Emergency contraception: which is the best?

Science.gov (United States)

Mittal, Suneeta

2016-12-01

Emergency contraception is a safe and effective method to prevent an unwanted pregnancy after an unprotected or inadequately protected sexual intercourse. Several methods for emergency contraception (EC) are currently registered in many countries for use in an emergency to prevent a pregnancy following an unprotected, possibly fertile intercourse or after a contraceptive accident like condom rupture. Different methods have varying modes of action, time frame of efficacy, dosage schedule and unwanted effects. Since several methods are available it is important to decide the best method. In this article the available literature on emergency contraception has been reviewed and an attempt has been made to discuss the need for emergency contraception and compare different options for emergency contraception in terms of their efficacy in pregnancy prevention, their safety profile and unwanted side effects. EC repeated use and initiating a regular method after EC use are also discussed. Emergency contraceptive methods include copper Intra-uterine devices (IUD) and different types of pills like estrogen progestin combination pill (Yuzpe Regimen), Progestin only pill (LNG), antiprogestin pill (Mifepristone), and progesterone modulator Uripristal Acetate (UPA). There is a marginal difference in the mechanism of action, efficacy including time frame and ability to protect from pregnancy with regular doses in obese women, drug interactions and side effects. These are discussed in detail. Copper IUD is the most effective emergency contraceptive with advantage of providing continued contraception. However, it cannot be used universally due to lack of infrastructure and a trained provider as well as not being suitable option for women at risk of sexually transmitted infections. Amongst different pills LNG is more effective with fewer side effects than Yuzpe regimen. LNG and UPA are comparable with similar efficacy and side effect profile. UPA has a wider window of efficacy, in

Efficacy of a combined contraceptive regimen consisting of condoms and emergency contraception pills.

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Zhao, Rui; Wu, Jun-Qing; Li, Yu-Yan; Zhou, Ying; Ji, Hong-Lei; Li, Yi-Ran

2014-04-14

To evaluate and compare the effectiveness of the combined regimen (consisting of condoms and emergency contraception pills (ECP)) and using condoms only for the purpose of preventing pregnancy. One-thousand-five-hundred-and-sixty-two (1,562) couples as volunteers enrolled at nine centers in Shanghai. Eight-hundred-and-twelve (812) were randomized to use male condoms and ECP (i.e., Levonorgestrel) as a back-up to condoms (the intervention group) and 750 to use male condoms only(the control group), according to their working unit. Participants were visited at admission and at the end of 1, 3, 6, 9, and 12 months. The cumulative life table rates were calculated for pregnancy and other reasons for discontinuation. The gross cumulative life table rates showed that the cumulative discontinuation rates for all reasons during the year of follow-up in the condoms plus emergency contraception group and the condoms only group were 7.76 ± 0.94 and 6.61 ± 0.91, respectively, per 100 women (χ2 = 0.41, p = 0.5227). The cumulative gross pregnancy rate of the condoms plus emergency contraception group and the condoms only group were 2.17 ± 0.52 and 1.25 ± 0.41, respectively, per 100 women (χ2 = 1.93, p = 0.1645). The Pearl Index in the condoms plus emergency contraception group and the condoms only group were 2.21% and 1.26%, respectively. Male condoms remain a highly effective contraceptive method for a period of one year while consistently and correctly used. In addition, the lowest pregnancy rate followed from perfect use condom.

Search for an Emergency Contraception Provider in the United States

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... emergency contraception provider. Concerned about cost? Click here . ---------- Emergency contraceptive pills are stocked by all major pharmacy chains, ... daily birth control pills you can use as emergency contraceptive pills. You can search for a provider in ...

Update on emergency contraception.

Science.gov (United States)

Fok, Wing Kay; Blumenthal, Paul D

2016-12-01

Emergency contraception provides a critical and time-sensitive opportunity for women to prevent undesired pregnancy after intercourse. Both access and available options for emergency contraception have changed over the last several years. Emergency contraceptive pills can be less effective in obese women. The maximum achieved serum concentration of levonorgestrel (LNG) is lower in obese women than women of normal BMI, and doubling the dose of LNG (3 mg) increases its concentration maximum, approximating the level in normal BMI women receiving one dose of LNG. Repeated use of both LNG and ulipristal acetate (UPA) is well tolerated. Hormonal contraception can be immediately started following LNG use, but should be delayed for 5 days after UPA use to avoid dampening the efficacy of UPA. The copper intrauterine device (IUD) is the only IUD approved for emergency contraception (and the most effective method of emergency contraception), but use of LNG IUD as emergency contraception is currently being investigated. Accurate knowledge about emergency contraception remains low both for patients and healthcare providers. Emergency contraception is an important yet underutilized tool available to women to prevent pregnancy. Current options including copper IUD and emergency contraceptive pills are safe and well tolerated. Significant gaps in knowledge of emergency contraception on both the provider and user level exist, as do barriers to expedient access of emergency contraception.

Emergency contraceptives bring a little peace of mind.

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Setty, V

1999-04-01

Although emergency contraceptive pills have been prescribed to US women since the discovery of the birth control pill, this regimen has been termed "America's best-kept secret." For fear of legal liability, many providers have been unwilling to prescribe oral contraceptive pills for a purpose other than that for which they are labeled on the packaging. There are indications, however, that access to emergency contraception in the US is improving. PREVEN, the first product to be approved by the US Food and Drug Administration specifically for emergency contraception, was released in 1998. The kit includes a step-by-step information booklet, a pregnancy test, and four birth control pills. In Washington State, collaborative drug agreements between volunteer pharmacists and licensed prescribers enable pharmacists to prescribe emergency contraception pills directly--a move that is estimated to have prevented 207 unintended pregnancies and 103 abortions in less than one year. Planned Parenthood has developed two programs to increase the use of emergency contraception. The first allows clinicians to discuss emergency contraception over the phone with clients (even new ones) and to call in prescriptions to local pharmacies; the second provides women with emergency contraceptive kits to keep on hand in advance of a need for the regimen.

Awareness and attitudes towards emergency contraceptive pills among young people in the entertainment places, Vientiane City, Lao PDR

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Sychareun, Vanphanom; Hansana, Visanou; Phengsavanh, Alongkone; Phongsavan, Keokedthong

2013-01-01

Background Emergency Contraception is not officially available to the public sector in Laos. The potential of emergency contraception to prevent unwanted pregnancies is well documented in developed countries, but in Laos no studies of ECPs exist. This study aimed to assess knowledge of and attitudes towards emergency contraceptive pills (ECPs) in Vientiane, the capital city of the Lao PDR. Methods A cross-sectional survey was conducted among 500 young adults in entertainment venues by using t...

Emergency Contraception: Do Your Patients Have a Plan B?

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Bullock, Holly; Salcedo, Jennifer

2015-12-01

Emergency contraception is used after unprotected sex, inadequately protected sex, or sexual assault to reduce the risk of pregnancy. Of emergency contraceptive methods available in the United States, the copper intrauterine device has the highest efficacy, followed by ulipristal acetate, levonorgestrel-containing emergency contraceptive pills, and the Yuzpe method. However, access to the most effective methods is limited. Although advanced prescription of emergency contraceptive pills and counseling on emergency contraception to all reproductive-aged women is recommended, women should be advised to contact their health care providers after taking emergency contraceptive pills to discuss possible copper intrauterine device placement and other follow-up. Copyright © 2015 Elsevier Inc. All rights reserved.

7. Emergency contraception

African Journals Online (AJOL)

Sitwala

individually on each day after satisfying the selection criteria. ... thought the pills can work up to a maximum of 24 hours. The main source of information was from friends (80%). ... 6 – 10 years .... emergency contraceptive pills among Swedish.

Usage patterns and attitudes towards emergency contraception: the International Emergency Contraception Research Initiative.

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Krassovics, Miklós; Virágh, Gabriella

2016-08-01

The aim of the survey was to gain understanding of women's usage patterns and attitudes towards emergency contraception (i.e., the 'morning after pill') and to gain insight into the role and attitudes of pharmacists as providers of emergency contraception. As part of the International Emergency Contraception Research Initiative, approximately 6500 women (15-49 years) and nearly 500 pharmacists from 14 countries in Western, Central and Eastern Europe, and Central Asia completed questionnaires via web-based interrogation or computer-assisted/paper-assisted personal interviews. Common to almost all countries and cultures was that, while awareness of emergency contraception was high (≥84% of respondents, except in Kazakhstan), usage was generally low (4-18%). In Austria, the Czech Republic, Spain, and the UK, better underlying protection with hormonal contraceptives or male condoms would have meant less need for emergency contraception. In Bulgaria, Lithuania, Romania, and Russia, greater dependence on less reliable contraceptive methods such as calendar + withdrawal was associated with higher use of the emergency contraceptive pill (11-18%) but also with higher abortion rates (19-21%). Overt rejection of emergency contraception in the event of an accident was low, except in countries (e.g., Austria, Poland) where the misperception that it acts as an abortifacient was common. Except for Bulgaria, pharmacists elsewhere tended to have limited knowledge and moralistic attitudes towards emergency contraception. Improved educational efforts, probably country-specific, are required to increase the use of highly effective methods of regular contraception and overcome barriers to acceptance of emergency contraception as a suitable postcoital solution to avoid unwanted pregnancy or abortion.

Emergency contraception: different bioethical perspectives

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Marco Bo

2007-10-01

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.

Ongoing contraception after use of emergency contraception from a specialist contraceptive service.

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Cameron, Sharon T; Glasier, Anna; Johnstone, Anne; Rae, Leanne

2011-10-01

A consultation for emergency contraception (EC) gives way to an opportunity to provide women with an ongoing effective method of contraception. A review of the case notes of women seeking EC from a large family planning clinic in Edinburgh, Scotland, was conducted to determine what percentage of women were provided with an effective method of ongoing contraception. Case notes of 460 women presenting for EC over a 2-year period were reviewed. Women were of mean age 26 years (range 15-49 years) and presented because they had used no contraception (47%), experienced condom failure (42%) or missed oral contraceptive pills (9%). Only 2% (n=11) were given an intrauterine device for EC. All women who had missed contraceptive pills prior to taking EC opted to continue this method. Only 23% (n=89) of women using no method or condoms at EC received supplies of an effective contraceptive method (pills, patch, injectable). Two thirds (n=263) of the women chose condoms for ongoing contraception. Research is required to develop strategies to improve the uptake of effective contraception after EC. Copyright © 2011 Elsevier Inc. All rights reserved.

Levonorgestrel emergency contraceptive pills use during breastfeeding; effect on infants' health and development.

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Shaaban, Omar M; Abbas, Ahmed M; Mahmoud, Hanaa R; Yones, Entsar M; Mahmoud, Ahmed; Zakherah, Mahmoud S

2018-02-20

The current study aims to evaluate the effect of the use of single packet of levonorgestrel emergency contraceptive pills (LNG-ECPs) during breastfeeding on the health and development of the nursing infant. The current study was an ancillary observational cohort study carried out in a university hospital. We counseled all women delivered and planning birth-space and breastfeed for at least 1 year for participation during postpartum hospital stay. Eligible participants for inclusion in the randomized controlled trial (NCT 01111929) were allocated to receive adequate Lactational Amenorrhea Method (LAM) counseling (LAM-only group) or the LAM counseling in addition to counseling about LNG-ECPs use (LAM + emergency contraception (EC) group). These pills were to be used once if unprotected intercourse did occur after expiry of any of the LAM prerequisites and before the couples started to use a reliable method of contraception. We included the first 100 women in the LAM + EC who did use the pills and the first 100 women in the control group who completed the follow-up visits for 6 months to draw the infants' outcome. The primary outcome was the difference of anthropometric measurements of the infants at 3 and 6 months postpartum. Secondary outcome was the difference in the Psycho-social, fine and gross motor, and language development using Denver development screening test. There were no statistical significant differences between both the groups regarding the infants' weight, length, head circumference, chest circumference, and mid-arm circumference at each visit (p > .05). Additionally, there were no statistically significant differences regarding all items (psycho-social, fine and gross motor, and language) of Denver development screening test between the infants in LAM-only and LAM + EC groups (p = .081). The use of single packet of LNG-ECPs during breastfeeding not objectively affects health and development of nursing infants or subjectively

A survey of knowledge, attitudes and practice of emergency contraception among university students in Cameroon

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Kouam Luc

2007-07-01

Full Text Available Abstract Background Unsafe abortion is a major public health problem in low-and-middle income countries. Young and unmarried women constitute a high risk group for unsafe abortions. It has been estimated that widespread use of emergency contraception may significantly reduce the number of abortion-related morbidity and mortality. The purpose of this study was to evaluate the knowledge, attitudes and experiences on emergency contraceptive pills by the university students in Cameroon in order to develop and refine a national health programme for reducing unwanted pregnancies and their associated morbidity and mortality. Methods A convenient sample of 700 students of the University of Buea (Cameroon was selected for the study. Data was collected by a self-administered, anonymous and pre-tested questionnaire. Results The response rate was 94.9% (664/700. General level of awareness of emergency contraceptive pills was 63.0% (418/664. However, knowledge of the general features of emergency contraceptive pills was low and misinformation was high among these students. Knowledge differed according to the source of information: informal source was associated with misinformation, while medical and informational sources were associated with better knowledge. Although the students generally had positive attitudes regarding emergency contraceptive pills, up to 65.0% (465/664 believed that emergency contraceptive pills were unsafe. Those with adequate knowledge generally showed favourable attitudes with regards to emergency contraceptive pills (Mann-Whitney U = 2592.5, p = 0.000. Forty-nine students (7.4% had used emergency contraceptive pills themselves or had a partner who had used them. Conclusion Awareness of emergency contraception pills by Cameroonian students is low and the method is still underused. Strategies to promote use of emergency contraception should be focused on spreading accurate information through medical and informational sources, which

Emergency contraception - potential for women's health.

Science.gov (United States)

Mittal, Suneeta

2014-11-01

Emergency contraception (EC) is a safe and effective method which is used to prevent unwanted pregnancy after unprotected sexual intercourse. Many of the unwanted pregnancies end in unsafe abortions. The search for an ideal contraceptive, which does not interfere with spontaneity or pleasure of the sexual act, yet effectively controls the fertility, is still continuing. Numerous contraceptive techniques are available, yet contraceptive coverage continues to be poor in India. Thus, even when not planning for a pregnancy, exposure to unprotected sex takes place often, necessitating the use of emergency contraception. This need may also arise due to failure of contraceptive method being used (condom rupture, diaphragm slippage, forgotten oral pills) or following sexual assault. Emergency contraception is an intervention that can prevent a large number of unwanted pregnancies resulting from failure of regular contraception or unplanned sexual activity, which in turn helps in reducing the maternal mortality and morbidity due to unsafe abortions. However, a concern has been expressed regarding repeated and indiscriminate usage of e-pill, currently the rational use of emergency contraception is being promoted as it is expected to make a significant dent in reducing the number of unwanted pregnancies and unsafe abortions. In fact, since the introduction of emergency contraception, the contribution of unsafe abortion towards maternal mortality has declined from 13 to 8 per cent.

First emergency contraceptive product hits U.S. market shelves.

Science.gov (United States)

1998-11-01

The Preven Emergency Contraceptive Kit, a product approved by the US Food and Drug Administration (USFDA) for emergency contraception, is now on the market for sale. Produced by Gynetics of Somerville, NJ, the kit consists of an easy-to-use pregnancy test, patient information guide, and 4 blue pills, each containing 0.05 mg ethinyl estradiol and 0.25 mg levonorgestrel. After a woman determines that she is not pregnant by using the kit's test, she takes 2 pills as soon as possible within 72 hours after having unprotected sexual intercourse. The remaining 2 pills are taken 12 hours later. Although Preven is available now only by prescription, Gynetics will cooperate with the USFDA in assessing whether it should be sold over the counter. One course of Preven costs about $20 at a pharmacy, less than any oral contraceptive pills currently used as emergency contraceptives. The Preven Kit carries Health Care Financing Administration approval for Medicaid reimbursement, and most health maintenance organizations have agreed to cover its costs. Two more progestin-only emergency contraceptive products may enter the US market in 1999. Gynetics is in the advanced stages of developing a levonorgestrel-only emergency contraceptive, while Women's Capital Corp. of Seattle, WA, and Washington, DC, plans to submit its application for product approval to the USFDA for a similar progestin-only product by the end of October.

Ulipristal acetate in emergency contraception.

Science.gov (United States)

Goldstajn, Marina Sprem; Baldani, Dinka Pavicić; Skrgatić, Lana; Radaković, Branko; Vrbić, Hrvoje; Canić, Tomislav

2014-03-01

Despite the widespread availability of highly effective methods of contraception, unintended pregnancy is common. Unplanned pregnancies have been linked to a range of health, social and economic consequences. Emergency contraception reduces risk of pregnancy after unprotected intercourse, and represents an opportunity to decrease number of unplanned pregnancies and abortions. Emergency contraception pills (ECP) prevent pregnancy by delaying or inhibiting ovulation, without interfering with post fertilization events. If pregnancy has already occurred, ECPs will not be effective, therefore ECPs are not abortificants. Ulipristal acetate (17alpha-acetoxy-11beta-(4N-N,N-dymethilaminophenyl)-19-norpregna--4,9-diene-3,20-dione) is the first drug that was specifically developed and licensed for use as an emergency contraceptive. It is an orally active, synthetic, selective progesterone modulator that acts by binding with high affinity to the human progesterone receptor where it has both antagonist and partial agonist effects. It is a new molecular entity and the first compound in a new pharmacological class defined by the pristal stem. Up on the superior clinical efficacy evidence, UPA has been quickly recognized as the most effective emergency contraceptive pill, and recently recommended as the first prescription choice for all women regardless of the age and timing after intercourse. This article provides literature review of UPA and its role in emergency contraception.

Perception and Practice of Emergency Contraception by Post ...

African Journals Online (AJOL)

A survey of 1500 students in post-secondary institutions in south west Nigeria showed that the concept of emergency contraception (EC) was well known. Respectively, 32.4%, 20.4% and 19.8% knew that combined pills, progesterone only pills and intrauterine contraceptive device (IUCD) were usable for EC, while 56.7% ...

Emergency contraception - Potential for women′s health

Directory of Open Access Journals (Sweden)

Suneeta Mittal

2014-01-01

Full Text Available Emergency contraception (EC is a safe and effective method which is used to prevent unwanted pregnancy after unprotected sexual intercourse. Many of the unwanted pregnancies end in unsafe abortions. The search for an ideal contraceptive, which does not interfere with spontaneity or pleasure of the sexual act, yet effectively controls the fertility, is still continuing. Numerous contraceptive techniques are available, yet contraceptive coverage continues to be poor in India. Thus, even when not planning for a pregnancy, exposure to unprotected sex takes place often, necessitating the use of emergency contraception. This need may also arise due to failure of contraceptive method being used (condom rupture, diaphragm slippage, forgotten oral pills or following sexual assault. Emergency contraception is an intervention that can prevent a large number of unwanted pregnancies resulting from failure of regular contraception or unplanned sexual activity, which in turn helps in reducing the maternal mortality and morbidity due to unsafe abortions. However, a concern has been expressed regarding repeated and indiscriminate usage of e-pill, currently the rational use of emergency contraception is being promoted as it is expected to make a significant dent in reducing the number of unwanted pregnancies and unsafe abortions. In fact, since the introduction of emergency contraception, the contribution of unsafe abortion towards maternal mortality has declined from 13 to 8 per cent.

[Contraceptive practices among university students: the use of emergency contraception].

Science.gov (United States)

Borges, Ana Luiza Vilela; Fujimori, Elizabeth; Hoga, Luiza Akiko Komura; Contin, Marcelo Vieira

2010-04-01

This study investigated contraceptive practices and especially the use of emergency contraception by 487 young students at a public university in São Paulo State. A structured questionnaire was sent by e-mail and completed online in December 2007. Contraceptive methods and use of emergency contraception were investigated. Female and male students reported a high proportion of contraceptive use, mainly condoms and the pill. Half of the students had already used emergency contraception, often when already using some other highly effective method. Among female students, multiple regression analysis showed that current age, age at sexual initiation, not having used condoms in sexual relations, condom failure, and knowing someone that has used emergency contraception were associated with use of the latter. The option for emergency contraception proved to be more closely related to inconsistencies in the use of regular methods than to lack of their use, and can thus be considered a marker for discontinuity in regular contraception.

An update on emergency contraception.

Science.gov (United States)

Bosworth, Michele C; Olusola, Patti L; Low, Sarah B

2014-04-01

Emergency contraception decreases the risk of unintended pregnancy after unprotected sexual intercourse or after suspected failure of routine contraception (e.g., a condom breaking). Oral methods include combined contraceptive pills (i.e., Yuzpe method), single- or split-dose levonorgestrel, and ulipristal. The Yuzpe method and levonorgestrel are U.S. Food and Drug Administration-approved for use 72 hours postcoitus, whereas the newest method, ulipristal, is approved for up to 120 hours postcoitus. The copper intrauterine device may be used as emergency contraception up to seven days after unprotected intercourse. It is nonhormonal and has the added benefit of long-term contraception. Advanced provision of emergency contraception may be useful for all patients, and for persons using ulipristal because it is available only by prescription. Physicians should counsel patients on the use and effectiveness of emergency contraception, the methods available, and the benefits of routine and consistent contraception use.

Are we overestimating the stroke risk related to contraceptive pills?

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Gompel, Anne; Plu-Bureau, Genevieve

2014-02-01

Hormonal contraceptives are used by million of women worldwide. Ischemic stroke is one of the major harmful effects of hormonal contraceptives, but remains a very uncommon disease before menopause. The increased risk of stroke under third and fourth-generation contraceptive pills and nonoral contraceptives has been recently highlighted. Given the benefits associated with combined hormonal contraceptives (COCs), it is important to properly evaluate their risks in order to provide a better benefit/risk balance to young women. Scarce studies addressing the rates of stroke in young women suggest that the fraction attributable to the contraceptive pill remains low. In contrast, there is abundant literature on the relative risks of stroke under COCs. The risk of arterial disease seems to be similar among users of second and third-generation pills, drospirenone-containing pills and nonoral hormonal contraceptives. Progestin-only contraceptives do not appear to be associated with an increased risk of stroke. New formulations of hormonal contraceptives are not safer than second-generation COCs. Even if the absolute numbers of strokes attributable to hormonal contraceptives is very low, stringent selection of patients should help to reduce the events still more, and progestin-only contraceptives/nonhormonal methods should be preferred in cases of associated risk factors.

Knowledge, attitude and practice of emergency contraceptives ...

African Journals Online (AJOL)

admin

contraceptives among female college students in Arba Minch ... those who mentioned pills as an emergency contraceptive method, 26.4% correctly ... The summary index for knowledge disclosed that 21.9% had good knowledge about EC.

Combining qualitative with quantitative approaches to study contraceptive pill use.

Science.gov (United States)

Oakley, D; Yu, M Y; Zhang, Y M; Zhu, X L; Chen, W H; Yao, L

1999-03-01

According to large-scale studies, oral contraceptive users become pregnant at rates that exceed ideal use failure rates. It is thought that a major cause is missed pills, but current research on consistent contraceptive pill taking is characterized by inadequate measures and a failure to investigate women's thinking about their own patterns of use. The purpose of this study was to gain some understanding about women's interpretations of consistency in their own pill taking through combining qualitative with quantitative data. The study was conducted in China, where contraception is free and widely available. Five urban and five rural oral contraceptive users were followed for up to three pill-taking cycles during 1996 for a total of 759 person-days. Consistency of pill taking was measured with electronic data obtained from a new blister package made by Anderson Clinical Technologies (Elmhurst, IL). Data from these devices were reviewed and interpreted by the study participants during in-depth private interviews. The users' reasons for missing pills included disruptions in their daily routines, their husband's absence, spotting, and trouble implementing the family planning program's instructions to take one pill per day for 22 days and start the next cycle on the fifth day of menses. One user gave these reasons for two cycles but denied missing numerous pills in her third cycle. Data from a series of four questionnaires showed that most demographic, psychosocial, and service system characteristics were not related to missed pills. However, results suggested that the daily routines of rural living may make consistent use more likely and that instructions for taking the pill may be associated with prolonged pill-free intervals and skipping pills during episodes of spotting. Three of the 10 women were at increased risk of pregnancy during the study period because of their pill-taking pattern. We concluded that the combination of qualitative with quantitative data

Emergency Contraception: a survey of Hospital Emergency Departments Staffs

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Marco Bo

2011-06-01

Full Text Available The World Health Organization defines emergency contraception (EC as a means to prevent unwanted pregnancy. In countries where EC is dispensed behind the counter, emergency departments are a preferred point of care for its prescription and dispensing. In light of this situation and as no studies on emergency contraception in emergency departments in Italy have been conducted to date, this study was designed with a view to analyze the responses of emergency room physicians in relation to their prescribing habits and knowledge about the drug and in relation to frequency and profile of women arriving for care at hospital emergency departments in Piedmont and requesting prescription for the morning-after pill. This cross-sectional survey involved 29 hospital emergency departments in Piedmont where no gynecologists are on active duty. The survey instrument was a 24-item questionnaire. Analysis of responses revealed that in the physicians’ opinion the vast majority of requests came from Italian nationals (97% ranging in age from 18 to 30 years (76%, single and not cohabiting with a partner (60%, and nulliparous (64.0%. Women mostly request EC for first-time and the most common reasons were condom breakage or slippage. Just over half the physicians (52% stated that emergency contraception prescription was not an appropriate part of care provided at an emergency department and 72% stated they felt uneasy about prescribing emergency contraception. The survey also revealed gaps in physician knowledge about the pharmacokinetic and pharmacodynamic properties of emergency contraception pills.

