaginalis, facultative lactobacilli, My coplasma hominis, Viridans streptococci & anaerobic bacteria. The most frequent manifestation s of genitourinary candidiasis is vulvovaginal candidiasis & is diagnosed in 40 % of women with vaginal complaints. The present study was undertaken to study the occurrence of Bac terial vaginosis & Vulvovaginal candidiasis in women with vaginal complaints. MATERIALS AND METHODS: The study included 100 High vaginal swabs with H/O white discharge per vaginum f or a period of 6 months from June 2011.Swabs were stained by Grams method & were cult ured. RESULTS: Out of 100 samples, in 35(35%Gram smear findings were normal & no growth in culture. 26(26%samples had polymorphs with Gardnerella morphotype, gram negative c urved rods, fusiforms & Lactobacilli were absent/present in low numbers(1 to 2+, the sme ar was interpreted as consistent with BV. 15 samples (15% had the growth of Candida spp. In the remaining 24 samples, the Gram stain findings had only vaginal epithelial cells with Lactobacilli, but the culture had the growth o f Group B Streptococcus 10(10%, E. coli & coliforms 10(10%,Enterococcus spp 14(14%which could just be colonisers. CONCLUSION: Bacterial vaginosis is the predominant cause of leuc orrhoea (26% followed by vulvovaginal candidiasis accounting for 15 % of the cases. Detection of intrapartum vaginal colonisation of Group B Streptococci, E. coli & colif orms & Enterococcus spp. in pregnant women is of significance as it can get transmitted to the neonate & cause sepsis

  20. Changes in contraceptive use in Vietnam. (United States)

    Thang, Nguyen Minh; Huong, Vu Thu


    This analysis used data, primarily from the 1997 Vietnamese Demographic and Health Survey (VN-DHS 1997), to determine the changes in contraceptive use in Vietnam. A descriptive analysis of individual, household and community characteristics was made to obtain a general description of contraceptive use. Multinomial logistic regression analyses were also performed on the currently married in (a) a sample of all women and (b) only those women who live in rural areas, to identify the strength of association that each variable has with the use of modern contraceptives. The use of any contraceptive method and the use of modern methods increased from 1988 to 1997. The primary contraceptive method utilized is the IUD and its use has increased substantially from 1988 to 1997. Younger women (aged 15-24) were less likely to use any contraceptive method. Women not desiring additional children were significantly more likely to use contraceptive methods than those desiring more children. Education has a clear impact on both contraceptive knowledge and use by women, with higher educated women being more likely to use a contraceptive method. Illiterate women with no formal education were significantly less likely to use modern methods of contraception. Differentials in contraceptive use exist regarding place of residence. Urban women are more likely than rural women to use contraception, but the difference is not large. Women living in mountainous areas are less likely to use contraception, compared with women living in the lowlands. Living standards, especially the availability of electricity in the community, have a large effect on the methods of contraception adopted by women. Religion is not strongly related to the contraceptive behaviour of women. There were significant differences in the use of contraceptives in communities with good quality of care, with increased contraceptive use corresponding to the increase in availability of family planning workers at communes

  1. Clinical characteristics of aerobic vaginitis and its association to vaginal candidiasis, trichomonas vaginitis and bacterial vaginosis. (United States)

    Jahic, Mahira; Mulavdic, Mirsada; Nurkic, Jasmina; Jahic, Elmir; Nurkic, Midhat


    Examine clinical characteristics of aerobic vaginitis and mixed infection for the purpose of better diagnostic accuracy and treatment efficiency. Prospective research has been conducted at Clinic for Gynecology and Obstetrics, Department for Microbiology and Pathology at Polyclinic for laboratory diagnostic and Gynecology and Obstetrics Department at Health Center Sapna. Examination included 100 examinees with the signs of vaginitis. anamnesis, clinical, gynecological and microbiological examination of vaginal smear. The average age of the examinees was 32,62±2,6. Examining vaginal smears of the examinees with signs of vaginitis in 96% (N-96) different microorganisms have been isolated, while in 4% (N-4) findings were normal. AV has been found in 51% (N-51) of the examinees, Candida albicans in 17% (N-17), BV in 15% (N-15), Trichomonas vaginalis in 13% (N-13). In 21% (N-21) AV was diagnosed alone while associated with other agents in 30% (N-30). Most common causes of AV are E. coli (N-55) and E. faecalis (N-52). AV and Candida albicanis have been found in (13/30, 43%), Trichomonas vaginalis in (9/30, 30%) and BV (8/30, 26%). Vaginal secretion is in 70,05% (N-36) yellow coloured, red vagina wall is recorded in 31,13% (N-16) and pruritus in 72,54% (N-37). Increased pH value of vagina found in 94,10% (N-48). The average pH value of vaginal environment was 5,15±0,54 and in associated presence of AV and VVC, TV and BV was 5,29±0,56 which is higher value considering presence of AV alone but that is not statistically significant difference (p>0,05). Amino-odor test was positive in 29,94% (N-15) of associated infections. Lactobacilli are absent, while leukocytes are increased in 100% (N-51) of the examinees with AV. AV is vaginal infection similar to other vaginal infections. It is important to be careful while diagnosing because the treatment of AV differentiates from treatment of other vaginitis.

  2. Oral contraceptives and exercise. (United States)

    Mostardi, R A; Woebkenberg, N R; Jarrett, M T


    A laboratory study was undertaken with volunteer females (aged 20-25) to determine the effect of OCs (oral contraceptives) on hematologic and metabolic variables during exercise. 5 of the women studied were naturally cycling and 7 were taking OCs. The women worked at 2 workloads on a bicycle ergometer at 50% and 90% of their maximal aerobic capacity during 3 different phases of their menstrual cycle. There was no better time of the month for doing the 50% or the 90% workload in either group. Heartrate for the OC group was significantly higher at the 50% maximal capacity. Results of the test indicate tha women on OCs have somewhat reduced cardiac efficiency and are ventilating more to carry out a given amount of work when compared to women who are naturally cycling. Possible explanations for the higher heart rate are put forward. The main limitation of the study is that the subject numbers involved are small and the number of cycles studied is also small.

  3. Recent advances in contraception. (United States)

    Erkkola, R


    The world population is expected to increase by 2.6 billion to 9.1 billion in 2050. This will occur, if fertility decreases from today's 2.6 children to about 2 children per woman. If fertility were to remain at the present level, 34 million persons would be added annually by mid-century and thus the world population would reach 10.6 billion by 2050. The most notable increase in the world population will occur in third world countries. Therefore immense investments are being made to develop safe, reliable and easily used contraceptive methods. It has not proven easy. Further, acceptance of the methods has been called into question. And even their distribution would be very difficult although Population Council and organizations like it have put a lot of effort into that matter also. In addition, the methods should preferably be such that they could to some extent prevent the rapid spread of sexually transmitted infections. So, the task is not easy, but every effort must be made on this question also at governmental and international political levels. It is noteworthy that this kind of approach has been given more currency since the beginning of this millennium.

  4. Effects of Contraceptive Education on Adolescent Male Contraceptive Behavior and Attitudes. (United States)

    Taylor, Mary E.; And Others


    The relationship between contraceptive education and teenage male contraceptive behavior was investigated. Findings indicated that brief or moderately in-depth contraceptive education had little effect on contraceptive behavior. The teenage pregnancy and other sex-related problems may make parents and schools more amenable to comprehensive…

  5. [The etiologic diversity of vaginitis]. (United States)

    Bohbot, J-M; Sednaoui, P; Verriere, F; Achhammer, I


    To establish the different etiologies of vaginitis and, especially, assess the distribution of responsible pathogens through a prospective study. One hundred and sixty-nine women aged between 18 and 65 years (average age: 33.7 years old), consulting a physician for symptoms of vaginitis, were examined in 21 centers of gynaecology or infectious diseases. The clinical evaluation was completed by bacteriological sample that was tested for infections (including sexually transmitted infections (STIs)). One hundred and eighteen patients (69.8%) had one or several infectious etiologies distributed as follows: 79 (46.7%) candidiasis (3 of which were caused by non albicans Candida), 37 (21.9%) bacterial vaginitis and 16 (9.5%) bacterial vaginosis. To be noticed that there were 38 cases of mixed etiologies out of the 118 infectious etiologies (32.2%), 3 of them were STIs. Although candidiasis was the most common etiology in this study, it only represented less than 1 out of every two patients. Among the infectious etiologies, 1 out of 3 women presented a bacterial or mixed vaginitis. The etiological diversity of vaginitis leads to consider broad-spectrum treatment as first-line therapy and to prescribe a microbiological analysis in case of failure. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  6. Comparison of Two Different Injectable Contraceptive Methods: Depo-medroxy Progesterone Acetate (DMPA and Cyclofem.

    Directory of Open Access Journals (Sweden)

    Firoozeh Veisi


    Full Text Available To compare side effects between users of two kinds of injectable contraceptives (Depo-medroxy progesterone acetate and Cyclofem.This cross-sectional descriptive study included 250 women, aged 18-40 years, using Depo-medroxy progesterone acetate (DMPA or Cyclofem. The volunteers were examined six months after using contraceptive, and they were asked about following symptoms: weight changes, irregular bleeding, dysparounia, vaginal dryness, headache, breast pain, bone pain, and discontinuation reason. The data were analyzed by statistical methods.THE IMPORTANT SIDE EFFECTS OF DMPA WERE: irregular bleeding (93.60%, weight gain (48%, bone pain (24% and vaginal dryness (10.40%, while the side effects in the Cyclofem group were: irregular bleeding (65.60%, headache (14.4% and breast sensitivity (20%. Bleeding pattern changes were the most important problem leading to discontinuation of both contraceptive methods in our participants.The results of the study showed that the most important problem in both groups was change in bleeding pattern. Proper consulting by a trained expert reduces the high amount of discontinuation and their failure rates.

  7. Spontaneous unscarred fundal rupture after normal vaginal delivery

    Directory of Open Access Journals (Sweden)

    Shreya Thapa


    Full Text Available Uterine rupture is one of the most dangerous obstetric situation carrying an increased risk of maternal and perinatal morbidity and mortality, associated with poorly managed labour. The incidence of spontaneous rupture of unscarred uterus is around 1 in 8000 to 1 in 15000 deliveries. We report this unusual case of spontaneous unscarred fundal rupture after normal vaginal delivery. This case under reference developed shock soon after delivery and was explored due to suspected intraperitoneal hemorrhage. This case is being reported to emphasis the need for proper post-delivery monitoring not only to diagnose post-partum hemorrhage but also to suspect uterine rupture as a cause of unexplained shock developing after delivery inspite of all resuscitative measures. Although unexpected in a woman with an unscarred uterus, rupture should be considered as a possible cause of unusual pain or hypotension in the mother. The most effective way to reduce the number of morbidity and mortality would be to prevent unwanted pregnancies by informed and effective use of contraception. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 780-782

  8. Sexual Activity and Contraceptive Use among Female

    African Journals Online (AJOL)

    Adolescents — A Report from Port Harcourt, Nigeria ... rather low level (56%) of knowledge of effective contraceptive methods, and limitation of .... Combined oral contraceptive pills 20.5 .... moted for its dual advantages —— prevention of.

  9. Long-acting reversible hormonal contraception

    African Journals Online (AJOL)

    Despite the advantages of long-acting reversible hormonal contraceptive methods, they are ... common; 9% of women used the pill in 2015, 8% relied on male condoms .... contraception for adolescents and young adults: patient and provider.

  10. knowledge, attitude and practice of emergency contraceptives ...

    African Journals Online (AJOL)


    BACKGROUND: Unwanted pregnancy followed by unsafe abortion is one of the major ... contraceptives among Adama University female students. Hence behavioral change strategies should be considered ... KEYWORDS: emergency contraceptives, knowledge, attitude, practice, Ethiopia .... Younger than 10 years. 7. 3.6.

  11. Contraceptive practice in the Philippines. (United States)


    Contraceptive use increased substantially in the Philippines from 1983 to 1986. Prevalence increased 32.1% in 1983, 45.7% in 1986. Increase in use was among married women in Northern Mindanao, Central Visayas, Southern Tagalog, Bicol, and Western Mindanao. Prevalence remained unchanged in Southern Mindanao. During this period, modern contraceptive methods also increased with more women opting to use the pill, IUD, injectables, and sterilization. In most areas in the Philippines, contraceptive use escalated with the more traditional methods like rhythm and withdrawal. Modern family planning increased most in urban areas such as Northern and Western Mindanao. Age also played a significant part in the study. Women aged 20-24 increased usage between 1983 and 1986. A more substantial increase was noticed in the 25-49 year old group, and the highest increase came from married women aged 30-34, with at least 3-4 children, during 1983. This figure shifted in 1986 with contraceptive use becoming more pronounced among 35-39 year olds. Modern methods declined at the 40-44 age bracket due to low fecundity. Throughout the country, modern contraceptive methods were more widely practiced by working women and was defined occupationally. Women in production, labor, and service occupations displayed a low level of modern usage, while those women in professional, administrative, and technical positions were more likely to use modern methods.

  12. [Post-abortion contraception: effects of contraception services and reproductive intention]. (United States)

    Borges, Ana Luiza Vilela


    Contraceptive counseling and the supply of contraceptive methods are part of post-abortion care and positively influence the subsequent use of contraceptive methods. Studies showing such evidence have been conducted predominantly in countries with no legal restrictions on abortion and with adequate care for women that terminate a pregnancy. However, little is known about contraceptive practices in contexts where abortion is illegal, as in Brazil, in which post-abortion contraceptive care is inadequate. The objective of this study was to analyze the effect of contraceptive care on male condom use and oral and injectable contraceptives in the six months post-abortion, considering reproductive intention. The results showed that contraceptive care only has a positive effect on the use of oral contraceptives in the first six months post-abortion, as long as the woman had a medical consultation in the same month in which she received information on contraception. One or the other intervention alone had no significant impact.

  13. Contraceptive practices and awareness of emergency contraception among Muslim women of urban slum of Raichur, Karnataka

    Directory of Open Access Journals (Sweden)

    Anju D. Ade


    Conclusions: Despite 76.8% literacy and 86.5% of awareness of the various methods of contraception, contraceptive practices were low among women. 32 (39.0% women didn’t use any contraceptive till they completed family. There is a gap between awareness and practice. Awareness of emergency contraception is quite low among women (13.4%. Emphasis has to be laid on delaying marriage and first pregnancy and education on planning and spacing children and reproductive contraceptive options, especially emergency contraception since all contraceptive methods can have potential failure; the use of emergency contraceptive of plays an important role in preventing unplanned pregnancies. There is a need to improve women\\'s education about EC. The primary health care providers can play a major role in informing their patients about emergency contraception. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 70-74

  14. Citología Vaginal


    Arrunategui, Ana María; Fundación Valle de Lili


    ¿Qué es una neoplasia?/ ¿Qué grupo de mujeres tiene un mayor riesgo de desarrollar cáncer del cuello de la matriz?/ ¿Cuáles son los síntomas más frecuentes del cáncer del cuello de la matriz?/ Anatomía de los órganos genitales femeninos/¿Cómo se realiza la prueba de la citología vaginal?/¿Cómo se interpretan los resultados de la citología vaginal?/ ¿Toda citología anormal es cáncer?/ ¿Qué otras utilidades tiene la citología vaginal?/ ¿Desde qué edad, hasta que edad y con qué frecuencia debe t...

  15. Vaginitis: current microbiologic and clinical concepts. (United States)

    Hill, L V; Embil, J A


    Infectious vaginitis occurs when the normal vaginal flora is disrupted; it may arise when saprophytes overwhelm the host immune response, when pathogenic organisms are introduced into the vagina or when changes in substrate allow an imbalance of microorganisms to develop. Examples of these types of vaginitis include the presence of chronic fungal infection in women with an inadequate cellular immune response to the yeast, the introduction of trichomonads into vaginal epithelium that has a sufficient supply of glycogen, and the alteration in bacterial flora, normally dominated by Lactobacillus spp., and its metabolites that is characteristic of "nonspecific vaginitis". The authors review microbiologic and clinical aspects of the fungal, protozoal and bacterial infections, including the interactions of bacteria thought to produce nonspecific vaginitis, that are now recognized as causing vaginitis. Other causes of vaginitis are also discussed. PMID:3510698

  16. Predictors of vaginal delivery in nulliparous mothers

    African Journals Online (AJOL)

    study. Vaginal delivery was achieved in 214 (74.8%) of the eligible parturient, while 72 (25.2%) had ..... Table 2: Logistic regression of factors influencing vaginal delivery in primigravidae ... times higher risk of emergency caesarean section.

  17. Emergency contraception: what teens need to know. (United States)


    Emergency contraception is contraception used soon after unprotected sexual intercourse. The following types of emergency contraception are currently available in the US: ordinary birth control pills containing estrogen and progestin, birth control pills which contain no estrogen and smaller amounts of progestin, and the copper-T IUD. Each of these forms of contraception require a physician's prescription. A woman may need emergency contraception if her regular contraceptive method has failed, if she did not use contraception, or if she has been sexually assaulted. Young women need to be told that emergency contraception exists and can be used when needed. However, they also need to be warned against using such contraception in lieu of the regular use of non-emergency contraception. Non-emergency contraception should still be used. Were emergency contraception widely used, it could prevent up to 2.3 million unintended pregnancies in America each year, 1 million of which are now terminated by abortion. RU-486 (mifepristone) is not generally available in the US.

  18. Choosing a combined oral contraceptive pill



    The combined oral contraceptive pill is an effective contraceptive method which can also offer other benefits. However, other contraceptive options should be discussed. If the pill is the chosen method, prescribe a pill with the lowest effective dose of oestrogen and progestogen.

  19. The effect of vaginal cream containing ginger in users of clotrimazole vaginal cream on vaginal candidiasis. (United States)

    Shabanian, Sheida; Khalili, Sima; Lorigooini, Zahra; Malekpour, Afsaneh; Heidari-Soureshjani, Saeid


    Vulvovaginal candidiasis is one of the most common infections of the genital tract in women that causes many complications. Therefore, we examined the clinical effect of ginger cream along with clotrimazole compared to vaginal clotrimazole alone in this study. This double-blind clinical trial was conducted on 67 women admitted to the Gynecology Clinic of Hajar Hospital with vaginal candidiasis. The patients were divided randomly into two groups of 33 and 34 people. The diagnosis was made according to clinical symptoms, wet smear, and culture. Ginger-clotrimazole vaginal cream 1% and clotrimazole vaginal cream 1% were administered to groups 1 and 2, respectively, once a day for 7 days and therapeutic effects and symptoms were evaluated in readmission. Data analysis was performed using SPSS version 22, t-test and Chi-square. The mean value of variables itching (P > 0.05), burning (P > 0.05), and cheesy secretion (P cream containing ginger and clotrimazole 1% was more effective and may be more useful than the clotrimazole to treat vaginal candidiasis.

  20. Smelling wrong: hormonal contraception in lemurs alters critical female odour cues (United States)

    Crawford, Jeremy Chase; Boulet, Marylène; Drea, Christine M.


    Animals, including humans, use olfaction to assess potential social and sexual partners. Although hormones modulate olfactory cues, we know little about whether contraception affects semiochemical signals and, ultimately, mate choice. We examined the effects of a common contraceptive, medroxyprogesterone acetate (MPA), on the olfactory cues of female ring-tailed lemurs (Lemur catta), and the behavioural response these cues generated in male conspecifics. The genital odorants of contracepted females were dramatically altered, falling well outside the range of normal female variation: MPA decreased the richness and modified the relative abundances of volatile chemicals expressed in labial secretions. Comparisons between treatment groups revealed several indicator compounds that could reliably signal female reproductive status to conspecifics. MPA also changed a female's individual chemical ‘signature’, while minimizing her chemical distinctiveness relative to other contracepted females. Most remarkably, MPA degraded the chemical patterns that encode honest information about genetic constitution, including individual diversity (heterozygosity) and pairwise relatedness to conspecifics. Lastly, males preferentially investigated the odorants of intact over contracepted females, clearly distinguishing those with immediate reproductive potential. By altering the olfactory cues that signal fertility, individuality, genetic quality and relatedness, contraceptives may disrupt intraspecific interactions in primates, including those relevant to kin recognition and mate choice. PMID:20667870

  1. American values and contraceptive acceptance. (United States)

    Rzepka, J R


    A number of individual personality factors and social norms may be associated with reproductive confusion and/or irresponsibility. More specifically, the values underlying common American social norms may contribute to ineffective birth planning in the following ways: 1) The traditional roles of women in our society seem to encourage parenthood. The rule has been early marriage, closely spaced children, and few alternate sources of satisfaction or self-esteem. 2) Our culture strongly encourages family life. Children are a symbol of normalcy. 3) The importance of sexual enjoyment per se often conflicts with contraceptive use. Conversely, innocence is also valued and also contributes to unprotected sexual activity. 4) Religious reasons or adherence to concepts of natural law are almost always given by people opposed to contraception. 5) Health is important to Americans, and birth control methods negatively affect health in real and imagined ways. Social norms, though changing, remain essentially congruent with former contraceptive technology and former ideologies, customs, and dreams.

  2. Vaginal radical trachelectomy: an update. (United States)

    Plante, Marie


    The vaginal radical trachelectomy has emerged as a valuable fertility-preserving treatment option for young women with early-stage disease. Cancer-related infertility is associated with feelings of depression, grief, stress, and sexual dysfunction. Data have shown that the overall oncological outcome is safe and that the obstetrical outcome is promising. In this article, we analyze the data on the vaginal radical trachelectomy published over the last 10 years in the context of what we have learned, what issues remain unclear, and what the future holds.