Emergency Contraception: a survey of Hospital Emergency Departments Staffs

Directory of Open Access Journals (Sweden)

Marco Bo

2011-03-01

Full Text Available The World Health Organization defines emergency contraception (EC as a means to prevent unwanted pregnancy. In countries where EC is dispensed behind the counter, emergency departments are a preferred point of care for its prescription and dispensing. In light of this situation and as no studies on emergency contraception in emergency departments in Italy have been conducted to date, this study was designed with a view to analyze the responses of emergency room physicians in relation to their prescribing habits and knowledge about the drug and in relation to frequency and profile of women arriving for care at hospital emergency departments in Piedmont and requesting prescription for the morning-after pill. This cross-sectional survey involved 29 hospital emergency departments in Piedmont where no gynecologists are on active duty. The survey instrument was a 24-item questionnaire. Analysis of responses revealed that in the physicians’ opinion the vast majority of requests came from Italian nationals (97% ranging in age from 18 to 30 years (76%, single and not cohabiting with a partner (60%, and nulliparous (64.0%. Women mostly request EC for first-time and the most common reasons were condom breakage or slippage. Just over half the physicians (52% stated that emergency contraception prescription was not an appropriate part of care provided at an emergency department and 72% stated they felt uneasy about prescribing emergency contraception. The survey also revealed gaps in physician knowledge about the pharmacokinetic and pharmacodynamic properties of emergency contraception pills.

[Estrogens and feminine brain maturation during adolescence: emergency contraceptive pill].

Science.gov (United States)

López Moratalla, Natalia; Errasti Alcalá, Tania; Santiago, Esteban

2011-01-01

In the period between puberty and maturity takes place the process of brain maturation. Hormone levels induce changes in neurons and direct the architecture and structural functionality thus affecting patterns of development of different brain areas. The onset of puberty brings with it the invasion of the female brain by high levels of hormones, cyclic surges of estrogen and progesterone in addition to steroids produced in situ. Control centers of emotions (amygdala), memory and learning (hippocampus) and sexual activity (hypothalamus) are modified according to the cyclical concentrations of both hormones. Sex hormones stimulate multimodal actions, both short and longer terms, because neurons in various brain areas have different types of receptors, membrane, cytoplasmic and nuclear. The composition of emergency contraceptive pill (postcoital pill) with high hormonal content raises the urgency of a thorough knowledge about the possible effect that the lack of control of the menstrual cycle in a time of consolidation of brain maturation, can bring in structuring and development of brain circuitry. Changes in the availability of sex steroids during puberty and adolescence underlie psychiatric disorders whose prevalence is typically feminine, such as depression, anxiety disorders. It is a fundamental ethical duty to present scientific data about the influence of estrogen in young female brain maturation, both for full information to potential users, and also to induce the appropriate public health measures.

The profile of women who seek emergency contraception from the family planning service.

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Lo, Sue S T; Ho, P C

2012-08-01

OBJECTIVES. To review the profile of emergency contraceptive users, their reasons for using emergency contraception, and whether they use it correctly. DESIGN. Retrospective analysis of medical records. SETTING. Six Birth Control Clinics and three Youth Health Care Centres of the Family Planning Association of Hong Kong. PARTICIPANTS. Women requesting emergency contraception between 2006 and 2008. MAIN OUTCOME MEASURES. Demographics of emergency contraception users, reasons for requesting emergency contraception, number of times the subject had unprotected intercourse before emergency contraception use, type of emergency contraception provided, coitus-treatment intervals, and outcomes. RESULTS. A total of 11 014 courses of emergency contraception were provided, which included 10 845 courses of levonorgestrel-only pills, 168 intrauterine contraceptive devices, and one course of pills plus an intrauterine contraceptive device. The mean age of the users was 30 years. Two thirds (65.6%) were nulliparous and 64.9% had not had a previous abortion. Their major reasons for requesting emergency contraception were: omission of contraceptive at the index intercourse (38.9%), condom accidents (38.0%), and non-use of any regular contraceptives (20.6%). Non-users of contraceptives were more likely to have had a previous abortion. In all, 97.9% of women took emergency contraception within 72 hours of their unprotected intercourse; 98% had had a single act of unprotected intercourse. None of the intrauterine contraceptive device users became pregnant. The failure rate for emergency contraceptive pills was 1.8%. CONCLUSIONS. Women requested emergency contraception because contraceptives were omitted or condom accidents. Health care providers should focus on motivating women with a history of abortion to use contraceptives, and ensure that condom users know how to use them correctly. Most women followed instructions on the use for emergency contraception and their outcomes were

Emergency contraception – a neglected option for birth control

Directory of Open Access Journals (Sweden)

Eka R. Gunardi

2013-12-01

Full Text Available Emergency contraception (EC is any method of contraception which is used after intercourse and before the potential time of implantation, in order to prevent pregnancy after an unprotected or inadequately protected sexual intercourse, or cases of rape. Use of emergency contraception could halve the number of unintended pregnancies and the consequent need for abortion, but unfortunately many medical professionals and the public are not aware of it. Two methods are available for emergency contraception, namely emergency contraception pills (ECPs and copper-bearing intrauterine devices (Cu-IUDs. There are two regimens of ECP, the levonorgestrel regimen and combined regimen. The levonorgestrel regimen is preferred as it is more effective and causes less side effects. ECPs should be administered as soon as possible after unprotected or inadequately protected sex, being most effective if initiated within 24 hours. Cu-IUDs can be inserted up to 5 days after unprotected sexual intercourse. Emergency contraception mainly works by preventing fertilization, and does not interrupt and established pregnancy. Emergency contraception is very safe, therefore can be offered to women who have had unprotected intercourse and wish to prevent pregnancy. It must only be used as a backup method of birth control. (Med J Indones. 2013;22:248-52. doi: 10.13181/mji.v22i4.609Keywords: Birth control, copper-IUD, emergency contraception, emergency contraceptive pills, levonorgestrel

EMERGENCY CONTRACEPTION

Directory of Open Access Journals (Sweden)

Dragana Pantić

2007-10-01

Full Text Available Emergency contraception refers to any device or drug that is used as an emergency procedure to prevent pregnancy after unprotected sexual intercourse.The first method of emergency contraception was high dose of estrogen. Concern about side effects led to subsequent development of the so-called Yuzpe regimen which combined ethinil estradiol with levonorgestrel and levonorgestrel alone. Less convenient to use is the copper intauterine contraceptive device.It is known that in some women sexual steroids may inhibit or delay ovulation and may interfere with ovum and sperm transport and implantation. Copper intrauterine device causes a foreign-body effect on the endometrium and a direct toxic effect to sperm and blastocyst.The Yuzpe regimen reduces the risk of pregnancy after a single act of sexual intercourse by about 75% and the levonorgestrel alone by about 85%. The copper intrauterine device is an extremely effective method for selected patients.Nausea and vomiting are common among women using the Yuzpe regimen and considerably less common among women using levonorgestrel alone regimen.Emergency contraception is relatively safe with no contraindications except pregnancy. It is ineffective if a woman is pregnant. There is no need for a medical hystory or a phisical examination before providing emergency contraceptive pills. They are taken long before organogenesis starts, so they should not have a teratogenic effect.Counseling should include information about correct use of the method, possible side effects and her preferences for regular contraception.Unintended pregnancy is a great problem. Several safe, effective and inexpensive methods of emergency contraception are available including Yuzpe regimen, levonorges-trel-only regimen and copper intrauterine device.

Patient understanding of oral contraceptive pill instructions related to missed pills: a systematic review.

Science.gov (United States)

Zapata, Lauren B; Steenland, Maria W; Brahmi, Dalia; Marchbanks, Polly A; Curtis, Kathryn M

2013-05-01

Instructions on what to do after pills are missed are critical to reducing unintended pregnancies resulting from patient non-adherence to oral contraceptive (OC) regimens. Missed pill instructions have previously been criticized for being too complex, lacking a definition of what is meant by "missed pills," and for being confusing to women who may not know the estrogen content of their formulation. To help inform the development of missed pill guidance to be included in the forthcoming US Selected Practice Recommendations, the objective of this systematic review was to evaluate the evidence on patient understanding of missed pill instructions. We searched the PubMed database for peer-reviewed articles that examined patient understanding of OC pill instructions that were published in any language from inception of the database through March 2012. We included studies that examined women's knowledge and understanding of missed pill instructions after exposure to some written material (e.g., patient package insert, brochure), as well as studies that compared different types of missed pill instructions on women's comprehension. We used standard abstract forms and grading systems to summarize and assess the quality of the evidence. From 1620 articles, nine studies met our inclusion criteria. Evidence from one randomized controlled trial (RCT) and two descriptive studies found that more women knew what to do after missing 1 pill than after missing 2 or 3 pills (Level I, good, to Level II-3, poor), and two descriptive studies found that more women knew what to do after missing 2 pills than after missing 3 pills (Level II-3, fair). Data from two descriptive studies documented the difficulty women have understanding missed pill instructions contained in patient package inserts (Level II-3, poor), and evidence from two RCTs found that providing written brochures with information on missed pill instructions in addition to contraceptive counseling significantly improved

Health care providers' knowledge of, attitudes toward and provision of emergency contraceptives in Lagos, Nigeria.

Science.gov (United States)

Ebuehi, Olufunke Margaret; Ebuehi, Osaretin A T; Inem, Victor

2006-06-01

Emergency contraception can play an important role in reducing the rate of unintended pregnancies in Nigeria. Although it is included in the national family planning guidelines, there is limited awareness of this method among clients. In 2003-2004, a sample of 256 health care providers within Lagos State were surveyed about their knowledge of, attitudes toward and provision of emergency contraceptives, using a 25-item, self-administered questionnaire. Frequencies were calculated for the various measures, and chi-square tests were used to determine significant differences. Nine in 10 providers had heard of emergency contraception, but many lacked specific knowledge about the method. Only half of them knew the correct time frame for effective use of emergency contraceptive pills, and three-fourths knew that the pills prevent pregnancy; more than a third incorrectly believed that they may act as an abortifacient. Fewer than a third of respondents who had heard of the pills knew that they are legal in Nigeria. Of those who had heard about emergency contraception, 58% had provided clients with emergency contraceptive pills, yet only 10% of these providers could correctly identify the drug, dose and timing of the first pill in the regimen. Furthermore, fewer than one in 10 of those who knew of emergency contraception said they always provided information to clients, whereas a fourth said they never did so. Nigerian health care providers urgently need education about emergency contraception; training programs should target the types of providers who are less knowledgeable about the method.

Experience with oral emergency contraception since the OTC switch in Germany.

Science.gov (United States)

Kiechle, Marion; Neuenfeldt, Miriam

2017-03-01

In March 2015, the oral emergency contraceptives levonorgestrel (LNG) and ulipristal acetate (UPA) were released from prescription-only status in Germany. The main research question is to analyse whether the OTC status of oral emergency contraceptives has an influence on the patterns of use. All information is based on searches for public domain sources on emergency contraception. Searches were made for scientific publications, statistics, and surveys. Due to additional active ingredient properties, UPA is superior to LNG in terms of ovulation-inhibiting effect. Since the OTC switch, demand for oral emergency contraceptives has risen by almost 50%, especially at weekends when sexual encounters and thus contraceptive failures are most frequent. However, the age distribution of the users has not changed as a result of the OTC switch. Doctors still play an important role in advising on emergency contraception after the removal of the prescription-only requirement. Pregnancies despite emergency contraception are terminated in more than half of the cases. In federal states with higher rates of use of the morning-after pill, fewer terminations of pregnancy were performed. As a result of the OTC switch, more women and girls use the morning-after pill after unprotected intercourse and the time between unprotected intercourse and taking the oral emergency contraceptive decreases. This is of great advantage in terms of the mechanism of action. UPA is used more frequently than LNG. Only half of all people aged between 16 and 39 years in Germany are aware of the morning-after pill and 94% of women who had a pregnancy terminated in 2015 did not use any emergency contraception after the unprotected intercourse. In the population, there is still a great need for information and education on contraception and emergency contraception.

Safety and effectiveness data for emergency contraceptive pills among women with obesity: a systematic review.

Science.gov (United States)

Jatlaoui, Tara C; Curtis, Kathryn M

2016-12-01

This study aims to determine whether emergency contraceptive pills (ECPs) are less safe and effective for women with obesity compared with those without obesity. We searched PubMed for articles through November 2015 regarding the safety and effectiveness of ECPs [ulipristal acetate (UPA), levonorgestrel (LNG) and combined estrogen and progestin] among obese users. We assessed study quality using the United States Preventive Services Task Force evidence grading system. We identified four pooled secondary analyses (quality: poor to fair), two of which examined UPA and three examined LNG formulations. Three analyses pooled overlapping data from a total of three primary studies and demonstrated significant associations between obesity and risk of pregnancy after ECP use. One analysis reported a 4-fold increased risk of pregnancy among women with obesity (BMI≥30kg/m 2 ) compared with women within normal/underweight categories (BMIcontraception; at weights less than 75 kg, the rate of pregnancy was less than 2%. Two analyses examining UPA suggested an approximate 2-fold increased risk of pregnancy among women with obesity compared with either normal/underweight women or nonobese (BMIemergency contraception options in order for them to understand their options, to receive advanced supplies of emergency contraception as needed and to understand how to access an emergency copper intrauterine device if desired. Copyright © 2016. Published by Elsevier Inc.

Contraceptive non-use and emergency contraceptive use at first sexual intercourse among nearly 12 000 Scandinavian women

DEFF Research Database (Denmark)

Guleria, Sonia; Juul, Kirsten E.; Munk, Christian

2017-01-01

or older, and with increasing age difference between the partner and the woman at her first sexual intercourse. Smoking initiation prior to first sexual intercourse increased risk of contraceptive non-use (prevalence ratio 1.70; 95% confidence interval 1.50–1.92), and alcohol initiation prior to first...... of contraceptive non-use increased in women who had first sexual intercourse at or before 14 years of age (13–14 years: prevalence ratio 1.40; 95% confidence interval 1.24–1.58). The risk of both non-use and emergency contraceptive pill use increased when the partner at first sexual intercourse was 20 years...... sexual intercourse increased risk of emergency contraceptive pill use at first sexual intercourse (prevalence ratio 1.95; 95% confidence interval 1.49–2.54). Conclusions. Contraceptive non-use at first sexual intercourse was strongly associated with early age at first sexual intercourse. Emergency...

Contraception with combined oral contraceptive pills in Port ...

African Journals Online (AJOL)

Mass media was the commonest source of information, and one accidental pregnancy occurred (Pearl index 0.03 per 100 woman years). Conclusion: This study shows that combined oral contraceptives pills appear to be acceptable, safe and effective in Port Harcourt. This compares to world wide experience. Concerted ...

Does the contraceptive pill alter mate choice in humans?

Science.gov (United States)

Alvergne, Alexandra; Lummaa, Virpi

2010-03-01

Female and male mate choice preferences in humans both vary according to the menstrual cycle. Women prefer more masculine, symmetrical and genetically unrelated men during ovulation compared with other phases of their cycle, and recent evidence suggests that men prefer ovulating women to others. Such monthly shifts in mate preference have been suggested to bring evolutionary benefits in terms of reproductive success. New evidence is now emerging that taking the oral contraceptive pill might significantly alter both female and male mate choice by removing the mid-cycle change in preferences. Here, we review support for such conclusions and speculate on the consequences of pill-induced choice of otherwise less-preferred partners for relationship satisfaction, durability and, ultimately, reproductive outcomes.

Awareness and Practice of Emergency Contraception Among ...

African Journals Online (AJOL)

Alasia Datonye

There is therefore an urgent need to improve the student's knowledge and use .... period to eliminate chances of correlated or block response. ... emergency contraception pills only in pharmacies and health facilities ... poor settings like ours.

Combined Oral Contraceptive Pills: Profile of Acceptors in a Tertiary Hospital in South-South Nigeria.

Science.gov (United States)

Abasiattai, A M; Utuk, M N; Ojeh, S O; Eyo, U E

2011-01-01

BACKGROUND: Combined oral contraceptive pills were the first contraceptive method to provide sexual freedom of choice for women through reliable, personal and private control of fertility. They are the most widely used hormonal contraceptives and also the most popular non-surgical method of contraception. OBJECTIVE: To review the profile of acceptors of combined oral contraceptive pills at the University of Uyo Teaching Hospital, Uyo. METHODOLOGY: An 8 year review of all clients that accepted combined oral contraceptive pills in the family planning clinic. RESULTS: There were 1,146 new contraceptive acceptors during the period of study out of which 309 (27.9%) accepted the pills. Majority of the clients were between 20 and 29 years of age (54.0%), were multiparous (72.8%), Christians (99.7%) and 61.2% had tertiary level education. Two hundred and fifty-five women (82.5%) desired to use combined oral contraceptive pills to space births while 7.8% wanted to limit child bearing. There was a high discontinuation rate among the women (45.0%) and out of these 87.9% of the clients changed to other contraceptive methods. All the clients commenced their pills within seven days of menstruation and only the low dose monophasic preparations were available in the family planning unit and thus were given to the clients. CONCLUSION: Women who accept to initiate combined oral contraceptive pills in our center are young, well educated, multiparous women who want to space their pregnancies. However, due to the high discontinuation rate among the clients, there is need for further studies evaluating reasons for the high discontinuation rate, exploring interactions between clients and providers' and also providers' attitude towards combined pills in our environment.

Emergency Contraceptive Pill (ECP) Use and Experiences at College Health Centers in the Mid-Atlantic United States: Changes since ECP Went Over-the-Counter

Science.gov (United States)

Miller, Laura M.

2011-01-01

Objective: To investigate the availability of emergency contraceptive pills (ECPs) at college health centers since ECP went over-the-counter (OTC) in 2006. Related issues, such as distribution procedure, existence of a written protocol, personnel involved, contraindications, follow-up procedures, methods of advertising, and staff attitudes, were…

Emergency Contraceptive Pills: A 10-Year Follow-up Survey of Use and Experiences at College Health Centers in the Mid-Atlantic United States

Science.gov (United States)

Miller, Laura McKeller; Sawyer, Robin G.

2006-01-01

The authors conducted a 10-year follow-up study using a telephone survey to investigate the availability of emergency contraceptive pills (ECPs) at college health centers in the mid-Atlantic region of the United States. They also examined related issues, such as distribution procedure, existence of a written protocol, personnel involved,…

Use of non-emergency contraceptive pills and concoctions as emergency contraception among Nigerian University students: results of a qualitative study

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Anthony Idowu Ajayi

2016-10-01

Full Text Available Abstract Background Emergency contraception (EC can significantly reduce the rate of unintended pregnancies and unsafe abortions especially in sub-Saharan Africa. Despite the increasing awareness of EC among educated young women in Nigeria, the rate of utilisation remains low. This study therefore explores the main barriers to the use of EC among female university students by analysing their knowledge of emergency contraception, methods ever used, perceived efficacy, and its acceptability. Methods This paper brings together the findings from several focus groups (N = 5 and in-depth interviews (N = 20 conducted amongst unmarried female undergraduate students in two Nigerian universities. Results Participants considered the use of condom and abstinence as the most effective methods of preventing unplanned pregnancy. However, many participants were misinformed about emergency contraception. Generally, participants relied on unconventional and unproven ECs; Ampiclox, “Alabukun”, salt water solution, and lime and potash and perceived them to be effective in preventing unplanned pregnancies. Furthermore, respondents’ narratives about methods of preventing unwanted pregnancies revealed that inadequate information on emergency contraception, reliance on unproven crude contraceptive methods, and misconception about modern contraception constitute barriers to the use of emergency contraception. Conclusions The findings suggested that female university students are misinformed about emergency contraception and their reliance on unproven ECs constitutes a barrier to the use of approved EC methods. These barriers have serious implications for prevention of unplanned pregnancies in the cohort. Behavioural interventions targeting the use of unproven emergency contraceptive methods and misperceptions about ECs would be crucial for this cohort in Nigeria.

Use of non-emergency contraceptive pills and concoctions as emergency contraception among Nigerian University students: results of a qualitative study.

Science.gov (United States)

Ajayi, Anthony Idowu; Nwokocha, Ezebunwa Ethelbert; Akpan, Wilson; Adeniyi, Oladele Vincent

2016-10-04

Emergency contraception (EC) can significantly reduce the rate of unintended pregnancies and unsafe abortions especially in sub-Saharan Africa. Despite the increasing awareness of EC among educated young women in Nigeria, the rate of utilisation remains low. This study therefore explores the main barriers to the use of EC among female university students by analysing their knowledge of emergency contraception, methods ever used, perceived efficacy, and its acceptability. This paper brings together the findings from several focus groups (N = 5) and in-depth interviews (N = 20) conducted amongst unmarried female undergraduate students in two Nigerian universities. Participants considered the use of condom and abstinence as the most effective methods of preventing unplanned pregnancy. However, many participants were misinformed about emergency contraception. Generally, participants relied on unconventional and unproven ECs; Ampiclox, "Alabukun", salt water solution, and lime and potash and perceived them to be effective in preventing unplanned pregnancies. Furthermore, respondents' narratives about methods of preventing unwanted pregnancies revealed that inadequate information on emergency contraception, reliance on unproven crude contraceptive methods, and misconception about modern contraception constitute barriers to the use of emergency contraception. The findings suggested that female university students are misinformed about emergency contraception and their reliance on unproven ECs constitutes a barrier to the use of approved EC methods. These barriers have serious implications for prevention of unplanned pregnancies in the cohort. Behavioural interventions targeting the use of unproven emergency contraceptive methods and misperceptions about ECs would be crucial for this cohort in Nigeria.

EMERGENCY CONTRACEPTION: AN OVERVIEW AMONG USERS.

Science.gov (United States)

Khan, Shazia Amir; Hafeez, Humaira; Akbar, Rabiya

2015-01-01

Emergency contraception Pills (ECP) provides a safe and effective means of post coital treatment and prevents at least 75% of expected pregnancies resulting from unprotected intercourse. The purpose of the study was to assess the awareness regarding emergency contraception and to see the knowledge attitude and preference about emergency contraception. This was a descriptive cross sectional study carried out at Combined Military Hospital (CMH) Khuzdar. A total of 200 married women of reproductive age group who agreed to participate in the study were interviewed using a self-reported comprehensive, structured closed ended questionnaire. 77% of the women were practicing some contraceptive method at the time of study. Most were using condoms for contraception. 16% of all respondents have never used any contraceptive in their life. 70% believe that religion of Islam is not a barrier in family planning. Only 7.5% of the women were aware about ECP. Knowledge about ECP is poor among the women of child bearing age. There is a room for improvement regarding the awareness and use of ECP which can contribute to prevention of unwanted pregnancies.

Attitudes and practices of pharmacists towards emergency contraception in Durban, South Africa.

Science.gov (United States)

Hariparsad, N

2001-06-01

Emergency contraception, which is used to prevent pregnancy following unprotected intercourse, could prove invaluable to a country like South Africa which has high fertility and pregnancy rates. However, the success of emergency contraception is dependent on the awareness, knowledge, attitudes and practices amongst health-care providers and the public towards it. The aim of this study was to assess the attitudes and practices of community pharmacists towards emergency contraception. The study was conducted in North and South Central Durban, South Africa. This questionnaire-based study sought from pharmacists the frequency of demand and supply of emergency contraception, as well as their attitudes and practices towards it. The sample included all 182 pharmacies located in the study area. A total of 96% of pharmacists had received requests for emergency contraception within the last year. On average, each pharmacist received 177 requests for emergency contraception. Sixty-nine per cent of pharmacists were in favor of making emergency contraceptive pills available without a prescription, 62% were already supplying emergency contraceptive pills without a prescription and 67% felt that it was important to increase public awareness regarding emergency contraception. Ninety-one per cent of pharmacists did not have any literature regarding emergency contraception to hand to clients, 68% had a private area in their pharmacy to counsel patients and 86% of pharmacists indicated that they discussed long-term contraception with clients. This study is the first in South Africa aimed at determining the utilization of emergency contraception. However, further studies are required in order to ascertain information that will assist in changing current health policies to improve those in reproductive health care.

A comparison of second and third generations combined oral contraceptive pills' effect on mood.

Science.gov (United States)

Shahnazi, Mahnaz; Farshbaf Khalili, Azizeh; Ranjbar Kochaksaraei, Fatemeh; Asghari Jafarabadi, Mohammad; Gaza Banoi, Kamal; Nahaee, Jila; Bayati Payan, Somayeh

2014-08-01

Most women taking combined oral contraceptives (COCs) are satisfied with their contraceptive method. However, one of the most common reasons reported for discontinuation of combined oral contraceptives (COCs) is mood deterioration. This study aimed to compare effects of the second and third generation oral contraceptive pills on the mood of reproductive women. This randomized, double-blind, controlled clinical trial was conducted in reproductive women at health centers in Tehran, Iran. Participants were randomized into the second and third generation oral contraceptive groups. Positive and negative moods were recorded using positive affect, negative affect scale (PANAS) tools at the end the second and fourth months of the study. Data analysis was carried out using ANOVA and P Values pills. The second generation oral contraceptive pills resulted in a decrease in positive mood (95% CI: 43.39 to 38.32 in second month and 43.39 to 26.05 in four month) and increase in negative mood (95% CI: 14.23 to 22.04 in second month and 14.23 to 32.26 in four month - P pills have a better effect on mood in women in reproductive ages than the second generation pills. It can be recommended as a proper combined oral contraceptive in Iran.

Availability of emergency contraception: a survey of hospital emergency department gynaecologists and emergency physicians in Piedmont, Italy.

Science.gov (United States)

Bo, Marco; Casagranda, Ivo; Charrier, Lorena; Gianino, Maria Michela

2012-10-01

To compare the knowledge and the willingness of emergency physicians and gynaecologists caring for women in Italian emergency departments (EDs) to prescribe levonorgestrel-only emergency contraceptive pills (LNG-EC pills). A cross-sectional survey was conducted in 2009; anonymous postal questionnaires were mailed to the medical staff working at the 30 EDs located in Piedmont (Italy). Emergency physicians and gynaecologists have similar knowledge of the pharmacokinetics and pharmacodynamics of LNG-EC pills, but do not feel at ease in prescribing these and consider the prescription of LNG-EC pills an inappropriate activity for ED staff. In Italy, unlike in most other European countries, LNG-EC pills are still prescription drugs. Thus it may be useful to further investigate the reasons why Italian ED medical staff do not feel the prescription of LNG-EC pills should be within their remit and whether women can successfully obtain the prescription from physicians working in other services that can be accessed around the clock.

Knowledge of Paramedical Students about Emergency Contraception in Baghdad City

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Suha A. Kadhum

2018-03-01

Full Text Available Objectives : To determine the knowledge and attitude of paramedical students about emergency contraception.   Methodology :A cross-sectional study conducted inn college of Health and Medical Technology, College of Nursing University of Baghdad, Institute of Medical Technol- ogy. Sampling was (non probability convenient & the sample size was 120 students. Study started from March 2015 to March 2016. Data was collected by questionnaire to obtain socio-demographic information (age, gender, contraception using intake of ,pills contained progesterone & estrogen ,pills without prescription ,family planning with con- traception, dual & signal pills ,disease prohibited from using ,side effects,. . . . . . ..etc.   Results: The result showed that there was a higher percentage of the received the answers were these of paramedical student in the college Nursing in age group ( 21-24whereas the higher level of knowledge of paramedical student was recorded in health and medical technologies their responses were about the emergency contraception contained progesterone and estrogens the percentage of their responses was ( 31.7 % .There is a sort of convergence in the level of education between the students ,Faculty of technical and those of the faculty of Nursing .   Recommendations: There is a great need to improve the quality of knowledge of paramedical student regarding the emergency contraception through supplying health education courses and seminars and tackling this thread intensively.

Sexual and Contraceptive Behaviors among Adolescents Requesting Emergency Contraception.

Science.gov (United States)

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

2016-12-01

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 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.

Emergency contraception: an overview among users

International Nuclear Information System (INIS)

Khan, S.; Hafiz, H.; Akbar, R.

2015-01-01

Emergency contraception Pills (ECP) provides a safe and effective means of post coital treatment and prevents at least 75% of expected pregnancies resulting from unprotected intercourse. The purpose of the study was to assess the awareness regarding emergency contraception and to see the knowledge attitude and preference about emergency contraception. Methods: This was a descriptive cross sectional study carried out at Combined Military Hospital (CMH) Khuzdar. A total of 200 married women of reproductive age group who agreed to participate in the study were interviewed using a self-reported comprehensive, structured closed ended questionnaire. Results: 77% of the women were practicing some contraceptive method at the time of study. Most were using condoms for contraception. 16% of all respondents have never used any contraceptive in their life. 70% believe that religion of Islam is not a barrier in family planning. Only 7.5% of the women were aware about ECP. Conclusion: Knowledge about ECP is poor among the women of child bearing age. There is a room for improvement regarding the awareness and use of ECP which can contribute to prevention of unwanted pregnancies. (author)

the effect of oral contraceptive pills

African Journals Online (AJOL)

Uwaifoh

2012-12-31

Dec 31, 2012 ... The relationship between oral contraceptives pills (OCP) and body weight gain has long been established and remains one of the major setback of OCP. This study therefore, was designed to establish the effect of OCP in rabbits. It was a six weeks study involving 15 female rabbits that were divided into ...

"I love my ECPs": challenges to bridging emergency contraceptive users to more effective contraceptive methods in Ghana.

Science.gov (United States)

L'Engle, Kelly Ladin; Hinson, Laura; Chin-Quee, Dawn

2011-07-01

Emergency contraceptive pills (ECPs) are becoming more popular, yet little is known about the contraceptive preferences of women who take ECPs. Women purchasing ECPs were recruited from pharmacies in Accra, Ghana. A total of 24 semi-structured, qualitative interviews were conducted in May 2008. Nearly all participants preferred ECPs to other contraceptive methods. Although fear of side effects from oral contraceptive pills (OCPs), intrauterine devices and injectables were deterrents to use of those methods, side effects from ECPs were acceptable to this small and highly self-selected group of ECP users. Participants had little knowledge about how other contraceptive methods work and expressed a strong distrust and dislike of condoms. Study participants loved their ECPs, despite minor discomforts like bleeding, and most had no concerns about repeated use, though these findings may not apply to women outside Accra or women who obtain ECPs from non-pharmacy settings. Future interventions should work to dispel myths about OCPs, condoms and other modern methods, and focus on basic contraception education.

Women’s level of knowledge on and attitude towards emergency contraception

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Ümit Korucuoglu

2007-09-01

Full Text Available OBJECTIVE: To evaluate reproductive age women’s level of knowledge on and attitude towards emergency contraception. Design: Questionnaire study Setting and participants: 300 women between the ages of 15-49 who applied to two “Mother-Child Health Care and Family Planning Centers” in Ankara and to Gazi University Hospital Obstetrics and Gynecology Department outpatient clinics were enrolled into the study.\tMaterials-METHODS: A questionnaire including questions about descriptive properties, current contraceptive use and level of knowledge on and attitude towards emergency contraception were applied to participants via face-to-face interviews. RESULTS: Among all participants, 102 women (41% told that it was possible to prevent a probable pregnancy after unprotected sexual intercourse, 46 women told (18.5% nothing could be done thereafter and 101 women (40.6% had no idea about the subject. 83 women (37.9% had already heard about morning-after pills. 21 women (7% claimed they had previously needed such a method, and 17 women (5.7% declared that they had used morning-after pills before.\tCONCLUSION: These findings demonstrate that our population is in need of emergency contraception but lack enough knowledge. Thus, we think that education about emergency contraception should be rendered available for all women and women should be able to use this important way of contraception whenever they require.

Knowledge and use of emergency contraceptive pill: An analysis of perception and practice among unmarried urban women

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Neetu Purohit

2013-01-01

Full Text Available Objective: The objective of this study was to collect evidence with respect to perception and practice of unmarried women toward the use of emergency contraceptive pills (ECPs. Materials and Methods: Non-probability purposive sampling was used to select respondents. A total of 250 respondents were administered the tools for the study, of which 228 were considered for analysis. Results and Discussion: Descriptive statistics showed that nearly 87% of the respondents were aware of ECPs and there was a significant difference in the knowledge of ECP of the respondents by type of the institution they had studied. More than half of the (52% respondents admitted to have boyfriends of which 16% were sexually involved and were using some form of contraception. Nearly 84% of the respondents used ECP, which superseded the use of other contraceptives. It was further found that around two-third respondents were using ECP regularly. The reason that "ECP did not hinder pleasure" and that it was handy in case of "unplanned contact" were the most cited reasons for using ECP as a regular contraceptive. Conclusion: The fact that ECPs was preferred over condom and was used regularly shows that the respondents were at a risk of sexually transmitted infection/human immunodeficiency virus. Health-care providers could be the most authentic source of information for orienting young women toward the use of safe sexual practices.

Knowledge and opinions of emergency contraceptive pills among female factory workers in Tijuana, Mexico.

Science.gov (United States)

García, Sandra G; Becker, Davida; de Castro, Marcela Martínez; Paz, Francisco; Olavarrieta, Claudia Díaz; Acevedo-García, Dolores

2008-09-01

Workers in Mexico's maquiladoras (assembly plants) are mainly young, single women, many of whom could benefit from emergency contraceptive pills (ECPs). Because ECPs are readily available in Mexico, women who know about the therapy can obtain it easily. Do maquiladora workers know about the method? Could worksite programs help increase awareness? To investigate these questions, we conducted a five-month intervention during which workers in three maquiladoras along the Mexico-United States border could attend educational talks on ECPs, receive pamphlets, and obtain kits containing EC supplies. Among the workers exposed to our intervention, knowledge of ECPs increased. Reported ECP use also increased. Although our intervention apparently increased workers' knowledge and use, the factory proved to be a difficult intervention setting. Problems we experienced included a factory closure and management/staff opposition to certain project elements. Future studies should continue to investigate work-site interventions and other strategies to reach workers.

Effect of progestin vs. combined oral contraceptive pills on lactation: A double-blind randomized controlled trial

Science.gov (United States)

Espey, Eve; Ogburn, Tony; Leeman, Larry; Singh, Rameet; Schrader, Ronald

2013-01-01

Objective To estimate the effect of progestin-only vs. combined hormonal contraceptive pills on rates of breastfeeding continuation in postpartum women. Secondary outcomes include infant growth parameters, contraceptive method continuation and patient satisfaction with breastfeeding and contraceptive method. Methods In this randomized controlled trial, postpartum breastfeeding women who desired oral contraceptives were assigned to progestin-only vs. combined hormonal contraceptive pills. At two and eight weeks postpartum, participants completed in-person questionnaires that assessed breastfeeding continuation and contraceptive use. Infant growth parameters including weight, length and head circumference were assessed at eight weeks postpartum. Telephone questionnaires assessing breastfeeding, contraceptive continuation and satisfaction were completed at 3-7 weeks and 4 and 6 months. Breastfeeding continuation was compared between groups using Cox proportional hazards regression. Differences in baseline demographic characteristics and in variables between the two intervention groups were compared using chi-square tests, Fisher’s Exact test, or two-sample t-tests as appropriate. Results Breastfeeding continuation rates, contraceptive continuation, and infant growth parameters did not differ between users of progestin-only and combined hormonal contraceptive pills. Infant formula supplementation and maternal perception of inadequate milk supply were associated with decreased rates of breastfeeding in both groups. Conclusions Choice of combined or progestin-only birth control pills administered two weeks postpartum did not adversely affect breastfeeding continuation. PMID:22143258

Emergency Contraception in Women of Slums in Northern India

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Sonia Puri

2009-09-01

Full Text Available Objective: To ascertain the utilization of the emergency contraception and to evaluate the impact of intervention on acceptability and utilization of emergency contraceptive pills. Materials and Methods: This community based cross sectional study was carried out by the department of community medicine in the slums of Chandigarh. The study sample was chosen by two stage systematic sampling. Participants were assessed regarding emergency contraception utilization and its various aspects and was also imparted correct knowledge regarding this mode of contraception. The women were reassessed again after six months to see the impact of the knowledge imparted to them on utilization of emergency contraception. Results: The study comprised of 1448, females and maximum were in the age group 26-35 years i.e. 717 (49.5% followed by those in age group 19-25 yr i.e. 485 (33.5%. Considering their education, 674 (46.5% women were illiterate. Only, 1.4% respondents had ever used emergency contraception. Sources of information so enumerated of emergency contraception were, health workers (0.8%, friends (0.6%, doctors/ health physicians (0.4% media (0.3% and books (0.1%. None of the respondent knew about the correct time span during which they should be used. The increase in utilization of emergency contraception from 1.4% to 4.2% was noticed in reassessment after 6months. Conclusion: Correct knowledge and awareness regarding emergency contraception can increase the utilization of it.

Evaluating the practice of Iranian community pharmacists regarding oral contraceptive pills using simulated patients.

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Foroutan, Nazanin; Dabaghzadeh, Fatemeh

2016-01-01

As oral contraceptive pills are available over the counter in pharmacies, pharmacists are professionally responsible for checking and informing patients about every aspect of taking these drugs. Simulated patient method is a new and robust way to evaluate professional performance of pharmacists. The aim of the present study was to evaluate the pharmacy practice of Iranian pharmacists regarding over-the-counter use of oral contraceptive pills using simulated patient method. Simulated patients visited pharmacy with a prescription containing ciprofloxacin and asked for oral contraceptive pills. The pharmacist was expected to ask important questions for using these drugs and to inform the patient about them properly. Moreover, the Pharmacists should advise patients in regard to the possible interaction. Ninety four pharmacists participated in this study. In 24 (25.3%) visits, the liable pharmacist was not present at the time of purchase. Furthermore, In 13 (18.57 %) visits by the simulated patients, the liable pharmacists did not pay any attention to the simulated patients even when they asked for consultation. Twenty nine (41.43%) pharmacists did not ask any question during dispensing. Nausea was the most frequent described side effect by pharmacists (27 (38.57%)). Yet important adverse effects of oral contraceptive pills were not mentioned by the pharmacists except for few ones. Only twelve (17.14%) pharmacists mentioned the possible interaction. There was a significant relation between the pharmacists' gender and detection of possible interaction (p value= 0.048). The quality of the pharmacists' consultations regarding the over the counter use of oral contraceptive pills was not satisfactory and required improvement.

Awareness and attitudes towards emergency contraceptive pills among young people in the entertainment places, Vientiane City, Lao PDR

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2013-01-01

Background Emergency Contraception is not officially available to the public sector in Laos. The potential of emergency contraception to prevent unwanted pregnancies is well documented in developed countries, but in Laos no studies of ECPs exist. This study aimed to assess knowledge of and attitudes towards emergency contraceptive pills (ECPs) in Vientiane, the capital city of the Lao PDR. Methods A cross-sectional survey was conducted among 500 young adults in entertainment venues by using the convenience sampling between May to July, 2007. Data were obtained through face-to-face interview. Participants were asked about socio- demographic characteristics, knowledge, attitudes related to ECPs, and source of information about ECPs. Data analysis was performed with chi-square test and logistic regression (p < .05). Results Only 22.4 percent of respondents had heard of ECPs and of these only 17.9 percent knew the correct time-frame for effective use. Most of the respondents (85%) agreed on the need for ECPs to be available in Laos and 66.8 percent stated that they would use them should the need arise, if they were available. Among those who said they would not use ECPs, 63.8 percent were concerned about possible health effects, or other side effects. Awareness of ECPs was associated with increasing age (OR = 2.78, p = .025) and male sex (OR = 2.91, p = .010). Conclusions There is needed to provide effective health education about the method, timing of use, and how to obtain ECPs through both informal, peer channels, and also through formal channels such as health care providers. PMID:23514104

The safety of available and emerging options for emergency contraception.

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Lee, Jessica K; Schwarz, Eleanor Bimla

2017-10-01

Emergency contraception (EC) is a way to significantly reduce the chance of becoming pregnant after an episode of unprotected intercourse. Considerable data support the safety of all available and emerging options for EC. Areas covered: This review presents a comprehensive summary of the literature regarding the safety of EC as well as directions for further study. PubMed was searched for all relevant studies published prior to June 2017. Expertopinion: All available methods of EC (i.e., ulipristal acetate pills, levonorgestrel pills, and the copper-IUD), carry only mild side effects and serious adverse events are essentially unknown. The copper IUD has the highest efficacy of EC methods. Given the excellent safety profiles of mifepristone and the levonorgestrel IUD, research is ongoing related to use of these products for EC.

Knowledge about missed contraceptive pills among married women at King Abdulaziz University Hospital

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Iftikhar, Rahila; Aba Al Khail, Bahaa Abdulrahman

2015-01-01

Background Oral contraceptive pills (OCPs) are one of the most reliable methods of contraception. However, lack of knowledge about oral contraceptive use and inconsistent pill-taking might result in decreased efficacy. The study reported here aimed to explore women’s knowledge about oral contraceptive use and assess the factors associated with knowledge about OCPs among users. Methods This cross-sectional survey was conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia between April and June 2014. We included married, non-pregnant women >18 years old who had used a combined 21-day OCP for at least 3 months prior to recruitment. A questionnaire was used to collect the participants’ demographic information. It also assessed their knowledge about OCPs. Data were entered into and analyzed using SPSS software. Results A total of 357 women were recruited. Of these, 57.7% reported they knew what to do after missing one or two pills, but only 18.3% knew exactly what to do after missing more than two pills consecutively. Postgraduate women had a significantly higher knowledge score than illiterate women (P=0.002) and those who had completed at least primary education (P=0.001). Conversely, there was no difference in knowledge scores between Saudi and expatriate women (P=0.2). Monthly incomes (P=0.2) and mode of OCP selection (P=0.2) were also not significantly associated with knowledge scores. Conclusion Women had poor knowledge about OCP use. Appropriate measures should be taken to educate women about proper oral contraceptive use. PMID:25792813

Postinor -- the unique method of emergency contraception developed in Hungary.

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Camp, S

1995-08-01

In Hungary, an important form of emergency contraception (EC) is the pill containing 0.75 mg levonorgestrel, which is marketed by Gedeon Richter under the name Postinor in four-pill packages. Women are instructed to take one pill within an hour of any unprotected act of intercourse, up to four pills per month. The nature of the administration requires that women be in possession of the pills before they need them, and, while Postinor is marketed as an EC, the target market is young, unmarried women who experience infrequent intercourse. When it was first offered a decade ago, Postinor gained widespread use in place of contraception. The product was overused and there was a backlash in the medical community. Thus, the manufacturer changed its packaging instructions and removed the original 10-pill package from the market. While the price of the drug is considered prohibitive for use by adolescents, more than three million pills were sold in the past three years in Hungary and more than 60 million pills were sold in over 20 countries. Clinical studies show a failure rate of less than 1% and relatively few side effects (10-20% nausea and 20-40% bleeding) if not more than four pills per month are used. The World Health Organization is currently conducting trials to compare use of Postinor with the Yuzpe method. Results of these trials will be available in 1996.

An assessment of the quality of advice provided by patent medicine vendors to users of oral contraceptive pills in urban Nigeria.

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Ujuju, Chinazo; Adebayo, Samson B; Anyanti, Jennifer; Oluigbo, Obi; Muhammad, Fatima; Ankomah, Augustine

2014-01-01

In Nigeria about 50% of oral contraceptive pill users obtain their products from proprietary patent medicine vendors (PPMVs). This group of service providers are poorly trained and have very limited knowledge about contraception. This paper investigated the nature of the advice offered to simulated current and potential users of oral contraceptive pills. The main objective was to assess the nature and quality of advice provided by PPMVs to pill users. This study is based on findings from a 'mystery client' approach in which three scenarios related to contraceptive pill use were simulated. Each of the 12 mystery clients simulated one of the following three scenarios: new pill users (new to family planning or switching from condom to pills); user seeking a resupply of pills; and dissatisfied pill users intending to discontinue use. Simple random sampling was used to select 410 PPMVs from a total of 1,826 in four states in Nigeria. Qualitative study using in-depth interviews was also conducted. A majority of the PPMVs had pills in stock on the day of the survey and resupplied pills to the clients. PPMVs also understood the reason and importance of referring clients who were new adopters of oral contraceptive methods to a health facility; 30% of the PPMVs referred new adopters to a health facility. However, demand from clients who do not want to go to health care facilities (for various reasons) necessitated the provision of oral contraceptive pills to 41% of the first time users. Some PPMVs prescribed treatment to mystery clients who presented with perceived complications arising from the use of pills, while 49% were referred to a health facility. The advice given by PPMVs often falls short of safety guidelines related to the use of oral contraceptive pills. There is a need to continuously update knowledge among the PPMVs to ensure that they provide quality oral contraceptive services as PPMVs bridge the gap between medical experts and users in rural communities.

An assessment of the quality of advice provided by patent medicine vendors to users of oral contraceptive pills in urban Nigeria

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Ujuju C

2014-04-01

Full Text Available Chinazo Ujuju,1 Samson B Adebayo,2 Jennifer Anyanti,3 Obi Oluigbo,3 Fatima Muhammad,4 Augustine Ankomah5 1Research and Evaluation Division, Society for Family Health, Abuja, Nigeria; 2Planning, Research and Statistics Directorate, National Agency for Food and Drug Administration and Control, Abuja, Nigeria; 3Technical Services Directorate, Society for Family Health, Abuja, Nigeria; 4Family Planning Directorate, Society for Family Health, Abuja, Nigeria; 5Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana Introduction: In Nigeria about 50% of oral contraceptive pill users obtain their products from proprietary patent medicine vendors (PPMVs. This group of service providers are poorly trained and have very limited knowledge about contraception. This paper investigated the nature of the advice offered to simulated current and potential users of oral contraceptive pills. The main objective was to assess the nature and quality of advice provided by PPMVs to pill users. Method: This study is based on findings from a 'mystery client' approach in which three scenarios related to contraceptive pill use were simulated. Each of the 12 mystery clients simulated one of the following three scenarios: new pill users (new to family planning or switching from condom to pills; user seeking a resupply of pills; and dissatisfied pill users intending to discontinue use. Simple random sampling was used to select 410 PPMVs from a total of 1,826 in four states in Nigeria. Qualitative study using in-depth interviews was also conducted. Results: A majority of the PPMVs had pills in stock on the day of the survey and resupplied pills to the clients. PPMVs also understood the reason and importance of referring clients who were new adopters of oral contraceptive methods to a health facility; 30% of the PPMVs referred new adopters to a health facility. However, demand from clients who do not want to go

Social constructions of the male contraception pill: When are we going to break the vicious circle?

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Dismore, Lorelle; Van Wersch, Anna; Swainston, Katherine

2016-05-01

Social constructions of men towards the availability of a male hormonal contraceptive, the 'male pill', were explored. A qualitative approach applying semi-structured interviews and scenarios with 22 men (mean age 35 years) from the North East of England revealed two core constructs and six sub-constructs using a Thematic-Construct Analysis in line with the method of Toerien and Wilkinson and Clarke and Kitzinger. Verbal accounts were inductively used to balance the deductively created two core constructs 'Constructing the male pill norm: dominant system of sensemaking' and 'Living by the male pill norm' to represent a normative framework within a changing ideology of shared responsibility in contraceptive choice. Constructing the male pill norm was divided into two sub-constructs: 'Male pill: we are going to join the women and become responsible - too!' and 'Male pill: you look so girly - what are they going to think of me?' The 'Living by the male pill norm' was further divided into four sub-constructs 'Male pill - thank you for giving me promises not to have to become a dad as yet!'; 'Male pill: thank you for the idea of fun - sorry about my morals!'; 'Male pill: in stable relations - yes, I would have you now - sorry, I am too late!' and 'Male pill, we love you - but we are too anxious - we are not ready as yet!' From this male discourse, it is clear that discussions over the male pill follow the line of a vicious circle. In order to establish long-term side effects, Phase IV studies are necessary, and these cannot commence without the male hormonal contraception being a marketable product. So, unless this circle gets broken by some brave men, the male pill will remain a virtual rotating idea for a long time. © The Author(s) 2014.

Benefits and risks of hormonal contraception for women

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Gorenoi, Vitali; Schönermark, Matthias P.; Hagen, Anja

2007-01-01

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 ri...

Knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital, southwest Ethiopia

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Tesfaye Tatek

2012-03-01

Full Text Available Abstract Background In Ethiopia maternal mortality rate is very high more than one in five women die from pregnancy or pregnancy related causes. The use of contraceptives to prevent unwanted pregnancies and unsafe abortion is an important strategy to minimize maternal mortality rate. Among various forms of contraception, emergency contraceptives are the only one that can be used after sexual intercourse offering chance to prevent unwanted pregnancy. The aim of this study was to assess the knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital (JUSH. Methods Institution base cross-sectional study on knowledge, attitude and practice of emergency contraceptive was conducted at JUSH from April to June, 2011Data was collected using structured questionnaire and analyzed using SPSS version 17.0. Results In this study 89 women were interviewed. More than half of them (48 were from urban area and 41 were from rural area.46 (51.7% of them were single. Of all the respondents only nine women had awareness about emergency contraceptive. Seven of the women mentioned pills as emergency contraception and only two of them mentioned both pills and injectable as emergency contraception. All of them have positive attitude towards emergency contraception but none of them have ever used emergency contraceptives. Conclusion and recommendation The finding revealed pregnancy among women of 15-19 years was very common. The knowledge and practice of emergency contraception is very low. But there is high positive attitude towards emergency contraceptives. Since there is much deficit on knowledge of women on emergency contraceptives, in addition to making them accessible; programs targeted at promotion and education of emergency contraceptives is helpful to prevent unwanted pregnancy.

Health education alone and health education plus advance provision of emergency contraceptive pills on knowledge and attitudes among university female students in Enugu, Nigeria.

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Arinze-Onyia, S U; Aguwa, E N; Nwobodo, Ed

2014-01-01

This was an intervention study to compare the effects of health education alone and health education plus advance provision of emergency contraception (EC) pills on the knowledge and attitudes to EC by female students of University of Nigeria in South-East Nigeria. A structured questionnaire was used to collect data in February, 2009 from 290 female students of a tertiary educational institution (140 in the study group and 150 from the control group) who were selected by multistage sampling. Subsequently, health education was conducted among all the students. In addition, a pack containing 2 tablets of EC pills (Postinor) was given only to the students in the study group. Three months after this intervention, its effects were assessed through a survey using the same structured questionnaire employed in the baseline survey. knowledge of EC was significantly higher among the study group than the controls at post-intervention, P education plus advance provision of EC pills effectively improved knowledge and attitudes to EC among female students of tertiary institutions more than health education alone and this should be promoted.

Peripheral arterial disease in a female using high-dose combined oral contraceptive pills.

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Pallavee, P; Samal, Sunita; Samal, Rupal

2013-01-01

The association between oral contraceptive (OC) pills and vascular diseases is well-known, although, the present generation of pills is considered to be relatively safer in this regard. Hormonal treatment for severe abnormal uterine bleeding is usually considered after ruling out malignancy, when such bleeding is resistant to all other forms of treatment. We report a case of severe peripheral arterial disease in a female, who had been on high-dose OC pills for an extended period of time for severe uterine bleeding.

Policy maker and provider knowledge and attitudes regarding the provision of emergency contraceptive pills within Lao PDR

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Hansana Visanou

2010-07-01

Full Text Available Abstract Background The Ministry of Health (MOH launched the National Reproductive Health Policy in 2005, which included recommendations regarding the use of emergency contraceptive pills (ECP. However, ECP have not yet been introduced officially in the public sector of the Lao PDR. Thus, their availability is limited. Understanding the knowledge of ECP and attitudes about their provision, barriers to use, and availability among health providers and policy makers is essential to successfully incorporate ECP into reproductive health services. Methods Qualitative research methods using in-depth interviews were employed to collect data from policy makers and health providers (auxiliary medical staff, nurses, and medical doctors. Altogether, 10 policy makers, 22 public providers, and 10 providers at private clinics were interviewed. Content analysis was applied to analyze the transcribed data. Results The majority of policy makers and health care providers had heard about ECP and supported their introduction in the public sector. However, their knowledge was poor, many expressed inconsistent attitudes, and their ability to meet the demand of potential users is limited. Conclusions There is a need to train health providers and policy makers on emergency contraception and improve their knowledge about ECP, especially regarding the correct timing of use and the availability of methods. In addition, the general public must be informed of the attributes, side effects, and availability of ECP, and policy makers must facilitate the approval of ECP by the Lao Food and Drug Administration. These interventions could lead to increased access to and demand for ECP.

Reasons for requesting emergency contraception: a survey of 506 Italian women.