  3. Spontaneous rupture of vaginal enterocele

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Galatius, H; Hansen, P K


    Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission.......Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission....

  4. Spontaneous rupture of vaginal enterocele

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Galatius, H; Hansen, P K


    Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission.......Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission....

  5. Planetary Rings (United States)

    Cuzzi, Jeffrey N.


    Just over two decades ago, Jim Pollack made a critical contribution to our understanding of planetary ring particle properties, and resolved a major apparent paradox between radar reflection and radio emission observations. At the time, particle properties were about all there were to study about planetary rings, and the fundamental questions were, why is Saturn the only planet with rings, how big are the particles, and what are they made of? Since then, we have received an avalanche of observations of planetary ring systems, both from spacecraft and from Earth. Meanwhile, we have seen steady progress in our understanding of the myriad ways in which gravity, fluid and statistical mechanics, and electromagnetism can combine to shape the distribution of the submicron-to-several-meter size particles which comprise ring systems into the complex webs of structure that we now know them to display. Insights gained from studies of these giant dynamical analogs have carried over into improved understanding of the formation of the planets themselves from particle disks, a subject very close to Jim's heart. The now-complete reconnaissance of the gas giant planets by spacecraft has revealed that ring systems are invariably found in association with families of regular satellites, and there is ark emerging perspective that they are not only physically but causally linked. There is also mounting evidence that many features or aspects of all planetary ring systems, if not the ring systems themselves, are considerably younger than the solar system

  6. Progress with contraceptives and abortifacients. (United States)

    Macpherson, A


    In Canada and most other comparatively rich countries, the total fertility rate (TFR) declined from approximately 2.5 in 1970 to 1.6-1.9 in 1990. The reduction was even greater in some countries such as China, Korea, Singapore, Mauritius, Barbados, Cuba, Guadeloupe, and Puerto Rico. TFR, however, has fallen little, if at all, in many poor countries; it remains at 8.1 in Kenya and has increased from already previously high levels in Somalia, Benin, Malawi, and Rwanda. The use of contraception has been instrumental in reducing fertility. An estimated 70% of married women in rich countries use contraceptives, and a larger proportion in Eastern Asia, but only less than 15% in Africa. Education for women generally increases the level of contraceptive use. Rates, however, depend upon the degree of both acceptance and availability. An estimated 20% of births in developing countries are unwanted, so it would seem that greater availability and variety of contraceptives could lead to reductions in fertility. Research into better contraceptive technology is frustrated by paternalism, most organized religions, concern over possible future legal liability, and fear of adverse health side effects, especially in North America. Depo-Provera and RU-486, for example, have yet to be licensed in Canada for use as contraceptive agents. Research nonetheless moves forward. A vaccine against pregnancy is reportedly being developed which may be available before the turn of the century. Clinical trials have been held, and the vaccine has been found to be effective in most women, lacking in side effects, and reversible. The prototype requires a series of injections. Elsewhere, the Alza Corporation of California is working on a transdermal patch to control fertility, while some success has been reported in trials of testosterone, alone or combined with a gonadotropin-releasing hormone, to suppress sperm production in men.

  7. Vaginal childbirth and pelvic floor disorders


    Memon, Hafsa U.; Handa, Victoria L.


    Childbirth is an important event in a woman’s life. Vaginal childbirth is the most common mode of delivery and it has been associated with increased incidence of pelvic floor disorders later in life. In this article, the authors review and summarize current literature associating pelvic floor disorders with vaginal childbirth. Stress urinary incontinence and pelvic organ prolapse are strongly associated with vaginal childbirth and parity. The exact mechanism of injury associating vaginal deli...

  8. Effects of vaginal prolapse surgery and ageing on vaginal vascularization

    NARCIS (Netherlands)

    Weber, M.A.


    Ageing affects pelvic floor anatomy and function, resulting in several disorders like pelvic organ prolapse (POP), lower urinary tract symptoms and vaginal atrophy (VA). In this thesis we searched for methods to link the function of pelvic organs to physiological changes. The effects of POP and vagi

  9. A New Method to Measure Vaginal Sensibility

    NARCIS (Netherlands)

    Lakeman, M. M. E.; Laan, E.; Vaart, C. H.; Roovers, J. P.


    Introduction: Vaginal surgery may affect sexual function both positively and negatively. Possibly, negative consequences of surgical interventions on sexuality may be caused by reduced sensibility of the vaginal wall. Aims: To develop a new method to measure vaginal sensibility. Methods: We develope

  10. Atrophic vaginitis: signs, symptoms, and better outcomes. (United States)

    Reimer, Annabelle; Johnson, Laura


    Atrophic vaginitis is a common finding in women with low estrogen states. Many women believe their symptoms are expected signs of aging. NPs can provide therapeutic options to improve vaginal health and quality of life. This article reviews physiology, clinical manifestations, signs, symptoms, and treatment methods for atrophic vaginitis.

  11. Contraceptive Coverage and the Affordable Care Act. (United States)

    Tschann, Mary; Soon, Reni


    A major goal of the Patient Protection and Affordable Care Act is reducing healthcare spending by shifting the focus of healthcare toward preventive care. Preventive services, including all FDA-approved contraception, must be provided to patients without cost-sharing under the ACA. No-cost contraception has been shown to increase uptake of highly effective birth control methods and reduce unintended pregnancy and abortion; however, some institutions and corporations argue that providing contraceptive coverage infringes on their religious beliefs. The contraceptive coverage mandate is evolving due to legal challenges, but it has already demonstrated success in reducing costs and improving access to contraception.

  12. A 19 year old with heavy vaginal bleeding; unlikely diagnosis of uterine carcinsarcoma

    Directory of Open Access Journals (Sweden)

    Andrew L. Atkinson


    Full Text Available Uterine carcinosarcoma is a rare malignancy that has a high recurrence rate after treatment with very poor long term prognosis. Women are diagnosed usually over the age of 50, with most cases occurring between the sixth and seventh decade of life. We present a rare case of uterine carcinosarcoma diagnosed a nineteen year old after having a dilation and curettage for heavy vaginal bleeding. The patient went on to have a total abdominal hysterectomy with transposition of the ovaries as well as adjuvant treatment with chemotherapy. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 221-223

  13. Optical clearing of vaginal tissues (United States)

    Chang, Chun-Hung; Myers, Erinn M.; Kennelly, Michael J.; Fried, Nathaniel M.


    Near-IR laser energy in conjunction with applied tissue cooling is being investigated for thermal remodeling of endopelvic fascia during minimally invasive treatment of female stress urinary incontinence. Previous simulations of light transport, heat transfer, and tissue thermal damage have shown that a transvaginal approach is more feasible than a transurethral approach. However, undesirable thermal insult to vaginal wall was predicted. This study explores whether an optical clearing agent (OCA) can improve optical penetration depth and completely preserve vaginal wall during subsurface treatment of endopelvic fascia. Several OCA mixtures were tested, and 100% glycerol was found to be optimal. Optical transmission studies, optical coherence tomography, reflection spectroscopy, and computer simulations of thermal damage to tissue using glycerol were performed. The OCA produced a 61% increase in optical transmission through porcine vaginal wall at 37 °C after 30 min. Monte Carlo (MC) light transport, heat transfer, and Arrhenius integral thermal damage simulations were performed. MC model showed improved energy deposition in endopelvic fascia using OCA. Without OCA, 62, 37, and 1% of energy was deposited in vaginal wall, endopelvic fascia, and urethral wall, compared with 50, 49, and 1% with OCA. Use of OCA also yielded 0.5 mm increase in treatment depth, allowing potential thermal tissue remodeling at 3 mm depth.

  14. 160例无伴随症状白带增多患者病因分析%Clinical analysis on 160 cases with uncomplicated increase in vaginal discharge

    Institute of Scientific and Technical Information of China (English)

    阳眉; 兰长贵; 梅晓锋


    目的 分析无伴随症状白带增多患者的常见病因.方法 160例白带标本作生理盐水(0.9%氯化钠注射液)湿片、10%的KOH湿片、美兰染色涂片、革兰染色涂片,检测念珠菌、阴道毛滴虫、线索细胞、乳酸杆菌、白细胞及胺试验.结果 细菌性阴道病、菌群失调、宫颈炎及涂片阴性比例依次为23.1%,18.1%、14.4%和25%.按年龄、病程、妊娠和安放宫内节育环分组,其病因构成无统计学差异.结论 细菌性阴道病、菌群失调、宫颈炎是无伴随症状白带增多患者的主要病因.%Objective To explore the cause of the uncomplicated increase in vaginal dischargeo Methods To assay 160 samples of vaginal discharge by diluting one sample in one to two drops of 0. 9% normal saline solution on one slide , a second sample in 10% potassium hydroxide (KOH) solution,and a third in Cram stain and a fourth in methylene blue . And to detect Candida sp. Ntrichomonads^clue cells Jactobacilli^WBC and sniff test. Results The causes of vaginal discharge were; bactgerial vaginosis 23.1% ,dysbacteriosisl8. 1% ,cervicitisl4.4% , and smear negative cases 25%. There was no clinically important differences between any demographic characteristic (age, course of disease, pregnancy and contraceptive ring)and diagnosis of cause of the discharge. Conclusion Bactgerial vaginosis , dysbacteriosis, cervicitis were the main causes of uncomplicated increase in vaginal discharge.


    Directory of Open Access Journals (Sweden)

    Rajesh G


    Full Text Available Supra mitral ring is a rare cause for congenital mitral valve obstr uction. The reported incidence of supramitral ring is 0.2-0.4% in general population and 8% in patients with congenital mitral valve disease. The condition is characterized by an abnormal ridge of connective tissue often circumferential in shape ,on the atrial side of the mitral valve encroaching on the orifice of the mitral valve. It may adhere to the leaflets of the valve and restrict their movements. Although a supramitral ring may be rarely nonobstructive, it often results in mitral valve inflow obstruction.

  16. Post-abortion contraception: care and practices. (United States)

    Borges, Ana Luiza Vilela; Monteiro, Renata Luciria; Hoga, Luiza Akiko Komura; Fujimori, Elizabeth; Chofakian, Christiane Borges do Nascimento; dos Santos, Osmara Alves


    to analyze assistance regarding contraception methods received by women during hospitalization due to abortion, and contraceptive practices the month after this episode. a longitudinal study of women hospitalized due to abortion in a public hospital in the city of São Paulo. Face-to-face interviews (n=170) followed by telephone interviews in the subsequent month (n=147) were conducted between May and December of 2011. a small number of women reported they received guidance on, and prescription for, contraceptive methods at hospital discharge. A trend of statistical significance was identified for prescription of contraceptive methods at discharge and its use in the following month, when adjusted for age. Most women reported sexual intercourse (69.4%) with the use of contraceptive method (82.4%), but no health professional guidance (63.1%). despite the fact that post-abortion contraception assistance was lower than the recommended guidelines by public health policies, women demonstrated willingness to use contraceptive methods.

  17. Why Iranian married women use withdrawal instead of oral contraceptives? A qualitative study from Iran

    Directory of Open Access Journals (Sweden)

    Kazemnejad Anoushiravan


    Full Text Available Abstract Background Withdrawal as a method of birth control is still used in Iran. The aim of this study was to explore married women's perspectives and attitudes on withdrawal use instead of oral contraceptive (OC in Tehran, Iran. Methods This was a qualitative study. Participants were 50 married women, not currently pregnant, not desiring pregnancy and who had been using withdrawal for contraception. Face-to face interviews were conducted to collect data. Content analysis was performed to analyze the data. Results Four major themes were extracted from the interviews: advantages, disadvantages, barriers for OC use, and husband-related factors. Advantages of withdrawal use were identified as: easy to use, convenient, ease of access, natural. Even those participants who had experienced unwanted pregnancy while using withdrawal, relied on withdrawal as their contraceptive method. Disadvantages of OC included concerns about side effects. Barriers related to use of OC included the need for medical advice, vaginal examination and daily use. Husband-related factors included: the husband wanted to be the primary decision maker on the number of children and that he preferred withdrawal. Conclusion Health providers should address misunderstandings that exist about OC and highlight the non-contraceptive health benefits of OC to balance the information provided for women. We suggest that not only women but also their spouses be advised in family planning programs.

  18. Comparative study of sublingual and vaginal misoprostol in second trimester induced abortion

    Directory of Open Access Journals (Sweden)

    Sangeeta Raman Jogi


    Full Text Available Background: To recognize an effective Misoprostol only regime and to compare the efficacy, safety and acceptability of sublingual and vaginal Misoprostol for the termination of second trimester of pregnancy. Methods: The study was a prospective randomized trial. Women attending OPD from January2012 to December 2013, for medical abortion between gestational ages 13-20 weeks were screened, selected and divided in to two groups. Group-A received misoprostol 400 and micro;g then 200 and micro;g sublingually 3 hourly, Group-B received misoprostol 400 and micro;g then 200 and micro;g vaginally 3 hourly. They were observed for 24 hours. Main outcomes were induction-abortion interval, dose required, success rate and side effects and comfort to the route of administration. Results: Mean induction-abortion interval was 9.28 +/- 5.824 hours, 95% CI: 7.62-10.94in sublingual misoprostol group and 13.68 +/- 6.179 hours, 95% CI: 11.92-15.44 in vaginal group. Mean dose required for abortion was 948 +/- 389.264 and micro;g, 95% CI: 837.37-1058.63 in sublingual and 1248 +/- 415.142 and micro;g, 95% CI: 1,130.02-1,365.98in vaginal group. Success rate was 98% and 94%, respectively in two groups. The differences were statistically significant. Comfort to the route of administration was 90% in sublingual and 60% in vaginal group. Conclusions: Both sublingual and vaginal routes of Misoprostol are equally effective, safe, inexpensive and acceptable method. Sublingual route is better and preferred by women. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1453-1459

  19. Engineering a segmented dual-reservoir polyurethane intravaginal ring for simultaneous prevention of HIV transmission and unwanted pregnancy.

    Directory of Open Access Journals (Sweden)

    Justin T Clark

    Full Text Available The HIV/AIDS pandemic and its impact on women prompt the investigation of prevention strategies to interrupt sexual transmission of HIV. Long-acting drug delivery systems that simultaneously protect womenfrom sexual transmission of HIV and unwanted pregnancy could be important tools in combating the pandemic. We describe the design, in silico, in vitro and in vivo evaluation of a dual-reservoir intravaginal ring that delivers the HIV-1 reverse transcriptase inhibitor tenofovir and the contraceptive levonorgestrel for 90 days. Two polyether urethanes with two different hard segment volume fractions were used to make coaxial extruded reservoir segments with a 100 µm thick rate controlling membrane and a diameter of 5.5 mm that contain 1.3 wt% levonorgestrel. A new mechanistic diffusion model accurately described the levonorgestrel burst release in early time points and pseudo-steady state behavior at later time points. As previously described, tenofovir was formulated as a glycerol paste and filled into a hydrophilic polyurethane, hollow tube reservoir that was melt-sealed by induction welding. These tenofovir-eluting segments and 2 cm long coaxially extruded levonorgestrel eluting segments were joined by induction welding to form rings that released an average of 7.5 mg tenofovir and 21 µg levonorgestrel per day in vitro for 90 days. Levonorgestrel segments placed intravaginally in rabbits resulted in sustained, dose-dependent levels of levonorgestrel in plasma and cervical tissue for 90 days. Polyurethane caps placed between segments successfully prevented diffusion of levonorgestrel into the tenofovir-releasing segment during storage.Hydrated rings endured between 152 N and 354 N tensile load before failure during uniaxial extension testing. In summary, this system represents a significant advance in vaginal drug delivery technology, and is the first in a new class of long-acting multipurpose prevention drug delivery systems.

  20. Engineering a segmented dual-reservoir polyurethane intravaginal ring for simultaneous prevention of HIV transmission and unwanted pregnancy. (United States)

    Clark, Justin T; Clark, Meredith R; Shelke, Namdev B; Johnson, Todd J; Smith, Eric M; Andreasen, Andrew K; Nebeker, Joel S; Fabian, Judit; Friend, David R; Kiser, Patrick F


    The HIV/AIDS pandemic and its impact on women prompt the investigation of prevention strategies to interrupt sexual transmission of HIV. Long-acting drug delivery systems that simultaneously protect womenfrom sexual transmission of HIV and unwanted pregnancy could be important tools in combating the pandemic. We describe the design, in silico, in vitro and in vivo evaluation of a dual-reservoir intravaginal ring that delivers the HIV-1 reverse transcriptase inhibitor tenofovir and the contraceptive levonorgestrel for 90 days. Two polyether urethanes with two different hard segment volume fractions were used to make coaxial extruded reservoir segments with a 100 µm thick rate controlling membrane and a diameter of 5.5 mm that contain 1.3 wt% levonorgestrel. A new mechanistic diffusion model accurately described the levonorgestrel burst release in early time points and pseudo-steady state behavior at later time points. As previously described, tenofovir was formulated as a glycerol paste and filled into a hydrophilic polyurethane, hollow tube reservoir that was melt-sealed by induction welding. These tenofovir-eluting segments and 2 cm long coaxially extruded levonorgestrel eluting segments were joined by induction welding to form rings that released an average of 7.5 mg tenofovir and 21 µg levonorgestrel per day in vitro for 90 days. Levonorgestrel segments placed intravaginally in rabbits resulted in sustained, dose-dependent levels of levonorgestrel in plasma and cervical tissue for 90 days. Polyurethane caps placed between segments successfully prevented diffusion of levonorgestrel into the tenofovir-releasing segment during storage.Hydrated rings endured between 152 N and 354 N tensile load before failure during uniaxial extension testing. In summary, this system represents a significant advance in vaginal drug delivery technology, and is the first in a new class of long-acting multipurpose prevention drug delivery systems.

  1. Vaginal leiomyoma: MRI features with pathologic correlation

    Directory of Open Access Journals (Sweden)

    Avantika Gupta


    Full Text Available We present a rare case of vaginal leiomyoma presenting as prolapsed vaginal mass in a 45 years old woman. The leiomyoma was found to arise from the right lateral vaginal fornix with a vascular stalk. MRI showed homogenous hypointense signals on T1W1 and iso to hyperintense signals on T2W1 images with moderate heterogenous enhancement on post contrast images. It was enucleated via vaginal route and the histopathological examination confirmed the diagnosis of vaginal leiomyoma.

  2. UniPron is A Fully Effective Non-hormonal Reversible Contraceptive in Baboon Model(Papio Anubis)

    Institute of Scientific and Technical Information of China (English)

    Jael A.Obiero; Maureen N.Mburu; Benson M.Ndung'u; Kenneth K.Waititu; Isaac Mulei; Idle O.Farah; Peter G.Mwethera


    Objective To determine the safety and efficacy of UniPron as a reversible contraceptive.Methods Vaginal swabs were obtained before and after UniPron administration.cultured onto appropriate culture media and bacteria identification was done based on type of media used,Gram stain reactions,colony morphology and biochemical tests.Vaginal biopsy tissues were processed using paraffin wax method,stained with hematoxylin and eosin and examined under light microscopy to determine the effect of the product on vaginal tissues.The effect of UniPron on sperm was examined by mixing the product with electroejaculated spermatozoa in vitro at different concentrations.For efficacy studies,male baboons of proven fertility were mated with UniPron treated or untreated females of proven fertility during the fertile stages.Results All the five females(100%)that were treated with UniPron did not conceive and they regained total fertitity when the treatment was stopped while all the controls conceived.At a concentration of 40%,UniPron completely immobilized spermatozoa in an in-vitro system.UniPron mechanism of action was by lowering the vaginal pH and on application in baboon,the pH was lowered for at least 3 h after which it went back to normal.Conclusions As we plan for a study to test UniPron as a microbicide to prevent STIs including HIV,our current study has established that this novel product is effective in contraception and harmless to vaginal tissues and vaginal microbial flora in a baboon model(Papio anubis).

  3. 围绝经期及绝经期妇女取环的临床观察及体会%Clinical observation and experience of women taking ring in peri menopausal and postmenopausal women

    Institute of Scientific and Technical Information of China (English)



    目的:探讨围绝经期及绝经期妇女取环的影响因素。方法:收治绝经期及围绝经期妇女500例,术前了解基本资料,并做盆腔超声学检查、心电图、血常规检查、阴道分泌物常规检查等。术前排空膀胱,取膀胱截石位,常规阴道消毒,采用窥阴器充分暴露宫颈,将避孕环取出。结果:500例取环绝经期及绝经期妇女顺利取出450例,取环困难50例。放环时间、绝经年限、宫颈萎缩程度、年龄和是否定期体检是影响取环顺利的重要因素。结论:影响围绝经期及绝经期妇女取环效果的因素较多,为减少取环困难,妇女应尽早取环,降低取环困难比例。%Objective:To explore the influencing factors of women taking ring in peri menopausal and postmenopausal women. Methods:500 cases of menopausal women and peri menopausal women were selected,we understood the basic information before operation,and did a pelvic ultrasound examination,electrocardiogram,blood routine examination,routine vaginal examination and so on.Preoperative emptying of the bladder,patients took the bladder section with conventional vaginal disinfection,using speculum fully exposed cervical,took contraceptive ring out.Results:450 cases were removed successfully in 500 cases of peri menopausal and postmenopausal women,takeing the ring difficult in 50 cases.The put time of the ring,duration of menopause, cervical atrophy degree,age and whether take regular physical examination are the important factors influencing the smooth taking the ring.Conclusion:There are many factors that affect the effect of women taking the ring in the peri menopausal period and menopause,in order to reduce the difficulties,women should take the ring as soon as possible,so as to reduce the proportion of the difficult.

  4. Contraception and abortion in Romania. (United States)

    Johnson, B R; Horga, M; Andronache, L


    After the downfall of the Ceausescu regime in December, 1989, the new Government of Romania abolished the law that prohibited abortions on request. Subsequently, the rate of legally induced abortions increased significantly while the rate of maternal mortality declined dramatically. Despite the large number of women who request induced abortions, most women and gynaecologists say that they would prefer to prevent unwanted pregnancies through the use of modern contraception. In this paper we examine factors that contribute to the disparity between women's desire to use modern contraception to prevent unwanted pregnancies and their practice of having induced abortions to prevent unwanted births. The results show that women (and suggest that men) need a wide choice of dependably available high-quality contraceptives; they need to be able to obtain information, counselling, and methods from a wide range of sources/health-care providers; both women's and men's perceptions about, and use of, modern contraception could be positively affected through sexual education started in secondary school; and, to reduce repeat abortions, women's post-abortion family-planning needs must not be neglected.

  5. Contraception and the Adolescent Diabetic. (United States)

    Fennoy, Ilene


    Data from a study of 11 teenage diabetics suggests that pregnancy among adolescent diabetics is more frequent than among the general population, at a time when diabetic control is poor because of psychosocial factors associated with adolescence. Current recommendations regarding contraception for diabetic women, focusing on barrier methods, are…

  6. Oral Contraceptive Pill and PCOS (United States)

    ... oral contraceptive pill is much more than a birth control pill. Adolescent girls and young women are frequently prescribed the ... Control Pills: General Information Medical Uses of the Birth Control Pill PCOS: All ... Chat with us! Our PCOS chats are safe places for teens and young women who share a common condition ...

  7. Progestin-Only Oral Contraceptives (United States)

    Nor-Q.D.® ... only oral contraceptives are safe for use by breast-feeding mothers. If you are fully breastfeeding (not ... 6 weeks after delivery. If you are partially breast-feeding (giving your baby some food or formula), ...

  8. Oral Contraceptives after Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    Joël Schlatter


    Full Text Available Objective: Bariatric surgery offers a highly effective mode of treatment for obese patients. Some procedures such as bypass cause an alteration in normal gastrointestinal tract with possible consequences for the uptake of orally administered drugs. Methods: We assessed the literature to ascertain whether the use of oral drugs and especially oral contraceptives is effective and adequate after bariatric surgery. Results: The bioavailability of drugs could be affected by the solubility and pH of the modified medium after bariatric surgery and by the loss of gastrointestinal transporters. Bariatric surgery could potentially result in a transient change in the absorption of drugs such as analgesics, antibiotics, antiarrhythmics, anticoagulants, psychotropic, and oral contraceptive drugs. Effective contraception is especially critical in the postoperative period, and implants might be representing a safe contraceptive method in women undergoing bariatric surgery. Conclusion: Each drug will have to be evaluated with respect to its site of absorption and its mechanism of absorption, with special attention on parameters influencing the effectiveness of the absorption processes.

  9. Breast-feeding: nature's contraceptive. (United States)

    Short, R V


    Our ancestors achieved the lowest rate of reproduction of any living mammal by the postponement of puberty until well into the 2nd decade of life, a maximal probability of conception of only about 24% per menstrual cycle even when ovulation had commenced, a 4-year birth interval as a result of the contraceptive effects of breastfeeding, and sharply declining fertility during the 4th decade of life, leading to complete sterility at the menopause. This pattern of reproduction was ideally suited to the prevailing lifestyle of the nomadic hunter-gatherer. The postponement of puberty resulted in a prolonged period of childhood dependency, thus enabling parents to transmit their acquired experience to their offspring. Long birth intervals were essential for a woman who had to wander 1000 or more miles each year in search of food, because she could not manage to carry more than 1 child with her at a time. The lifestyle of comparatively recent times of a settled agricultural economy made possible subsequent rural and urban development, but this transition from nomad to city dweller also stimulated fertility. The cultivation of crops and the domestication of animals led to the development of permanent housing, where the mother could leave her baby in a safe place while she worked in the field. The resultant reduction in mother-infant contact coupled with the availability of early weaning foods reduced the suckling frequency, thereby eroding the contraceptive effect of breastfeeding and decreasing the birth interval. The model conquest of disease eventually led to rapid rates of population growth. In the developed countries of Europe and North America, reproduction was subsequently held in check by the use of artificial forms of contraception, but this has yet to take place in the developing countries of Asia, Africa, and South America. For a developing country, contraceptives are expensive, may be culturally unacceptable, and carry health risks. Breastfeeding is 1 form of

  10. Chronical cervical infections and dysplasia (CIN I, CIN II): Vaginal vitamin D (high dose) treatment: A new effective method? (United States)

    Schulte-Uebbing, C; Schlett, S; Craiut, Id; Antal, L; Olah, H


    In a small praxis/ambulance study we evaluated data of 200 women with chronical recurrent cervical infections and with a cervix dysplasia (CIN 1, CIN 2). who got after the primary therapy a treatment with vitamin D vaginal suppositories (12.500 IU, 3 nights a week, for 6 weeks). We found that - when compared with the lactobacillus vaginal suppositories - the high dose vitamin D vaginal treatment might be more effective. Vitamin D showed very good anti-inflammatory effects. In the survey after six weeks therapy 79% of the women had "less vaginal problems," "less discharge" and "less problems with the sexual intercourse." Objectively after six weeks therapy only 7% of the patients still had bacterial and/or fungal vaginal infections that required a treatment. We found that vitamin D is reabsorbed by the vaginal mucosa, but the reabsorption may be individually very different. In the CIN 1 group we found six weeks after treatment good antidysplastic effects, in the CIN 2 group we often found no or only temporary antidysplastic effects. So this vaginal vitamin D treatment method might be an option for the therapy and prevention of chronical cervical infections and maybe of a cervic dysplasia CIN 1 (good antiinflammatory effects, antidysplastic effects). This small study is not representative. We need much bigger studies with much more dates and with a longer follow up. Caution: At the moment we do not know, if the vaginal vitamin D treatment with 12500 IE is possible in pregnancy. We have no experience. Therefore we recommend an effective contraception during the application.

  11. Determinantal rings

    CERN Document Server

    Bruns, Winfried


    Determinantal rings and varieties have been a central topic of commutative algebra and algebraic geometry. Their study has attracted many prominent researchers and has motivated the creation of theories which may now be considered part of general commutative ring theory. The book gives a first coherent treatment of the structure of determinantal rings. The main approach is via the theory of algebras with straightening law. This approach suggest (and is simplified by) the simultaneous treatment of the Schubert subvarieties of Grassmannian. Other methods have not been neglected, however. Principal radical systems are discussed in detail, and one section is devoted to each of invariant and representation theory. While the book is primarily a research monograph, it serves also as a reference source and the reader requires only the basics of commutative algebra together with some supplementary material found in the appendix. The text may be useful for seminars following a course in commutative ring theory since a ...

  12. Pregnancy in HIV clinical trials in Sub Saharan Africa: failure of consent or contraception?

    Directory of Open Access Journals (Sweden)

    Agnes Ssali

    Full Text Available OBJECTIVE: Higher than expected pregnancy rates have been observed in HIV related clinical trials in Sub-Saharan Africa. We designed a qualitative study to explore the factors contributing to high pregnancy rates among participants in two HIV clinical trials in Sub-Saharan Africa. METHODS: Female and male participants enrolled in one of two clinical HIV trials in south-west Uganda were approached. The trials were a phase III microbicide efficacy trial among HIV negative women using vaginal gel (MDP; and a trial of primary prevention prophylaxis for invasive cryptococcal disease using fluconazole among HIV infected men and women in Uganda (CRYPTOPRO. 14 focus group discussions and 8 in-depth interviews were conducted with HIV positive and negative women and their male partners over a six month period. Areas explored were their experiences about why and when one should get pregnant, factors affecting use of contraceptives, HIV status disclosure and trial product use. RESULTS: All respondents acknowledged being advised of the importance of avoiding pregnancy during the trial. Factors reported to contribute to pregnancy included; trust that the investigational product (oral capsules/vaginal gel would not harm the baby, need for children, side effects that led to inconsistent contraceptive use, low acceptance of condom use among male partners. Attitudes towards getting pregnant are fluid within couples over time and the trials often last for more than a year. Researchers need to account for high pregnancy rates in their sample size calculations, and consider lesser used female initiated contraceptive options e.g. diaphragm or female condoms. In long clinical trials where there is a high fetal or maternal risk due to investigational product, researchers and ethics committees should consider a review of participants contraceptive needs/pregnancy desire review after a fixed period, as need for children, partners and health status of participants may

  13. Cave Rings (United States)


    hypothesis, that cave rings are formed in the same manner as coffee rings[3], that is, due to the enhanced deposition at the edges of sessile drops ...ring’ is the deposit formed when a sessile drop of a solution containing dissolved particles, such as coffee or salt, dries. This was investigated by...who expanded on Deegan et al.[3] to find an exact form for the evaporation flux over a sessile drop . It turns out that solving 179 for the flux is

  14. Birth Control (United States)

    Birth control, also known as contraception, is designed to prevent pregnancy. Birth control methods may work in a number of different ... eggs that could be fertilized. Types include birth control pills, patches, shots, vaginal rings, and emergency contraceptive ...

  15. Vascular rings. (United States)

    Backer, Carl L; Mongé, Michael C; Popescu, Andrada R; Eltayeb, Osama M; Rastatter, Jeffrey C; Rigsby, Cynthia K


    The term vascular ring refers to congenital vascular anomalies of the aortic arch system that compress the esophagus and trachea, causing symptoms related to those two structures. The most common vascular rings are double aortic arch and right aortic arch with left ligamentum. Pulmonary artery sling is rare and these patients need to be carefully evaluated for frequently associated tracheal stenosis. Another cause of tracheal compression occurring only in infants is the innominate artery compression syndrome. In the current era, the diagnosis of a vascular ring is best established by CT imaging that can accurately delineate the anatomy of the vascular ring and associated tracheal pathology. For patients with a right aortic arch there recently has been an increased recognition of a structure called a Kommerell diverticulum which may require resection and transfer of the left subclavian artery to the left carotid artery. A very rare vascular ring is the circumflex aorta that is now treated with the aortic uncrossing operation. Patients with vascular rings should all have an echocardiogram because of the incidence of associated congenital heart disease. We also recommend bronchoscopy to assess for additional tracheal pathology and provide an assessment of the degree of tracheomalacia and bronchomalacia. The outcomes of surgical intervention are excellent and most patients have complete resolution of symptoms over a period of time. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Ilioinguinal nerve entrapment after tension-free vaginal tape (TVT) procedure. (United States)

    Geis, K; Dietl, J


    The anatomy of the ilioinguinal nerve makes it vulnerable to entrapment near its exit from the superficial inguinal ring, where it lies almost directly superior to the pubic tubercle. Ilioinguinal nerve entrapment is a documented complication of inguinal herniorrhaphy, inguinal lymph node dissection, appendectomy, Pfannenstiel incision and the needle suspension procedure. It has not previously been described as a complication of the tension-free vaginal tape (TVT) procedure, which is the most recent technique for the treatment of genuine urinary stress incontinence. This paper describes a clinical history to illustrate the diagnosis and management of ilioinguinal nerve entrapment occurring as a complication of tension-free vaginal tape procedure.

  17. [Contraception and hepatogastroenterology]. (United States)

    Grimaud, J C; Bourliere, M


    Complications of oral contraceptives (OCs) affecting the gastrointestinal tract, liver and pancreas are rare but potentially serious. Hepatobiliary complications are by far the most frequent and varied. Hepatic lesions will probably decline in frequency as low-dose OCs replace higher dosed pills. Intrahepatic cholestasis induced by OCs resembles that of pregnancy. There may be a genetic predisposition to both conditions involving a dose-dependent estrogen effect of decreasing bile secretion. Intrahepatic cholestasis appears within 6 cycles of OC use. Symptoms include pruritus with anorexia, asthenia, vomiting, and weight loss without fever, rash or abdominal pain. Termination of OCs clears the condition without sequelae within 1-3 months, sometimes after a temporary aggravation. A moderate and asymptomatic cytolysis may appear when OC treatment is begun. Sinusoidal dilatation has been conclusively linked to OCs although few cases have been published. Clinical manifestations other than hepatomegaly are variable. Abdominal pain and fever are the most common. The condition is not related to duration of use and disappears 5-15 days after OC use is terminated. The relative risk of Budd-Chiari syndrome in OC users is estimated at 2.37. OCs increase the prevalence of hepatic adenomas as a function of duration of treatment. They are usually discovered fortuitously but may be revealed by vague abdominal pains. Hemorrhagic complications are more likely in OC users. It may be difficult to distinguish between adenomas, hepatocellular carcinoma, and focal nodular hyperplasia. A puncture biopsy guided by sonography may aid diagnosis. The natural history of adenomas is poorly understood and treatment remains controversial. OCs do not appear to increase the risk of focal nodular hyperplasia but they increase the size of the tumor and the risk of hemorrhage. OCs should be terminated because of risk of hemorrhage. Surgical resection is not indicated unless there are complication or

  18. Intravaginal rings as delivery systems for microbicides and multipurpose prevention technologies

    Directory of Open Access Journals (Sweden)

    Thurman AR


    Full Text Available Andrea Ries Thurman, Meredith R Clark, Jennifer Hurlburt, Gustavo F Doncel CONRAD, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA, USA Abstract: There is a renewed interest in delivering pharmaceutical products via intravaginal rings (IVRs. IVRs are flexible torus-shaped drug delivery systems that can be easily inserted and removed by the woman and that provide both sustained and controlled drug release, lasting for several weeks to several months. In terms of women's health care products, it has been established that IVRs effectively deliver contraceptive steroids and steroids for the treatment of postmenopausal vaginal atrophy. A novel application for IVRs is the delivery of antiretroviral drugs for the prevention of human immunodeficiency virus (HIV genital infection. Microbicides are antiviral drugs delivered topically for HIV prevention. Recent reviews of microbicide IVRs have focused on technologies in development and optimizing ring design. IVRs have several advantages, including the ability to deliver sustained drug doses for long periods of time while bypassing first pass metabolism in the gut. IVRs are discreet, woman-controlled, and do not require a trained provider for placement or fitting. Previous data support that women and their male sexual partners find IVRs highly acceptable. Multipurpose prevention technology (MPT products provide protection against unintended/mistimed pregnancy and reproductive tract infections, including HIV. Several MPT IVRs are currently in development. Early clinical testing of new microbicide and MPT IVRs will require a focus on safety, pharmacokinetics and pharmacodynamics. Specifically, IVRs will have to deliver tissue concentrations of drugs that are pharmacodynamically active, do not cause mucosal alterations or inflammation, and do not change the resident microbiota. The emergence of resistance to antiretrovirals will need to be investigated. IVRs should not

  19. Intrauterine devices: an effective alternative to oral hormonal contraception. (United States)


    trachomatis infection. There are about 6 pelvic infections per 1000 woman-years of IUD use. Routine antibiotic prophylaxis is unnecessary. The interview and physical examination may lead to diagnosis of C. trachomatis infection or other sexually transmitted infections. In these cases, treatment may be needed before IUD insertion. Women must be warned that IUDs do not protect them from sexually transmitted diseases; (11) Menstrual bleeding is often heavier in women with cooper IUDs than in women who do not use IUDs, and may be associated with menstrual pain; (12) The levonorgestrel IUD is associated with a marked reduction in menstrual blood loss and irregular bleeding; amenorrhoea occurs in 35% of women after 2 years of use. The levonorgestrel IUD also has hormonal adverse effects such as headache, acne, breast tension and functional ovarian cysts; (13) IUDs can safely be used in breastfeeding women, immediately after a pregnancy, in cases of diabetes or HIV infection, during nonsteroidal antiinflammatory drug therapy, and after an ectopic pregnancy. The only problems occurring in women who have never had children are pain during insertion and more frequent expulsions; (14) A copper IUD is a first-line contraceptive method for women with a history of deep venous thrombosis, pulmonary embolism, or coronary events; (15) It is better to postpone IUD insertion when the woman has a genital tract infection or unexplained vaginal bleeding; (16) IUD insertion is an effective alternative to "morning-after" hormonal contraception.

  20. Group B-beta haemolytic streptococcal colonization in women using intrauterine contraceptive devices. (United States)

    Farrag, O A; Gawad, A A; Antar, S


    Two-hundred-and-eighteen gynaecological patients were screened for group B-beta haemolytic streptococci (GBS) colonization of the vagina, cervix, urethra and rectum. The overall colonization rate was 17%. There is no relation between the rate of colonization and the patient's age or parity. The colonization rate among the intrauterine contraceptive device (IUCD) users (31%) is significantly higher than the non-users (14.5%). The IUCD does not cause GBS vaginal colonization. Nevertheless, its presence helps the microorganisms' vertical spread through the cervical canal. The short duration of IUCD use among the Saudi patients may have provided a protective mechanisms against the development of PID. All the four sites were colonized in the IUCD users and only in 8.1% of the non-users. The urethra was the most common site involved in both groups (83.8%). A higher incidence of GBS colonization was found among patients presenting with excessive vaginal discharge as the main complaint. The presence of excessive vaginal discharge is a significant factor towards the spread of the microorganism to the cervix and urethra. Therefore, an IUCD user with excessive vaginal discharge has a higher chance of getting cervical and urethral colonization.

  1. Students’ Perceptions of Contraceptives in University of Ghana


    Nana Nimo Appiah-Agyekum; Esinam Afi Kayi


    Objective This study sought to explore University of Ghana Business School diploma student's knowledge of contraceptives, types of contraceptives, attitudes towards contraceptive users, preference for contraceptives, benefits, and side-effects of contraceptives. Materials and methods Data was conducted with three sets of focus group discussions. Participants were systematically sampled from accounting and public administration departments. Results Findings showed that students had little know...

  2. The role of previous contraception education and moral judgment in contraceptive use. (United States)

    Bader, Valerie; Kelly, Patricia J; Cheng, An-Lin; Witt, Jackie


    The knowledge and attitudes that lead to nonuse of contraception are not well understood. The goal of this study was to determine whether an association exists between contraceptive use and specific knowledge and attitudinal factors. We conducted a secondary analysis of data from a nationally representative telephone survey of 897 unmarried women aged 18 to 29 years to examine the relationship between contraceptive use and comprehensive sex education, attitude toward pregnancy prevention, perceived infertility, distrust toward the health care system or contraception, and moral attitude toward contraception. Both ever having made a visit to a physician or clinic for women's health care and ever having used any method of contraception to prevent pregnancy were significantly impacted by more comprehensive sex education and less likelihood to view contraception as morally wrong. Consistent with other research, we found no association between the desire to avoid pregnancy and contraceptive use. We found an association between health system distrust and contraceptive use, but health system distrust did not predict contraceptive use. Our findings show that contraceptive use among a sample of young women is influenced by previous contraceptive education and moral attitudes toward contraception. Clinicians should be cognizant of these realities, which may need to be addressed in both clinical and nonclinical venues. © 2014 by the American College of Nurse-Midwives.

  3. Emergency contraception in Wisconsin: a review. (United States)

    Sabo, Laura; Schrager, Sarina


    Emergency contraception is used to prevent pregnancy in the event of unprotected sexual intercourse. The most common methods of emergency contraception are combination and progestin-only oral contraceptive pills. They are effective, safe, and have few side effects. Most physicians are aware of emergency contraception, yet it is not widely prescribed or used. The American Medical Association and the American College of Obstetricians and Gynecologists recommend providing information and access to emergency contraceptive pills at routine gynecologic visits. Evidence has shown that women provided with advance supplies of emergency contraceptive pills were more likely to use them. There is no evidence of increased sexual risk-taking behavior or reduction in use of regular birth control methods. It is estimated that with wider use of emergency contraceptive, nearly half of unplanned pregnancies and abortions could be prevented. Access and knowledge of emergency contraception are the biggest barriers to use. Many emergency departments in Wisconsin do not prescribe emergency contraception, making access for women in rural areas difficult. By increasing use of emergency contraceptive pills by improving access and improving patient knowledge, unplanned pregnancies and abortions may be reduced.

  4. Contraceptive effect and potential side-effects of deslorelin acetate implants in rats (Rattus norvegicus): preliminary observations. (United States)

    Grosset, Claire; Peters, Stijn; Peron, Franck; Figuéra, Joëlle; Navarro, Christelle


    During the last ten years, numerous species have been treated with deslorelin implants to induce contraception. The aims of the study were 1) to assess contraceptive efficacy of 4.7 mg subcutaneous deslorelin implants in rats, 2) to determine the latency of contraceptive effect, and 3) to determine potential side effects. Three experimental females were implanted and their estrous cycle was studied by vaginal smear. Two weeks after implantation, a male whose fertility was previously assessed with a control female, was introduced into their cage. No female conceived during the 4 mo following implantation. Additionally, 38 pet rats were recruited from clients in practice to test for potential side effects, including 6 males and 32 females with a mean age of 14 mo. Local reaction and transient weight gain during the first 2 wk, as well as behavioral changes were recorded. According to this pilot study, deslorelin implant could be used as a contraceptive method in female rats. The latency period is about 2 wk. Nevertheless, it might be possible to refine the treatment further using hormonal measurements. The duration of contraceptive effect is to be determined in an upcoming study.