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Bastianelli, C; Farris, M; Benagiano, G

2005-09-01

To evaluate the reason for requesting emergency contraception (EC), previous use of contraceptive methods and provision route in a Family Planning Clinic in Italy. Women requesting EC were interviewed, through a questionnaire containing questions on demographic characteristics, about their reasons for requesting EC, their prior contraceptive use, their reasons for not using an effective contraceptive method (or possible reasons for its failure) and specifically about the so-called 'provision route' (i.e. whether and where they had previously requested EC receiving a negative response). Almost 70% of all women requesting EC were aged between 18 and 25 years. Some 80% of all women were in a stable relationship with their partner, with fewer than 20% having had an occasional intercourse. The vast majority of women (83%) reported prior use of a modern contraceptive method, i.e. 64% with a condom, 27% for combined oral contraceptives and 1.1% for the intrauterine device (IUD). In addition, 15% of the women had used more than one method (oral pills and condoms). Concerning the reasons for requesting EC, condom breakage or slipping was the most frequently cited (64%), followed by totally unprotected intercourse (28%), failed withdrawal (5%) and forgetting one or more pill (only 1.1%). More than one-third of the women interviewed had previously used an emergency contraceptive modality; although no one did so more than four times. Therefore, it can be inferred that-at least in the present series-EC had not been used as a routine contraceptive method. Finally, it seems clear that in Italy, even in large cities, information about the availability, proper usage and mechanism of action is lacking. This seems due to information being spread by word of mouth between peers and friends, with more formal communication channels lagging behind.

Utilization of and Adherence to Oral Contraceptive Pills and Associated Disparities in the United States: A Baseline Assessment for the Impact of the Affordable Care Act of 2010.

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Lin, Hsien-Chang; Lee, Hsiao-Yun

2015-01-01

This study investigated sociological factors that may influence women's utilization of and adherence to oral contraceptive pills. This was a retrospective cross-sectional study using the 2010-2012 Medical Expenditure Panel Survey. Female adults aged 18-50 years were included. Logistic regression was performed to discern women's decisions to use oral contraceptive pills or not. Ordinary least squares and Poisson regressions were conducted to examine the number of oral contraceptive pills received, refill frequency, and annual out-of-pocket expenditure on oral contraceptive pills. Covariates were based on the Andersen model of health care utilization. Among the study sample (weighted n = 207,007,531), 14.8% were oral contraceptive pill users. Factors positively related to oral contraceptive pill use included non-Hispanic white ethnicity, younger age, not currently married, having private insurance, residing in the Midwest, higher education level, and higher annual family income. Being non-Hispanic white and having a higher education level were positively related to oral contraceptive pill adherence. Our findings therefore demonstrate disparities in oral contraceptive pill utilization and adherence, especially according to women's race/ethnicity and educational level. This study serves as a baseline assessment for the impact of the Affordable Care Act on oral contraceptive pill utilization and adherence for future studies. © The Author(s) 2015.

Emergency Contraceptive Pills (ECP) Knowledge, Attitudes, and Practices Among Women Working in the Entertainment Industry and Men in the Trucking Industry, Bhutan.

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Pem, Deki; Nidup, Tshewang; Wangdi, Ugyen; Pelzom, Dorji; Mirzazadeh, Ali; McFarland, Willi

2018-02-12

Emergency contraceptive pills (ECP) were recently made available over the counter in Bhutan. We evaluated knowledge, attitudes, and practices concerning ECP in 2 populations at risk for HIV and STI (sexually transmitted infections): entertainment women (drayang) and male truck drivers and helpers (truckers). Of 179 drayang and 437 truckers intercepted at venues, 73.7 and 21.1%, respectively, had heard of ECP; 47.0% of drayang had used them. Their concerns about ECP use included harm to the body, impact on future pregnancy, side effects, and HIV/STI risk. Education programs are needed in Bhutan to increase awareness of ECP for unplanned pregnancy and condoms to prevent HIV and STI.

Knowledge and Attitude of Married Women in the Reproductive Age Group Regarding Emergency Contraception in Selected Rural Areas of Udupi District

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Preethi Fernandes

2014-01-01

Full Text Available Background: Unwanted pregnancy is still a major problem in the modern world despite the widely available contraception services. This study was conducted to determine the knowledge and attitude of married women in the reproductive age group regarding emergency contraception in selected rural areas of Udupi district, India. Material and Methods: The study group comprised of 350 married women in the reproductive age group residing in rural areas of Udupi district, India. A structured questionnaire and an attitude scale were used to assess the knowledge and the attitude. Results: Majority, 69.1% of the married women belonged to Hindu religion, 46.9% had an educational qualification of 10th standard and below. About 13.1% of the married women had undergone abortion. Nearly 96.9% of the married women had heard about emergency contraceptives and only 2% of the married women had used emergency contraceptive pills. About 63.7% out of 339 married women had got information about emergency contraceptive pills from health personnel and about 77.7% from television. Majority 84% had poor knowledge on emergency contraception. About 99.7% had favourable attitude on the use of emergency contraceptives. There was a significant association between knowledge scores and selected variable like education, knowledge and the attitude scores had a correlation. Conclusion: The study identifies the knowledge and attitude of the rural married women regarding emergency contraception, hence to help them to plan future pregnancies and prevent any unwanted or unintended pregnancies.

Offering extended use of the combined contraceptive pill: a survey of specialist family planning services

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Sauer U

2013-09-01

Full Text Available Ulrike Sauer,1 Sue Mann,2 Nataliya Brima,3 Judith Stephenson21Reproductive and Sexual Health, Enfield Community Service, Enfield, 2Sexual and Reproductive Health Research Group, Institute for Women’s Health, 3Research Department of Infection and Population Health, University College London, London, UKBackground: The purpose of this study was to determine attitudes to, and provision of, extended regimens for taking the combined oral contraceptive pill (COC by specialist contraception practitioners from three contrasting specialist contraception services in London.Methods: An online cross-sectional survey was administered to all doctors and nurses, who counsel, provide, or prescribe the oral contraceptive pill at each clinic.Results: A total of 105 clinicians received the questionnaire and 67 (64% responded. Only one of three clinics initiated and maintained guidelines for extended COC use. In that service, 60% of staff prescribing COC advised more than 50% of patients regarding alternative COC regimens. In the other two services, this was discussed with 20% and 6% of patients, respectively (P < 0.001. The reasons for prescribing extended use included cyclic headaches, menorrhagia, patient request, menstrual-related cramps, and endometriosis, and did not differ between the three different settings. The most common extended regimens were 63 pills or continuous use until bleeding occurs, followed by a hormone-free interval. Concerns highlighted by providers and patients were “unhealthy not to have a monthly bleed”, “future fertility”, and “breakthrough bleeding”. Such comments highlight the need for further information for providers and patients.Conclusion: There is growing evidence, backed by national guidance, about extended COC use, but routine provision of this information is patchy and varies ten-fold, even within specialist family planning services. Targeted training, use of service guidelines, and implementation research will be

Pharmacy-based interventions for initiating effective contraception following the use of emergency contraception: a pilot study.

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Michie, L; Cameron, S T; Glasier, A; Larke, N; Muir, A; Lorimer, A

2014-10-01

In Scotland most women get emergency contraception (EC) from pharmacies. Pharmacists currently cannot provide effective ongoing contraception after EC. In this pilot study, we aimed to determine the feasibility of a larger study designed to ascertain if pharmacy-based interventions can increase the uptake of effective contraception after EC. This is a pilot study of women presenting for levonorgestrel EC to community pharmacies in Edinburgh, UK, in 2012. Pharmacies were cluster randomized to provide either standard care or one of two interventions: (a) one packet of progestogen-only pills (POPs), giving women 1 month to arrange ongoing contraception; (b) invitation to present the empty EC packet to a family planning clinic (FPC) for contraceptive advice (rapid access). One hundred sixty-eight women were recruited from 11 pharmacies to POP (n=56), rapid access (n=58) and standard care (N=54) groups, respectively. Telephone follow-up was conducted successfully in 102 women (61%) 6-8 weeks later to determine current contraceptive use. In the POP arm, 35/39 (90%) women used the pills provided, and 9/28 women (32%) in the rapid access arm attended the FPC. The proportion of women using effective contraception at follow-up was significantly greater in both POP [56% (22/39), p=contraception versus barrier/no method, after use of EC, was 3.13 [95% confidence interval (CI), 1.90-5.13] in the POP group and 2.57 (95% CI, 1.55-4.27) in the rapid access group. This promising pilot study suggests that simple pharmacy-based interventions may increase the uptake of effective contraception after EC. A larger study is required to provide further validation of these findings. For women obtaining EC from a pharmacy, simple interventions such as supplying 1 month of a POP, or offering rapid access to a FPC, hold promise as strategies to increase the uptake of effective contraception after EC. Copyright © 2014 Elsevier Inc. All rights reserved.

Systematic Review of the profile of emergency contraception users

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Maria de Lluc Bauzà Amengual

2016-01-01

Full Text Available Abastract Objective: to discern the profile of the Spanish Emergency Contraceptive users (EC. Design: systematic review of contraceptive use in the Spanish population. Data Source: Spanish and international databases, between January 2006 - March 2011. Keywords: Contraceptives, Postcoital pills, emergency contraception, levonorgestrel, data collection. Study selection: original papers, letters to the editor in which stated aims were the description, prediction or measurement of variables related to EC use. Twenty-two papers were retrieved and fourteen were finally selected, all of which were descriptive. Data extraction: manuscripts were evaluated by two independent reviewers. Results: Women requesting EC have ages between 21-24 years, mostly single and university students; declare that they have not previously used EC, and attend an Emergency department, at weekends and within 48 hours following unprotected sexual intercourse. The reason is condom rupture. None of the studies reviewed measured alcohol and other drug consumption, the number of sexual partners, nor any of the studies performed a comparison with a group not using EC. Conclusions: lack of homogeneity and comprehensiveness of studied variables resulted in a limited profile of Spanish EC users. Further studies are needed with a more comprehensive approach if sexual health interventions are to be carried out in possible users.

[Emergency contraception in Latin America and the Caribbean].

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Martin, Antonieta

2004-12-01

Introducing the post-coital birth control method in the family-planning services of Latin American countries has not been an easy task. Catholic and other conservative groups with great influence in the political arena have time and again stopped it from being adopted as an alternative method and have even succeeded in having it removed from official directives after formal acceptance by health authorities. The main objections are triggered by the erroneous supposition that "emergency contraception" pills are abortifacients. However, a large dose of cultural discrimination against women seems also to be involved. It has been extremely difficult to register dedicated products and make them available in drug-stores and even more difficult to distribute them without charge at public health centers. They are hard to find, expensive, and unavailable to adolescents at risk for unwanted pregnancies and to most low-income women, especially in rural areas. Dissemination of appropriate information has been scarce and slow and there are still great numbers of people that do not understand how or why the method works. Brazil has been the only exception, as its open society has readily accepted this method of contraception. The Latin American Consortium on Emergency Contraception founded in the year 2000 and its regional conference two years later had an important impact on the situation, as they encouraged the coordination of efforts by governmental and nongovernmental entities with those of women's groups to fight for sexual and reproductive rights. A number of studies have shown that the more people learn about emergency contraception, the more they find it acceptable and necessary, and radio spots and other media techniques have begun to educate the public about this matter. In spite of the many difficulties encountered, in the last few years several countries have made strides to include this method in their public health guidelines. However, because of the powerful forces

Stagnant contraceptive sales after the Zika epidemic in Brazil.

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

2017-10-01

Our aim was to assess national hormonal and non-hormonal contraceptive sales in Brazil after the Zika virus outbreak. Pharmaceutical companies based in Brazil provided data on monthly sales from September 2016 to June 2017. Data from both the public and private sectors were obtained about sales of registered, available modern contraceptive methods: combined oral contraceptive pill; progestin-only pill; vaginal and transdermal contraceptives; injectable contraceptives; long-acting reversible contraceptive (LARC) methods, including the copper-releasing intrauterine device, the levonorgestrel-releasing intrauterine system and the etonogestrel-releasing subdermal implant; and emergency contraceptive pills. Seventy-eight percent of sales comprised pills, patches and vaginal rings (11.1-13.8 million cycles/units per month), followed by emergency contraceptive pills (1.8-2.6 million pills), injectables (1.2-1.4 million ampoules) and LARC methods (6500-17,000 devices). The data showed much higher sales of short-acting methods compared with more effective LARC methods. The public sector needs to strengthen its focus on ensuring better access to LARC methods through a systematic approach ensuring regular supply, improved professional skills and better demand generation to couples wishing to avoid or delay pregnancy. In Zika virus-affected areas, many women of reproductive age may want to delay or postpone pregnancy by using an effective LARC method. The public sector should review its policies on LARC, as the need for these methods especially in Zika virus endemic areas may increase. A clear emphasis on quality in services, access and use is warranted.

Reproductive Health Outcomes of Insured Women Who Access Oral Levonorgestrel Emergency Contraception

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Raine-Bennett, Tina; Merchant, Maqdooda; Sinclair, Fiona; Lee, Justine W.; Goler, Nancy

2015-01-01

Objectives To assess the level of risk for women who seek emergency contraception through various clinical routes and the opportunities for improved care provision. Methods This study looked at a retrospective cohort to assess contraception and other reproductive health outcomes among women aged 15-44 who accessed oral levonorgestrel emergency contraception through an office visit or the call center at Kaiser Permanente Northern California from 2010 to 2011. Results Of 21,421 prescriptions, 14,531(67.8%) were accessed through the call center. In the subsequent 12 months, 12,127(56.6%) women had short-acting contraception (pills, patches, rings, depot medroxyprogesterone) dispensed and 2,264(10.6%) initiated very effective contraception (intrauterine contraception, implants, sterilization). Initiation of very effective contraception was similar for women who accessed it through the call center -1,569(10.8%) and office visits – 695(10.1%) (adjusted OR 1.02 95% confidence interval (CI) 0.93-1.13). In the subsequent 6 months, 2,056(9.6%) women became pregnant. Women who accessed emergency contraception through the call center were less likely to become pregnant within 3 months of accessing emergency contraception than woman who accessed it through office visits (adjusted OR 0.82 95% CI 0.72-0.94); however they were more likely to become pregnant within 4-6 months (adjusted OR 1.37 95%CI 1.16-1.60). Among women who were tested for chlamydia and gonorrhea, 689(7.8%) and 928(7.9%) were positive in the 12 months before and after accessing emergency contraception, respectively. Conclusions Protocols to routinely address unmet need for contraception at every call for emergency contraception and all office visits including visits with primary care providers should be investigated. PMID:25751211

Comparing the effects of low-dose contraceptive pills to control dysfunctional uterine bleeding by oral and vaginal methods.

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Mehrabian, Ferdous; Abbassi, Fariba

2013-09-01

Background and Objective : Contraceptive pills are generally taken orally and can cause side effects such as nausea, vomiting and hypertension. The vaginal use of these pills can reduce such complications. Our objective was to compare the efficacy and side effects of low dose contraceptive pills by oral and vaginal route in the management of dysfunctional uterine bleeding-(DUB) Methods: This comparative observational study was conducted at Beheshti and Alzahra (SA) teaching hospitals, affiliated to Isfahan University of Medical Sciences in 2010-2011. One hundred women who presented with DUB were randomly assigned into two groups of equal number, receiving the low dose oral contraceptive pills by oral or vaginal route for three month. The amount and duration of bleeding were compared at the beginning and at the end of the study and side effects by these two methods compared. The results of this study showed that both oral and vaginal routes effectively reduced the duration and amount of bleeding due to DUB after three courses of treatment. This effect was better in the vaginal method compared with oral administration (P = 0.03). Regarding the side effects, nausea and vomiting were significantly higher in the oral group than in the vaginal group (P = 0.03). Vulvovaginitis infection was more frequent in the vaginal group than in the oral group (P = 0.03). Low dose contraceptive pills are effective in reducing the amount, time, and duration of bleeding in patients with DUB. In addition, reduction of gastrointestinal side effects by vaginal route helps to use these pills by the patient with proper training of physicians, midwives and patients.

Emergency Contraception Pill Awareness and Knowledge in Uninsured Adolescents: High Rates of Misconceptions Concerning Indications for Use, Side Effects, and Access.

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Yen, Sophia; Parmar, Deepika D; Lin, Emily L; Ammerman, Seth

2015-10-01

To determine the awareness of, access to, and knowledge of the proper use of emergency contraception pills (ECPs) among uninsured adolescents. Anonymous surveys were used to assess awareness of, knowledge of, and access to ECPs. From 2010 to 2012 at mobile primary care clinic in the San Francisco Bay Area. Patients were uninsured adolescents aged 13 to 25; 40% of the participants were currently or had been homeless in the past year. Ethnicity was 50% Asian, 22% Hispanic, 17% Pacific Islanders, 5.5% white, and 5.5% other/mixed ethnicity. Post survey completion, patients received one-on-one 15-minute dedicated ECP education. Awareness of, knowledge of, and access to ECPs. Of the study population of 439, 30% of the participants were 13-16 years old and 70% were 17-25 years old (mean age 17.8 years); 66% were women. Young women (86%) reported higher rates of "hearing about emergency contraception" than did young men (70%) (P < .0001). Many incorrectly identified or were uncertain if ECPs were an abortion pill (40%) or could be used as regular birth control (40%) or to prevent sexually transmitted infections (19%). Only 40% of women and 43% of men aged 17 and older correctly answered that they could obtain EC over the counter; 72% did not know that males could receive EC for use by their partner; 12% incorrectly selected that infertility was a side effect; 44% were under the false impression that EC had to be taken within 1 day of unprotected sex. Uninsured adolescents have high rates of ECP awareness but low ECP knowledge. These adolescents need more ECP education to alleviate misconceptions and increase practical knowledge, specifically, education about male access, side effects, over-the-counter availability for young men and women, and the 120-hour window of use. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Emergency contraception: update and review.

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Langston, Aileen

2010-03-01

Emergency contraception (EC) is the postcoital method of pregnancy prevention. Three methods of EC are used in the United States: (1) levonorgestrel-only pills, Plan B (Barr Pharmaceuticals, LLC, New Jersey) (2) combined estrogen and progestin pills, and (3) the copper intrauterine device. Used within 120 hours after unprotected sexual intercourse, EC reduces the risk of pregnancy by 60 to 94%. EC is a critical component of medical care for sexual assault survivors, and several states have laws mandating this standard of care. Levonorgestrel-only EC is available to women >or=17 years of age without a prescription. Women who were counseled by their clinician about EC were 11 times more likely to use EC in the following 12 months. Advance provision of EC to women has not been found to decrease rates of unintended pregnancy compared with routine pharmacy access; however, women routinely prefer advance provision. The newly approved by the Food and Drug Administration single-dose EC, Plan B One-Step (Barr Pharmaceuticals, LLC), may affect unintended pregnancy rates among EC users by simplifying use. Thieme Medical Publishers.

Knowledge and Attitudes About Emergency Contraception Among Married Women in the Eastern Black Sea Region of Turkey

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Yeşim Bayoğlu Tekin

2016-02-01

Full Text Available OBJECTIVE: Emergency contraception (EC is an effective contraceptive method that can be used after having unprotected intercourse to prevent the implantation of the unintended pregnancy. We aimed to evaluate the knowledge level of reproductive aged women about EC pills and its relation to the contraceptive attitudes and personal characteristics. STUDY DESIGN: A cross-sectional prospective study conducted in a university hospital in Turkey. A questionnaire was given to married women ages 18 to 49 years old. The frequency distribution of dependent (knowledge, attitudes, and beliefs and independent (age, gravidity, parity, income and education level, contraceptive methods variables was calculated. RESULTS: Of the 187 women, who completed the survey, 40.8% were aware of EC pills, 35.1% correctly answered regarding the timing of use, and 26.6% reported using EC pills. Negative beliefs about the morning after pill were commonly about adverse effects and lack of experience (62.6% and 45.9%, respectively. The other common reasons for not using EC were described as religious reasons (20.8% and responsibilities (40.8%. CONCLUSIONS: Awareness and knowledge of EC was low among the women interviewed. The major barriers to use of EC are lack of information and misconceptions about EC. To increase their awareness and dispel negative attitudes, Turkish women need intensive information about EC.

Oral contraceptive pills: Risky or protective in case of Trichinella spiralis infection?

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Hasby Saad, M A; Radi, D A; Hasby, E A

2017-08-01

The aim of this study was to investigate how Trichinella spiralis infection can be affected by contraceptive pills in vivo. Methods included six groups of female Wistar rats; healthy, Trichinella infected, receiving combined contraceptive pills (COCPs), receiving progestin only pills (POPs), infected receiving COCPs and infected receiving POPs. Parasite burden was measured; adult worm counts, gravidity, larvae and reproductive capacity index). Histopathological examination, immunohistochemical detection of C-kit+ mast cells and Foxp3+ T-reg. cells in intestinal sections, eosinophils muscle infiltration and CPK level were performed. Rats infected and receiving COCPs showed a significant increase in parasitic burden, and infected receiving POPs showed a significant reduction compared to infected only, with a significant increase in nongravid females (Mean total worms=964.40±55.9, 742±52.63, 686±31.68, larvae/g=5030±198.75, 2490±143.18 and 4126±152,91, respectively). Intestinal sections from infected receiving COCPs showed intact mucosa (though the high inflammatory cells infiltrate), and significant increase in C-kit+ mast cells number and intensity (30.20±4.15 and 60.40±8.29), and Foxp3+ T-reg. cells (10±1.58). Infected receiving POPs showed a significantly less CPK (5886±574.40) and eosinophilic muscle infiltration (58±13.51). Oestrogen-containing pills established a favourable intestinal environment for Trichinella by enhancing Foxp+T-reg. cells and stabilizing C-kit+mast cells, while POPs gave a potential protection with less gravidity, larval burden and eosinophilic infiltrate. © 2017 John Wiley & Sons Ltd.

The Role of Oral Contraceptive Pills on Increased Risk of Breast Cancer in Iranian Populations: A Meta-analysis.

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Soroush, Ali; Farshchian, Negin; Komasi, Saeid; Izadi, Neda; Amirifard, Nasrin; Shahmohammadi, Afshar

2016-12-01

Cancer is one of the main public health issues in the world. Breast cancer is one of the most common types of cancer among women. It is also the second cause of mortality in women. The association between the use of oral contraceptive pills and breast cancer is controversial and a main issue in public health. Some findings have shown that taking these pills does not have a significant effect in increasing the risk of breast cancer, while others have confirmed the carcinogenic effect of these products. These contradictory findings necessitated this meta-analysis, through of all correlated studies in Iran. All published studies were considered from June 2000 until June 2015, using reliable Latin databases like PubMed, Google Scholar, Google search, Scopus, and Science Direct, and Persian database like SID, Irandoc, IranMedex, and Magiran. Finally, 26 papers were selected: 24 studies were case control while two were population based studies. A total of 26 papers with 46,260 participants were assessed since 2001. Overall estimate of OR for the effect of oral contraceptive pills on breast cancer is 1.521 (CI = 1.25-1.85), which shows that the intervention group had more chance (52%) compared to the control group ( P = 0.001). Using these pills increased the risk of breast cancer up to 1.52 times. Because of directly increasing levels of estrogen and the role of estrogen in gaining weight indirectly, oral contraceptive pills can stimulate the occurrence of breast cancer. More studies should be conducted for controlling the period of pill use.

Serum levels of T3 and T4 among workers of contraceptive pills industry

International Nuclear Information System (INIS)

Abbas, E.Z.; Emara, A.; Yassen, Y.Z.; Amr, M.M.; Jaras, M.S.

1985-01-01

Serum levels of thyroxine and triiodothyronine were determined in 24 workers engaged in contraceptive pills industry and 20 control subjects. Serum thyroxine in exposed subjects was significantly lower, compared to its level in controls. On the other hand, triiodothyronine was significantly higher in exposed workers. Thus, it is concluded that exposure to the dust of contraceptive drugs, namely estrogen and progesterone, produced disturbances in thyroid gland function and thyroid hormone metabolism. (author)

Emergency contraception in a public health emergency: exploring pharmacy availability in Brazil.

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Tavares, Marilia P; Foster, Angel M

2016-08-01

Dedicated progestin-only emergency contraceptive pills (ECPs) have been available with a prescription in Brazil since 1999. However, utilization of emergency contraception has been limited. We conducted a mystery client study at retail pharmacies in three regions to assess current availability. Using a predetermined client profile, we approached a random sample of chain and independent pharmacies in urban areas in the southeastern, northeastern and central-west regions. We documented product availability, price and the client-pharmacy representative interaction at each site. We analyzed these data with descriptive statistics and for content and themes. We visited 122 pharmacies in early 2016. All but three pharmacies (97.5%) had ECPs in stock at the time of the interaction and offered our client the medication without a prescription. In general, pharmacy representatives did not ask questions or provide our client with information about emergency contraception. When prompted, over one third of the pharmacy representatives (37.7%) inaccurately reported that levonorgestrel ECPs could only be used immediately or within 12, 24 or 48h from the time of intercourse. Despite the current regulatory status, our findings suggest that progestin-only ECPs are widely available without a prescription. Additional efforts to ensure that women have up-to-date and medically accurate information about progestin-only ECPs appear warranted. Our findings suggest that more work needs to be done to align national regulatory policies with international standards and evidence-based practices. The Zika virus epidemic has shined a spotlight on the importance of providing timely access to emergency contraception in Latin America. This public health emergency offers a window of opportunity to advance national policies and practices to ensure that Brazilian women have access to a full range of reproductive health services. Copyright © 2016 Elsevier Inc. All rights reserved.

Knowledge of emergency contraceptives among secondary school learners in the rural area of MoletjiMashashane Limpopo Province South Africa

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P Mamabolo

2017-12-01

Full Text Available Background. Teenagers at the reproductive age face the dilemma of choosing the best birth control method. Knowledge of emergency contraceptive pills (ECPs associated with an intention to use other contraceptive methods has rarely been investigated. This study investigated the knowledge of emergency contraceptives among secondary school learners in the rural area of Moletji-Mashashane, Limpopo Province, South Africa. Objective. To assess the knowledge of and barriers against emergency contraception among secondary school learners. Methods. An anonymous questionnaire was used in the study. It included single and multiple-choice questions. Results. A total of 469 learners aged 14 - 18 years completed the anonymous, self-administered questionnaire. The results showed that secondary school learners did not have good knowledge of emergency contraceptives; 47.5% reported that they had heard of emergency contraceptives, while 52.5% reported that they had never heard of emergency contraceptives. The majority of learners had misperceptions about the details and safety of ECPs. However, 48.4% reported that emergency contraceptives are effective in preventing pregnancy. Conclusion. The awareness of ECPs was not high in this group. An improved multisectoral approach to education about emergency contraceptives, with greater participation by schools and the Department of Health, is advised. A systematic and long-term intervention among secondary school learners must be conducted to educate learners about emergency contraceptives.