  5. The Effects of Hormones and Vaginal Microflora on the Glycome of the Female Genital Tract: Cervical-Vaginal Fluid.

    Directory of Open Access Journals (Sweden)

    Bernard J Moncla

    Full Text Available In this study, we characterized the glycome of cervical-vaginal fluid, collected with a Catamenial cup. We quantified: glycosidase levels; sialic acid and high mannose specific lectin binding; mucins, MUC1, MUC4, MUC5AC, MUC7; and albumin in the samples collected. These data were analyzed in the context of hormonal status (day of menstrual cycle, hormonal contraception use and role, if any, of the type of the vaginal microflora present. When the Nugent score was used to stratify the subjects by microflora as normal, intermediate, or bacterial vaginosis, several important differences were observed. The activities of four of six glycosidases in the samples from women with bacterial vaginosis were significantly increased when compared to normal or intermediate women: sialidase, P = <0.001; α-galactosidase, P = 0.006; β-galactosidase, P = 0.005; α-glucosidase, P = 0.056. Sialic acid binding sites as measured by two lectins, Maackia amurensis and Sambucus nigra binding, were significantly lower in women with BV compared to women with normal and intermediate scores (P = <0.0001 and 0.008 respectively. High mannose binding sites, a measure of innate immunity were also significantly lower in women with BV (P = <0.001. Additionally, we observed significant increases in MUC1, MUC4, MUC5AC, and MUC7 concentrations in women with BV (P = <0.001, 0.001, <0.001, 0.02 respectively. Among normal women we found that the membrane bound mucin MUC4 and the secreted MUC5AC were decreased in postmenopausal women (P = 0.02 and 0.07 respectively, while MUC7 (secreted was decreased in women using levonorgestrel-containing IUDs (P = 0.02. The number of sialic acid binding sites was lower in the postmenopausal group (P = 0.04, but the number of high mannose binding sites, measured with Griffithsin, was not significantly different among the 6 hormonal groups. The glycosidase levels in the cervical-vaginal mucus were rather low in the groups, with exception of

  6. Antigonococcal effects of vaginal tampons. (United States)

    Arko, R J; Wong, K H; Smith, S J; Finley-Price, K G


    Different brands of vaginal tampons varied significantly (p less than 0.0001) in their anti-bacterial effects when tested with 46 strains of Neisseria gonorrhoeae. Gonococcal strains recovered from patients with disseminated infections were substantially more sensitive to the anti-bacterial effects of tampons than were strains from patients with uncomplicated genital infections. Strains from patients with pelvic inflammatory disease were moderately sensitive. Tampons showing strong in-vitro antigonococcal effects were also generally effective in vivo in eliminating gonococcal infections from subcutaneous chambers in mice. Extracts of the Rely tampon showed no in-vitro antigonococcal effect, however, but did induce antibacterial activity when injected into subcutaneous chambers in mice. These results emphasise the importance of both in-vitro as well as in-vivo testing of tampon materials to elucidate more fully the nature of their antibacterial effects and their potential for affecting vaginal pathogens and disease processes. PMID:6403199

  7. Evaluation and Management of Vaginitis (United States)

    Carr, Phyllis L; Felsenstein, Donna; Friedman, Robert H


    OBJECTIVE To evaluate recent advances in our understanding of the clinical relevance, diagnosis, and treatment of vaginal infections, and to determine an efficient and effective method of evaluating this clinical problem in the outpatient setting. DATA SOURCES Relevant papers on vaginitis limited to the English language obtained through a MEDLINE search for the years 1985 to 1997 were reviewed. DATA SYNTHESIS Techniques that enable the identification of the various strains of candida have helped lead to a better understanding of the mechanisms of recurrent candida infection. From this information a rationale for the treatment of recurrent disease can be developed. Bacterial vaginosis has been associated with complications, including upper genital tract infection, preterm delivery, and wound infection. Women undergoing pelvic surgery, procedures in pregnancy, or pregnant women at risk of preterm delivery should be evaluated for bacterial vaginosis to decrease the rate of complications associated with this condition. New, more standardized criteria for the diagnosis of bacterial vaginosis may improve diagnostic consistency among clinicians and comparability of study results. Use of topical therapies in the treatment of bacterial vaginosis are effective and associated with fewer side effects than systemic medication. Trichomonas vaginalis, although decreasing in incidence, has been associated with upper genital tract infection. Therapy of T. vaginalis infection has been complicated by an increasing incidence of resistance to metronidazole. CONCLUSIONS Vaginitis is a common medical problem in women that is associated with significant morbidity and previously unrecognized complications. Research in recent years has improved diagnostic tools as well as treatment modalities for all forms of vaginitis. PMID:9613891

  8. Sexual Dysfunction in Two Types of Hormonal Contraception: Combined Oral Contraceptives versus Depot Medroxyprogesterone Acetate

    Directory of Open Access Journals (Sweden)

    Nourossadat Kariman


    Full Text Available Background & aim: Sexual health is an essential element of quality of life, affecting both physical and psychological domains. Hormones used in contraceptive methods have contradictory effects on sexual function. In this study, we aimed to compare sexual function in women using combined oral contraceptives (COC and depot medroxyprogesterone acetate (DMPA, referred to healthcare centers affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran in 2013. Methods: This descriptive, comparative study was performed on 240 women (n=120 per group, selected through multistage sampling in Tehran, Iran. A questionnaire consisting of three parts, General Health Questionnaire (GHQ-28, demographic characteristics, and Female Sexual Function Index (FSFI, was completed through interviews. For data analysis, descriptive statistics were calculated, and independent t-test, Mann-Whitney test, Chi-square, and Fisher's exact test were performed, using SPPS version 16. P-value less than 0.05 was considered statistically significant. Results: The mean age at marriage in women using DMPA was lower than those using COC (18.55±3.61 vs. 19.92±3.98 years. Based on the findings, the menstrual status in the majority of DMPA users was irregular (46.7% in DMPA group vs. 8.3% in COC group. The difference in sexual function between the COC and DMPA groups was significant. Sexual arousal and lubrication were more favorable in the COC group in comparison with the DMPA group; also, pain in this group was lower than the DMPA group. Scores of total sexual function (27.35±5.22 in DMPA group vs. 29.15±6.13 in COC group, sexual arousal (4.11±0.90 in DMPA group vs. 4.51±1.39 in COC group, and vaginal lubrication (4.82±1.30 in DMPA group vs. 5.26±1.35 in COC group were lower in the DMPA group, compared to the COC group. Pain scores (4.91±1.25 in DMPA group vs. 5.28±1.19 in COC group were higher in the DMPA group in comparison with the COC group (P

  9. Vaginal birth after cesarean section

    Directory of Open Access Journals (Sweden)

    Vidyadhar B Bangal


    Full Text Available Background: The rate of primary cesarean section (CS is on the rise. More and more women report with a history of a previous CS. A trial of vaginal delivery can save these women from the risk of repeat CS. Aims: The study was conducted to assess the safety and success rate of vaginal birth after CS (VBAC in selected cases of one previous lower segment CS (LSCS. Materials and Methods: The prospective observational study was carried out in a tertiary care teaching hospital over a period of two years. One hundred pregnant women with a history of one previous LSCS were enrolled in the study. Results: In the present study, 85% cases had a successful VBAC and 15% underwent a repeat emergency LSCS for failed trial of vaginal delivery. Cervical dilatation of more than 3 cm at the time of admission was a significant factor in favor of a successful VBAC. Birth weight of more than 3,000 g was associated with a lower success rate of VBAC. The incidence of scar dehiscence was 2% in the present study. There was no maternal or neonatal mortality. Conclusion: Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas.

  10. Antifungal resistance in yeast vaginitis. (United States)

    Dun, E.


    The increased number of vaginal yeast infections in the past few years has been a disturbing trend, and the scientific community has been searching for its etiology. Several theories have been put forth to explain the apparent increase. First, the recent widespread availability of low-dosage, azole-based over-the-counter antifungal medications for vaginal yeast infections encourages women to self-diagnose and treat, and women may be misdiagnosing themselves. Their vaginitis may be caused by bacteria, parasites or may be a symptom of another underlying health condition. As a result, they may be unnecessarily and chronically expose themselves to antifungal medications and encourage fungal resistance. Second, medical technology has increased the life span of seriously immune compromised individuals, yet these individuals are frequently plagued by opportunistic fungal infections. Long-term and intense azole-based antifungal treatment has been linked to an increase in resistant Candida and non-Candida species. Thus, the future of limiting antifungal resistance lies in identifying the factors promoting resistance and implementing policies to prevent it. PMID:10907778

  11. Contraceptive options for women living with HIV. (United States)

    Phillips, Sharon; Steyn, Petrus; Temmerman, Marleen


    Women living with HIV are often of reproductive age, and many desire effective contraceptive options to delay or prevent pregnancy. We review the safety of various hormonal and non-hormonal contraceptive methods for women living with human immunodeficiency virus (HIV). Additionally, we discuss drug interactions between contraceptive methods and antiretrovirals and the safety of methods with respect to onward transmission to HIV-negative partners for women in sero-discordant partnerships. In general, most methods are safe for most women living with HIV. An understanding of the reproductive goals of each individual patient, as well as her medical condition and medication, should be taken into account when counselling women on their contraceptive options. Further research is needed to understand drug interactions between contraceptives and antiretrovirals better and how to fulfil the contraceptive needs of HIV-positive women.

  12. Recent innovations in oral contraception. (United States)

    Cremer, Miriam; Phan-Weston, Scarlett; Jacobs, Adam


    Traditional forms of oral contraception contain 21 days of hormone-containing pills and 7 days of placebo during the hormone-free interval (HFI). Since 2003, the Food and Drug Administration has approved 24/4, 84/7, and 365-day regimens. These regimens shorten the HFI in an attempt to decrease bleeding and menstrual-associated side effects. Safety and efficacy of these regimens is comparable with traditional 21/7 dosing. Extended regimens are associated with high patient satisfaction. Bleeding patterns are similar or shorter in women using extended regimens, along with improvement in menstrual symptoms. One of the new formulations contains the new progestin drospirenone, which has antimineralocorticoid and antiandrogenic properties. This review summarizes the data about new formulations of oral contraception available in the United Sates and also provides a summary of the current literature on drospirenone.

  13. Reproductive Life Plan Counseling and Effective Contraceptive Use among Urban Women Utilizing Title X Services. (United States)

    Bommaraju, Aalap; Malat, Jennifer; Mooney, Jennifer L


    Although the Centers for Disease Control and Prevention and the U.S. Office of Population Affairs recommend inclusion of reproductive life plan counseling (RLPC) in all well-woman health care visits, no studies have examined the effect of RLPC sessions on the decision to use effective contraception at publicly funded family planning sites. RLPC could be a particularly impactful intervention for disadvantaged social groups who are less likely to use the most effective contraceptive methods. Using data from 771 nonpregnant, non-pregnancy-seeking women receiving gynecological services in the Cincinnati-Hamilton County Reproductive Health and Wellness Program, multinomial logistic regression models compared users of nonmedical/no method with users of 1) the pill, patch, or ring, 2) depot medroxyprogesterone acetate, and 3) long-acting reversible contraception (LARC). The effect of RLPC on the use of each form of contraception, and whether it mediated the effect of race/ethnicity and education on contraceptive use, was examined while controlling for age, insurance status, and birth history. The interaction between RLPC and race/ethnicity and the interaction between RLPC and educational attainment was also assessed. RLPC was not associated with contraceptive use. The data suggested that RLPC may increase LARC use over nonmedical/no method use. RLPC did not mediate or moderate the effect of race/ethnicity or educational attainment on contraceptive use in any comparison. In this system of publicly funded family planning clinics, RLPC seems not to encourage effective method use, providing no support for the efficacy of the RLPC intervention. The results suggest that this intervention requires further development and evaluation. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  14. Progestogen-only injectable contraceptive: Experience of women in ...

    African Journals Online (AJOL)

    menstrual pattern are a well known side effect of this effective contraceptive method. .... For most teenagers requesting contraceptive, ... Injectables offer the advantage of not requiring ... insertion, and the combined oral contraceptive pills.

  15. Contraceptive choices amongst women in Kano, Nigeria: A five (5 ...

    African Journals Online (AJOL)

    Contraceptive choices amongst women in Kano, Nigeria: A five (5) year review. ... Log in or Register to get access to full text downloads. ... of contraceptive usage the preferred method and the source of information on contraception among the ...

  16. Contraceptive practices adopted by women attending an urban ...

    African Journals Online (AJOL)


    couples using contraceptive methods, identify reasons for their adoption & non adoption and to assess unmet needs for contraception. .... emergency contraception, and two traditional methods ..... It Up: The Benefits of Investing in Sexual and.

  17. Topological rings

    CERN Document Server

    Warner, S


    This text brings the reader to the frontiers of current research in topological rings. The exercises illustrate many results and theorems while a comprehensive bibliography is also included. The book is aimed at those readers acquainted with some very basic point-set topology and algebra, as normally presented in semester courses at the beginning graduate level or even at the advanced undergraduate level. Familiarity with Hausdorff, metric, compact and locally compact spaces and basic properties of continuous functions, also with groups, rings, fields, vector spaces and modules, and with Zorn''s Lemma, is also expected.

  18. Microbial and cytopathological study of intrauterine contraceptive device users

    Directory of Open Access Journals (Sweden)

    Agarwal Krishna


    Full Text Available CONTEXT: Intrauterine contraceptive device (IUCD is a commonly used birth-spacing method which is fitted into maternal system. Clinical, microbial and cytopathological monitoring of women using these devices are important for ascertaining their side effects, risk of genital tract infection and carcinogenic potential. AIMS: To study clinical, microbial and cytopathological changes in IUCD users in a tertiary care hospital. DESIGN: Prospective analytic. SETTING: Tertiary hospital. MATERIAL AND METHODS: women visiting Family Planning clinic for follow up (IUCD users, n=100 or for IUCD insertion (controls, n=50 were enrolled in the study. Each subject underwent detailed history, general physical, systemic, and per local examination. Vaginal discharge was subjected to pH testing, KOH and wet mount examination, gram staining, and for culture and sensitivity. Bacterial vaginosis was defined using Nugent criteria. Cervical smears were examined and reported as per Bethesda system. STATISTICAL ANALYSIS: The information was entered into Microsoft Excel spreadsheet. The results were analyzed using EPI Info version-6 and Stata statistical software version 7 packages. Two-tailed t-test, chi2 test with Yates correction and two-tailed Fisher Exact tests were applied. RESULTS: Most women used CuT 200 (92%. Median duration of use was 2 years. Chief complaints of IUCD users included backache (54%, vaginal discharge (46%, pain lower abdomen (34%, dyspareunia (22%, menorrhagia (18% and dysmenorrhea (14%. Mean hemoglobin was lower in IUCD users than controls (11.2±1.7 versus 11.9±1.8 g/dL, p 0.02. Proportion of women with anemia was higher in IUCD users than in controls (29% versus 16%, p 0.12. Cervical erosion was significantly increased in study group as compared the controls (20% versus 0%, p=0.00 whereas only insignificant increase in vaginitis (6% versus 0%, p=0.17. Trichomonas vaginalis and fungal hyphae positivity and gram stain findings and bacterial

  19. Pharmacologic development of male hormonal contraceptive agents. (United States)

    Roth, M Y; Amory, J K


    The world population continues to increase dramatically despite the existence of contraceptive technology. The use of male hormonal contraception may help in preventing un intended pregnancies and managing future population growth. Male hormonal contraception relies on the administration of exogenous hormones to suppress spermatogenesis. Clinical trials have tested several regimens using testosterone, alone or in combination with a progestin. These regimens were shown to be >90% effective in preventing conception and were not associated with serious adverse events.

  20. Lactobacillus for Vaginal Microflora Correction

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    Saule Saduakhasova


    Full Text Available Introduction. Despite the significant progress made in prevention, diagnosis, and treatment, there is still a high rate of vaginal dysbiosis in Kazakh women. The use of antibiotics in the treatment of vaginal dysbiosis contributes to the elimination of pathogens as well as microflora, which can lead to a decrease in local immunity and more favorable conditions for infection spread. The most physiologically safe and promising method for the restoration of vaginal biocenosis is the use of probiotics administered by a vaginal route.Methods. We have allocated 64 of cultures of Lactobacillus from the vaginal epithelium of healthy women of reproductive age and women with diagnosed bacterial vaginosis (BV. Identification of cultures was performed by PCR analysis of 16S ribosomal RNA.  Evaluation of biological significance was determined by the following criteria: high antagonistic activity against Candida albicans, Escherichia coli, Serratia marcescens, Proteus mirabilis, Klebsiella ozaenae, and Staphylococcus aureus; and production of hydrogen peroxide, resistance to antibiotics, adhesive activity. We studied the symbiotic relationship of selected biologically active of cultures to each other and received options for consortiums with  properties of  probiotics through co-cultivation.Results. Results of genotyping  showed that the isolated lactobacilli belong to the seven species: L. fermentum, L. salivarius, L. gasseri, L. crispatus, L. jensenii, L. plantarum, and L. delbrueskii. L. fermentum, L. salivarius, L. gasseri, and L. jensenii occur in women with suspected BV. The highest percentage of occurrence in the vagina of healthy women was L. fermentum (28%. Most strains of lactobacilli possess high inhibitory activity for all test-strains, except Candida albicans (37.5%. 56% of studied cultures revealed high adhesion to human erythrocytes. All lactobacillus strains were resistant to metronidazole, 80% to kanamycin, 57%  to vancomycin, and

  1. Concurrent chemoradiation for vaginal cancer.

    Directory of Open Access Journals (Sweden)

    David T Miyamoto

    Full Text Available BACKGROUND: It is not known whether the addition of chemotherapy to radiation therapy improves outcomes in primary vaginal cancer. Here, we review clinical outcomes in patients with primary vaginal cancer treated with radiation therapy (RT or concurrent chemoradiation therapy (CRT. METHODS: Seventy-one patients with primary vaginal cancer treated with definitive RT with or without concurrent chemotherapy at a single institution were identified and their records reviewed. A total of 51 patients were treated with RT alone; 20 patients were treated with CRT. Recurrences were analyzed. Overall survival (OS and disease-free survival (DFS rates were estimated using the Kaplan-Meier method. Cox regression analysis was performed. RESULTS: The median age at diagnosis was 61 years (range, 18-92 years and the median follow-up time among survivors was 3.0 years. Kaplan-Meier estimates for OS and DFS differed significantly between the RT and CRT groups (3-yr OS = 56% vs. 79%, log-rank p = 0.037; 3-yr DFS = 43% vs. 73%, log-rank p = 0.011. Twenty-three patients (45% in the RT group had a relapse at any site compared to 3 (15% in the CRT group (p = 0.027. With regard to the sites of first relapse, 10 patients (14% had local only, 4 (6% had local and regional, 9 (13% had regional only, 1 (1% had regional and distant, and 2 (3% had distant only relapse. On univariate analysis, the use of concurrent chemotherapy, FIGO stage, tumor size, and date of diagnosis were significant predictors of DFS. On multivariate analysis, the use of concurrent chemotherapy remained a significant predictor of DFS (hazard ratio 0.31 (95% CI, 0.10-0.97; p = 0.04. CONCLUSIONS: Vaginal cancer results in poor outcomes. Adequate radiation dose is essential to ensure curative management. Concurrent chemotherapy should be considered for vaginal cancer patients.

  2. Oral contraceptive compliance during adolescence. (United States)

    Serfaty, D


    A review of the available literature suggests that adolescent lack of compliance with oral contraceptives (OCs) is a multifactorial problem that requires a multifactorial solution. Because of their lack of experience with contraception, higher frequency of intercourse, higher intrinsic fertility, and pattern of frequent stopping or switching of methods, adolescents experience higher OC failure rates than do adult women. Adolescents also are more likely to forget to take the pill or to discontinue due to side effects, without consulting their physician. A survey of European young women identified contraceptive protection without weight gain as the most necessary change in OCs. Adolescents must be counseled not to miss a single pill, observe the pill-free interval, take phasic formulations in the right order, and use a back-up method in case of diarrhea and vomiting or when certain medications (e.g., antibiotics and anti-epileptics) are used concurrently, and be informed of steps to take in the event of side effects and unprotected intercourse. The quality of the counseling appears to be more important to compliance than the quantity of information provided. Pharmacists should complete the counseling initiated by the physician and explain prescription use. The most significant predictor of consistent OC use is the adolescent's motivation.

  3. The use of oral contraception by adolescents for contraception, menstrual cycle problems or acne

    NARCIS (Netherlands)

    Hooff, M.H.A. van; Hirasing, R.A.; Kaptein, M.B.M.; Koppenaal, C.; Voorhorst, F.J.; Schoemaker, J.


    Background. Oral contraceptives are prescribed as contraception but also as therapy for menstrual cycle disturbances and acne. We studied the prevalence of oral contraceptive (OC) use and the indications to start OC use among adolescents. Methods. A cohort consisting of ninth grade secondary school

  4. The use of oral contraception by adolescents for contraception, menstrual cycle problems or acne

    NARCIS (Netherlands)

    Hooff, M.H.A. van; Hirasing, R.A.; Kaptein, M.B.M.; Koppenaal, C.; Voorhorst, F.J.; Schoemaker, J.


    Background. Oral contraceptives are prescribed as contraception but also as therapy for menstrual cycle disturbances and acne. We studied the prevalence of oral contraceptive (OC) use and the indications to start OC use among adolescents. Methods. A cohort consisting of ninth grade secondary school

  5. Communication about Contraception and Knowledge of Oral Contraceptives amongst Norwegian High School Students. (United States)

    Hansen, Thomas; Skjeldestad, Finn Egil


    Examines communication about contraception and specific knowledge of oral contraceptives (OCs) in a sample of Norwegian high school students. More females than males discussed contraception at least monthly. Discussions were predominantly held with peers and not adults. Females were far more knowledgeable about OCs than males. The most significant…

  6. Community influences on contraceptive use in Mozambique. (United States)

    Cau, Boaventura Manuel


    Fertility in sub-Saharan Africa remains the highest in the world. Yet, the average contraceptive prevalence in Africa is the lowest in major world regions and there is limited understanding of the mechanisms through which community context shapes contraceptive use in the region. Using data from the 2011 Mozambique Demographic and Health Survey, we examine the mechanisms through which community context influences women's use of modern methods of contraception in Mozambique. We find that community context influences the use of modern methods of contraception by shaping the environment in which women live.

  7. Contraception in the Developing World: Special Considerations. (United States)

    Schivone, Gillian B; Blumenthal, Paul D


    The United States Agency for International Development (USAID) estimates that there are 225 million women and girls with unmet contraceptive need yearly. Unmet need for contraception is defined as women who desire a delay in childbearing and are not using a modern method of contraception. It is projected that providing contraception to these women would avert 36 million abortions, 70,000 maternal deaths, and 52 million unintended pregnancies overall. In the past 30 years, there has been an increase both in population and in contraception use in the developing world. As a result, it is estimated that in 2015 there were 500 million contraceptive users in developing countries, which is nearly double the prevalence in 2000. Unfortunately, women and girls in developing nations still face many obstacles in obtaining modern methods of contraception. Particular challenges in the developing world include lack of access due to inadequate number of trained providers, fewer method options, and "stock-outs" of contraceptive supplies. Innovative strategies for decreasing unmet need will have to address these challenges, and will necessarily involve programmatic solutions such as community-based distribution and social marketing campaigns. Additionally, increasing uptake of long-acting reversible contraceptive methods will be essential for achieving the goal of decreasing unmet need.

  8. Ring interferometry

    CERN Document Server

    Malykin, Grigorii B; Zhurov, Alexei


    This monograph is devoted to the creation of a comprehensive formalism for quantitative description of polarized modes' linear interaction in modern single-mode optic fibers. The theory of random connections between polarized modes, developed in the monograph, allows calculations of the zero shift deviations for a fiber ring interferometer. The monograph addresses also the

  9. Vaginal rejuvenation using energy-based devices

    Directory of Open Access Journals (Sweden)

    Cheryl Karcher, MD


    Full Text Available Physiologic changes in a woman’s life, such as childbirth, weight fluctuations, and hormonal changes due to aging and menopause, may alter the laxity of the vaginal canal, damage the pelvic floor, and devitalize the mucosal tone of the vaginal wall. These events often lead to the development of genitourinary conditions such as stress urinary incontinence; vaginal atrophy; dryness; and physiologic distress affecting a woman’s quality of life, self-confidence, and sexuality. Various treatment modalities are currently available to manage these indications, varying from invasive vaginal surgery to more benign treatments like topical vaginal hormonal gels or hormone-replacement therapy. A new trend gaining momentum is the advent of energy-based devices for vaginal rejuvenation that apply thermal or nonthermal energy to the various layers of the vaginal tissue, stimulating collagen regeneration contracture of elastin fibers, neovascularization, and improved vaginal lubrication. This review aims to present the available technologies offering vaginal rejuvenation and the scientific evidence that underlines their safety and efficacy for this indication.

  10. Dynamic Clinical Measurements of Voluntary Vaginal Contractions and Autonomic Vaginal Reflexes

    NARCIS (Netherlands)

    Broens, Paul M. A.; Spoelstra, Symen K.; Weijmar Schultz, Willibrord C. M.


    IntroductionThe vaginal canal is an active and responsive canal. It has pressure variations along its length and shows reflex activity. At present, the prevailing idea is that the vaginal canal does not have a sphincter mechanism. It is hypothesized that an active vaginal muscular mechanism exists a

  11. On SAP-rings


    Zhixiang, Wu


    The rings whose simple right modules are absolutely pure are called right $SAP$-rings. We give a new characterization of right $SAP$ rings, right $V$ rings, and von Neumann regular rings. We also obtain a new decomposition theory of right selfinjective von Neumann regular rings. The relationships between $SAP$-rings, $V$-rings, and von Neumann regular rings are explored. Some recent results obtained by Faith are generalized and the results of Wu-Xia are strengthened.

  12. The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception. (United States)

    Secura, Gina M; Allsworth, Jenifer E; Madden, Tessa; Mullersman, Jennifer L; Peipert, Jeffrey F


    To introduce and promote the use of long-acting reversible methods of contraception (LARC; intrauterine contraceptives and subdermal implant) by removing financial and knowledge barriers. The Contraceptive CHOICE Project is a prospective cohort study of 10,000 women 14-45 years who want to avoid pregnancy for at least 1 year and are initiating a new form of reversible contraception. Women screened for this study are read a script regarding long-acting reversible methods of contraception to increase awareness of these options. Participants choose their contraceptive method that is provided at no cost. We report the contraceptive choice and baseline characteristics of the first 2500 women enrolled August 2007 through December 2008. Sixty-seven percent of women enrolled (95% confidence interval, 65.3-69.0) chose long-acting methods. Fifty-six percent selected intrauterine contraception and 11% selected the subdermal implant. Once financial barriers were removed and long-acting reversible methods of contraception were introduced to all potential participants as a first-line contraceptive option, two-thirds chose long-acting reversible methods of contraception. Copyright (c) 2010 Mosby, Inc. All rights reserved.

  13. Premenstrual vaginal colonization of Candida and symptoms of vaginitis. (United States)

    Watson, Cathy J; Grando, Danilla; Garland, Suzanne M; Myers, Stephen; Fairley, Christopher K; Pirotta, Marie


    Although premenstrual exacerbation of vulvovaginal symptoms attributed to Candida spp. is well documented, the causation of these symptoms is not well understood. This study describes the daily vaginal colonization of Candida in three women. A single pilot study was designed to test the methodology of the proposed randomized controlled trial, Garlic and Candida. This study reports the colonization of Candida spp. in three women. Ten women aged 18-50 who reported at least one episode of vulvovaginal candidiasis were recruited by the University of Melbourne. Each participant took daily vaginal swabs for 2 weeks during the luteal phase of their menstrual cycle, which were analysed for quantitative colony counts of Candida spp. Of these, three women were colonized with Candida spp. For the first time, to our knowledge, daily colonization of Candida during the luteal phase of the menstrual cycle is described in three women, demonstrating an increase in the colony count preceding symptom development. This small study demonstrated the colonization of Candida spp. during the luteal phase of the menstrual cycle in three women. Candida colonization is poorly understood, yet investigating the relevance of the link between symptom exacerbation and the menstrual cycle in those women who experience recurrent episodes of vulvovaginal candidiasis may influence the management of this condition.

  14. Efficacy and Tolerability of Fitostimoline (Vaginal Cream, Ovules, and Vaginal Washing) and of Benzydamine Hydrochloride (Tantum Rosa Vaginal Cream and Vaginal Washing) in the Topical Treatment of Symptoms of Bacterial Vaginosis


    Papa, R; Ascione, L.; Rullo, V.; Campedelli, A; Muzi, M.; Petrella, E.; Boselli, F.; Saponati, G.


    Two hundred and 91 patients showing signs and symptoms of bacterial vaginosis (BV) were randomized to receive topical treatment with Fitostimoline (vaginal cream and vaginal ovules + vaginal washing) or benzydamine hydrochloride (vaginal cream + vaginal washing) for 7 days. Signs (leucorrhoea, erythema, oedema, and erosion) and symptoms (burning, pain, itching, vaginal dryness, dyspareunia, and dysuria) (scored 0–3) were evaluated at baseline and at the end of treatment; the total symptoms sc...

  15. Long-retained vaginal foreign body causing chronic vaginitis in a bulldog. (United States)

    Snead, Elisabeth C; Pharr, John W; Ringwood, Brendon P; Beckwith, Jennifer


    A vaginal foreign body consisting of a piece of retained calvarium from a macerated fetus was identified and removed using vaginoscopy in a 4-year-old, spayed female bulldog. The dog had a 12-month history of chronic mucopurulent vaginitis. Vaginal foreign bodies, although uncommon, are a differential diagnosis for recurrent mucopurulent or hemorrhagic chronic vaginal discharge. A case of chronic vaginitis caused by a long-retained intravaginal foreign body in a dog is described and compared to four other canine cases reported in the literature.

  16. Use of Contraception and Attitudes towards Contraceptive Use in Swedish Women--A Nationwide Survey.

    Directory of Open Access Journals (Sweden)

    Helena Kopp Kallner

    Full Text Available To describe contraceptive use and attitudes towards contraceptive use in Sweden which has the highest abortion rate in Western Europe. Secondary objectives were to investigate knowledge of contraceptive methods and outcomes of unplanned and unwanted pregnancies.Telephone survey.National survey of women living in Sweden.Women between 16 and 49 years.The survey contained 22 questions with free text and multi choice answers on demographics, contraceptive use, knowledge of and attitudes towards contraception, the importance of monthly bleeding and experience of unintended pregnancy.Distribution of use of contraceptive methods and non-use of contraception among Swedish women. Prevalence and outcome of unintended pregnancies.A total of 1001 women participated in the survey. Of all women, 721/1001 (72.1% currently used contraception whereas 268/1001 (26.8% women did not. Long acting reversible contraception, (LARC; implant and intra uterine contraception was used by 24.3% of women. The unmet need of contraception in Sweden was estimated at 8.9% (89/1001 women. A total of 781 (78% women had never experienced an unintended pregnancy whereas 220 (22% women had had at least one unintended pregnancy. Users and non-users alike stated that one of the most important characteristics of a contraceptive method is its effectiveness.Sweden has a large unmet need for contraception. Furthermore, a large proportion of women have experienced at least one unintended pregnancy. Increasing contraceptive use and promotion of LARC is a possible way forward in the effort to reduce the rates of unwanted pregnancies.

  17. Use of Contraception and Attitudes towards Contraceptive Use in Swedish Women - A Nationwide Survey (United States)

    Kopp Kallner, Helena; Thunell, Louise; Brynhildsen, Jan; Lindeberg, Mia; Gemzell Danielsson, Kristina


    Objective To describe contraceptive use and attitudes towards contraceptive use in Sweden which has the highest abortion rate in Western Europe. Secondary objectives were to investigate knowledge of contraceptive methods and outcomes of unplanned and unwanted pregnancies. Design Telephone survey. Setting National survey of women living in Sweden. Population Women between 16 and 49 years. Methods The survey contained 22 questions with free text and multi choice answers on demographics, contraceptive use, knowledge of and attitudes towards contraception, the importance of monthly bleeding and experience of unintended pregnancy. Main Outcome Measures Distribution of use of contraceptive methods and non-use of contraception among Swedish women. Prevalence and outcome of unintended pregnancies. Results A total of 1001 women participated in the survey. Of all women, 721/1001 (72.1%) currently used contraception whereas 268/1001 (26.8%) women did not. Long acting reversible contraception, (LARC; implant and intra uterine contraception) was used by 24.3% of women. The unmet need of contraception in Sweden was estimated at 8.9% (89/1001 women). A total of 781 (78%) women had never experienced an unintended pregnancy whereas 220 (22%) women had had at least one unintended pregnancy. Users and non-users alike stated that one of the most important characteristics of a contraceptive method is its effectiveness. Conclusions Sweden has a large unmet need for contraception. Furthermore, a large proportion of women have experienced at least one unintended pregnancy. Increasing contraceptive use and promotion of LARC is a possible way forward in the effort to reduce the rates of unwanted pregnancies. PMID:25992901

  18. Use of Contraception and Attitudes towards Contraceptive Use in Swedish Women--A Nationwide Survey. (United States)

    Kopp Kallner, Helena; Thunell, Louise; Brynhildsen, Jan; Lindeberg, Mia; Gemzell Danielsson, Kristina


    To describe contraceptive use and attitudes towards contraceptive use in Sweden which has the highest abortion rate in Western Europe. Secondary objectives were to investigate knowledge of contraceptive methods and outcomes of unplanned and unwanted pregnancies. Telephone survey. National survey of women living in Sweden. Women between 16 and 49 years. The survey contained 22 questions with free text and multi choice answers on demographics, contraceptive use, knowledge of and attitudes towards contraception, the importance of monthly bleeding and experience of unintended pregnancy. Distribution of use of contraceptive methods and non-use of contraception among Swedish women. Prevalence and outcome of unintended pregnancies. A total of 1001 women participated in the survey. Of all women, 721/1001 (72.1%) currently used contraception whereas 268/1001 (26.8%) women did not. Long acting reversible contraception, (LARC; implant and intra uterine contraception) was used by 24.3% of women. The unmet need of contraception in Sweden was estimated at 8.9% (89/1001 women). A total of 781 (78%) women had never experienced an unintended pregnancy whereas 220 (22%) women had had at least one unintended pregnancy. Users and non-users alike stated that one of the most important characteristics of a contraceptive method is its effectiveness. Sweden has a large unmet need for contraception. Furthermore, a large proportion of women have experienced at least one unintended pregnancy. Increasing contraceptive use and promotion of LARC is a possible way forward in the effort to reduce the rates of unwanted pregnancies.

  19. Hormonal contraception and risk of cancer

    DEFF Research Database (Denmark)

    Cibula, D; Gompel, A; Mueck, A O


    Fear from increased cancer risk is one of the most significant reasons for low acceptance of reliable contraceptive methods and low compliance.......Fear from increased cancer risk is one of the most significant reasons for low acceptance of reliable contraceptive methods and low compliance....

  20. Ultrasound appearances of Implanon implanted contraceptive devices.

    LENUS (Irish Health Repository)

    McNeill, G


    Subdermal contraceptive devices represent a popular choice of contraception. Whilst often removed without the use of imaging, circumstances exist where imaging is required. Ultrasound is the modality of choice. The optimal technique and typical sonographic appearances are detailed in this article.

  1. Residual ovarian activity during oral contraception

    NARCIS (Netherlands)

    A.M. van Heusden


    textabstractThe study objectives in this thesis focus on pituitary-ovarian activity in women using oral contraceptive steroids. Contraceptive steroids influence the hypothalamic-pituitary-ovarian axis in order to interfere with normal follicular development and ovulation. Additional effects on the e

  2. Model for Effective Contraceptive Counseling on Campus. (United States)

    Bachmann, Gloria A.


    A study compared the effective v ineffective use of contraceptives at a major university by comparing college women who had experienced birth control failure with those who had not. Factors related to a woman's use of a contraceptive device include: satisfaction with its aesthetic properties; trust in its effectiveness; a feeling of comfort…

  3. Hormonal contraception and risk of cancer

    DEFF Research Database (Denmark)

    Cibula, D.; Gompel, A.; Mueck, A.O.;


    Fear from increased cancer risk is one of the most significant reasons for low acceptance of reliable contraceptive methods and low compliance.......Fear from increased cancer risk is one of the most significant reasons for low acceptance of reliable contraceptive methods and low compliance....

  4. Ultrasound appearances of Implanon implanted contraceptive devices. (United States)

    McNeill, G; Ward, E; Halpenny, D; Snow, A; Torreggiani, W


    Subdermal contraceptive devices represent a popular choice of contraception. Whilst often removed without the use of imaging, circumstances exist where imaging is required. Ultrasound is the modality of choice. The optimal technique and typical sonographic appearances are detailed in this article.

  5. Prescribing contraceptives for women with schizophrenia. (United States)

    Seeman, Mary V; Ross, Ruth


    Although women with serious mental illness have high rates of lifetime sexual partners, they infrequently use contraception. Consequently, the prevalence of sexually transmitted infections is high in this population. In addition, while the overall rate of pregnancy in women with schizophrenia of child-bearing age is lower than in the general population, the percentage of pregnancies that are unwanted is higher than that in the general population. The objective of this paper is to help clinicians explore knowledge of appropriate methods of contraception for women who suffer from schizophrenia. The authors reviewed recent literature on the use of contraceptive methods by women with schizophrenia treated with antipsychotic and adjunctive medications. Contraceptive counseling to women and their partners is an important part of comprehensive care for women with serious and persistent mental illness. Women with schizophrenia who smoke, are overweight, or have diabetes, migraine, cardiovascular disease, or a family history of breast cancer should be offered non-hormonal contraception. Women with more than one sexual partner should be advised on barrier methods in addition to any other contraceptive measures they are using. Clinicians should be alert for potential interactions among oral hormonal contraceptives, smoking, and therapeutic drugs. Long-lasting contraceptive methods, such as intrauterine devices, progesterone depot injections, or tubal ligation are reasonable options for women having no wish to further expand their families.

  6. Sexual and Contraceptive Practices among Female Undergraduates ...

    African Journals Online (AJOL)

    One hundred and eighty six (60.8%) students were currently sexually active. ... Contraceptive knowledge was 100%, but consistent use was 34.4%. ... had sex for material rewards and/or under the influence of alcohol and recreational drugs. ... CONCLUSION: There is a high level of sexual activity and low contraceptive use ...

  7. Gender and risk assessment in contraceptive technologies

    NARCIS (Netherlands)

    Kammen, van Jessika; Oudshoorn, Nelly


    This paper concerns a comparison of risk assessment practices of contraceptives for women and men. Our analysis shows how the evaluation of health risks of contraceptives does not simply reflect the specific effects of chemical compounds in the human body. Rather, we show how side-effects were rated

  8. Factors Influencing Acceptance Of Contraceptive Methods

    Directory of Open Access Journals (Sweden)

    Anita Gupta


    Full Text Available Research Problem: What are the factors influencing acceptance of contraceptive methods.Objective: To study the determinants influencing contra­ceptive acceptance.Study design: Population based cross - sectional study.Setting: Rural area of East DelhiParticipants: Married women in the reproductive age group.Sample:Stratified sampling technique was used to draw the sample.Sample Size: 328 married women of reproductive age group.Study Variables: Socio-economic status, Type of contraceptive, Family size, Male child.Outcome Variables: Acceptance of contraceptivesStatistical Analysis: By proportions.Result: Prevalence of use of contraception at the time of data collection was 40.5%. Tubectomy and vasectomy were most commonly used methods. (59.4%, n - 133. Educational status of the women positively influenced the contraceptive acceptance but income did not. Desire for more children was single most important deterrent for accepting contraception.Recommendations:(i             Traditional method of contraception should be given more attention.(ii            Couplesshould be brought in the contraceptive use net at the early stage of marriage.

  9. Managing adverse effects of hormonal contraceptives. (United States)

    Grossman Barr, Nancy


    Adverse effects of hormonal contraceptives usually diminish with continued use of the same method. Often, physi- cians only need to reassure patients that these symptoms will likely resolve within three to five months. Long-acting injectable depot medroxyprogesterone acetate is the only hormonal contraceptive that is consistently associated with weight gain; other hormonal methods are unlikely to increase weight independent of lifestyle choices. Switching com- bined oral contraceptives is not effective in treating headaches, nor is the use of multivitamins or diuretics. There are no significant differences among various combined oral contraceptives in terms of breast tenderness, mood changes, and nausea. Breakthrough bleeding is common in the first months of combined oral contraceptive use. If significant abnormal bleeding persists beyond three months, other methods can be considered, and the patient may need to be evaluated for other causes. Studies of adverse sexual effects in women using hormonal contraceptives are inconsistent, and the pharmacologic basis for these symptoms is unclear. If acne develops or worsens with progestin-only contra- ceptives, the patient should be switched to a combination method if she is medically eligible. There is insufficient evidence of any effect of hormonal contraceptives on breast milk quantity and quality. Patient education should be encouraged to decrease the chance of unanticipated adverse effects. Women can also be assessed for medical eligibility before and during the use of hormonal contraceptives.

  10. Knowledge, attitude and practice of emergency contraceptives ...

    African Journals Online (AJOL)


    Background: Young and unmarried women constitute a high risk group for unplanned pregnancies and unsafe abortions. It has been estimated that widespread use of emergency contraception (EC) may significantly ... single women, teenagers and students (3). ... contraceptive method and their sexual behavior is rather.

  11. Residual ovarian activity during oral contraception

    NARCIS (Netherlands)

    A.M. van Heusden


    textabstractThe study objectives in this thesis focus on pituitary-ovarian activity in women using oral contraceptive steroids. Contraceptive steroids influence the hypothalamic-pituitary-ovarian axis in order to interfere with normal follicular development and ovulation. Additional effects on the e

  12. Drug interactions between hormonal contraceptives and antiretrovirals (United States)

    Nanda, Kavita; Stuart, Gretchen S.; Robinson, Jennifer; Gray, Andrew L.; Tepper, Naomi K.; Gaffield, Mary E.