Knowledge and Determinants of Emergency Contraception use ...

African Journals Online (AJOL)

practices, including EC in existing students' health enlightenment programs on campuses. KEY WORDS: ... of parental guidance, under great peers influence, and often indulging in alcohol or other ..... i) Oral contraceptive pills [ ] ii) IUCD [ ].

Emergency Contraception Education for Health and Human Service Professionals: An Evaluation of Knowledge and Attitudes

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Colarossi, Lisa; Billowitz, Marissa; Breitbart, Vicki

2010-01-01

Objective: To assess the knowledge and attitudes of health care providers, health educators, and social service providers before and after a training session on emergency contraceptive pills. Design: A survey study using pre-post training measurements. Setting: Two hundred and twenty-three medical, social service, and health education providers in…

Investigation on the association between breast cancer and consumption patterns of combined oral contraceptive pills in the women of Isfahan in 2011.

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Ehsanpour, Soheila; Nejad, Fahime Seyed Ahmadi; Rajabi, Fariborz Mokarian; Taleghani, Fariba

2013-05-01

Oral contraceptive pills are among the most popular contraceptive methods, but the fear of cancer and cardiovascular disease overshadows its continuous use among women. This study aimed to define the association between consumption patterns of combined oral contraceptives among women with breast cancer. This is an analytical case-control study conducted on 175 women with breast cancer, referring to Seyed al Shohada Medical Center and private clinics in Isfahan to be treated and followed up in 2011, as well as 350 healthy women who were identical with the subjects in the study group regarding age and residential location. The data were collected using a researcher-made questionnaire. Content validity and Cronbach's alpha were employed to confirm validity and scientific reliability of the questionnaire, respectively. The data were analyzed by descriptive and analytical statistical methods through SPSS. The findings showed that there was a significant association between history of contraceptive pills' consumption and incidence of breast cancer (P pills' consumption compared to those with no history of that. It was also shown that pills' consumption for 36-72 months increased the risk of breast cancer by 2.18-fold, the age of the first use being less than 20 years increased the risk by 3.28-fold, and time since the last use of less than 25 years increased the risk by 2.63-fold. There was no significant association between duration of use, age of the first and last use, and time since the first and last use in the study and control groups. The results showed that history of pills' consumption is associated with incidence of breast cancer regardless of the consumption pattern. Use of oral contraceptives pills at any age and for any duration can increase the risk of breast cancer.

Frequency of Candidiasis and Colonization of Candida albicans in Relation to Oral Contraceptive Pills.

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Aminzadeh, Atousa; Sabeti Sanat, Ali; Nik Akhtar, Saeed

2016-10-01

Candidiasis, the infection caused by Candida albicans , is one of the most common infections of the oral cavity in humans. Candidiasis causes irritation and is known for its carcinogenic effects. Thus, it is important to recognize the predisposing factors for this opportunistic infection. Several previous studies have demonstrated an increased frequency of vaginal candidiasis in relation to oral contraceptive consumption. Only a few studies on the relation between oral contraceptives and oral candidiasis have been previously conducted. This study aims to evaluate the possible relation between oral contraceptive pills and oral candidiasis. This analytic, case-control study included 40 non-pregnant women divided into two groups: 20 who used oral contraceptive pills and 20 who did not. The groups were matched according to age, oral health, and past and present medical history. Samples were collected from the tongue's dorsum using a cotton swab and inoculated on CHROMagar culture plates. The frequency of positive cultures and the number of Candida colonies were compared between the two groups using independent t-tests and Mann-Whitney statistical tests with SPSS18 software. The frequency of positive cultures of Candida albicans was higher (P value = 0.03) for the case group. Also, the number of C. albicans and C. krusei was significantly higher for the case group compared to the control group (P value = 0.04, P value = 0.03). The results of the present study demonstrate that oral contraceptives containing estradiol can lead to Candida colonization in the oral cavity. It is recommended that further studies comparing the influence of oral contraceptives on Candida's adherence to the epithelium is highly recommended.

Knowledge and Practices of Medical And Traditional Emergency Contraception among Married Women in Odemis

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Zeynep Daşıkan

2013-06-01

Full Text Available Objectives: The present study was designed to determine medical and traditional knowledge and practices of emergency contraception among married women after unprotected sexual intercourse.\tMaterials and Methods: The present study was carried out as a descriptive study on 367 married women registered to Primary Health Center number one in Odemis County of Izmir City between the dates 12.05.2005 and 20.06.2005. The data were collected through a questionnaire consisting of characteristic desciriptive, reproductive data and knowledge and use of medical and traditional emergency contraception. For collecting data, face-to-face interview technique was used. Data were evaluated by as number, percentage and chi-square tests on the SPSS version 12.0.\tResults: It was found that 25.1% of the women knew medical methods of emergency contraception and 1.4% of them (n = 5 used morning after pills. It was also found that 50.1% of the women knew at least one traditional practice for contraception and 19.3% of them used traditional practice at least for one time, and the most frequently used traditional practice was vaginal douche with rate of 75.7%. Conclusions: It was concluded that rate of having knowledge on and using medical emergency contraceptive methods was lower for contraception from unintended pregnancies whereas rate of having knowledge on and using traditional contraceptive practice was higher among married women in Odemis. The women should be informed on emergency contraceptive methods and they should be given counselling.

Reproductive health outcomes of insured adolescent and adult women who access oral levonorgestrel emergency contraception.

Science.gov (United States)

Raine-Bennett, Tina; Merchant, Maqdooda; Sinclair, Fiona; Lee, Justine W; Goler, Nancy

2015-04-01

To assess the level of risk for adolescents and women who seek emergency contraception through various clinical routes and the opportunities for improved care provision. This study looked at a retrospective cohort to assess contraception and other reproductive health outcomes among adolescents and women aged 15-44 years who accessed oral levonorgestrel emergency contraception through an office visit or the call center at Kaiser Permanente Northern California from 2010 to 2011. Of 21,421 prescriptions, 14,531 (67.8%) were accessed through the call center. In the subsequent 12 months, 12,127 (56.6%) adolescents and women had short-acting contraception (pills, patches, rings, depot medroxyprogesterone) dispensed and 2,264 (10.6%) initiated very effective contraception (intrauterine contraception, implants, sterilization). Initiation of very effective contraception was similar for adolescents and women who accessed it through the call center-1,569 (10.8%) and office visits-695 (10.1%) (adjusted odds ratio [OR] 1.02, 95% confidence interval [CI] 0.93-1.13). In the subsequent 6 months, 2,056 (9.6%) adolescents and women became pregnant. Adolescents and women who accessed emergency contraception through the call center were less likely to become pregnant within 3 months of accessing emergency contraception than woman who accessed it through office visits (adjusted OR 0.82, 95% CI 0.72-0.94); however, they were more likely to become pregnant within 4-6 months (adjusted OR 1.37, 95% CI 1.16-1.60). Among adolescents and women who were tested for chlamydia and gonorrhea, 689 (7.8%) and 928 (7.9%) were positive in the 12 months before and after accessing emergency contraception, respectively. Protocols to routinely address unmet needs for contraception at every call for emergency contraception and all office visits, including visits with primary care providers, should be investigated.

History of oral contraception.

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Dhont, Marc

2010-12-01

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.

Unprotected intercourse in the 2 weeks prior to requesting emergency intrauterine contraception.

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Sanders, Jessica N; Howell, Laura; Saltzman, Hanna M; Schwarz, E Bimla; Thompson, Ivana S; Turok, David K

2016-11-01

Previous emergency contraception studies have excluded women who report >1 episode of unprotected or underprotected intercourse. Thus, clinical recommendations are based on exposure to a single episode of underprotected intercourse. We sought to assess the prevalence and timing of underprotected intercourse episodes among women requesting emergency contraception and to examine the probability of pregnancy following an emergency contraception regimen including placement of either a copper intrauterine device or a levonorgestrel intrauterine device with simultaneous administration of an oral levonorgestrel pill in women reporting multiple underprotected intercourse episodes, including episodes beyond the Food and Drug Administration-approved emergency contraception time frame (6-14 days). Women seeking emergency contraception who had a negative pregnancy test and desired either a copper intrauterine device or levonorgestrel emergency contraception regimen enrolled in this prospective observational study. At enrollment, participants reported the number and timing of underprotected intercourse episodes in the previous 14 days. Two weeks later, participants reported the results of a self-administered home pregnancy test. Of the 176 women who presented for emergency contraception and received a same-day intrauterine device, 43% (n = 76) reported multiple underprotected intercourse episodes in the 14 days prior to presenting for emergency contraception. Women with multiple underprotected intercourse episodes reported a median of 3 events (range 2-20). Two-week pregnancy data were available for 172 (98%) participants. Only 1 participant had a positive pregnancy test. Pregnancy occurred in 0 of 97 (0%; 95% confidence interval, 0-3.7%) women with a single underprotected intercourse episode and 1 of 75 (1.3%; 95% confidence interval, 0-7.2%) women reporting multiple underprotected intercourse episodes; this includes 1 of 40 (2.5%; 95% confidence interval, 0-13.2%) women

Knowledge about emergency contraception among women referred for treatment at a university hospital in Brazil

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Jaqueline Neves Lubianca

2014-04-01

Full Text Available Objective: To evaluate knowledge about emergency contraception (EC in women who are referred for treatment at the HCPA. The study investigated prevalence of use and of knowledge about correct use of the method. Study Design: Cross-sectional study. Settings: The study was conducted with patients admitted at the Hospital de Clínicas de Porto Alegre, from 2009 to 2010. Patients: Sexually active women, age range 18 to 50 years. Interventions: Patients answered a questionnaire about the use and knowledge about emergency contraception. Main Outcome Measures:  Primary outcome: prevalence of knowledge about the correct use of EC. Secondary outcome: prevalence of use of emergency contraception. Results: 61.2% of women reported using regular birth control pills, 18.7% used condoms, 9.0% used other methods, 3.0% used intrauterine device and 8.2% did not use a contraceptive method. Emergency contraception: 86.5% of interviewees reported having knowledge about the method, and 43.1% of those interviewees reported knowing how to use EC. In our study, 12.0% of interviewees correctly reported how to use EC. The prevalence of the use of EC in our sample was 19.4%. Conclusions: Though most interviewees reported having some knowledge about EC, only a small number were able to accurately describe its proper use.

The intrauterine device as emergency contraception: how much do young women know?

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Goodman, Suzan R; El Ayadi, Alison M; Rocca, Corinne H; Kohn, Julia E; Benedict, Courtney E; Dieseldorff, Jessica R; Harper, Cynthia C

2018-04-18

Unprotected intercourse is common, especially among teens and young women. Access to intrauterine device (IUD) as emergency contraception (EC) can help interested patients more effectively prevent unintended pregnancy and can also offer ongoing contraception. This study evaluated young women's awareness of IUD as EC and interest in case of need. We conducted a secondary analysis of data from young women aged 18-25 years, not desiring pregnancy within 12 months, and receiving contraceptive counseling within a cluster-randomized trial in 40 US Planned Parenthood health centers in 2011-2013 (n=1500). Heath centers were randomized to receive enhanced training on contraceptive counseling and IUD placement, or to provide standard care. The intervention did not focus specifically on IUD as EC. We assessed awareness of IUD as EC, desire to learn more about EC and most trusted source of information of EC among women in both intervention and control groups completing baseline and 3- or 6-month follow-up questionnaires (n=1138). At follow-up, very few young women overall (7.5%) visiting health centers had heard of IUD as EC. However, if they needed EC, most (68%) reported that they would want to learn about IUDs in addition to EC pills, especially those who would be very unhappy to become pregnant (adjusted odds ratio [aOR], 1.3; 95% confidence interval, 1.0-1.6, pContraceptive education should explicitly address IUD as EC. Few young women know that the IUD can be used for EC or about its effectiveness. However, if they needed EC, most reported that they would want to learn about IUDs in addition to EC pills, especially those very unhappy to become pregnant. Contraceptive education should explicitly address IUD as EC. Copyright © 2018 Elsevier Inc. All rights reserved.

Urinary steroid profile in females - the impact of menstrual cycle and emergency contraceptives.

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Mullen, Jenny E; Thörngren, John-Olof; Schulze, Jenny J; Ericsson, Magnus; Gårevik, Nina; Lehtihet, Mikael; Ekström, Lena

2017-07-01

Today's doping tests involving longitudinal monitoring of steroid profiles are difficult in women. Women have more complex hormonal fluctuations than men and commonly take drugs such as hormonal contraceptives that are shown to affect biomarkers used in these doping tests. In this study, we followed six women's urinary steroid profile during one menstrual cycle, including both glucuronides and sulfate conjugated fractions. Additionally, we studied what happens to the steroidal module of the Athlete Biological Passport (ABP) after administration of an emergency contraceptive (levonorgestrel, NorLevo®). The study shows that there are large individual variations in all metabolites included in the ABP and that the administration of emergency contraceptives may lead to suspicious steroid profile findings in the ABP. Urinary epitestosterone concentration increased during the menstrual cycle, leading to a decrease in the testosterone/epitestosterone ratio. The ratios followed in the ABP varied widely throughout the menstrual cycle, the coefficient of variation (CV) ranging from 4 to 99%. There was a 3-fold decrease in epitestosterone 24 h post administration of the emergency contraceptive pill and androsterone, etiocholanolone, and 5β- androstan-3α,17β-diol concentrations decreased about 2-fold. When analyzed with the ABP software, one of the six women had an atypical profile after taking the emergency contraceptive. Furthermore, we could not find any alterations in excretion routes (i.e., if the metabolites are excreted as glucuronide or sulfate conjugates) during the menstrual cycle or after administration of emergency contraceptive, indicating no direct effect on phase II enzymes. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

"Pregnancy and labour cause more deaths than oral contraceptives": The debate on the pill in the Spanish press in the 1960s and 1970s.

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Ortiz-Gómez, Teresa; Ignaciuk, Agata

2015-08-01

From 1941 to 1978, Franco's regime in Spain banned all contraceptive methods. The pill started circulating in Spain from the 1960s, officially as a drug used in gynaecological therapy. However, in the following decade it was also increasingly used and prescribed as a contraceptive. This paper analyses debates about the contraceptive pill in the Spanish daily newspaper ABC and in two magazines, Blanco y Negro and Triunfo, in the 1960s and 1970s. It concludes that the debate on this contraceptive method was much more heterogeneous than might be expected given the Catholic-conservative character of the dictatorship. The daily press focused on the adverse effects of the drug and magazines concentrated on the ethical and religious aspects of the pill and discussed it in a generally positive light. Male doctors and Catholic authors dominated the debate. © The Author(s) 2013.

Práticas contraceptivas entre jovens universitários: o uso da anticoncepção de emergência Contraceptive practices among university students: the use of emergency contraception

Directory of Open Access Journals (Sweden)

Ana Luiza Vilela Borges

2010-04-01

Full Text Available Este estudo investigou as práticas contraceptivas de 487 jovens estudantes de uma universidade pública paulista, tendo como enfoque o uso da anticoncepção de emergência. Um questionário estruturado foi enviado por endereço eletrônico em dezembro de 2007. Os jovens referiram altas proporções de uso de métodos, principalmente o preservativo masculino e a pílula. A anticoncepção de emergência já havia sido utilizada por metade dos estudantes, muitas vezes concomitantemente a métodos de alta eficácia. Entre as mulheres, análise de regressão logística múltipla mostrou associação do uso da anticoncepção de emergência com a idade, idade de início da vida sexual, ter deixado de usar preservativo masculino em alguma relação sexual, ter vivenciado ruptura acidental do preservativo masculino e conhecer alguém que já a tenha utilizado. A opção pela anticoncepção de emergência mostrou-se mais relacionada a inconsistências no uso de métodos regulares do que ao não uso propriamente dito, podendo ser considerada um marcador de descontinuidades nas práticas contraceptivas.This study investigated contraceptive practices and especially the use of emergency contraception by 487 young students at a public university in São Paulo State. A structured questionnaire was sent by e-mail and completed online in December 2007. Contraceptive methods and use of emergency contraception were investigated. Female and male students reported a high proportion of contraceptive use, mainly condoms and the pill. Half of the students had already used emergency contraception, often when already using some other highly effective method. Among female students, multiple regression analysis showed that current age, age at sexual initiation, not having used condoms in sexual relations, condom failure, and knowing someone that has used emergency contraception were associated with use of the latter. The option for emergency contraception proved to be

Missed pills: frequency, reasons, consequences and solutions.

Science.gov (United States)

Chabbert-Buffet, Nathalie; Jamin, Christian; Lete, Iñaki; Lobo, Paloma; Nappi, Rossella E; Pintiaux, Axelle; Häusler, Günther; Fiala, Christian

2017-06-01

Oral hormonal contraception is an effective contraceptive method as long as regular daily intake is maintained. However, a daily routine is a constraint for many women and can lead to missed pills, pill discontinuation and/or unintended pregnancy. This article describes the frequency of inconsistent use, the consequences, the risk factors and the possible solutions. The article comprises a narrative review of the literature. Forgetting one to three pills per cycle is a frequent problem among 15-51% of users, generally adolescents. The reasons for this are age, inability to establish a routine, pill unavailability, side effects, loss of motivation and lack of involvement in the initial decision to use oral contraceptives. The consequences are 'escape ovulations' and, possibly, unintended pregnancy. Solutions are either to use a long-acting method or, for women who prefer to take oral contraceptives, use a continuous or long-cycle regimen to reduce the risks of follicular development and thus the likelihood of ovulation and unintended pregnancy. A progestogen with a long half-life can increase ovarian suppression. For women deciding to use oral contraceptives, a shortened or eliminated hormone-free interval and a progestogen with a long half-life may be an option to reduce the negative consequences of missed oral contraceptive pills.

[Contraception and adolescence].

Science.gov (United States)

Amate, P; Luton, D; Davitian, C

2013-06-01

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

Practice Bulletin No. 152: Emergency Contraception.

Science.gov (United States)

2015-09-01

Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Common indications for emergency contraception include contraceptive failure (eg, condom breakage or missed doses of oral contraceptives) and failure to use any form of contraception (). Although oral emergency contraception was first described in the medical literature in the 1960s, the U.S. Food and Drug Administration (FDA) approved the first dedicated product for emergency contraception in 1998. Since then, several new products have been introduced. Methods of emergency contraception include oral administration of combined estrogen-progestin, progestin only, or selective progesterone receptor modulators and insertion of a copper intrauterine device (IUD). Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when a need arises (). The purpose of this Practice Bulletin is to review the evidence for the efficacy and safety of available methods of emergency contraception and to increase awareness of these methods among obstetrician-gynecologists and other gynecologic providers.

Pharmacy Professionals' Dispensing Practice, Knowledge, and Attitude towards Emergency Contraceptives in Gondar Town, Northwestern Ethiopia: A Cross-Sectional Study.

Science.gov (United States)

Belachew, Sewunet Admasu; Yimenu, Dawit Kumilachew; Gebresillassie, Begashaw Melaku

2017-01-01

Pharmacy professionals, as the most available members of medical team, have an important role in educating patients about the effective and appropriate use of contraceptives. The purpose of this study was to assess pharmacy professionals' dispensing practice, knowledge, and attitude towards emergency contraceptives use in Gondar town, northwestern Ethiopia. An institution based cross-sectional study was employed from May 14 to June 14, 2016, on 60 pharmacy professionals, who have been working in 8 randomly selected pharmacies and 6 drug stores. The collected data was entered to and analyzed using Statistical Packages for Social Sciences (SPSS) version 20. More than half 33 (55.0%) of the participants were druggist with 5-9 years of experience. About 56 (93.3%) of the participants knew about the dosing schedule (when and how much to take) and side effects of emergency contraceptives. More than two-thirds of the participants (39, 65%) agreed that the existence of emergency contraceptives is a positive thing and considered their use is ethical (42, 63.3%). The majority of participants (51, 85%) also reported that they counsel all women when dispensing emergency contraceptive pills (ECPs). This study revealed that knowledge, attitude, and dispensing practice of emergency contraceptives are very good even though there were variations with respect to different factors. Findings suggested that additional training and proper counseling technique on emergency contraceptives will improve the service delivery.

Emergency contraception: Focus on the facts.

Science.gov (United States)

Najera, Deanna Bridge

2016-01-01

Significant progress on contraception, and in particular emergency contraception, has been made in the past decade. Emergency contraception was first introduced as a stand-alone prescription in 1998, and the interaction of politics and medicine meant a tumultuous course to the drug becoming available over the counter. This article reviews how emergency contraception works, the effectiveness of different methods, pros and cons, and the history of emergency contraception.

Copper intrauterine device for emergency contraception: clinical practice among contraceptive providers.

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Harper, Cynthia C; Speidel, J Joseph; Drey, Eleanor A; Trussell, James; Blum, Maya; Darney, Philip D

2012-02-01

The copper intrauterine device (IUD) is the most effective emergency contraceptive available but is largely ignored in clinical practice. We examined clinicians' recommendations of the copper IUD for emergency contraception in a setting with few cost obstacles. We conducted a survey among clinicians (n=1,246; response rate 65%) in a California State family planning program, where U.S. Food and Drug Administration-approved contraceptives are available at no cost to low-income women. We used multivariable logistic regression to measure the association of intrauterine contraceptive training and evidence-based knowledge with having recommended the copper IUD for emergency contraception. The large majority of clinicians (85%) never recommended the copper IUD for emergency contraception, and most (93%) required two or more visits for an IUD insertion. Multivariable analyses showed insertion skills were associated with having recommended the copper IUD for emergency contraception, but the most significant factor was evidence-based knowledge of patient selection for IUD use. Clinicians who viewed a wide range of patients as IUD candidates were twice as likely to have recommended the copper IUD for emergency contraception. Although more than 93% of obstetrician-gynecologists were skilled in inserting the copper IUD, they were no more likely to have recommended it for emergency contraception than other physicians or advance practice clinicians. Recommendation of the copper IUD for emergency contraception is rare, despite its high efficacy and long-lasting contraceptive benefits. Recommendation would require clinic flow and scheduling adjustments to allow same-day IUD insertions. Patient-centered and high-quality care for emergency contraception should include a discussion of the most effective method. III.

Contraceptive technology.

Science.gov (United States)

Potts, M; Atkinson, L

1984-06-01

A question of the 1980s is how will contraceptive technology contribute to improving family planning services to meet the goal of making available a simple, safe, effective, and widely acceptable contraceptive method. Significant changes in existing technology in the 1970s resulted in safer and more effective contraceptive methods. Voluntary sterilization emerged as the primary method in developed and developing countries, as important modifications simplified the procedure for women. The tolerance and effectiveness of the IUD were improved by reducing its size, adding copper to its surface, or encapsulating progesterone within it. The steroid content of the birth control pill was reduced 10-fold, leading to fewer side effects, and the pill was found to be an effective postcoital contraceptive when taken at specific intervals. Vacuum aspiration for the termination of 1st trimester pregnancy proved to be 1 of the safest surgical techniques practiced. Belated attention is now being focused on adapting existing contraceptive methods for use during the postpartum period and breast feeding. The insertion of an IUD immediately following childbirth is a particularly useful option in the developing world as an increasing number of women have their babies in urban hospitals. A method of enhancing the contraceptive effect of breast feeding should neither change milk production nor transfer the drug to the nursing infant. Fortunately, progestin-only pills have been found to have no effect on breast milk and an attempt is being made to expand the use of this approved method. More simplification of female sterilization is needed. Current techniques require back-up facilities in case of complications and are unlikely to meet the developing world's enormous demand. 2 methods not widely used -- spermicides and periodic abstinence -- are coming under new scrutiny. In mid-1983 the US Food and Drug Administration approved a spermicide-impregnanated disposable sponge for over

Pharmacy Professionals’ Dispensing Practice, Knowledge, and Attitude towards Emergency Contraceptives in Gondar Town, Northwestern Ethiopia: A Cross-Sectional Study

Directory of Open Access Journals (Sweden)

Sewunet Admasu Belachew

2017-01-01

Full Text Available Background. Pharmacy professionals, as the most available members of medical team, have an important role in educating patients about the effective and appropriate use of contraceptives. The purpose of this study was to assess pharmacy professionals’ dispensing practice, knowledge, and attitude towards emergency contraceptives use in Gondar town, northwestern Ethiopia. Methods. An institution based cross-sectional study was employed from May 14 to June 14, 2016, on 60 pharmacy professionals, who have been working in 8 randomly selected pharmacies and 6 drug stores. The collected data was entered to and analyzed using Statistical Packages for Social Sciences (SPSS version 20. Result. More than half 33 (55.0% of the participants were druggist with 5–9 years of experience. About 56 (93.3% of the participants knew about the dosing schedule (when and how much to take and side effects of emergency contraceptives. More than two-thirds of the participants (39, 65% agreed that the existence of emergency contraceptives is a positive thing and considered their use is ethical (42, 63.3%. The majority of participants (51, 85% also reported that they counsel all women when dispensing emergency contraceptive pills (ECPs. Conclusion. This study revealed that knowledge, attitude, and dispensing practice of emergency contraceptives are very good even though there were variations with respect to different factors. Findings suggested that additional training and proper counseling technique on emergency contraceptives will improve the service delivery.

Association between knowledge about levonorgestrel emergency contraception and the risk of ectopic pregnancy following levonorgestrel emergency contraception failure: a comparative survey.

Science.gov (United States)

Zhang, Duo; Yan, Ming-Xing; Ma, Jue; Xia, Wei; Xue, Rui-Hong; Sun, Jing; Zhang, Jian

2016-08-01

To study the association between knowledge about levonorgestrel emergency contraception (LNG-EC) and the risk of ectopic pregnancy (EP) following LNG-EC failure. This study included 600 women who had visited the hospital with LNG-EC failure. Of these, 300 with EP and 300 with intrauterine pregnancy (IUP) were recruited to the EP group and IUP group respectively. The participants were interviewed face-to-face using a standardized questionnaire. Pearson's chi-square tests and t-test were used to compare the sociodemographic characteristics, reproductive and gynecological history, surgical history, previous contraceptive experience, and answers to 10 questions concerning the knowledge about LNG-EC. Those who gave incorrect answers to the question regarding the basic mechanism and specific method of levonorgestrel emergency contraceptive pills (LNG-ECPs) were at a higher risk of EP after LNG-EC failure. Women who did not strictly follow instructions or advice from healthcare professionals were more likely to subsequently experience EP (p < 10(-4) ). Women with LNG-EC failure reported friends/peers, TV, and Internet as the main sources of information. No difference was observed with regard to the sources of knowledge on LNG-EC (p = 0.07). The results illustrate the importance of strictly following the doctor's guidance or drug instructions when using LNG-ECPs. The media should be used to disseminate information about responsible EC, and pharmacy staff should receive regular educational training sessions in this regard. © 2016 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd. © 2016 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd.