    Objective: To summarize published evidence on drug interactions between hormonal contraceptives and antiretrovirals. Design: Systematic review of the published literature. Methods: We searched PubMed, POPLINE, and EMBASE for peer-reviewed publications of studies (in any language) from inception to 21 September 2015. We included studies of women using hormonal contraceptives and antiretrovirals concurrently. Outcomes of interest were effectiveness of either therapy, toxicity, or pharmacokinetics. We used standard abstraction forms to summarize and assess strengths and weaknesses. Results: Fifty reports from 46 studies were included. Most antiretrovirals whether used for therapy or prevention, have limited interactions with hormonal contraceptive methods, with the exception of efavirenz. Although depot medroxyprogesterone acetate is not affected, limited data on implants and combined oral contraceptive pills suggest that efavirenz-containing combination antiretroviral therapy may compromise contraceptive effectiveness of these methods. However, implants remain very effective despite such drug interactions. Antiretroviral plasma concentrations and effectiveness are generally not affected by hormonal contraceptives. Conclusion: Women taking antiretrovirals, for treatment or prevention, should not be denied access to the full range of hormonal contraceptive options, but should be counseled on the expected rates of unplanned pregnancy associated with all contraceptive methods, in order to make their own informed choices. PMID:28060009

  13. Contraceptive use in the Nordic countries

    DEFF Research Database (Denmark)

    Lindh, Ingela; Skjeldestad, Finn E; Gemzell-Danielsson, Kristina


    INTRODUCTION: The aim was to compare contraceptive use in the Nordic countries and to assess compliance with recommendations from the European Medicines Agency regarding the use of combined oral contraception containing low-dose estrogen and levonorgestrel, norethisterone or norgestimate. MATERIA...

  14. Clinical implementation of MR‐guided vaginal cylinder brachytherapy

    National Research Council Canada - National Science Library

    Owrangi, Amir M; Jolly, Shruti; Balter, James M; Cao, Yue; Maturen, Katherine E; Young, Lisa; Zhu, Tong; Prisciandaro, Joann I


    ...)‐guided vaginal brachytherapy using commercially available solid applicator models. To test the fidelity of solid applicator models to digitize vaginal cylinder applicators, three datasets were evaluated...

  15. Treatment of postmenopausal vaginal atrophy with 10-μg estradiol vaginal tablets. (United States)

    Panay, Nick; Maamari, Ricardo


    Postmenopausal estrogen deficiency can lead to symptoms of urogenital atrophy. Individuals with urogenital atrophy have symptoms that include vaginal dryness, vaginal and vulval irritation, vaginal soreness, pain and burning during urination (dysuria), increased vaginal discharge, vaginal odour, vaginal infections, recurrent urinary tract infections, pain associated with sexual activity (dyspareunia) and vaginal bleeding associated with sexual activity. Despite the frequency and effects of vaginal atrophy symptoms, they are often under-reported and, consequently, under-treated. Therefore, care of a menopausal woman should include a physical assessment of vaginal atrophy and a dialogue between the physician and the patient that explores existing symptoms and their effect on vulvovaginal health, sexuality and quality-of-life issues. The development of the ultra-low-dose 10-µg estradiol vaginal tablets is in line with the requirements of regulatory agencies and women's health societies regarding the use of the lowest effective hormonal dose. Because of its effectiveness and safety profiles, in addition to its minimal systemic absorption, the 10-µg estradiol vaginal tablet can offer greater reassurance to health-care providers and postmenopausal women with an annual estradiol administration of only 1.14 mg.

  16. [The difficulties of contraception: conflicts and paradoxes]. (United States)

    Cribier, F


    This work uses clinical examples to explore sources of conflict and denial of patients and physicians during contraception consultations. The discovery of oral contraceptives (OCs) and improvements in mechanical contraception raised hopes that couples could achieve total control of their fertility. But continued high abortion rates and the persistence of sexual problems and maladjustments have demonstrated that contraception alone is not a panacea. Conflicts about contraception may be conscious and quickly expressed during a consultation, even if a medical pretext is given. The resentment when 1 partner desires a child and the other does not for example can translate into a conflict about contraception. Some women are fully aware of their own ambivalence about pregnancy and contraception and able to express it openly, but very often the woman's concerns are expressed by questions, fears, and verbal slips. The fear that pills are unnatural or will cause congenital defects can be interpreted as an expression of guilt over the pleasure that pills permit. Sterility is the ultimate fear caused by this unlimited possibility for pleasure. In the majority of cases, physical complaints are the means by which contraception clients address their physicians. In some cases, intolerance to OCs may actually be a hysterical manifestation that is not understood. Such symptoms as nausea, breast swelling, dizziness, vomiting, nervousness, and insomnia may be signs of early pregnancy as well as of intolerance for pills. Intolerance to pills may be caused by intolerance of a sexuality in which all things seem possible but in which the individual feels unrecognized by the partner. The resulting aggression may be turned inward in the form of a morbid symptom or of forgetting or stopping pill use, recourse to abortion, and demand for recognition. Acting out, especially by adolescents, is common in the area of contraception. In some cases the psychological or emotional needs of the patient

  17. Contraception. Slow train gathers speed. (United States)

    Hampton, N; Kubba, A

    The otherwise slow pace of contraceptive research developments has recently quickened, with new products developed, more on the way, and encouraging new data emerging about existing methods. While the 1995 UK pill scare called attention to a differential in the risk of venous thromboembolism (VTE) between pills containing levonorgestrel or norethisterone and those containing desogestrel or gestodene, there is only an extremely small level of excess mortality attributable to third-generation progestogens, less than 2 per million women per year. Tentative evidence suggests that pills with less anti-estrogenic progestogens are neutral with regard to coronary artery disease. The pill remains extremely safe for healthy young women, although additional research with larger numbers of participants is warranted. Salient research findings are that the combined oral contraceptive pill may protect against colon cancer, the pill appears to offer no protection against bone fractures, new products contain less estrogen and have a shortened pill-free interval, a WHO paper showed no significant association between cardiovascular disease and the use of oral or injectable progestogens, a UK study showed no correlation between bone density and plasma estrogen concentrations among long-term users of depot medroxyprogesterone acetate, and a WHO controlled trial found a progestogen-only method of emergency contraception to be considerably more effective in preventing expected pregnancies than the Yuzpe regimen. The T 380 copper IUD provides very high protection against intrauterine and extrauterine pregnancies for 10 years and is now available in an improved inserting mechanism, the Mirena levonorgestrel-releasing IUD system is now licensed for 5 years, and the GyneFIX IUD implant is a frameless device fixed during insertion to the fundal myometrium.

  18. Treatment of Vaginal Atrophy with Vaginal Estrogen Cream in Menopausal Indian Women (United States)

    Shah, Maitri; Karena, Zalak; Patel, Sangita V.; Parmar, Niyati; Singh, Pawan K.; Sharma, Atul


    Objectives To measure the effect of vaginal estrogen cream in the treatment of vaginal atrophy in menopausal Indian women. Methods A total of 50 menopausal women aged between 40 and 80 years old with symptoms of vaginal atrophy were selected and treated with 0.5 g vaginal estrogen cream, twice weekly for 12 weeks. The women were followed-up monthly where symptom score, Genital Health Clinical Evaluation (GHCE) score, vaginal pH, and vaginal maturation index (VMI) were assessed and compared to baseline data. Any adverse events were recorded. Results There was a significant improvement (p cream causes symptomatic relief in women of menopausal age in India suffering from vaginal atrophy. PMID:28042397

  19. Use of vaginal estrogen in Danish women

    DEFF Research Database (Denmark)

    Meaidi, Amani; Goukasian, Irina; Lidegaard, Oejvind


    INTRODUCTION: We know little about the use of vaginal estrogen in perimenopausal and postmenopausal women. We aimed to assess the prevalence of vaginal estrogen use in Denmark. MATERIAL AND METHODS: The study was designed as a nationwide cross-sectional study of all Danish women aged 40-79 years,...

  20. Reoccurrence of retained placenta at vaginal delivery

    DEFF Research Database (Denmark)

    Løkkegaard, Ellen Christine Leth; Bergholt, Thomas; Nikolajsen, Sys


    To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery.......To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery....


    NARCIS (Netherlands)


    The aim of this study was to estimate the risk of vulvo-vaginal candidiasis among the users of acitretin. The incidence rate ratio of vulvo-vaginal candidiasis was estimated in a cohort of acitretin users by using prescription sequence analysis. Study subjects were 196 women between 15 and 45 years


    NARCIS (Netherlands)



    The aim of this study was to estimate the risk of vulvo-vaginal candidiasis among the users of acitretin. The incidence rate ratio of vulvo-vaginal candidiasis was estimated in a cohort of acitretin users by using prescription sequence analysis. Study subjects were 196 women between 15 and 45 years

  3. 21 CFR 884.3900 - Vaginal stent. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vaginal stent. 884.3900 Section 884.3900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... stent. (a) Identification. A vaginal stent is a device used to enlarge the vagina by stretching, or...

  4. Reoccurrence of retained placenta at vaginal delivery

    DEFF Research Database (Denmark)

    Nikolajsen, Sys; Løkkegaard, Ellen Christine Leth; Bergholt, Thomas


    To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery.......To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery....

  5. Use of vaginal hysterectomy in Denmark

    DEFF Research Database (Denmark)

    Nielsen, Sidsel Lykke; Daugbjerg, Signe B; Gimbel, Helga


    To describe the use of vaginal, abdominal and laparoscopic hysterectomy in Denmark from 1999 to 2008, the influence of national guidelines and the patient and procedure-related characteristics associated with the choice of vaginal hysterectomy. Design. Nationwide register-based cohort study....

  6. Estrogen receptors in human vaginal tissue

    NARCIS (Netherlands)

    Wiegerinck, M.A.H.M.; Poortman, J.; Agema, A.R.; Thijssen, J.H.H.


    The presence of specific estrogen receptors could be demonstrated in vaginal tissue, obtained during operation from 38 women, age 27–75 yr. In 23 premenopausal women the receptor concentration in the vaginal tissue varied between 12 and 91 fmol/mg protein, no significant difference in the receptor

  7. Preconception counseling and contraception after gestational diabetes

    DEFF Research Database (Denmark)

    Mølsted-Pedersen, L; Skouby, S O; Damm, P


    a subsequent pregnancy. Therefore, family planning and contraceptive guidance should follow the lines for women with pregestational diabetes. When low-dose hormonal contraceptives containing ethinyl estradiol and levonorgestrel were given to women with previous GDM, glucose tolerance and lipoprotein levels......-contraceptive compounds appear to be safe for women with previous GDM when administered for limited periods. At the follow-up examination, we found no increased risk of developing diabetes in women with previous GDM who used oral contraception. We consider the intrauterine contraceptives (IUD) a safe and effective......Women with gestational diabetes mellitus (GDM) diagnosed in the period 1978-1984 were followed for on average 6 yr after the index pregnancy. Thirty percent had diabetes mellitus at the follow-up examination, and preliminary results indicate that at least another third will develop diabetes during...

  8. The Catholic Bishops vs. the Contraceptive Mandate

    Directory of Open Access Journals (Sweden)

    Leslie C. Griffin


    Full Text Available The Roman Catholic bishops of the United States have publicly opposed artificial contraception since they first issued a public statement condemning it in 1919. Thereafter, the bishops were generally unsuccessful in persuading the public that contraceptive access should be restricted. Recently, however, the bishops succeeded in a campaign to restrict access to contraceptives for Catholic and non-Catholic women alike. Their lobbying and public criticism of the contraceptive mandate of the Affordable Care Act (ACA, which requires employer health plans to offer preventive reproductive care coverage, forced Obama administration officials into a series of accommodations that gutted portions of the law intended to provide contraception to employees without copayment or cost sharing. In contrast to their earlier efforts to restrict reproductive freedom, the bishops successfully characterized their efforts against the ACA as a battle for religious freedom rather than against reproductive rights. This successful strategy may lead to future setbacks for women’s reproductive liberty.

  9. Preconception counseling and contraception after gestational diabetes

    DEFF Research Database (Denmark)

    Mølsted-Pedersen, L; Skouby, S O; Damm, P


    a subsequent pregnancy. Therefore, family planning and contraceptive guidance should follow the lines for women with pregestational diabetes. When low-dose hormonal contraceptives containing ethinyl estradiol and levonorgestrel were given to women with previous GDM, glucose tolerance and lipoprotein levels......Women with gestational diabetes mellitus (GDM) diagnosed in the period 1978-1984 were followed for on average 6 yr after the index pregnancy. Thirty percent had diabetes mellitus at the follow-up examination, and preliminary results indicate that at least another third will develop diabetes during......-contraceptive compounds appear to be safe for women with previous GDM when administered for limited periods. At the follow-up examination, we found no increased risk of developing diabetes in women with previous GDM who used oral contraception. We consider the intrauterine contraceptives (IUD) a safe and effective...

  10. Advances of Contraception in China

    Institute of Scientific and Technical Information of China (English)



    Family planning is an important component of reproductive health. Reduction in total fertility rate is closely related to the decrease of maternal and infant mortality rate and the advances in maternal and child health care. In the last two decades the reduction of total fertility rate from 5.6% in the 70s to 2. 5% in average at present occurs along with the decrease in maternal and infant mortality. This achievement should be attributed partly to the success in the development of contraceptive

  11. Marketing contraceptives in rural Thailand. (United States)

    Viravaidya, M


    It can be difficult to administer and motivate field workers in family planning programs. In the case of social marketing, the last distributors in the chain are small shopkeepers who keep part of the final sale price. Thus contraceptives become part and parcel of their routine business, and the margin becomes both their remuneration and their motivation. In Thailand and most other countries with social marketing programs, part of the selling price also returns to the program, providing some degree of cost recovery. As family planning succeeds and per capita incomes rise, individuals will be able to pay an increasing part of the total cost of family planning. In the interim, international agencies and governments will continue to provide subsidies. In rural countries like Thailand, social marketing programs can be initiated and expanded relatively rapidly because they build on an existing infrastructure; they can also reach the most distant parts of the country. Skills of local advertising agencies are available in practically all Third World countries. Sales are a reliable record of progress and can be used to suggest innovations or practical solutions to problems. Small shopkeepers often feel more comfortable vending contraceptives than many experts would expect and as members of the community, intuitively know what the community's standards are. Individuals handling oral contraceptives often require some training and supervision by full-time staff who can answer questions that arise; local physicians may also be notified of the program for referral of problem cases. If there is a problem with social marketing programs, it is that they are sometimes too successful--leading to large bills for contraceptive commodities. However, if evaluated in terms of cost-effectiveness, they are less expensive than their alternatives. Along with access to voluntary sterilization and community-based distribution programs, social marketing is a keystone in the arch of family

  12. Vaginal yeast flora of pregnant women in the Cusco region of Peru. (United States)

    Vidotto, V; Guevara Ochoa, L; Ponce, L M; Tello, G M; Prada, G R; Bruatto, M


    A study of the vaginal yeast flora in pregnant women living in Cusco and in its region (Peru), located approximately 3000 m above sea level, is reported. We observed 300 pregnant, healthy and non-diabetic women who attended a gynaecological clinic in the Lorena, Regional or IPSS (Instituto Peruano de Seguridad Social) hospitals in Cusco. A comprehensive clinical history was obtained from each patient. It included age, work, parity, time of pregnancy, use of contraceptives or antibiotics, type of vaginal symptoms, type and amount of vaginal secretion. The yeasts were isolated from 44.3% of the cases. The positive cases were more frequently found in the following categories: 20-30 year-old patients (69.2%), ninth month of pregnancy (49.6%), first pregnancy (41.4%), no delivery (58.7%) and no abortion (66.9%). Most women complained of leukorrhea (75.9%) with mucus, scarce without odour (18.8%) or lumpy, regular, without odour (15.8%) secretion. The yeasts isolated were Candida albicans (66.2%), other Candida species (12.8%), Torulopsis glabrata (8.3%) or other Torulopsis species (2.2%), Saccharomyces cerevisiae (7.5%), Rhodotorula sp. (1.5%) and Trichosporon cutaneum (1.5%).

  13. Unmet need of contraception: a critical juncture toward family planning goals. (United States)

    Haldar, Dibakar; Saha, Indranil; Paul, Bobby; Mukherjee, Abhijit; Ray, Tapobrata Guha


    India is the first country in the world to implement a family planning program, and this program has succeeded in generating universal knowledge about family planning methods. In spite of this, there exists a wide gap between knowledge and acceptance of family planning methods reflecting an unmet need for contraception. Different communication channels used to disseminate knowledge like television, radio, and newspapers aim to change the family planning methods. Being a didactic method, these have the least potential to change the attitudes of the people. This article represents the tip of the iceberg of the fate arising out of incomplete information provided through mass media not supported by a formal family planning program. One primipara woman after getting pregnant took an emergency contraceptive pill and attended a clinic with vaginal bleeding, abdominal pain, and pallor. Ultimately she underwent suction evacuation and survived. This indicates that mass media should not be a substitute, but rather a supplement to the routine program of the health worker to promote contraception.

  14. Value of bacterial culture of vaginal swabs in diagnosis of vaginal infections

    Directory of Open Access Journals (Sweden)

    Nenadić Dane


    Full Text Available Bacground/Aim. Vaginal and cervical swab culture is still very common procedure in our country’s everyday practice whereas simple and rapid diagnostic methods have been very rarely used. The aim of this study was to show that the employment of simple and rapid diagnostic tools [vaginal fluid wet mount microscopy (VFWMM, vaginal pH and potassium hydroxide (KOH test] offers better assessment of vaginal environment than standard microbiologic culture commonly used in Serbia. Methods. This prospective study included 505 asymptomatic pregnant women undergoing VFWMM, test with 10% KOH, determination of vaginal pH and standard culture of cervicovaginal swabs. Combining findings from the procedures was used to make diagnoses of bacterial vaginosis (BV and vaginitis. In addition, the number of polymorphonuclear leukocytes (PMN was determined in each sample and analyzed along with other findings. Infections with Candida albicans and Trichomonas vaginalis were confirmed or excluded by microscopic examination. Results. In 36 (6% patients cervicovaginal swab cultures retrieved several aerobes and facultative anaerobes, whereas in 52 (11% women Candida albicans was isolated. Based on VFWMM findings and clinical criteria 96 (19% women had BV, 19 (4% vaginitis, and 72 (14% candidiasis. Of 115 women with BV and vaginitis, pH 4.5 was found in 5, and of 390 with normal findings 83 (21% had vaginal pH 4.5. Elevated numbers of PMN were found in 154 (30% women - in 83 (54% of them VFWMM was normal. Specificity and sensitivity of KOH test and vaginal pH determination in defining pathological vaginal flora were 95% and 81%, and 79% and 91%, respectively. Conclusion. Cervicovaginal swab culture is expensive but almost non-informative test in clinical practice. The use of simpler and rapid methods as vaginal fluid wet mount microscopy, KOH test and vaginal pH offers better results in diagnosis, and probably in the treatment and prevention of sequels of vaginal

  15. Dermatologic causes of vaginitis: a clinical review. (United States)

    Edwards, Libby


    The concept of vaginitis is widely accepted. Most physicians assume that vaginitis represents an infection, with nearly all vaginal complaints diagnosed as Candidiasis, bacterial vaginosis, or trichomonas. However, like the mouth, the vagina is covered with squamous epithelium, and therefore affected by various dermatoses. Some dermatoses prominently affect mucous membranes, such as lichen planus, pemphigus vulgaris, cicatricial pemphigoid, and blistering forms of erythema multiforme. In addition, some dermatoses affect only the vagina, including desquamative inflammatory vaginitis and atrophic vaginitis. The diagnosis and management of these diseases are hampered by the difficulty of visualizing the vagina, and the lack of medications other than antimicrobials available for use in the vagina. Copyright © 2010. Published by Elsevier Inc.

  16. Evaluation of the spermicidal and contraceptive activity of Platycodin D, a Saponin from Platycodon grandiflorum.

    Directory of Open Access Journals (Sweden)

    Zongliang Lu

    Full Text Available BACKGROUND: The extract of Platycodon grandiflorum has been reported to have effective spermicidal activity. This study was designed to evaluate the spermicidal and contraceptive activity, as well as the safety, of Platycodin D (PD, a major saponin in Platycodon grandiflorum. METHODS: Using the computer-aided sperm analysis (CASA test criteria, the sperm-immobilizing activity of PD was studied using highly motile human sperm. The sperm viability was assessed by fluorescent staining using SYBR-14 (living sperm and propidium iodide (dead sperm. The sperm membrane integrity was assessed by evaluating the hypo-osmotic swelling (HOS and examinations by transmission electron microscopy (TEM and scanning electron microscopy (SEM. The in vivo contraceptive efficacy was evaluated in rats using post-intrauterine PD application. The comet assay was employed to determine whether PD caused DNA damage in the sperm. Vaginal biopsies were also performed to determine whether the PD gel induced vaginal inflammation. RESULTS: A dose-dependent effect of PD on the sperm motility and viability was observed. The maximum spermicidal effect was observed with a 0.25 mM concentration of PD. More than 70% of the PD-treated sperm lost their HOS responsiveness at a concentration of 0.20 mM PD, indicating that PD caused injury to the sperm plasma membrane. TEM and SEM revealed significant damage to both the head and tail membranes of the sperm. PD decreased the fertility to zero in rats, was non-DNA damaging and was not harmful to the vaginal tissue in the rats. CONCLUSION: PD has significant spermicidal activity that should be explored in further studies.

  17. [Resistance and compliance to contraception in adolescents]. (United States)

    Pichot, F; Dayan-lintzer, M


    Although inadequate information on sex and contraception is frequently believed to account for contraceptive failure in adolescents, other factors including resistence to contraception or poor compliance with method requirements have been invoked to explain contraceptive failures in well-informed adolescents. Sexual relations are beginning at ever-younger ages in France; a 1980 survey indicated that 50% had their 1st sexual relations before age 17. Sexual activity is sporadic and irregular but usually occurs with the same partner. At least 50% of 1st sexual relations are unprotected by contraception, and half of adolescent pregnancies occur in the 1st 6th months of sexual activity. 6-12 months pass on average before sexually active adolescents begin to use contraception. Rates of pregnancy and abortion have increased especially among adolescents under 16, and in 1979 almost 20% of all abortions were in women under 20 years old. In 1980, only 20% of adolescents used contraception, with 17.3% using oral contraceptives. Few statistics exist on the complex phenomenon of conscious or subconscious contraceptive resistence in adolescence, and clinical experience serves as a better guide. A frequent attitude among adolescents is that sexual relations should be spontaneous and romantic, traits viewed as incompatible with contraception. "Magical thinking", failure to appreciate the real risk of pregnancy, and dissociation of sex and pregnancy are common. Adolescents who doubt their fecundity may engage in unprotected relations to reassure themselves, while some seeking to assert their femininity may use pills although they have no need for contraception. Guilt and ambivalence may be unconscious motivations for poor contraceptive use. Young girls in cold, uncaring, neglectful, or conflict-ridden homes may seek affection from a sexual partner and wish to have a baby to demonstrate their attachment. Such situations often lead to well-accepted pregnancies and may also

  18. Efficacy and safety of the new antiandrogenic oral contraceptive Belara. (United States)

    Zahradnik, H P; Goldberg, J; Andreas, J O


    The aim of this open, noncontrolled phase III study was the assessment of the contraceptive efficacy and the evaluation of the safety of long-term use of Belara (30 micrograms ethinyl estradiol plus 2 mg chlormadinone acetate). Furthermore, cycle stability during administration of Belara and the influence of Belara on acne and seborrhea as clinical signs of androgenization were observed. Belara was taken by 1655 women for a total of 22,337 cycles. For the theoretical Pearl index, a value of 0.269 (95% CI [0.109, 0.600]) was calculated. In 1655 of 22,337 cycles (7.4%), no withdrawal bleeding was documented, whereas in 2565 of 22,308 cycles (11.5%), spottings and, in 786 of 22,308 cycles (3.5%), breakthrough bleeding occurred. After the intake of Belara for 12 cycles, acne on the face/neck improved in 64.1% of the women (209 of 326). In 53.4% of the women (175 of 326), acne disappeared completely. Seborrhea improved after 12 cycles in 89 of 131 women (67.9%), of whom 76 women (58.0%) were completely cured. Sixty-two serious adverse events (SAE) occurred in 59 of 1655 women. Accidents and injuries of the musculoskeletal system were the SAE with the highest incidence (0.66%). Two cases of deep venous thrombosis, one pulmonary embolism, and two cases of visual disturbances were observed. Only for the two cases of deep venous thrombosis could a relation to Belara be assumed. Of the adverse events commonly reported for oral contraceptives, headache was observed for the first time under study medication in 37.4%, nausea in 23.1%, breast tenderness in 21.7%, and vaginal discharge in 19.4% of the women. The frequency of adverse events decreased with longer duration of a drug consisting of intake of Belara. In conclusion, Belara can be described as an effective and safe oral contraceptive with marked antiandrogenic properties.

  19. Name that Contraceptive! A Game for the Human Sexuality Classroom (United States)

    Rosenthal, Martha S.


    There are many contraceptive choices available to people today. Learning about them can be dry, but the game "Name that Contraceptive!" can be a fun and interactive way to review, remember, and retain the details about contraceptive options. Name that Contraceptive is a card game in which students "bid" on the number of clues it will take them to…

  20. The Contraceptive Needs for STD Protection among Women in Jail (United States)

    Oswalt, Krista; Hale, Galen J.; Cropsey, Karen L.; Villalobos, Gabriella C.; Ivey, Sara E.; Matthews, Catherine A.


    We assessed the contraceptive needs of women in jails and their sexually transmitted disease (STD) history and risk to determine effective contraceptive methods for this population. A survey of demographics, sexual health, contraceptive use, and preferred method of contraception was completed by participants recruited at jails in a medium-sized…

  1. The Contraceptive Needs for STD Protection among Women in Jail (United States)

    Oswalt, Krista; Hale, Galen J.; Cropsey, Karen L.; Villalobos, Gabriella C.; Ivey, Sara E.; Matthews, Catherine A.


    We assessed the contraceptive needs of women in jails and their sexually transmitted disease (STD) history and risk to determine effective contraceptive methods for this population. A survey of demographics, sexual health, contraceptive use, and preferred method of contraception was completed by participants recruited at jails in a medium-sized…

  2. Males and Morals: Teenage Contraceptive Behavior Amid the Double Standard (United States)

    Scales, Peter


    This paper reviews literature on teenage contraceptive behavior and teenage contraceptive decision making. The paper describes the persistence of a sexual double standard in terms of moral motivation to use contraception and in terms of the relative lack of communication about contraception among young partners. (Author)

  3. The Male Role in Contraception: Implications for Health Education. (United States)

    Chng, Chwee Lye


    Many males still perceive contraception as a woman's responsibility. This paper describes male contraceptives and their effectiveness and draws implications for school and community health education professionals. More equitable sharing of the responsibility for contraception might result in more effective contraception. (PP)

  4. Adolescent women's contraceptive decision making. (United States)

    Weisman, C S; Plichta, S; Nathanson, C A; Chase, G A; Ensminger, M E; Robinson, J C


    A modified rational decision model incorporating salient events and social influences (particularly from sexual partners) is used to analyze adolescent women's consistent use of oral contraceptives (OCs) over a six-month period. Data are taken from a panel study of 308 clients of an inner-city family planning clinic. Expected OC use was computed for each subject on the basis of subjective expected utility (SEU) theory, and is found in multivariate analyses to be a significant predictor of actual OC use. In addition, variables representing baseline and follow-up partner influences, the salience of pregnancy for the subject, and positive side effects of OCs during the first months of use are found to predict OC use. Partner's support of OC use during follow-up and positive side effects of OCs are found to predict OC use among subjects for whom OC use was not the expected decision according to baseline SEU. Implications of the findings for models of adolescents' contraceptive behavior and for clinicians are discussed.

  5. Emergency Contraception – An Overview

    Directory of Open Access Journals (Sweden)

    Berger C


    Full Text Available The ability to control fertility through the use of effective and safe contraception is essential in preventive medicine. EC offers a second chance to prevent an unwanted pregnancy after the event of an UPSI, contraceptive failure or after rape. Health care providers should routinely and more frequently recognize and inform women about the risk of an unintended pregnancy and EC options to avoid this and women should be provided the correct information about the mechanism of action of various EC options. Lack of knowledge on the mechanisms of action obstructs wide spread access and use globally. Currently, the three most commonly licensed methods of EC are insertion of a Cu-IUD or the hormonal pills UPA 30 mg or LNG 1.5 mg. All EC methods are safe with almost no contraindications and minimal side effects. Considering that ovulation and the fertile window are difficult to assess, it is recommended that EC is administered after an UPSI, regardless of cycle With an extremely low failure rate, the Cu-IUD is an attractive option for EC regardless of the woman’s weight or concomitant medication and has the additional propensity to serve as a long-term contraceptive after insertion including if further acts of UPSI should take place in the same cycle. A Cu-IUD inserted within 5 days after ovulation, or when not known 5 days after UPSI, should be the first method of choice if available and suitable. The additional post-ovulatory effect makes the Cu-IUD a superior EC Of the available hormonal EC treatments, UPA 30 mg should be the first choice being the most effective option with a wider window of effect than LNG. UPA has the ability to delay or inhibit ovulation beyond the life span of sperm even when given at an advanced follicular phase when the risk of pregnancy is high. In comparison, LNG has a narrower window of effect on ovulation with no effect after LH has started to rise, but LNG in a dose of 1.5 mg is recommended where UPA is

  6. The Current Status of Oral Contraceptives: Progress and Recent Innovations. (United States)

    Golobof, Alexandra; Kiley, Jessica


    Millions of women in the United States and abroad use oral contraceptive pills. These popular contraceptives are the most common reversible birth control method in the United States, and a wide variety of pills are available for prescription. Oral contraceptives provide safe and effective protection against pregnancy and offer several noncontraceptive benefits. Over the years, advances in the laboratory and knowledge gained through epidemiologic data promoted the development of new contraceptive preparations. Generations of oral contraceptives emerged over time, containing lower doses of estrogens and new and novel progestins. The current review discusses the clinical characteristics of oral contraceptives, with emphasis on basic pharmacology and the evolution of various contraceptive formulations and regimens.

  7. A large primary vaginal calculus in a woman with paraplegia. (United States)

    Avsar, Ayse Filiz; Keskin, Huseyin Levent; Catma, Tuba; Kaya, Basak; Sivaslioglu, Ahmet Akın


    The study aimed to report a primary vaginal stone, an extremely rare entity, without vesicovaginal fistula in a woman with disability. We describe the case of a large primary vaginal calculus in a 22-year-old woman with paraplegia, which, surprisingly, was not diagnosed until she was examined under general anesthesia during a preparation for laparoscopy for an adnexal mass. The stone had not been identified by physical examination with the patient in a recumbent position or by transabdominal ultrasonography and pelvic tomography during the preoperative preparation. Vaginoscopy was not performed because the vagina was completely filled with the mass. As a result of its size and hard consistency, a right-sided episiotomy was performed and a 136-g stone was removed using ring forceps. A vesicovaginal fistula was excluded. There was no evidence of a foreign body or other nidus on the cut section of the stone, and it was determined to be composed of 100% struvite (ammonium magnesium phosphate). Culture of urine obtained via catheter showed Escherichia coli. After the surgical removal of the calculus without complications, a program of intermittent catheterization was started. The follow-up period was uneventful, and the patient was symptom free at 6 months after the operation. We postulate that the calculus formed as a consequence of urinary contamination of the vagina in association with incontinence and prolonged maintenance in a recumbent posture. This report is important because it highlights that, although vaginal stones are very rare, their possibility should be considered in the differential diagnosis of individuals with long-term paraplegia.

  8. Microbial colonization of tailed and tailless intrauterine contraceptive devices: influence of the mode of insertion in the rabbit. (United States)

    Jacques, M; Olson, M E; Costerton, J W


    An experimental rabbit model was developed to study the microbial colonization of intrauterine contraceptive devices. Tailed and tailless devices were surgically inserted into into the uterus by two different routes: surgically, directly into the uterine horn, thus avoiding contact with the vaginal and cervical microfloras, or via the vagina and cervix. After 1 to 8 weeks the devices were recovered and prepared for scanning electron microscopy. The surfaces of surgically inserted devices remained uncolonized all through the experiment whereas in those inserted via the cervix microorganisms colonized the core surface as early as 2 weeks after insertion. Our data suggest that in our experimental conditions the mode of insertion appears to be the major factor influencing the microbial colonization of intrauterine contraceptive devices and that the presence of a tail does not seem to play a significant role.

  9. Controversies in contraception for women with epilepsy

    Directory of Open Access Journals (Sweden)

    Sanjeev V Thomas


    Full Text Available Contraception is an important choice that offers autonomy to women with regard to prevention of unintended pregnancies. There is wide variation in the contraceptive practices between continents, countries, and societies. The medical eligibility for contraception for sexually active women with epilepsy (WWE is determined by the type of anti-epileptic drugs (AEDs that they use. Enzyme inducing AEDs such as phenobarbitone, phenytoin, carbamazepine, and oxcarbazepine increase the metabolism of orally administered estrogen (and progesterone to a lesser extent. Estrogen can increase the metabolism of certain AEDs, such as lamotrigine, leading to cyclical variation in its blood level with resultant adverse effect profile or seizure dyscontrol. AEDs and sex hormones can increase the risk of osteoporosis and fracture in WWE. The potential interactions between AEDs and hormonal contraception need to be discussed with all women in reproductive age-group. The alternate options of oral contraception such as intrauterine copper device, intrauterine levonorgestrel release system, and supplementary protection with barriers need to be presented to them. World Health Organization has recommended to avoid combination contraceptive pills containing estrogen and progesteron in women who desire contraception and in breastfeeding mothers. Care providers need to consider the option of non-enzyme-inducing AEDs while initiating long-term treatment in adolescent and young WWE.

  10. Post-abortion contraception: care and practices

    Directory of Open Access Journals (Sweden)

    Ana Luiza Vilela Borges


    Full Text Available OBJECTIVE: to analyze assistance regarding contraception methods received by women during hospitalization due to abortion, and contraceptive practices the month after this episode.METHODS: a longitudinal study of women hospitalized due to abortion in a public hospital in the city of São Paulo. Face-to-face interviews (n=170 followed by telephone interviews in the subsequent month (n=147 were conducted between May and December of 2011.RESULTS: a small number of women reported they received guidance on, and prescription for, contraceptive methods at hospital discharge. A trend of statistical significance was identified for prescription of contraceptive methods at discharge and its use in the following month, when adjusted for age. Most women reported sexual intercourse (69.4% with the use of contraceptive method (82.4%, but no health professional guidance (63.1%.CONCLUSION: despite the fact that post-abortion contraception assistance was lower than the recommended guidelines by public health policies, women demonstrated willingness to use contraceptive methods.

  11. Controversies in contraception for women with epilepsy. (United States)

    Thomas, Sanjeev V


    Contraception is an important choice that offers autonomy to women with regard to prevention of unintended pregnancies. There is wide variation in the contraceptive practices between continents, countries, and societies. The medical eligibility for contraception for sexually active women with epilepsy (WWE) is determined by the type of anti-epileptic drugs (AEDs) that they use. Enzyme inducing AEDs such as phenobarbitone, phenytoin, carbamazepine, and oxcarbazepine increase the metabolism of orally administered estrogen (and progesterone to a lesser extent). Estrogen can increase the metabolism of certain AEDs, such as lamotrigine, leading to cyclical variation in its blood level with resultant adverse effect profile or seizure dyscontrol. AEDs and sex hormones can increase the risk of osteoporosis and fracture in WWE. The potential interactions between AEDs and hormonal contraception need to be discussed with all women in reproductive age-group. The alternate options of oral contraception such as intrauterine copper device, intrauterine levonorgestrel release system, and supplementary protection with barriers need to be presented to them. World Health Organization has recommended to avoid combination contraceptive pills containing estrogen and progesteron in women who desire contraception and in breastfeeding mothers. Care providers need to consider the option of non-enzyme-inducing AEDs while initiating long-term treatment in adolescent and young WWE.

  12. Contraception in diabetic women: an Italian study. (United States)

    Napoli, A; Colatrella, A; Botta, R; Di Cianni, G; Fresa, R; Gamba, S; Italia, S; Mannino, D; Piva, I; Suraci, C; Tonutti, L; Torlone, E; Tortul, C; Lapolla, A


    Over 1 year, a survey on contraception and obstetric history was performed on a cohort of 667 Caucasian fertile diabetic women (446, type 1 and 201, type 2) living in Italy. Of these women, 30.4% used hormonal contraceptives, 12.0% intra-uterine device (IUD), 10.7% declared they used no contraception, 47.0% only utilised barrier and/or natural methods. However, irrespective of their previous contraceptive strategy, 7.2% of all the studied population was surgically sterilized during caesarean section. Of these women, 60.4% was prescribed by a gynaecologist, 11.2% by a diabetologist, 15% by both of them and 13.4% by others. The proportion using oral contraception was similar among types 1 and 2 women (29.4% versus 27.8%, chi(2) = ns). Of women taking hormonal contraception, 30.0% were smokers. University graduates (37.1%), high school leaves (32.2%), secondary school (28.2%) and primary school leaves (15.5%) used oral contraceptives (OC). The mean number of deliveries was 1.14 +/- 1.1, of miscarriages was 1.3 +/- 0.7 and of induced abortions 0.17 +/- 0.5. Planning of at least one pregnancy was reported in 29.4% of patients.

  13. Survey of correlation factors for vaginal infection%阴道炎相关因素调查分析

    Institute of Scientific and Technical Information of China (English)

    王冰; 胡秀珍; 宋桂芹


    Objective To survey correlation factors for vaginal infection. Methods Selected 800 cases with vaginal infection as subjects. Morbidity of vaginal infection was surveyed. Correlation factors were analyzed by compared with 200 cases of healthy women. Results Multivariate regression analysis showed vaginal cleaning times, contraception, sexual health habits, spouse health habits were influencing factors of vaginal infection(P<0.05). Conclusion Good sexual health habits, usage of condom are effective methods for preventing vaginal infection.%  目的调查阴道炎的发病情况及其影响因素,为临床上的预防治疗提供依据。方法整群抽样我院妇科患者800例为调查对象,调查其中阴道炎的发病率,同时与进行妇科体检的育龄女性200例作为对比,分析影响阴道炎发病的相关因素。结果多因素回归分析结果显示阴道清洁次数、避孕方式、性卫生习惯、配偶卫生习惯是影响阴道炎发病的相关因素(P<0.05)。结论良好的个人卫生习惯,使用避孕套避孕是预防阴道炎的有效方法。

  14. Origami rings

    CERN Document Server

    Buhler, Joe; de Launey, Warwick; Graham, Ron


    Motivated by a question in origami, we consider sets of points in the complex plane constructed in the following way. Let $L_\\alpha(p)$ be the line in the complex plane through $p$ with angle $\\alpha$ (with respect to the real axis). Given a fixed collection $U$ of angles, let $\\RU$ be the points that can be obtained by starting with $0$ and $1$, and then recursively adding intersection points of the form $L_\\alpha(p) \\cap L_\\beta(q)$, where $p, q$ have been constructed already, and $\\alpha, \\beta$ are distinct angles in $U$. Our main result is that if $U$ is a group with at least three elements, then $\\RU$ is a subring of the complex plane, i.e., it is closed under complex addition and multiplication. This enables us to answer a specific question about origami folds: if $n \\ge 3$ and the allowable angles are the $n$ equally spaced angles $k\\pi/n$, $0 \\le k < n$, then $\\RU$ is the ring $\\Z[\\zeta_n]$ if $n$ is prime, and the ring $\\Z[1/n,\\zeta_{n}]$ if $n$ is not prime, where $\\zeta_n := \\exp(2\\pi i/n)$ is ...

  15. The mechanism of action of hormonal contraceptives and intrauterine contraceptive devices. (United States)

    Rivera, R; Yacobson, I; Grimes, D


    Modern hormonal contraceptives and intrauterine contraceptive devices have multiple biologic effects. Some of them may be the primary mechanism of contraceptive action, whereas others are secondary. For combined oral contraceptives and progestin-only methods, the main mechanisms are ovulation inhibition and changes in the cervical mucus that inhibit sperm penetration. The hormonal methods, particularly the low-dose progestin-only products and emergency contraceptive pills, have effects on the endometrium that, theoretically, could affect implantation. However, no scientific evidence indicates that prevention of implantation actually results from the use of these methods. Once pregnancy begins, none of these methods has an abortifacient action. The precise mechanism of intrauterine contraceptive devices is unclear. Current evidence indicates they exert their primary effect before fertilization, reducing the opportunity of sperm to fertilize an ovum.

  16. What impact has England's Teenage Pregnancy Strategy had on young people's knowledge of and access to contraceptive services? (United States)

    French, Rebecca S; Mercer, Catherine H; Kane, Roslyn; Kingori, Patricia; Stephenson, Judith M; Wilkinson, Paul; Grundy, Chris; Lachowycz, Kate; Jacklin, Paul; Stevens, Maryjane; Brooker, Sue; Wellings, Kaye


    To describe young people's knowledge and use of contraceptive services over initial stages of England's Teenage Pregnancy Strategy, and to investigate factors associated with use of different services. A random location sample of young people aged 13-21 years (n = 8879) was interviewed in 12 waves over 2000-2004. Individual data were analysed to investigate factors associated with knowledge and use of contraceptive services and to observe trends over time. Area-level data were analyzed to explore differences in key variables. In all, 77% of young women and 65% of young men surveyed knew a service they could use to obtain information about sex. Amongst those who had had vaginal sexual intercourse, the most common source of contraceptive supplies was general practice for young women (54%) and commercial venues for young men (54%). Young women's use of school-based services to obtain supplies increased significantly from 15.4% in Year 1 to 24.4% in Year 4, p < .001. Young men's use of the commercial sector declined significantly over the same time period (60.3% to 50.6%, p = .002), while their use of general practice and family planning clinics increased (from 8.9% to 12.4%, p = .008, and 21.2% to 29.1%, p = .054, respectively). Use of family planning clinics and designated young people's clinics was associated with first vaginal intercourse before the 16th birthday and living in a deprived area. Young people's patterns of contraceptive service use have changed since implementation of the Strategy; although no increase in overall service use was observed. The contribution of school-based services needs further exploration.

  17. Voluntary surgical contraception women of late reproductive age suffering from pelvic organ prolapse – features and benefits

    Directory of Open Access Journals (Sweden)

    Nigina Nasinova


    Full Text Available We have proposed the method of transvaginal Voluntary Surgical Contraception, conducted in conjunction with surgical treatment of descent and prolapse of the vaginal walls. Were studied the early and late results of the surgery in 50 women to which during the surgical treatment of genital prolapse simultaneously was carries out transvaginal occlusion of the fallopian tubes. Control groups consisted of 30 women to which in the first step before surgical correction of pelvic organ prolapse have been performed minilaparotomy and DCA. Our method consists in penetrating into the abdominal cavity through the front vaginal vault, to downgrade the fallopian tubes with a hook Ramatibodi and tubal sterilization method Pomeroy. Intra - and postoperative complications were not recognized. In the long-term period after surgery - the effectiveness of the method was 100%. Marked tendency to improve the quality of sexual life tells about the positive impact of removing the genital prolapse with simultaneous DCA on the quality of life of women.