Practice Bulletin Summary No. 152: Emergency Contraception.

Science.gov (United States)

2015-09-01

Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Common indications for emergency contraception include contraceptive failure (eg, condom breakage or missed doses of oral contraceptives) and failure to use any form of contraception (1-3). Although oral emergency contraception was first described in the medical literature in the 1960s, the U.S. Food and Drug Administration (FDA) approved the first dedicated product for emergency contraception in 1998. Since then, several new products have been introduced. Methods of emergency contraception include oral administration of combined estrogen-progestin, progestin only, or selective progesterone receptor modulators and insertion of a copper intrauterine device (IUD). Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when a need arises (4-6). The purpose of this Practice Bulletin is to review the evidence for the efficacy and safety of available methods of emergency contraception and to increase awareness of these methods among obstetrician-gynecologists and other gynecologic providers.

The underutilization of emergency contraception.

Science.gov (United States)

Devine, Kit S

2012-04-01

Despite the availability of effective contraceptive methods, unintended pregnancy continues to be a significant health problem for women throughout the world. The reasons for unplanned pregnancy include failure to use contraception, incorrect use of contraception, unplanned consensual intercourse, and rape. Emergency contraception was once heralded as a means of reducing the rates of unintended pregnancy, elective abortion, and unwanted childbirth. But more than three decades after the first oral form was introduced, the use of emergency contraception remains suboptimal-even in the United States, where it is available to most women of childbearing age without a prescription. Nurses can help narrow this clinical gap in women's health care by increasing awareness of emergency contraception, correcting common misconceptions about its mechanism of action and potential adverse effects, and facilitating patient access.

Unplanned pregnancy-risks and use of emergency contraception: a survey of two Nigerian Universities.

Science.gov (United States)

Ajayi, Anthony Idowu; Nwokocha, Ezebunwa Ethelbert; Adeniyi, Oladele Vincent; Ter Goon, Daniel; Akpan, Wilson

2017-06-02

The vulnerabilities of young women of low socio-economic status and those with little or no formal education tend to dominate the discourse on unplanned pregnancy, unsafe abortion and emergency contraception (EC) in sub-Saharan Africa. This article draws on a survey conducted among female undergraduate students to shed light on sexual behaviour and the dynamics of emergency contraceptive use among this cohort. The survey involved 420 female undergraduate students drawn using a multistage sampling technique, while a self-administered questionnaire was used for data collection. Univariate and bivariate analyses were applied to examine the factors associated with the use of emergency contraception. Of the 176 female students who reported being sexually active in the year preceding the survey, only 38.6% reported the use of condom during the entire year. Of those who reported unplanned pregnancy anxiety n = 94, about 30.1% used EC, 20.4% used non-EC pills as EC, while others reported having used no EC. A few respondents (n = 3) had terminated a pregnancy under unsafe conditions. Awareness of EC (p contraceptive methods. Poor knowledge of EC methods and timing of use, as well as wrong perception about EC side effects, are barriers to the utilisation of EC for the prevention of unplanned pregnancy among the study participants.

Why use of dienogest for the first contraceptive pill with estradiol?

Science.gov (United States)

Mueck, Alfred O; Seeger, Harald; Bühling, Kai J

2010-02-01

Dienogest (DNG) has the essential properties of an effective progestogen for use in a new contraceptive pill using estradiol valerate as estrogenic component -- it inhibits ovulation and protects against endometrial proliferation. DNG is a derivative of norethisterone (NET), but has a cyanomethyl- instead of an ethinyl-group in C17 position which may offer a variety of benefits regarding hepatic effects. The similarity to NET is reflected in the high endometriotropy and in similar pharmacokinetics like short plasma half-live and high bioavailability. However, DNG also elicits properties of progesterone derivatives like neutrality in metabolic and cardiovascular system and considerable antiandrogenic activity, the latter increased by lack of binding to SHBG as specific property of DNG. It has no glucocorticoid and antimineralocorticoid activity and has no antiestrogenic activity with the consequence that possible beneficial estradiol effects should not be antagonized. This may be of special importance for the tolerability and safety of the first pill with estradiol valerate instead of ethinylestradiol, although well-designed postmarketing studies are still ongoing to demonstrate what can be expected on the basis of pharmacology.

Hormonal emergency contraception: a clinical primer.

Science.gov (United States)

Ziebarth, Angela; Hansen, Keith A

2007-03-01

Unintended and teenage pregnancies are major public health concerns in the United States. Emergency contraception is used to prevent pregnancy after failure of a contraceptive method or after unprotected intercourse. Expanded use of emergency contraception has the potential to reduce unintended pregnancy and induced abortions, while reducing state and federal healthcare expenditures. The recent approval of Plan B as an over-the-counter medication for individuals over 18 years of age should improve access to this medication. However, there are still widespread misconceptions about the mechanisms and implications of emergency contraception. Expanded access to emergency contraception is associated with increased use, but not associated with decreased efficacy, increased sexual risk-taking behavior, or less consistent use of traditional birth control methods. This review is designed to provide clinicians with information regarding the use of emergency contraception for reproductive age patients. It includes a brief description of methods of use, mechanisms of action, and side effect profiles of the most commonly used methods of emergency contraception, levonorgestrel and the Yuzpe method.

Contraceptive efficacy of emergency contraception with levonorgestrel given before or after ovulation.

Science.gov (United States)

Noé, Gabriela; Croxatto, Horacio B; Salvatierra, Ana María; Reyes, Verónica; Villarroel, Claudio; Muñoz, Carla; Morales, Gabriela; Retamales, Anita

2011-11-01

The contraceptive efficacy of emergency contraceptive pills containing levonorgestrel (LNG-EC) has been estimated in most previous studies by judging the day of ovulation from presumptive menstrual cycle data, thus providing poorly reliable estimates. In the present study, the efficacy of LNG-EC was determined in 393 cycles by dating ovulation on the basis of reliable hormonal and ovarian parameters validated by a database constructed in a separate study. In addition, the efficacy was determined separately for cycles in which LNG-EC was given before or after ovulation. For the 148 women who had sexual intercourse during the fertile days, the overall accumulated probability of pregnancy was 24.7, while altogether 8 pregnancies were observed. Thus, the overall contraceptive efficacy of LNG-EC was 68%. Among the 103 women who took LNG-EC before ovulation (days -5 to -1), 16 pregnancies were expected and no pregnancy occurred (p<.0001). Among the 45 women who took LNG-EC on the day of ovulation (day 0) or thereafter, 8 pregnancies occurred and 8.7 were expected (p=1.00). These findings are incompatible with the inhibition of implantation by LNG-EC in women. The same cases were also analyzed using the presumptive menstrual cycle data, and important discrepancies were detected between the two methods. The efficacy of LNG-EC has been overestimated in studies using presumptive menstrual cycle data. Our results confirm previous similar studies and demonstrate that LNG-EC does not prevent embryo implantation and therefore cannot be labeled as abortifacient. Copyright © 2011 Elsevier Inc. All rights reserved.

Knowledge of emergency contraceptives among secondary school ...

African Journals Online (AJOL)

2017-12-05

Dec 5, 2017 ... emergency contraceptives, while 52.5% reported that they had never heard of emergency contraceptives. ... are freely available to women of all ages in South Africa (SA).[4] ..... Contraceptive Technology. .... prescribing pattern of emergency contraceptives by health care workers in Kampala, Uganda. Acta.

Obesity and hormonal contraceptive efficacy.

Science.gov (United States)

Robinson, Jennifer A; Burke, Anne E

2013-09-01

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.

Committee Opinion No 707: Access to Emergency Contraception.

Science.gov (United States)

2017-07-01

Emergency contraception refers to contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to emergency contraception remain. The purpose of this Committee Opinion is to examine barriers to the use of emergency contraception, emphasize the importance of increasing access, and review new methods of emergency contraception and limitations in efficacy in special populations.

Knowledge of pharmacists on proper use of oral contraceptive pills ...

African Journals Online (AJOL)

community pharmacists and senior pharmacy students in UAE. The survey ... contraceptive methods use among women in. UAE [3]. More than 58 % of women in the Middle. East are using ... week, age, gender, social status and pharmacy location. In ..... knowledge and attitudes regarding oral emergency contraception.

Impact of the 2013 French Pill Crisis on Women's Behaviour Regarding Contraception.

Science.gov (United States)

Lemaitre, Magali; Lastennet, Glenn; Syr, David; Emmerich, Joseph; Zureik, Mahmoud

2015-03-01

In the last decade, several epidemiological studies have shown the increased risk of venous thromboembolism associated with third- and fourth-generation oral contraceptives (C3Gs and C4Gs) versus older combined first- and second-generation oral contraceptives (C1Gs and C2Gs). In France, in December 2012, a lawsuit filed against the National Agency for the Safety of Medicines and Health Products (ANSM) by a patient who had experienced a stroke, possibly due to the use of a C3G, triggered a national 'pill crisis'. Consequently, a 'crisis cell' was set up and pre-existing health recommendations were reinforced. The main aim of this study was to evaluate, in real time, the impact of the French health authorities' recommendations and communications on French women's behaviour regarding contraception. Real-time monthly sales data reported during 2013 were compared with monthly sales data reported in 2012. Analyses were stratified according to the type of contraceptive and age. An index corresponding to the number of months of contraception sold was developed to facilitate comparison of the different contraceptives despite their distinct features and to assess the overall trend of contraception. After a 2-year analysis (2013 versus 2012), a significant 45 % decrease (p sales was observed, compared with a significant increase of 30 % (p sales. The sharp increase in C1G-2G sales focused specifically on C2Gs with an oestrogen concentration below 20 µg. Moreover, a large (47 %) increase was reported in sales of intrauterine devices (p sales into account, a slight decrease (1 %) in overall sales was identified. Thanks to an effective national communication plan, real-time monitoring of drug sales and favourable reactions from physicians and patients, French women changed their behaviour regarding contraception. However, this study was conducted over a short period following the crisis. A longitudinal analysis is required in order to assess any real long-term changes.

Overdose of oral contraceptive pills as a means of intentional self-poisoning amongst young women in Sri Lanka

DEFF Research Database (Denmark)

Weerasinghe, Manjula; Konradsen, Flemming; Eddleston, Michael

2017-01-01

OBJECTIVE: Oral contraceptive pills (OCPs) are one of the most popular family planning methods in Sri Lanka. As part of two hospital-based studies on self-harm, the use of OCPs was identified, from yet unpublished results, as a means of intentional self-poisoning. To inform future guidelines for ...

Missed Opportunities: Emergency Contraception Utilisation by ...

African Journals Online (AJOL)

Although contraceptives, including emergency contraceptives, are widely available free at public health facilities in South Africa, rates of teenage and unintended pregnancy are high. This paper analyses awareness and utilisation of emergency contraception amongst 193 young women (aged 15-24 years) attending public ...

[Emergency contraception: efficacy difference between levonorgestrel and ulipristal acetate depending on the follicular size at the time of an unprotected sexual intercourse].

Science.gov (United States)

Jamin, C

2015-03-01

The most used treatment in the world for emergency contraception is the levonorgestrel (LNG) pill. However, its efficacy decreases if it is administered 3 days after unprotected sexual intercourse, whereas the ulipristal acetate (UPA) pill is effective up until 5 days afterwards. Pooled clinical data show that UPA is more effective than LNG when taken very shortly after intercourse (within 24h) or, conversely, between 72 and 120 h after intercourse. UPA is also more effective than LNG in inhibiting follicular rupture when administered near the time of ovulation. We show here why overall UPA is more effective than LNG in reducing the rate of unwanted pregnancies by demonstrating the effect of each product depending on the follicular size at the time of an unprotected sexual intercourse We also explain the difference between UPA and LNG in the maximum time to administration simply by the shift in ovulation and the fact that UPA has an effect on larger follicles than LNG does (18 mm vs. 14 mm), without postulating a hypothetical endometrial effect. We also explain why UPA and LNG remain emergency contraceptives and should not be used for daily contraception. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Impact and mechanistic role of oral contraceptive pills on the number and epithelial type of ovarian cortical inclusion cysts; a clinicopathology and immunohistochemical study.

Science.gov (United States)

DastranjTabrizi, Ali; MostafaGharabaghi, Parvin; SheikhzadehHesari, Farzam; Sadeghi, Liela; Zamanvandi, Sharareh; Sarbakhsh, Parvin; Ghojazadeh, Morteza

2016-03-22

Ovarian epithelial cancers are among the most lethal women's cancers. There is no doubt about the preventive role of oral contraceptive pills (OCPs) in development of ovarian cancers. But, there are limited numbers of studies to address the effect of these agents on the number of cortical inclusion cysts (CICs), their epithelial type and suppression of the metaplastic phenomenon by these pills. The aim of this study was to clarify the role of these agents in the prevention of these cyst formation and tubal metaplasia and also examine the mesenchymal-epithelial transition theory in this context by immunohistochemical methods. The representative section(s) of ovarian cortex from a total number of 201 consecutive total abdominal hysterectomy with bilateral or unilateral salpingo-oophorectomy specimens were examined for mean number of CICs and their epithelial type between two groups of the patients. Group A included the patients who were on oral contraceptive pills for more than 5 years. All of the subjects with other contraceptive methods or a history of less than 5 years contraceptive pills usage were stratified in group B. Sections from 20 cases in which more than five inclusion cysts were found, were selected for IHC staining with calretinine and PAX8 as markers for mesothelium and mullerian epithelium respectively. The mean age of the patients was 51.67 years with no significant differences between two groups. The mean number of cysts were 1.27 and 3.23 in group A and B respectively (P =0.0001). Similarly the mean number of CICs, lined by tubal epithelium, was significantly different between two groups (0.65 vs 2.65, P =0.0001). In IHC staining 123 out of 150 CICs (82 %) were PAX+ while only 7 CICs (4.8 %) showed positive reaction for calretinin irrespective of type of epithelium. Our findings showed that the use of OCP for more than five years in women, significantly prevents development of cortical inclusion cysts in the ovaries which lined by tubal

Committee Opinion No. 707 Summary: Access to Emergency Contraception.

Science.gov (United States)

2017-07-01

Emergency contraception refers to contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to emergency contraception remain. The purpose of this Committee Opinion is to examine barriers to the use of emergency contraception, emphasize the importance of increasing access, and review new methods of emergency contraception and limitations in efficacy in special populations.

Knowledge, Attitude and Practice of Emergency Contraceptives ...

African Journals Online (AJOL)

About 309 (46.8%) of the students had heard about emergency contraceptives and from those who heard emergency contraceptives, 27.2% had good knowledge. Majority, four hundred fifteen (62.9%) of the students had positive attitude towards it. However, only 31(4.7%) had used emergency contraceptive methods.

The comparative study of side effect of the two kinds of LD combined oral contraceptive pills containing Norgestimate and Levonorgestrel

Directory of Open Access Journals (Sweden)

Ghazizade Sh

1998-05-01

Full Text Available In order to compare the new generation of oral contraceptive pills containing Norgestimate (NGM with currently available pills containing levonorgestrel (LNG a clinical trial was conducted. 413 women (age 18-35 years with no contrainindication to pill use entered the study and randomly received one type of pills. Premenstrual syndrome and depression were significantly decreased in NGM group (P=0.00016, P=0.005, on the other hand, breast tenderness, mood changes and hair loss were significantly increased in LNG group (P=0.001, P=0.042, P=0.011. Comparing two groups with each other, following variables were significantly lower in NGM group: headache (P<0.05, vertigo (P<0.05, cloasma (P<0.05, acne (P<0.04, depression (P<0.05, appetite change (P<0.03. Overall patient satisfaction was similar in two groups.

Active-learning instruction on emergency contraception counseling.

Science.gov (United States)

Young, Shardae; Griffin, Brooke; Vest, Kathleen

2013-06-12

To increase pharmacy students' knowledge of and confidence in counseling patients regarding emergency contraception and to identify any barriers to counseling patients about emergency contraception. Approximately 200 third-year pharmacy students participated in the Women's Health Therapeutics workshop at Midwestern University Chicago College of Pharmacy. Students observed a 5-minute skit of a counseling session on emergency contraception and then were asked to pair up with a classmate and practice counseling each other regarding the use of emergency contraception following a checklist of key points. One hundred eighty-nine students completed pre- and post-workshop survey instruments. Students' knowledge scores increased from 86% to 93% (pemergency contraception before completing the active-learning exercise compared to 58.5% after (pemergency contraception and significantly reduced several barriers to counseling identified prior to participation.

Contraception: a questionnaire on knowledge and attitude of adolescents, distributed on Facebook.

Science.gov (United States)

Denis, Lies; Storms, Machteld; Peremans, Lieve; Van Royen, Kathleen; Verhoeven, Veronique

2016-11-01

The contraceptive pill is widely used. An accurate knowledge is necessary for correct use. This study sheds light on adolescents' knowledge, attitude and behavior in regard to contraceptive use, in the year 2014. The goal is to provide general practitioners (GP) with information about the potential gaps in knowledge concerning contraceptive use in order to give better counseling and prevent high-risk behavior in adolescents. A quantitative descriptive study was carried out among 14-25-year-old female and male adolescents. Data were collected through a web-based survey using the online survey software Qualtrics (Qualtrics, Provo, UT, USA) and was distributed via the social networking site Facebook. The survey was started by 1185 participants. The most popular contraceptive method among females is the oral contraceptive pill (63.7%). Four out of ten females (42.6%) do not know that when using an emergency pill, they must still take their regular contraceptive pill on the same day. The majority of female respondents (80.0%) go to their general practitioner for a prescription for the pill. Ninety-five percent (95.1%) of the females would feel comfortable asking their GP for extra information about the drug. The sex of the GP does not influence the likelihood of female patients seeking more information. The Internet also seems to serve as an important source of information. We defined a female subgroup, called "vulnerable". The majority of females in the non-vulnerable group (70.4%) protected themselves before their first sexual contact instead of only half of the members in the vulnerable group (51.0%). The level of knowledge among adolescents about contraception is not alarming, but there are a few blind spots. Eliminating these gaps should be the aim of the doctor and pharmacologist.

Advance provision of emergency contraception to young men: An exploratory study in a clinic setting.

Science.gov (United States)

Garbers, Samantha; Bell, D L; Ogaye, K; Marcell, A V; Westhoff, C L; Rosenthal, S L

2018-04-17

To explore the acceptability of advance provision of emergency contraceptive pills (ECPs) to young men seeking health care. For this exploratory study in a clinic setting, we approached young men aged 16-35 to participate in a survey eliciting socio-demographics, sexual and contraceptive history, and knowledge about ECPs. We offered young men advance provision of ECPs and compared characteristics of 126 young men who did and did not accept the ECPs. Most (76%) of the participants accepted advance provision and left with an ECP pack, with even higher proportions among males whose sexual histories were suggestive of increased risk of involvement in an unintended pregnancy. This study holds promise to inform scale up of advance provision of ECPs among young men. Copyright © 2018 Elsevier Inc. All rights reserved.

Mechanisms of action of hormonal emergency contraceptives.

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Leung, Vivian W Y; Levine, Marc; Soon, Judith A

2010-02-01

Hormonal emergency contraceptives have been used to prevent unwanted pregnancy for more than 3 decades. The mechanisms of action of the regimen containing a combination of estrogen and progestin, known as the Yuzpe regimen, and those of the levonorgestrel regimen continue to be controversial, especially over the possibility that these regimens might act by interfering with implantation of the fertilized ovum. We performed a search of the PubMed (1949-July 2009) and EMBASE (1980-July 2009) databases to identify literature on the mechanisms of action of these contraceptive regimens, and data were extracted from pertinent English-language studies. We classified studies according to the approach taken by the investigators to study the actions of emergency contraceptives on pregnancy: an indirect method that uses statistical models to determine whether emergency contraceptives would be as effective as reported if they act only by disrupting ovulation; direct observation of the effects of emergency contraceptives on surrogate outcomes, including ovulation, sperm activity, hormonal levels, and endometrial receptivity to implantation; and analysis of directly observed pregnancy outcomes against statistical data. Acceptability of emergency contraceptives by women and clinicians may depend on personal opinions about when life or pregnancy begins. The evidence strongly supports disruption of ovulation as a mechanism of action. The data suggest that emergency contraceptives are unlikely to act by interfering with implantation, although the possibility has not been completely excluded. The data also suggest that emergency contraceptives are ineffective after ovulation. Women and clinicians who consider implantation or later events to be the beginning of pregnancy should be aware that emergency contraceptives are likely nonabortive by this definition of pregnancy.

Factors affecting awareness of emergency contraception among women

Directory of Open Access Journals (Sweden)

Gamze Can

2015-04-01

CONCLUSION: Being aware of emergency contraception and its usage were low in our study. As emergency contraception is considered to be a second chance method, indications of emergency contraception should firstly be known by health professionals and correct informations should be transferred to public. Thereby, emergency contraception methods can be used effectively and practically. [TAF Prev Med Bull 2015; 14(2.000: 101-106

Knowledge, Attitude and Practice of Emergency Contraception ...

African Journals Online (AJOL)

BACKGROUND: Emergency contraception refers to methods that women can use to prevent pregnancy after unprotected sexual intercourse, method failure or incorrect use. Unwanted pregnancy followed by unsafe abortion can be avoided by using different contraceptive methods including emergency contraceptives.

Knowledge, attitude, and practice on emergency contraceptives ...

African Journals Online (AJOL)

Background: Unwanted pregnancy followed by unsafe abortion can be avoided by using different contraceptive methods, including emergency contraceptives. Information on knowledge, attitude and practice of emergency contraceptives among women is particularly important because of high rates of teenage and ...

ACOG Committee Opinion Number 542: Access to emergency contraception.

Science.gov (United States)

2012-11-01

Emergency contraception includes contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to access to emergency contraception remain. The purpose of this Committee Opinion is to examine the barriers to the use of oral emergency contraception methods and to highlight the importance of increasing access.

Acceptability of emergency contraception in Brazil, Chile, and Mexico. 2 - Facilitating factors versus obstacles

Directory of Open Access Journals (Sweden)

Díaz Soledad

2003-01-01

Full Text Available A multi-center study was performed in Brazil, Chile, and Mexico to identify factors that may facilitate or hinder the introduction of emergency contraception (EC as well as perceptions concerning emergency contraceptive pills. Background information on the socio-cultural, political, and legal context and the characteristics of reproductive health services was collected. The opinions of potential users and providers were obtained through discussion groups, and those of authorities and policymakers through semi-structured interviews. Barriers to introduction included: perception of EC as an abortifacient, opposition by the Catholic Church, limited recognition of sexual and reproductive rights, limited sex education, and insensitivity to gender issues. Facilitating factors were: perception of EC as a method that would prevent abortion and pregnancy among adolescents and rape victims; interest in the method shown by potential users as well as by some providers and authorities. It appears possible to reduce barriers through support from segments of society committed to improving sexual and reproductive health and adequate training of health care providers.

Acceptability of emergency contraception in Brazil, Chile, and Mexico. 2 - Facilitating factors versus obstacles

Directory of Open Access Journals (Sweden)

Soledad Díaz

Full Text Available A multi-center study was performed in Brazil, Chile, and Mexico to identify factors that may facilitate or hinder the introduction of emergency contraception (EC as well as perceptions concerning emergency contraceptive pills. Background information on the socio-cultural, political, and legal context and the characteristics of reproductive health services was collected. The opinions of potential users and providers were obtained through discussion groups, and those of authorities and policymakers through semi-structured interviews. Barriers to introduction included: perception of EC as an abortifacient, opposition by the Catholic Church, limited recognition of sexual and reproductive rights, limited sex education, and insensitivity to gender issues. Facilitating factors were: perception of EC as a method that would prevent abortion and pregnancy among adolescents and rape victims; interest in the method shown by potential users as well as by some providers and authorities. It appears possible to reduce barriers through support from segments of society committed to improving sexual and reproductive health and adequate training of health care providers.

A review of global access to emergency contraception.

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Westley, Elizabeth; Kapp, Nathalie; Palermo, Tia; Bleck, Jennifer

2013-10-01

Emergency contraception has been known for several decades, and dedicated products have been on the market for close to 20 years. Yet it is unclear whether women, particularly in low-resource countries, have access to this important second-chance method of contraception. To review relevant policies, regulations, and other factors related to access to emergency contraception worldwide. A wide range of gray literature was reviewed, several specific studies were commissioned, and a number of online databases were searched. Several positive policies and regulations are in place: emergency contraception products are registered in the majority of countries around the world, listed in many countries' essential medicines lists, included in widely used guidance, and supported by most donors. Yet analysis of demographic data shows that the majority of women in low-income countries have never heard of emergency contraception, and surveys find that many providers have negative attitudes toward providing emergency contraception. Despite more than a decade of concerted international and country-level efforts to ensure that women have access to emergency contraception, accessibility remains limited. © 2013.

Supplying emergency contraception to adolescents: the nurse's role.

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Hopkins, Craig

2014-12-02

This article explores issues surrounding the supply of emergency contraception to adolescents to reduce the risk of unintended pregnancy. It explains the female reproductive cycle, and describes the types of emergency contraception that may be supplied following unprotected sexual intercourse or contraception failure. The aftercare that should be offered to adolescents following the supply of emergency contraception is discussed, alongside issues surrounding the safeguarding of children and vulnerable adults.

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

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McCarraher, Donna R; Martin, Sandra L; Bailey, Patricia E

2006-03-01

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

Use of ulipristal acetate and levonorgestrel for emergency contraception: a follow-up study.