  18. A comparative study of vaginal estrogen cream and sustained-release estradiol vaginal tablet (Vagifem in the treatment of atrophic vaginitis in Isfahan, Iran in 2010-2012

    Directory of Open Access Journals (Sweden)

    Pardis Hosseinzadeh


    Full Text Available Background: Atrophic vaginitis is a disease, which affects up to 50% of postmenopausal women. This study compared the effectiveness and user-friendliness of Vagifem (an estradiol vaginal tablet and vaginal estrogen cream in the treatment of atrophic vaginitis. Materials and Methods: One hundred and sixty postmenopausal women with symptoms of atrophic vaginitis were randomly divided into two groups of treatment with Vagifem or with vaginal estrogen cream for 12 weeks. Patients used the medication daily for the first 2 weeks of the study, and twice weekly. Severity of vaginal atrophy and four main symptoms of atrophic vaginitis including dysuria, dyspareunia, vaginal itching, and dryness were evaluated and compared before and after treatment. In addition, patients were asked regarding user-friendliness and hygienic issues of medications. Results: Both vaginal estrogen cream and Vagifem significantly improved symptoms of atrophic vaginitis but in terms of effectiveness for the treatment symptoms of atrophic vaginitis, there was no significant difference between the two medications. Vagifem compared to estrogen cream resulted in significantly lower rate of hygienic problems (0% versus 23%, P < 0.001, and was reported by the patients as a significantly easier method of treatment (90% versus 55%, P < 0.0001. Conclusion: This investigation showed that Vagifem is an appropriate medication for the treatment of atrophic vaginitis, which is as effective as vaginal estrogen creams and is more user-friendly.

  19. A comparative study of vaginal estrogen cream and sustained-release estradiol vaginal tablet (Vagifem) in the treatment of atrophic vaginitis in Isfahan, Iran in 2010-2012. (United States)

    Hosseinzadeh, Pardis; Ghahiri, Atallah; Daneshmand, Freshteh; Ghasemi, Mojdeh


    Atrophic vaginitis is a disease, which affects up to 50% of postmenopausal women. This study compared the effectiveness and user-friendliness of Vagifem (an estradiol vaginal tablet) and vaginal estrogen cream in the treatment of atrophic vaginitis. One hundred and sixty postmenopausal women with symptoms of atrophic vaginitis were randomly divided into two groups of treatment with Vagifem or with vaginal estrogen cream for 12 weeks. Patients used the medication daily for the first 2 weeks of the study, and twice weekly. Severity of vaginal atrophy and four main symptoms of atrophic vaginitis including dysuria, dyspareunia, vaginal itching, and dryness were evaluated and compared before and after treatment. In addition, patients were asked regarding user-friendliness and hygienic issues of medications. Both vaginal estrogen cream and Vagifem significantly improved symptoms of atrophic vaginitis but in terms of effectiveness for the treatment symptoms of atrophic vaginitis, there was no significant difference between the two medications. Vagifem compared to estrogen cream resulted in significantly lower rate of hygienic problems (0% versus 23%, P vaginitis, which is as effective as vaginal estrogen creams and is more user-friendly.

  20. Feminism and the Moral Imperative for Contraception. (United States)

    Espey, Eve


    This commentary is adapted from the Irvin M. Cushner Memorial Lecture, "Feminism and the Moral Imperative for Contraception," given at 2014 Annual Clinical Meeting of the American College of Obstetricians and Gynecologists in Chicago. It provides a brief and simplified historical review of the feminist movement, primarily in the United States, focusing on feminism's association with contraception. This commentary reflects the perspective and opinions of the author. Contraception is fundamental to a woman's ability to achieve equality and realize her full social, economic, and intellectual potential.

  1. Abortion and contraceptive practices in eastern Europe. (United States)

    Kovács, L


    In countries of the CCEE region (Countries of Central and Eastern Europe) the very high incidence of pregnancy termination is characteristic of family planning and the notion 'contraception instead of abortion' has not yet been achieved. The causes and consequences of this unfortunate situation will be reviewed: the reproductive health indicators in the area; the status of contraceptive use and of abortion; the impact of legislation in the different countries; and the efforts to achieve changes. The conclusions of the 'Szeged Declaration' which led to an increase in contraceptive prevalence will be discussed.

  2. Contraceptive failure in the United States. (United States)

    Trussell, James


    This review provides an update of previous estimates of first-year probabilities of contraceptive failure for all methods of contraception available in the United States. Estimates are provided of probabilities of failure during typical use (which includes both incorrect and inconsistent use) and during perfect use (correct and consistent use). The difference between these two probabilities reveals the consequences of imperfect use; it depends both on how unforgiving of imperfect use a method is and on how hard it is to use that method perfectly. These revisions reflect new research on contraceptive failure both during perfect use and during typical use.

  3. Contraception for women with diabetes mellitus

    DEFF Research Database (Denmark)

    Damm, Peter; Mathiesen, Elisabeth; Clausen, Tine Dalsgaard


    Planned pregnancy is mandatory in women with diabetes, and their need for contraception is essential. Basically, the same methods can be used as in women without diabetes, but a number of specific conditions have to be considered when guiding these women, as we discuss in this review. Unfortunately......, the field is limited in studies in certain areas, especially considering contraception for women with type 1 diabetes and late diabetic complications and women with type 2 diabetes. Thus, in the real clinical world, the choice of contraceptive often will be a kind of compromise, balancing pro and cons...

  4. Clinical Trials in Male Hormonal Contraception

    Directory of Open Access Journals (Sweden)

    Nieschlag E


    Full Text Available Research has established the principle of hormonal male contraception based on suppression of gonadotropins and spermatogenesis. All hormonal male contraceptives use testosterone, but only in East Asian men can testosterone alone suppress spermatogenesis to a level compatible with contraceptive protection. In Caucasians, additional agents are required of which progestins are favored. Clinical trials concentrate on testosterone combined with norethisterone, desogestrel, etonogestrel or depot-medroxyprogesterone acetate. The first randomized, placebo-controlled clinical trial performed by the pharmaceutical industry demonstrated the effectiveness of a combination of testosterone undecanoate and etonogestrel in suppressing spermatogenesis in volunteers.

  5. Contraception for women with diabetes mellitus

    DEFF Research Database (Denmark)

    Damm, Peter; Mathiesen, Elisabeth; Clausen, Tine Dalsgaard


    Planned pregnancy is mandatory in women with diabetes, and their need for contraception is essential. Basically, the same methods can be used as in women without diabetes, but a number of specific conditions have to be considered when guiding these women, as we discuss in this review. Unfortunately......, the field is limited in studies in certain areas, especially considering contraception for women with type 1 diabetes and late diabetic complications and women with type 2 diabetes. Thus, in the real clinical world, the choice of contraceptive often will be a kind of compromise, balancing pro and cons...

  6. Chlamydial salpingitis in female guinea pigs receiving oral contraceptives. (United States)

    Barron, A L; Pasley, J N; Rank, R G; White, H J; Mrak, R E


    Female guinea pigs were given daily doses of a combination of oral contraceptive (OC) agents, consisting of mestranol and norethynodrel suspended in sesame oil or distilled H2O, and were infected in the genital tract with the chlamydial agent of guinea pig inclusion conjunctivitis (GPIC). Counts of chlamydial inclusions in cells of vaginal smears collected during infection, showed prolongation and enhancement of infection in OC-treated animals as compared with controls. Appearance of IgG and IgA antibodies to GPIC in genital secretions, as determined by enzyme-linked immunosorbent assay (ELISA), was also delayed in OC-treated animals as compared with controls. OC-treated infected animals were killed on days 15 and 43, and gross pathological evidence for ascending infection culminating in salpingitis was found in all of five and four of five animals, respectively. On the other hand, among untreated infected controls on each sacrifice day, only one of five animals had any evidence for ascending infection. Chlamydiae were detected by light and electron microscopy in fallopian tube tissue collected on day 15 following OC-treatment but not in tissue from control animals.

  7. Endometrial safety of ultra-low-dose estradiol vaginal tablets

    DEFF Research Database (Denmark)

    Simon, James; Nachtigall, Lila; Ulrich, Lian G;


    To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17ß-estradiol vaginal tablets in postmenopausal women with vaginal atrophy.......To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17ß-estradiol vaginal tablets in postmenopausal women with vaginal atrophy....

  8. Endometrial safety of ultra-low-dose estradiol vaginal tablets

    DEFF Research Database (Denmark)

    Simon, James; Nachtigall, Lila; Ulrich, Lian G;


    To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17β-estradiol vaginal tablets in postmenopausal women with vaginal atrophy.......To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17β-estradiol vaginal tablets in postmenopausal women with vaginal atrophy....

  9. Pyometra and complete vaginal adhesion in a miniature horse (United States)

    Cozens, Elizabeth R.W.


    A 4-year-old miniature horse experienced intermittent episodes of pyrexia, lethargy, and purulent vaginal discharge following dsytocia. Vaginal endoscopy and transrectal ultrasonography revealed a blind-ending vaginal cavity and distended uterus. Surgical treatment was declined and the mare was euthanized. Post-mortem examination confirmed the diagnosis of pyometra and vaginal adhesions. PMID:19949560

  10. The Role of Contraceptive Attributes in Women’s Contraceptive Decision Making (United States)

    Madden, Tessa; Secura, Gina M.; Nease, Robert; Politi, Mary; Peipert, Jeffrey F.


    Objective Contraceptive methods have differing attributes. Women’s preferences for these attributes may influence contraceptive decision making. Our objective was to identify women’s contraceptive preferences among women initiating a new contraceptive method. Study Design We conducted a cross-sectional, self-administered survey of women’s contraceptive preferences at the time of enrollment into the Contraceptive CHOICE Project. Participants were asked to rank the importance of 15 contraceptive attributes on a three-point scale (1=”not at all important,” 2=”somewhat important,” and “3=very important”) and then to rank the 3 attributes that were the most important when choosing a contraceptive method. The survey also contained questions about prior contraceptive experience and barriers to contraceptive use. Information about demographic and reproductive characteristics was collected through the CHOICE Project baseline survey. Results There were 2,590 women who completed the survey. Our sample was racially and socioeconomically diverse. Method attributes with the highest importance score were effectiveness (mean score 2.97 [standard deviation 0.18]), safety (2.96 [0.22]), affordability (2.61 [0.61]), whether the method is long-lasting (2.58 [0.61]), and whether the method is “forgettable” (2.54 [0.66]). The attributes most likely to be ranked by respondents among the top three attributes included effectiveness (80.5%), safety (64.8%) and side effects of the method (42.7%). Conclusion Multiple contraceptive attributes influence decision making and no single attribute drives most women’s decisions. Tailoring communication and helping women make complex trade offs between attributes can better support their contraceptive decisions and may assist them in making value-consistent choices. This process could improve continuation and satisfaction. PMID:25644443

  11. Students' perceptions of contraceptives in university of ghana.

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    Nana Nimo Appiah-Agyekum


    Full Text Available This study sought to explore University of Ghana Business School diploma student's knowledge of contraceptives, types of contraceptives, attitudes towards contraceptive users, preference for contraceptives, benefits, and side-effects of contraceptives.Data was conducted with three sets of focus group discussions. Participants were systematically sampled from accounting and public administration departments.Findings showed that students had little knowledge of contraceptives. The male and female condoms were the main contraceptive types reported out of the many modern and traditional methods of contraceptives. The main benefits of contraceptives were; ability to protect against STIs, abortions, unwanted pregnancy and psychological trauma. Whilst most respondents preferred future use of pills, side-effects of contraceptives were mostly reported for condoms than other contraceptive methods. Results showed that participants had bad attitudes towards unmarried contraceptive users.Generally, our findings show that detailed knowledge about contraceptives is low. There is a little gap of information on contraception knowledge, timing, and contraceptive types among university diploma students. Reproductive and maternal services should be available and accessible for tertiary students.

  12. Proinflammatory Cytokines as Regulators of Vaginal Microbiota. (United States)

    Kremleva, E A; Sgibnev, A V


    It was shown that IL-1β, IL-8, and IL-6 in concentrations similar to those in the vagina of healthy women stimulated the growth of normal microflora (Lactobacillus spp.) and suppressed the growth and biofilm production by S. aureus and E. coli. On the contrary, these cytokines in higher concentrations typical of vaginal dysbiosis suppressed normal microflora and stimulated the growth of opportunistic microorganisms. TGF-β1 in both doses produced a stimulating effects on study vaginal microsymbionts. It is hypothesized that pro-inflammatory cytokines serve as the molecules of interspecies communication coordinating the interactions of all components of the vaginal symbiotic system.

  13. Bilateral hydronephrosis caused by vaginal prolapse

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    Helio Begliomini


    Full Text Available INTRODUCTION: Even though it is uncommon, uterine prolapse can cause compression of ureters and bilateral hydronephrosis, predisposing to arterial hypertension and renal failure. Hydronephrosis consequent to cystocele and to vaginal prolapse is even rarer. CASE REPORT: This paper reports on a 59 year-old patient, Caucasian, obese and hysterectomized who presented complete vaginal prolapse with bilateral hydronephrosis and slight alteration in serum urea and creatinine. Patient underwent correction of vaginal prolapse by endoscopic suspension technique with improvement of hydronephrosis and normalization of renal function. This work emphasizes the rarity of such case and the requirement of surgical approach.

  14. Pudendal nerve block for vaginal birth. (United States)

    Anderson, Deborah


    Pudendal nerve block is a safe and effective pain relief method for vaginal birth. Providing analgesia to the vulva and anus, it is used for operative vaginal birth and subsequent repair, late second stage pain relief with spontaneous vaginal birth, repair of complex lacerations, or repair of lacerations in women who are unable to achieve adequate or satisfactory pain relief during perineal repair with local anesthesia. Key to its efficacy is the knowledge of pudendal nerve anatomy, the optimal point of infiltration of local anesthetic, and an understanding of the amount of time necessary to effect adequate analgesia.

  15. Mifepristone 5 mg versus 10 mg for emergency contraception: double-blind randomized clinical trial

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    Carbonell JL


    Full Text Available Josep Lluis Carbonell,1 Ramon Garcia,2 Adriana Gonzalez,2 Andres Breto,2 Carlos Sanchez2 1Mediterranea Medica Clinic, Valencia, Spain; 2Eusebio Hernandez Gynecology and Obstetrics Teaching Hospital, Havana, Cuba Purpose: To estimate the efficacy and safety of 5 mg and 10 mg mifepristone for emergency contraception up to 144 hours after unprotected coitus. Methods: This double-blind randomized clinical trial was carried out at Eusebio Hernandez Hospital (Havana, Cuba. A total of 2,418 women who requested emergency contraception after unprotected coitus received either 5 mg or 10 mg mifepristone. The variables for assessing efficacy were the pregnancies that occurred and the fraction of pregnancies that were prevented. Other variables assessed were the side effects of mifepristone, vaginal bleeding, and changes in the date of the following menstruation. Results: There were 15/1,206 (1.2% and 9/1,212 (0.7% pregnancies in the 5 mg and 10 mg group, respectively (P=0.107. There were 88% and 93% prevented pregnancies in the 5 mg and 10 mg group, respectively. The side effect profiles were similar in both groups. Delayed menstruation ≥7 days was experienced by 4.9% and 11.0% of subjects in the 5 mg and 10 mg group, respectively (P=0.001. There was a significant high failure rate for women weighing >75 kg in the 5 mg group. Conclusion: It would be advisable to use the 10 mg dose of mifepristone for emergency contraception as there was a trend suggesting that the failure rate of the larger dose was lower. Keywords: mifepristone, emergency contraception

  16. Surgical removal of a large vaginal calculus formed after a tension-free vaginal tape procedure. (United States)

    Zilberlicht, Ariel; Feiner, Benjamin; Haya, Nir; Auslender, Ron; Abramov, Yoram


    Vaginal calculus is a rare disorder which has been reported in association with urethral diverticulum, urogenital sinus anomaly, bladder exstrophy and the tension-free vaginal tape (TVT) procedure. We report a 42-year-old woman who presented with persistent, intractable urinary tract infection (UTI) following a TVT procedure. Cystoscopy demonstrated an eroded tape with the formation of a bladder calculus, and the patient underwent laser cystolithotripsy and cystoscopic resection of the tape. Following this procedure, her UTI completely resolved and she remained asymptomatic for several years. Seven years later she presented with a solid vaginal mass. Pelvic examination followed by transvaginal ultrasonography and magnetic resonance imaging demonstrated a large vaginal calculus located at the lower third of the anterior vaginal wall adjacent to the bladder neck. This video presents the transvaginal excision and removal of the vaginal calculus.

  17. Pharmacist interest in and attitudes toward direct pharmacy access to hormonal contraception in the United States. (United States)

    Landau, Sharon; Besinque, Kathleen; Chung, Frances; Dries-Daffner, Ingrid; Maderas, Nicole Monastersky; McGhee, Belle Taylor; Foster, Diana Greene


    To assess pharmacist interest, comfort level, and perceived barriers regarding providing pharmacist-initiated access to hormonal contraceptives (i.e., tablets, patches, rings, injectables, emergency contraception [EC]). Descriptive, nonexperimental, cross-sectional study. United States between November 2004 and January 2005. 2,725 pharmacists working in community chain pharmacies (64%), community independent pharmacy (31%), and other practice settings, including hospitals and home care facilities (5%). Survey sent electronically by the American Pharmacists Association to a random sample of 14,142 of its 50,000 pharmacist members nationally. Pharmacist interest and comfort level in providing pharmacy access to hormonal contraception (HC), perceived barriers and training needs, and familiarity with and provision of EC. 2,725 survey responses (19% response rate) were received. Pharmacists reported being very familiar with HC. The majority of respondents were comfortable and interested in providing direct access to HC in the pharmacy. Perceived barriers to providing HC in the pharmacy included lack of time, no mechanism of reimbursement for the service, and possible resistance from physicians. Strong interest, comfort level, and capability from pharmacists, combined with a documented demand for direct pharmacy access from patients, indicate that pharmacy access to HC has the potential to meet patient needs and increase access to HC. Education about current clinical practice recommendations-which no longer require pelvic examinations and Papanicolaou (Pap) smears before hormonal contraception is initiated-may increase pharmacist support for providing hormonal methods directly.

  18. Vaginal dose point reporting in cervical cancer patients treated with combined 2D/3D external beam radiotherapy and 2D/3D brachytherapy. (United States)

    Westerveld, Henrike; Pötter, Richard; Berger, Daniel; Dankulchai, Pittaya; Dörr, Wolfgang; Sora, Mircea-Constantin; Pötter-Lang, Sarah; Kirisits, Christian


    Traditionally, vaginal dose points have been defined at the vaginal source level, thus not providing dose information for the entire vagina. Since reliable vaginal dose volume/surface histograms are unavailable, a strategy for comprehensive vaginal dose reporting for combined EBRT and BT was established and investigated. An anatomical vaginal reference point was defined at the level of the Posterior-Inferior Border of Symphysis (PIBS), plus two points ±2 cm (mid/introitus vagina). For BT extra points were selected for the upper vagina at 12/3/6/9 o'clock, at the vaginal surface and 5 mm depth. A vaginal reference length (VRL) was defined from ring centre to PIBS. Fifty-nine patients treated for cervical cancer were included in this retrospective feasibility study. The method was applicable to all patients. Total EQD2 doses at PIBS and ±2 cm were 36.7 Gy (3.1-68.2), 49.6 Gy (32.1-89.6) and 4.3 Gy (1.0-46.6). At the vaginal surface at ring level doses were respectively 266.1 Gy (67.6-814.5)/225.9 Gy (61.5-610.5) at 3/9 o'clock, and 85.1 Gy (55.4-140.3)/72.0 Gy (49.1-108.9) at 12/6 o'clock. Mean VRL on MRI was 5.6 cm (2.0-9.4). With this novel system, a comprehensive reporting of vaginal doses is feasible. The present study has demonstrated large dose variations between patients observed in all parts of the vagina, resulting from different contributions from EBRT and BT. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. Vaginal Calculus in a Woman With Mixed Urinary Incontinence and Vaginal Mesh Exposure. (United States)

    Winkelman, William D; Rabban, Joseph T; Korn, Abner P


    Vaginal calculi are extremely rare and are most commonly encountered in the setting of an urethrovaginal or vesicovaginal fistula. We present a case of a 72-year-old woman with mixed urinary incontinence and vaginal mesh exposure incidentally found to have a large vaginal calculus. We removed the calculus surgically and analyzed the components. Results demonstrated the presence of ammonium-magnesium phosphate hexahydrate and carbonate apatite.

  20. Vaginal atrophy in breast cancer survivors: role of vaginal estrogen therapy. (United States)

    Mariani, Luciano; Gadducci, Angiolo; Vizza, Enrico; Tomao, Silverio; Vici, Patrizia


    Early menopause and related vaginal atrophy is a well known side-effect of hormone adjuvant treatment in breast cancer patients, particularly during aromatase-inhibitors therapy. Due to estrogens contra-indication, proper therapy for such symptom remains often an inadequately addressed clinical problem. After an accurate assessment of the risk/benefit ratio, vaginal low-dose estrogen treatment (better with estriol) [corrected] may have a role in controlling vaginal atrophy in selected and informed breast cancer women.