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Baird, Aisling Susan; Trussell, James; Webb, Anne

2015-04-01

Previously we showed that increasing the choice of emergency contraception (EC) guided by medical eligibility did not result in wholesale large-scale usage of ulipristal acetate (UPA). This further 12-month study aimed to answer three questions. (1) Does offering choice of EC lead to change in methods used? (2) Are women who choose UPA more likely than those who choose levonorgestrel (LNG) to continue using condoms for subsequent contraception or to decline any ongoing contraception? (3) Do more women choosing LNG 'quick start' hormonal contraception? A retrospective study of EC episodes (1 April 2012 to 31 March 2013) by quarters. Among women offered all three methods of EC (49.1%) we noted the method chosen, and decisions on ongoing contraception among those choosing either LNG or UPA. Differences were tested for statistical significance. In 6110 episodes of EC, LNG was issued in 69.2%, UPA in 26.0%, and a copper intrauterine device (Cu-IUD) was fitted in 4.8%. Quarter by quarter, the data show a small decline in LNG use, suggesting plateauing by the last quarter, and a significant increase in UPA use between the first and the other three quarters (pcontraception already used (pcontraception (p=0.13). There was a significant increase in women using UPA for EC compared with our previous study, particularly among those wishing to use condoms for continuing contraception. Women choosing LNG were more likely to quick start pills or to continue current hormonal contraception. Detailed attention to continuing contraception following EC may be an important factor in the prevention of unwanted pregnancy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Current methods and attitudes of women towards contraception in Europe and America.

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Johnson, Sarah; Pion, Christine; Jennings, Victoria

2013-02-05

The choice of available contraceptive methods has increased in recent years; however, recent data on women's awareness of methods and reasons for their method choice, or reasons for changing methods, is limited. The aim of this study was to examine the use and awareness of contraceptive methods in the USA, UK, Germany, Italy and Spain. Quantitative survey of heterosexual women aged 25-44 years (n=2544), with no known infertility. Questions related to knowledge and use of contraceptive methods, reasons for choice and for changing methods, and sources of advice. There was generally good awareness of most forms of contraception in all five countries. Awareness and current usage was greatest for the contraceptive pill (awareness >98%, usage varied from 35% [Spain] to 63% [Germany]); and male condom (awareness >95%, usage varied from 20% [Germany] to 47% [Spain]); awareness of other methods varied between countries. Doctors have the greatest influence on women's choice of contraceptive method (>50% for all countries), and are most likely to suggest the contraceptive pill or male condom.Women's contraceptive needs change; 4-36% of contraceptive pill users were likely to change their method within 12 months. For previous contraceptive pill users (n=377), most common reason for change was concern about side effects (from 26% [Italy] to 10% [UK]); however, awareness of many non-hormonal contraceptive methods was low. Women aged 25-44 are aware of a wide variety of contraceptive methods, but knowledge and usage of the contraceptive pill and condoms predominates. Changing contraception method is frequent, occurring for a variety of reasons, including change in life circumstances and, for pill users, concerns about side effects.

Contraceptive applications of progesterone receptor modulators.

Science.gov (United States)

Chabbert-Buffet, Nathalie; Ouzounian, Sophie; Kairis, Axelle Pintiaux; Bouchard, Philippe

2008-09-01

Currently developed progesterone receptor modulators (PRMs) are steroid-derived compounds with mild or potent antiprogestin activity. PRMs may exert a contraceptive activity by different mechanisms such as blockade of ovulation and endometrial desynchronization. Their potential clinical applications are manifold and are very promising in major public health areas, including emergency contraception, long term oestrogen-free contraception (administered alone, or in association with a progestin-only pill to improve bleeding patterns), endometriosis and myoma treatment. The mechanisms of their anti-ovulatory effects and of the endometrial modifications elicited during long term PRM treatment are still not fully elucidated. In future clinical applications, PRMs will be administered orally, via intrauterine systems or vaginal rings.

Emergency Contraception in Post-Conflict Somalia: An Assessment of Awareness and Perceptions of Need.

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Gure, Faduma; Dahir, Mohammed Koshin; Yusuf, Marian; Foster, Angel M

2016-03-01

In conflict-affected settings such as Somalia, emergency contraception (EC) has the potential to serve as an important means of pregnancy prevention. Yet Somalia remains one of the few countries without a registered progestin-only EC pill. In 2014, we conducted a qualitative, multi-methods study in Mogadishu to explore awareness of and perceptions of need for EC. Our project included 10 semi-structured key informant interviews, 20 structured in-person interviews with pharmacists, and four focus group discussions with married and unmarried Somali women. Our findings reveal a widespread lack of knowledge of both existing family planning methods and EC. However, once we described EC, participants expressed enthusiasm for expanding access to post-coital contraception. Our results shed light on why Somalia continues to be a global exception with respect to an EC product and suggest possible politically and culturally acceptable and effective avenues for introducing EC into the health system. © 2016 The Population Council, Inc.

Cost-effectiveness of emergency contraception options over 1 year.

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Bellows, Brandon K; Tak, Casey R; Sanders, Jessica N; Turok, David K; Schwarz, Eleanor B

2018-05-01

The copper intrauterine device is the most effective form of emergency contraception and can also provide long-term contraception. The levonorgestrel intrauterine device has also been studied in combination with oral levonorgestrel for women seeking emergency contraception. However, intrauterine devices have higher up-front costs than oral methods, such as ulipristal acetate and levonorgestrel. Health care payers and decision makers (eg, health care insurers, government programs) with financial constraints must determine if the increased effectiveness of intrauterine device emergency contraception methods are worth the additional costs. We sought to compare the cost-effectiveness of 4 emergency contraception strategies-ulipristal acetate, oral levonorgestrel, copper intrauterine device, and oral levonorgestrel plus same-day levonorgestrel intrauterine device-over 1 year from a US payer perspective. Costs (2017 US dollars) and pregnancies were estimated over 1 year using a Markov model of 1000 women seeking emergency contraception. Every 28-day cycle, the model estimated the predicted number of pregnancy outcomes (ie, live birth, ectopic pregnancy, spontaneous abortion, or induced abortion) resulting from emergency contraception failure and subsequent contraception use. Model inputs were derived from published literature and national sources. An emergency contraception strategy was considered cost-effective if the incremental cost-effectiveness ratio (ie, the cost to prevent 1 additional pregnancy) was less than the weighted average cost of pregnancy outcomes in the United States ($5167). The incremental cost-effectiveness ratios and probability of being the most cost-effective emergency contraception strategy were calculated from 1000 probabilistic model iterations. One-way sensitivity analyses were used to examine uncertainty in the cost of emergency contraception, subsequent contraception, and pregnancy outcomes as well as the model probabilities. In 1000 women

Emergency contraception in Albania: a multimethods qualitative study of awareness, knowledge, attitudes and practices.

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Doci, Florida; Thaci, Jonida; Foster, Angel M

2018-04-11

Contraceptive prevalence is relatively low in Albania, and abortion is the mainstay of family planning. Although levonorgestrel-only emergency contraceptive pills are available, uptake of this method is minimal. Emergency contraception (EC) could play a significant role in addressing women's need for an effective and discreet pregnancy prevention method. However, information about the dynamics surrounding EC is limited. In 2016-2017, we conducted a multimethods qualitative study that aimed to explore awareness, knowledge, attitudes and practices toward EC in Albania. This project comprised four components: a community-based survey with 115 respondents, six focus group discussions with women of reproductive age, 19 semistructured key informant interviews, and 16 structured interviews with retail pharmacists. We analyzed our data using descriptive statistics and for content and themes. Our findings suggest that EC is widely available in pharmacies in Albania. However, a quarter of our survey participants did not know whether EC was available, and more than a third did not think EC was safe to use. Women face numerous barriers to accessing this form of contraception. Misconceptions about hormonal contraceptives, in general, and about progestin-only EC in particular, lack of training among providers, and stigma and fear of judgment were common obstacles identified by participants. Misinformation and lack of knowledge about EC among women and providers in Albania appears common. Training health service providers, raising awareness among women, and developing linguistically and culturally resonant materials for distribution could be keys to improving access to and use of EC. Although the availability of progestin-only EC is widespread in Albania, our findings suggest that more work needs to be done to align national regulatory policies with international standards, facilitate evidence-based service delivery, and increase access to medically accurate information in

Women's willingness to use emergency contraception: Experience ...

African Journals Online (AJOL)

Access to emergency contraception (EC) has little restriction in South Africa. EC is a contraceptive method that can be used by women up to 7 days after unprotected intercourse. It can be used in the following situations: when no contraceptive has been used; for condom accidents; after intrauterine contraceptive device ...

Oral contraceptives and venous thromboembolism: a five-year national case-control study

DEFF Research Database (Denmark)

Lidegaard, Øjvind; Edström, Birgitte; Kreiner, Svend

2002-01-01

Venous thromboembolism; Oral contraceptives; Pulmonary embolism; Third-generation; Second-generation; Pill Scare......Venous thromboembolism; Oral contraceptives; Pulmonary embolism; Third-generation; Second-generation; Pill Scare...

Side and site of deep vein thrombosis in women using oral contraceptives.

Science.gov (United States)

Kierkegaard, A

1985-01-01

The anatomy of the thrombus in acute deep vein thrombosis (DVT) in women using oral contraceptives was studied in 277 reports on DVT received by the Swedish Adverse Drug Reaction Advisory Committee (SADRAC). The study revealed a similarity between the anatomy of DVT in women on oral contraceptives and that of DVT in pregnant women, suggesting a pharmacologic influence of the hormones in the pill on the pathogenesis of DVT in women on oral contraceptives. The anatomy of DVT in women on low-estrogen pills was identical with that of DVT in women on high-estrogen pills, suggesting an identical pharmacologic influence of the two types of pill on the pathogenesis of DVT in women on oral contraceptives.

Emergency Contraception: A Wareness And Knowledge Among ...

African Journals Online (AJOL)

A cross sectional descriptive survey of awareness and knowledge of emergency contraception among medical/paramedical and non-medical workers was carried out in the National Hospital Abuja, Nigeria. Most of the hospital workers were not aware of emergency contraceptive methods. 59.9% were not aware of ...

Emergency Contraception: A Global Overview of Knowledge ...

African Journals Online (AJOL)

Context: Recent concerns over teenage pregnancy, abortion and sexuality have pushed emergency contraceptive methods to the fore once again. The studies on knowledge and attitudes of providers are of particular importance, as they will have direct effects on potential users of emergency contraception. Aim/Method: ...

Advance Provision of Emergency Contraception for Adolescents

Science.gov (United States)

Adamji, Jehan-Marie; Swartwout, Kathryn

2010-01-01

Emergency contraception is most effective at preventing unintended pregnancy when taken as early as possible following unprotected sexual intercourse. Advance provision of this medication supports more timely and effective use. In the midst of rising teen pregnancy rates, current policies often limit access to emergency contraception for…

Analysis on the Emergency Contraception Knowledge Level and Its Influencing Factors among Abortion Patients in Shanghai City

Institute of Scientific and Technical Information of China (English)

赵双玲; 楼超华; 高尔生

2000-01-01

Objective To evaluate the knowledge level of emergency contraception, explore the determinants of the knowledge level among women seeking abortion and give suggestions on how to improve the quality of emergency contraception service.Method A total of 606 women requiring abortion at three MCHs in Shanghai City were interviewed face to face with structured questionnaire.Results 63. 7% of unwanted pregnancy could use EC to prevent. Subjects got their knowledge on EC mainly from books~newspapers~magazines and relatives/friends/parents. The proportion of the awareness of EC was 28. 5%. Most subjects were aware of hormonal EC pill, but only 14. 9% of them knew that the pill should be taken within 72 hours after the intercourse. Among the subjects who were aware of EC, the average score of the knowledge was lower than half of the full marks. The lower the subject's educational level was, the less likely they were aware of EC and the lower score of the knowledge of EC they had. The score of the knowledge of EC was higher among subjects who learned of EC mainly from family planning publicity.Conclusion It is urgent to popularize EC in order to reduce unwanted pregnancy and induced abortion. The information, including EC can be used in which situations, it's advantages and disadvantages as well as indication, should be given to women in an appropriate way and using plain language. The departments of family planning should play a leading role in improving women's knowledge of EC.

Italian Adolescents and Emergency Contraception: A Focus Group Study.

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Olivari, Maria Giulia; Cuccì, Gaia; Confalonieri, Emanuela

2017-02-01

Using a qualitative method, the purpose of this study was to: (1) obtain information directly from the adolescents on their attitudes and knowledge regarding emergency contraception; and (2) investigate the presence of differences between male and female participants' attitudes and knowledge. This study consisted of 24 single-sex focus groups with 160 adolescents (male = 46.3% (74 of 160); female = 53.7% (86 of 160)) aged 15-19 years conducted among high schools in 3 regions of Italy. Data were analyzed through thematic analysis taking into account gender differences and 2 main themes emerged. The first was labeled "Adolescents' attitudes toward emergency contraception" and it was divided into 3 subthemes: You should be aware; It's a life line; and Everything but a child. The second theme was labeled "Adolescents' knowledge toward emergency contraception" and it was divided into 3 subthemes: False myths; Baseline information; and Just take it. Italian adolescents believed it is important to prevent the risk of unprotected sex by using contraceptive methods and their motivation to use emergency contraception is related to critical attitudes toward the consequences of irresponsible/ineffective contraception. Although adolescents have an awareness of emergency contraception, more comprehensive knowledge is needed. These findings can inform specific interventions aimed at educating adolescents in need of emergency contraception. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Use of IUDs for emergency contraception: current perspectives

Directory of Open Access Journals (Sweden)

McKay R

2014-08-01

Full Text Available Rebecca McKay,1 Lynne Gilbert2 1Department of Obstetrics and Gynaecology, Peterborough City Hospital, Peterborough, Cambridgeshire, United Kingdom; 2Department of Contraception and Sexual Health, Cambridgeshire Community Services NHS Trust, Cambridge, Cambridgeshire, United Kingdom Abstract: Emergency contraception is an essential intervention for the prevention of unplanned pregnancy worldwide. The copper intrauterine device (IUD is highly effective at preventing pregnancy after unprotected sex or contraceptive failure. Unfortunately, its usage in this context is low and far exceeded by hormonal forms of emergency contraception. These have higher failure rates and, unlike the IUD, are not effective post-fertilization. This review aims to summarize the literature surrounding IUD use as emergency contraception, contrast it with the hormonal options, and provide suggestions for increased usage. Keywords: levonorgestrel, ulipristal acetate, copper intrauterine device

Knowledge and use of emergency contraception among students of ...

African Journals Online (AJOL)

Knowledge and use of emergency contraception among students of public secondary schools in Ilorin, Nigeria. ... Knowledge about Emergency contraception and prevalence of use were low. Contraceptive education should be introduced early in the school curriculum for adolescents. Pan African Medical Journal 2016; 23 ...

Emergency contraception: clinical outcomes.

Science.gov (United States)

Glasier, Anna

2013-03-01

Emergency contraception (EC) is widely used to prevent unwanted pregnancy. This review considers the safety and efficacy of three commonly used methods -- levonorgestrel (LNG-EC), ulipristal acetate (UPA) and the copper intrauterine device. All are extremely safe, and side effects are minimal. Concerns about increased risks of ectopic pregnancy after EC use have proved unfounded, and possible teratogenic effects seem unlikely. Although the true effectiveness of EC is impossible to estimate, recent research suggests that LNG-EC prevents around 50% of expected pregnancies in women using the method within 72 h of intercourse, whereas UPA appeared to prevent almost two thirds of pregnancies. Emergency intrauterine device insertion probably prevents over 95% of pregnancies. However, although improved accessibility of EC has clearly led to increased use, it does not appear to have had any public health benefit in reducing unintended pregnancy rates. Most of the data on sexual behavior following improved access to EC do not show any detrimental effect on subsequent use of other more effective methods of contraception or on the incidence of unintended pregnancy or sexually transmitted infection. However, unless these other methods of contraception are also made easily available from pharmacies, improved access to EC risks unlinking its use with use of subsequent ongoing contraception. Copyright © 2013 Elsevier Inc. All rights reserved.

Current contraceptive management in Australian general practice: an analysis of BEACH data.

Science.gov (United States)

Mazza, Danielle; Harrison, Christopher; Taft, Angela; Brijnath, Bianca; Britt, Helena; Hobbs, Melissa; Stewart, Kay; Hussainy, Safeera

2012-07-16

To determine current contraceptive management by general practitioners in Australia. Analysis of data from a random sample of 3910 Australian GPs who participated in the Bettering the Evaluation and Care of Health (BEACH) survey, a continuous cross-sectional survey of GP activity, between April 2007 and March 2011. Consultations with female patients aged 12-54 years that involved all forms of contraception were analysed. GP and patient characteristics associated with the management of contraception; types of contraception used; rates of encounters involving emergency contraception. Increased age, ethnicity, Indigenous status and holding a Commonwealth Health Care Card were significantly associated with low rates of encounters involving management of contraception. The combined oral contraceptive pill was the most frequently prescribed method of contraception, with moderate prescription of long-acting reversible contraception (LARC), especially among women aged 34-54 years. Rates of consultations concerned with emergency contraception were low, but involved high rates of counselling, advice or education (48%) compared with encounters for general contraception (> 20%). A shift towards prescribing LARC, as recommended in clinical guidelines, has yet to occur in Australian general practice. Better understanding of patient and GP perspectives on contraceptive choices could lead to more effective contraceptive use.

The conscientious objection: debate on emergency contraception.

Science.gov (United States)

Montanari Vergallo, G; Zaami, S; Di Luca, N M; Marinelli, E

2017-01-01

The authors discuss the emergency contraception (EC) topic, assessing scientific and ethical aspects. The almost totality of the studies carried out tends to report on the use of drugs as an emergency measure to prevent pregnancy. However, it is not yet completely excluded that emergency contraceptives can induce medical abortion. The debate on side effects of EC continues to be a highly emotional and controversial issue both for advocates who believe they will lower considerably the number of unintended pregnancies and abortions, and for opponents who believe that using emergency contraception amounts to an abortion. This latter hypothesis highlights the conflicting aspect of the conscientious objection to abortion of physicians and pharmacists. This research work is aimed at investigating the emergency contraception issue, paying particular attention to the medico-legal and regulatory aspects of this subject. Particularly, the authors focus on the conscientious objection in order to assess, if any, legal protection for physicians and pharmacists who claim a right to conscientious objection. Inappropriate use of EC could be resolved through a registry of user. This registry, of course, would not have the intention of persecution, but would only serve to detect possible cases of subjugation, exploitation and harassment.

Sex, tensions and pills : Young people’s use of contemporary reproductive and sexual health technologies in Addis Ababa, Ethiopia

NARCIS (Netherlands)

Both, R.E.C.

2017-01-01

This study sheds light on why some young men and women from diverse backgrounds in Addis Ababa use emergency contraceptive pills (ECs) and sildenafil citrate (Viagra) repeatedly, sometimes in a routinized manner. It unravels the reasons behind the frequent yet secretive purchasing of these two

Acceptability of Contraceptives in Young Couples

Institute of Scientific and Technical Information of China (English)

楼超华; 郭友宁

1997-01-01

Based on the data from the survey of 7826 young couples in two districts of Shanghai, we analyzed the acceptability of oral pill, IUD, condom and injection in women. The results showed that 63.4% of subjects were unwilling to use pill and 5.7% were unwilling to use injection, mainly for the reasons that the pill was “harmful tohealth” and the “cause of obesity”; 8.7% of subjects were unwilling to use IUD, mainly for the reasons of the “cause of menorrhagia or spotting” and“being easy to fail”; 6.2% of subjects were unwilling to use condom, mainly for the reasons of “interference with intercourse” and “inconvenience in use”. The most important source of getting the information was “heard from person's talking”.Simple variate and Logistic analysis showed that women's age at marriage, education, occupation, contraceptive knowledge score, history of using the contraceptives,some women's traits etc. affected the acceptability of the contraceptives. The study implies that it is necessary to strengthen provision of contraceptive knowledge for young couples and to make them have correct understanding of the side effects of contraceptives for improving family planning program.

La anticoncepción de emergencia en América Latina y el Caribe Emergency contraception in Latin America and the Caribbean

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Antonieta Martin

2004-12-01

Full Text Available Introducing the post-coital birth control method in the family-planning services of Latin American countries has not been an easy task. Catholic and other conservative groups with great influence in the political arena have time and again stopped it from being adopted as an alternative method and have even succeeded in having it removed from official directives after formal acceptance by health authorities. The main objections are triggered by the erroneous supposition that "emergency contraception" pills are abortifacients. However, a large dose of cultural discrimination against women seems also to be involved. It has been extremely difficult to register dedicated products and make them available in drugstores and even more difficult to distribute them without charge at public health centers. They are hard to find, expensive, and unavailable to adolescents at risk for unwanted pregnancies and to most low-income women, especially in rural areas. Dissemination of appropriate information has been scarce and slow and there are still great numbers of people that do not understand how or why the method works. Brazil has been the only exception, as its open society has readily accepted this method of contraception. The Latin American Consortium on Emergency Contraception founded in the year 2000 and its regional conference two years later had an important impact on the situation, as they encouraged the coordination of efforts by governmental and nongovernmental entities with those of women's groups to fight for sexual and reproductive rights. A number of studies have shown that the more people learn about emergency contraception, the more they find it acceptable and necessary, and radio spots and other media techniques have begun to educate the public about this matter. In spite of the many difficulties encountered, in the last few years several countries have made strides to include this method in their public health guidelines. However, because of

Survey of patient awareness and beliefs regarding emergency contraception

International Nuclear Information System (INIS)

Amir, F.; Saeed, A.; Fakhar, S.; Saeed, A.A.

2015-01-01

Objective: To investigate patient's knowledge and beliefs regarding emergency contraception and its use. Study Design: Cross-sectional descriptive study Place and Duration of Study: A six months cross-sectional descriptive study, from 1st July 2009 till 31st December 2009 carried out at Shifa international Hospital (SIH) and Shifa community health centre (SFCHC) Islamabad. Patients and Methods: All married women of reproductive age coming to SIH or SFCHC clinics after informed consent were interviewed regarding their knowledge of emergency contraception. Results: A total of 770 women were interviewed, but the data was completed for 759 women. 131 women (17.3%) had knowledge about emergency contraception but only 79 (10.4%) had actually used this method for contraception. Conclusion: There is a very low awareness level regarding emergency contraception among women of developing countries even in the urban population. (author)

Contraception and hormonal management in the perimenopause.

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Long, Margaret E; Faubion, Stephanie S; MacLaughlin, Kathy L; Pruthi, Sandhya; Casey, Petra M

2015-01-01

This literature review focuses on contraception in perimenopausal women. As women age, their fecundity decreases but does not disappear until menopause. After age 40, 75% of pregnancies are unplanned and may result in profound physical and emotional impact. Clinical evaluation must be relied on to diagnose menopause, since hormonal levels fluctuate widely. Until menopause is confirmed, some potential for pregnancy remains; at age 45, women's sterility rate is 55%. Older gravidas experience higher rates of diabetes, hypertension, and death. Many safe and effective contraceptive options are available to perimenopausal women. In addition to preventing an unplanned and higher-risk pregnancy, perimenopausal contraception may improve abnormal uterine bleeding, hot flashes, and menstrual migraines. Long-acting reversible contraceptives, including the levonorgestrel intrauterine system (LNG-IUS), the etonogestrel subdermal implant (ESI), and the copper intrauterine device (Cu-IUD), provide high efficacy without estrogen. LNG-IUS markedly decreases menorrhagia commonly seen in perimenopause. Both ESI and LNG-IUS provide endometrial protection for women using estrogen for vasomotor symptoms. Women without cardiovascular risk factors can safely use combined hormonal contraception. The CDC's Medical Eligibility Criteria for Contraceptive Use informs choices for women with comorbidities. No medical contraindications exist for levonorgestrel emergency-contraceptive pills, though obesity does decrease efficacy. In contrast, the Cu-IUD provides reliable emergency and ongoing contraception regardless of body mass index (BMI).

Ulipristal acetate as an emergency contraceptive agent.

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Martinez, Alan M; Thomas, Michael A

2012-09-01

Emergency contraceptive agents play a crucial role in preventing unplanned pregnancy. These agents and devices have been studied since the 1960s and have had varied results in terms of side effects and efficacy. A new oral tablet for emergency contraception (EC), ulipristal acetate (UPA) , is a selective progesterone receptor modulator and can be used up to 120 h following unprotected intercourse, without an increase in adverse effects or a decrease in efficacy. This article reviews studies that evaluate the pharmacodynamics, pharmacokinetics, clinical efficacy, and safety profile of UPA as an emergency contraceptive agent. UPA, a selective progesterone receptor modulator, is administered as a single 30 mg dose for EC. This agent provides a comparable, if not better, efficacy and side effect profile than seen with levonorgestrel or mifepristone. Because it has both agonistic and antagonistic effects on the progesterone receptor, ongoing clinical trials are documenting UPA's use for patients with endometriosis and as an extended use contraceptive.

[The difficulties of contraception: conflicts and paradoxes].

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Cribier, F

1988-06-01

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

Knowledge and practice of emergency contraception among female ...

African Journals Online (AJOL)

Objectives: To assess the level of knowledge and practice of emergency contraception among female undergraduates in University of Lagos and to determine the factors that influence knowledge and practice of emergency contraception among female undergraduates. Design: Cross-sectional descriptive study. Setting: The ...

Ulipristal acetate: a new emergency contraceptive.

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Sullivan, Jade L; Bulloch, Marilyn N

2011-07-01

Ulipristal acetate (UPA) is a newly developed emergency contraceptive currently available in the USA and Europe. It is approved as a 30 mg one-time dose taken within 120 h (5 days) of unprotected intercourse or failed contraception. This selective progesterone receptor modulator appears to be more effective than the levonorgestrel-containing emergency contraceptive, which must be taken within 72 h of unprotected intercourse. According to pharmacodynamic trials, UPA delays follicular maturation and ovulation. In addition, UPA may modulate the endometrium. Both Phase III clinical trials found that UPA does not lose efficacy within the 120-h dosing interval. Throughout all phases of clinical studies, UPA was shown to be well tolerated with only minimal adverse drug reactions, all of which are similar to competitor therapies.

The Contraceptive Pill-Current Status

African Journals Online (AJOL)

16 Okt 1974 ... the method and a certain amount of inherent risk, and nonetheless request it. The onus is therefore on the medical profession to select the most suitable type of pill for each type of patient. An attempt must be made to assess the risks in specific indi- viduals, and to prevent prescription of oral contra-. 2085 ...

Pregnancy, contraception and emergency contraception: the language of urban adolescent young women.

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Mollen, C J; Fernando, M; Hayes, K L; Barg, F K

2012-08-01

We sought to characterize how a group of urban adolescent females understands the domains of pregnancy, contraception, and emergency contraception (EC). We used the research strategy of freelisting as part of an in-depth interview study. Urban adolescent females presenting to a Pediatric Emergency Department. Participants were enrolled using a purposive sampling strategy if they were black, English-speaking females, 15-19 years old, who resided in 1 of 11 zip codes surrounding the hospital. Smith's saliency score. Freelists were analyzed for the entire sample, as well as for subgroups. Thirty adolescents completed the interview. We found that this group of adolescents uses different words to characterize the domains of pregnancy, contraception, and EC. The only overlapping salient term was "abortion," which appeared in the overall lists for pregnancy and EC and in the younger group's list for contraception. In addition, lack of knowledge was cited as an important factor related to contraception. Adolescent patients may not fully understand the concepts of contraception and EC. Providers should consider the potential need to provide an explanation for terms used, and they should consider explicitly differentiating between routine forms of contraception and EC, as well as between EC and abortion. Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Contraceptive availability during an emergency response in the United States.

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Ellington, Sascha R; Kourtis, Athena P; Curtis, Kathryn M; Tepper, Naomi; Gorman, Susan; Jamieson, Denise J; Zotti, Marianne; Barfield, Wanda

2013-03-01

This article provides the evidence for contraceptive need to prevent unintended pregnancy during an emergency response, discusses the most appropriate types of contraceptives for disaster situations, and details the current provisions in place to provide contraceptives during an emergency response.

Knowledge and use of emergency contraception among educated ...

African Journals Online (AJOL)

Background: One of the effective ways to reduce unwanted pregnancy and its consequences is the knowledge and effective use of emergency contraception among the population. Aim: To evaluate the knowledge of emergency contraception among educated men and women and how often they use it. Methodology: ...

Effect of emergency oral contraceptive use on condom utilization and sexual risk taking behaviours among university students, Northwest Ethiopia: a cross-sectional study

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Wasie Belaynew

2012-09-01

Full Text Available Abstract Background Young people between the ages of 15 and 24 years are both the most at risk of HIV and the greatest hope for turning the tide against HIV/AIDS. Although various surveys have been done on sexual behaviour of youth in Ethiopia, studies assessing the effect of emergency oral contraceptives on condom utilization of university students are lacking. Methods A cross-sectional study was conducted in two major universities of Ethiopia from January to May 2011 using structured self administered questionnaire with the aim to assess the effect of introducing oral emergency contraceptive pills on condom utilization and sexual risk taking behaviours among female university students. Study participants were selected by simple random sampling using the list from the associate registrars of each University. Data were entered, cleaned and analyzed using SPSS version 17.0. Bivariate and multiple logistic regression analyses were used to determine factors associated with condom utilization. Results a total of 623 students out of 660 were included giving response rate of 94.4%. A total of 103(16.5% had history of sexual intercourse and nearly half (45.6% of them had sex before the age of 20 years. Forty (6.4% students had history of sexually transmitted infections (STI. Sixty seven percent of students had heard about emergency oral contraceptives. One hundred and ninety one (45.7% of students believe that EOC is effective in preventing pregnancy. Believing that EOC is effective in preventing pregnancy (adjusted Odds ratio, AOR = 0.22 95% CI 0.06, 0.87, condom prevents STI (AOR = 10.37, 95% CI 1.73, 62.24 and younger age below 20 years (AOR = 11.68 95% CI 1.25, 109.19 were statistically significantly associated with condom use. Conclusion a significant number of students had history of sexual intercourse and used emergency contraception. The belief in the effectiveness of EOC negatively affects condom use. The preference for the

Effect of emergency oral contraceptive use on condom utilization and sexual risk taking behaviours among university students, Northwest Ethiopia: a cross-sectional study.

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Wasie, Belaynew; Belyhun, Yeshambel; Moges, Beyene; Amare, Bemnet

2012-09-13

Young people between the ages of 15 and 24 years are both the most at risk of HIV and the greatest hope for turning the tide against HIV/AIDS. Although various surveys have been done on sexual behaviour of youth in Ethiopia, studies assessing the effect of emergency oral contraceptives on condom utilization of university students are lacking. A cross-sectional study was conducted in two major universities of Ethiopia from January to May 2011 using structured self administered questionnaire with the aim to assess the effect of introducing oral emergency contraceptive pills on condom utilization and sexual risk taking behaviours among female university students. Study participants were selected by simple random sampling using the list from the associate registrars of each University. Data were entered, cleaned and analyzed using SPSS version 17.0. Bivariate and multiple logistic regression analyses were used to determine factors associated with condom utilization. a total of 623 students out of 660 were included giving response rate of 94.4%. A total of 103(16.5%) had history of sexual intercourse and nearly half (45.6%) of them had sex before the age of 20 years. Forty (6.4%) students had history of sexually transmitted infections (STI). Sixty seven percent of students had heard about emergency oral contraceptives. One hundred and ninety one (45.7%) of students believe that EOC is effective in preventing pregnancy. Believing that EOC is effective in preventing pregnancy (adjusted Odds ratio, AOR = 0.22 95% CI 0.06, 0.87), condom prevents STI (AOR = 10.37, 95% CI 1.73, 62.24) and younger age below 20 years (AOR = 11.68 95% CI 1.25, 109.19) were statistically significantly associated with condom use. a significant number of students had history of sexual intercourse and used emergency contraception. The belief in the effectiveness of EOC negatively affects condom use. The preference for the pill may make teenagers less prepared to practice STI protective behaviours in

A Comparison of Second and Third Generations Combined Oral Contraceptive Pills’ Effect on Mood

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Shahnazi, Mahnaz; Farshbaf Khalili, Azizeh; Ranjbar Kochaksaraei, Fatemeh; Asghari Jafarabadi, Mohammad; Gaza Banoi, Kamal; Nahaee, Jila; Bayati Payan, Somayeh

2014-01-01

Background: Most women taking combined oral contraceptives (COCs) are satisfied with their contraceptive method. However, one of the most common reasons reported for discontinuation of combined oral contraceptives (COCs) is mood deterioration. Objectives: This study aimed to compare effects of the second and third generation oral contraceptive pills on the mood of reproductive women. Materials and Methods: This randomized, double-blind, controlled clinical trial was conducted in reproductive women at health centers in Tehran, Iran. Participants were randomized into the second and third generation oral contraceptive groups. Positive and negative moods were recorded using positive affect, negative affect scale (PANAS) tools at the end the second and fourth months of the study. Data analysis was carried out using ANOVA and P Values pills. The second generation oral contraceptive pills resulted in a decrease in positive mood (95% CI: 43.39 to 38.32 in second month and 43.39 to 26.05 in four month) and increase in negative mood (95% CI: 14.23 to 22.04 in second month and 14.23 to 32.26 in four month - P pills have a better effect on mood in women in reproductive ages than the second generation pills. It can be recommended as a proper combined oral contraceptive in Iran. PMID:25389478

Determinants of emergency contraception non-use among women in unplanned or ambivalent pregnancies

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Osmara Alves dos Santos

2014-08-01

Full Text Available Objective To analyze the determinants of emergency contraception non-use among women in unplanned and ambivalent pregnancies. Method Cross-sectional study with a probabilistic sample of 366 pregnant women from 12 primary health care units in the city of São Paulo, Brazil. A multinomial logistic regression was performed, comparing three groups: women who used emergency contraception to prevent ongoing pregnancies (reference; women who made no use of emergency contraception, but used other contraceptive methods; and women who made no use of any contraceptive methods at all. Results Cohabitation with a partner was the common determinant of emergency contraception non-use. No pregnancy risk awareness, ambivalent pregnancies and no previous use of emergency contraception also contributed to emergency contraception non-use. Conclusion Apart from what is pointed out in the literature, knowledge of emergency contraception and the fertile period were not associated to its use.

Providers' knowledge, attitude and dispensing practices of e-pills in government dispensaries of South district in delhi, India.

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Kishore, Vertika; Misro, Man M; Nandan, Deoki

2010-01-01

South Delhi is one of the well developed districts in the capital with best public health care facilities. Knowledge, attitude and dispensing practices of emergency contraceptive pills (E-pills) were assessed among health care providers of government dispensaries in South Delhi. A descriptive epidemiological study. Both medical and paramedical (n = 428) providers in 63 government health care facilities were interviewed between August to December 2007 using a semi-structured interview schedule. Among the different categories of the providers, medical officers were observed to be most knowledgeable about E-pills and the pharmacists were the least. The correct prescribed dose of E-pill was known only to 32% of the providers while 49% knew about its right time of intake. Misconceptions and apprehensions for promoting its use were very much prevalent even among medical officers as majority felt that open access to E-pills would increase promiscuity. The dispensing practice of providers was found positively (P pills.

A survey regarding acceptability of oral emergency contraception according to the posited mechanism of action.

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Willetts, S J; MacDougall, M; Cameron, S T

2017-08-01

The objective was to determine the acceptability to women of oral emergency contraception (EC) that works by inhibiting ovulation, preventing implantation or disrupting implantation, and also to determine the characteristics of women associated with the acceptability of each posited mechanism of action. Women completed a self-administered, anonymous questionnaire asking whether they would consider using an EC pill based on each of three hypothetical mechanisms of action: inhibiting ovulation, preventing implantation or disrupting implantation. The questionnaire was distributed among women in Edinburgh, UK, (a) presenting for EC at a community pharmacy, (b) attending a clinic for insertion of intrauterine contraception (IUC) or (c) attending a clinic for an induced abortion. Descriptive analyses stratified women according to healthcare setting and personal characteristics. Univariable and multivariable analyses were used to establish factors which may predict acceptability of each EC pill's mechanism of action. Four hundred and nineteen out of 458 (91%) women responded to the survey. Overall, women reported that EC would be acceptable if it worked by inhibiting ovulation (89%), preventing implantation (83%) or disrupting implantation (75%). Among women seeking abortion, more would accept an EC pill which disrupted implantation compared to women seeking IUC (odds ratio, 2.19; 95% confidence interval, 1.30-3.69; p=.004). Based on multivariable analyses, factors associated with acceptability included previous use of EC, previously holding strong views against abortion and having had a previous abortion. For each of the posited mechanisms of action, a majority of women surveyed would be willing to consider oral EC to prevent unintended pregnancy. The scope of the study was limited, and further work on the views of women in the wider population is needed. This is important as the development of such drugs to prevent pregnancy is likely to raise political and ethical

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

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Rafie S

2017-03-01

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

Ectopic Pregnancy After Plan B Emergency Contraceptive Use.

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Steele, Brianne Jo; Layman, Kerri

2016-04-01

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.

Abortion - Multiple Languages

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... Simplified (Mandarin dialect)) PDF Reproductive Health Access Project Emergency Contraceptive Pill and the Abortion Pill: What's the Difference? - English PDF Emergency Contraceptive Pill and the Abortion Pill: What's the Difference? - ...

Knowledge and Practices About the Subject Emergency Contraception of the Pharmacists and Their Helpers in the Pharmacies in Manisa

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Ayten Taspinar

2012-08-01

Full Text Available AIM: The study was carried out as descriptive to determine the knowledge and practices about the subject emergency contraception of the pharmacists and their helpers in the pharmacies in central Manisa. METHOD: The universe of the research was formed by the 113 pharmacies registered to Manisa chamber of pharmacists in the year 2008 and all the pharmacies were included in the study. 47 pharmacists and 88 helpers agreed to join the study. The research which was planned to be descriptive March-to-June 2008. A questionnaire was produced by researchers and filled in during face-to face interviews with the pharmacists and their helpers. RESULTS: The pharmacists and their helpers stated that combined pills (46.8% and 44.5% and condoms (41.5% and 42.7% the most requested family planning methods their pharmacy. It was determined that 48.9% of the pharmacists, 33% of the pharmacist’s helpers gave information to customers about their use of family planning methods, 38.3% of the pharmacists, 23.9 % of the pharmacist’s helpers gave information what to do in case of failure to use/ where to apply to. 91.5% of the pharmacists, 95.5% of the pharmacist’s helpers stated that they had emergency contraception (EC purpose pills in their pharmacies. It was determined that 61.7% of the pharmacists, 28.4% of the pharmacist’s helpers had the knowledge about EC, 61.7% of the pharmacists, 52.3% of the pharmacist’s helpers could consider the EC methods true, 68.1% of the pharmacists, 70.5% of the pharmacist’s helpers gave the correct answers to the question of when the EC – purpose pills would be used. 68.1% of the pharmacists, 45.5% of the pharmacist’s helpers stated that EC methods might have adverse effects, 14.9% of the pharmacists, 25% of the pharmacist’s helpers stated that EC methods were protect agains to STD or not information about it, 12.8% of the pharmacists, 9.1% of the pharmacist’s helpers stated that these pills might be effective after the

Intrauterine devices and other forms of contraception: thinking outside the pack.

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Allen, Caitlin; Kolehmainen, Christine

2015-05-01

A variety of contraception options are available in addition to traditional combined oral contraceptive pills. Newer long-acting reversible contraceptive (LARC) methods such as intrauterine devices and subcutaneous implants are preferred because they do not depend on patient compliance. They are highly effective and appropriate for most women. Female and male sterilization are other effective but they are irreversible and require counseling to minimize regret. The contraceptive injection, patch, and ring do not require daily administration, but their typical efficacy rates are lower than LARC methods and similar to those for combined oral contraceptive pills. Copyright © 2015 Elsevier Inc. All rights reserved.

Contraception.

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Bourne, G L

1967-01-01

Contraception is discussed in this article. Abstinence is the only certain method of contraception. The normal pregnancy rate in the normal unprotected population would be somewhere between 60 to 80 pregnancies per 100 woman-years. Contraceptive methods vary in effectiveness. The failure rate of the safe period method is between 10-50 per 100 woman-years while the failure rate of spermicidal pessaries and creams is somewhere between 20 and 80 per 100 woman-years. Occlusive diaphragms fit over the anterior vaginal wall, such as the Dutch cap, or over the cervix itself, such as the cervical or Dumas cap. The failure rate of the Dumas cap is about 4 per 100 woman-years and the Dutch cap 6 per 100 woman-years. Perhaps the ideal female contraceptive is just around the corner in the alteration of cervical mucus by changing its pH or other constituents so that it becomes a spermicidal barrier or causes either sperm agglutination or a reduction of sperm motility. Between 8% and 15% of plastic IUDs are extruded spontaneously and a further 10% may be removed because of pain, intermenstrual bleeding, or menorrhagia. They are well tolerated in about 80% of patients, in whom the failure rate is about 2 per 100 woman years. The douche and sponge are unacceptable and unreliable methods of contraception. The main advance in contraceptive technique over the past 10 years has been the introduction of the oral contraceptives. The combined type of pill was developed first, followed by the sequential type. It has been estimated that between half a million and 1 million women in this country now take oral contraceptive pills and nothing detrimental has so far been proved about the method in spite of persistent and widely published doubts about its possible dangers. The failure rate of the oral contraceptives is less than 1 per 100 woman years.

Health literacy and contraception: a readability evaluation of contraceptive instructions for condoms, spermicides and emergency contraception in the USA.

Science.gov (United States)

El-Ibiary, Shareen Y; Youmans, Sharon L

2007-03-01

To assess readability of over-the-counter (OTC) contraceptive product instructions currently available, compare the results with previous studies from a decade ago, and review the implications for health care providers, in particular pharmacists counseling on OTC contraceptives. A sample of contraceptive instructions was submitted to a readability analysis using four standard readability formulas. Products included condoms, spermicides, and emergency contraception instruction pamphlets. Reading grade levels for condoms ranged from 6th to 12th grade. The average reading levels for the spermicides were 9th-10th grade and for the emergency contraceptives 10th-12th grade. These results were consistent with those of similar studies performed a decade ago. Consumers need to have at least a high school reading level in order to comprehend current product instructions. Very little has changed in the past decade regarding readability of OTC contraceptive patient instructions, despite calls to simplify written instructions. Healthcare providers, in particular pharmacists, must be aware of these disparities to enhance patient education and advocate for simpler reading materials.

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

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Bahamondes L

2014-02-01

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 Clinicaltrial.gov 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

Contraception for adolescents with chronic rheumatic diseases

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Benito Lourenço

Full Text Available ABSTRACT Contraception is an important issue and should be a matter of concern in every medical visit of adolescent and young patients with chronic rheumatic diseases. This narrative review discusses contraception methods in adolescents with juvenile systemic lupus erythematosus (JSLE, antiphospholipid syndrome (APS, juvenile idiopathic arthritis (JIA and juvenile dermatomyositis (JDM. Barrier methods are safe and their use should be encouraged for all adolescents with chronic rheumatic diseases. Combined oral contraceptives (COC are strictly prohibited for JSLE and APS patients with positive antiphospholipid antibodies. Reversible long-acting contraception can be encouraged and offered routinely to the JSLE adolescent patient and other rheumatic diseases. Progestin-only pills are safe in the majority of rheumatic diseases, although the main concern related to its use by adolescents is poor adherence due to menstrual irregularity. Depot medroxyprogesterone acetate injections every three months is a highly effective contraception strategy, although its long-term use is associated with decreased bone mineral density. COC or other combined hormonal contraceptive may be options for JIA and JDM patients. Oral levonorgestrel should be considered as an emergency contraception method for all adolescents with chronic rheumatic diseases, including patients with contraindication to COC.

Emergency contraceptive use in Addis Ababa, Ethiopia: Challenging common assumptions about young people's contraceptive practices.

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Both, Rosalijn

2015-05-01

Drawing on an ethnographic case study of young people's (aged 18-29) use of emergency contraceptives (ECs) in Addis Ababa, Ethiopia, this article highlights areas of disconnect between how reproductive health experts envision EC use and local meanings ascribed to ECs by young people. ECs - designed by reproductive health experts to be used only in case of emergency - were preferred by study participants over other contraceptive methods because of their ease of use, discreetness, perceived minimal side effects on beauty and future fertility, and usefulness in navigating reproductive intentions. The findings point to features that young people find desirable when it comes to contraceptive methods and suggest that common assumptions of reproductive health experts about young people's contraceptive practices need to be reconsidered, namely: 1) that young people can plan for prevention of unwanted pregnancy by buying a contraceptive method in advance; 2) that existing contraceptive technologies are appropriate for young people; 3) that young people prefer to use modern contraceptive methods; and 4) that young people in premarital relationships aim to prevent unplanned pregnancy. Copyright © 2015. Published by Elsevier Ltd.

Knowledge and Perception of Emergency Contraception of Women in Shahrekord-Iran

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Masoumeh Delaram

2008-09-01

Full Text Available AbstractObjective: The aim of this study was to determine knowledge and attitude about emergency contraception among women using condom, coitus interruptus and rhythm methods. Materials and methods: Between April and September 2006, 400 women referring to the health centers in Shahrekord, were evaluated. They entered the study if they were using condom, coitus interruptus or rhythm methods. A questionnaire including demographic information, contraceptive method in use, and patients' awareness and attitude/practice about emergency contraception was completed for each participant.Results: Of the 400 responders, 60.5% were using condom, 38.7% were using coitus interruptus and 0.8% were practicing rhythm method. The awareness was inadequate in 22.5% of women, moderate in 55% and adequate in 22% of them. The attitude of users was positive in more than 70% of them and only 20.5% of women had practiced emergency contraception. The relation of age and job with awareness was significant (P<0.001. A significant relation was considered between the level of education and knowledge of women (P<0.01. The women who had adequate knowledge had practiced the emergency contraception better than those with inadequate knowledge (P<0.001. However, only 27.1% of responders who reported knowing about emergency contraception knew the correct time frame in which emergency contraceptives must be used.Conclusion: There is a critical need to train the women about emergency contraception, emphasizing available methods and correct timing.

Knowledge and use of emergency contraception: a multicountry analysis.

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Palermo, Tia; Bleck, Jennifer; Westley, Elizabeth

2014-06-01

Globally, evidence on knowledge and use of emergency contraception from population-based data is limited, though such information would be helpful in increasing access to the method. We examined knowledge and use of emergency contraception in 45 countries using population-based survey data. Demographic and Health Survey (DHS) data on women aged 15-49 were analyzed by country in logistic regressions to identify associations between women's characteristics and their having heard of emergency contraception or having ever used it. Trends were examined, by region and globally, according to individual, household and community descriptors, including women's age, education, marital status, socioeconomic status, and urban or rural location. The proportion of women who had heard of emergency contraception ranged from 2% in Chad to 66% in Colombia, and the proportion of sexually experienced women who had used it ranged from less than 0.1% in Chad to 12% in Colombia. The odds of having heard of or used the method generally increased with wealth, and although the relationship between marital status and knowing of the method varied by region, never-married women were more likely than married women to have used emergency contraception in countries where significant differences existed. In some countries, urban residence was associated with having heard of the method, but in only three countries were women from urban areas more likely to have used it. Our findings support the need for broader dissemination of information on emergency contraception, particularly among low-income individuals. Variations in use and knowledge within regions suggest a need for programs to be tailored to country-level characteristics.

Pharmacists’ Provision of Contraception: Established and Emerging Roles

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Lindsey M Peters

2016-10-01

Full Text Available Pharmacists’ roles in provision of family planning products is expanding in the United States (U.S.. This article details established as well as emerging roles for U.S. pharmacists in the provision of contraception. These include helping patients develop reproductive life plans; dispensing prescription contraceptive products and counseling patients; assisting and educating patients with non-prescription contraceptive products, including emergency contraception; participating in collaborative practice agreements; administering contraception products; and making referrals and developing partnerships. The provision of contraception in the U.S. is dynamic, and pharmacists should continue to be aware of changes that will impact them professionally. As approximately 45% of pregnancies in the U.S. are unintended, through these roles pharmacists can impact an important public health priority. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties   Type: Idea Paper

Knowledge, attitude, and practice of emergency contraception ...

African Journals Online (AJOL)

Background: The contraceptive prevalence in our environment is very low with attendant increase in unwanted pregnancy and unsafe abortion. The use of emergency contraception (EC) in women with unprotected intercourse could be the only option that can avoid the unwanted pregnancy and unsafe abortion. Objective: ...

Awareness and utilization of emergency contraception among ...

African Journals Online (AJOL)

Majority of the students, 321 (71.3%), were single. Overall, 295 ... Information from health personnel, news media and schools were the major influences of emergency contraceptive ... of its availability and advantages, women make better choices. .... where information about sex and/or contraception came from parents ...

Considerations for the use of progestin-only contraceptives.

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Freeman, Sarah; Shulman, Lee P

2010-02-01

To highlight the characteristics of progestin-only contraceptives (POCs) currently available in the United States, and to explore the potential of these agents as first-line contraceptive options for women seeking health promotion by prevention of an unwanted pregnancy. The progestin-only pills (Micronor and Ovrette), depot medroxyprogesterone acetate (DMPA) injections (Depo-Provera and depo-subQ provera 104), levonorgestrel intrauterine system (IUS) (Mirena), and etonogestrel implant (Implanon) will be reviewed. The use of levonorgestrel (Plan B) as an emergency contraceptive will also be considered briefly. Worldwide medical literature and the prescribing information for the specified products. A number of POCs are currently available for routine birth control in the United States, ranging from the daily progestin-only pill to nondaily contraceptive options such as injectable DMPA, the levonorgestrel-releasing IUS, and the etonogestrel-releasing contraceptive implant. Each of these methods has specific advantages, but also specific drawbacks that can result in discontinuation of treatment if users are not given adequate information about what to expect in terms of side effects. It is critical that clinicians provide adequate and accurate information along with detailed counseling to women who are considering using POCs, as well as providing periodic reinforcement of the information at regular clinic visits for those already using POCs. Given that a large number of pregnancies are unplanned and create a significant impact on social, economic, and health outcomes, it is important for the clinician to have a vast knowledge of contraceptive options. POCs offer significant choices in contraception. By proactively addressing common concerns (such as potential effects on weight, mood, menstrual bleeding patterns, and bone mineral density), clinicians may improve the likelihood of adherence and continuation with POCs for routine birth control.

Emergency contraception. General practitioner knowledge, attitudes and practices in New South Wales.

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Weisberg, E; Fraser, I S; Carrick, S E; Wilde, F M

1995-02-06

To assess the knowledge, attitudes and practices of general practitioners in New South Wales regarding the provision of emergency contraception. Randomised group comparison of 100 rural and 100 urban general practitioners (GPs) by questionnaire. Eighty-four rural and 76 urban GPs responded. More rural GPs were knowledgeable about emergency contraception than urban GPs (95% v. 78%), and more women knew about it than men. More urban GPs frequently prescribed emergency contraception than rural GPs (26% v. 6%) and female GPs prescribed it more readily than male GPs (22% v. 12%). There was great variation in the regimens prescribed, especially among rural GPs. Twenty-five per cent of urban GPs and 31% of rural GPs did not offer women information about emergency contraception, while 16% of both groups included such information in any discussion about contraceptive options, and 18% gave information only if requested by the woman. More than 60% of the GPs would provide information about emergency contraception as a back-up to use of barrier methods. The sex, attitude and knowledge of the GPs influence the likelihood of women being made aware of or being given emergency contraception in NSW. There is a need to further educate both the public and practitioners about emergency contraception.

Benefits and risks of hormonal contraception for women

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Hagen, Anja

2007-08-01

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

Effect of hormonal contraceptives on serum serotonin in females of reproductive age group

International Nuclear Information System (INIS)

Faryal, U.; Hajra, B.; Saqib, J.; Rashid, S.; Hassan, M.; Ali, M.A.

2016-01-01

Background: Many types of hormonal contraceptives are in use nowadays for example oral pills, emergency contraceptive pills, vaginal rings, implantable rods and injectable contraceptives (combined and progestogens only). The purpose of this study was to determine and compare serum serotonin levels in married fertile females of reproductive age group using hormonal contraceptives with non-contraceptive users. Methods: A total of 300 women were selected in the study. This cross sectional study included three groups; Group-1 (control), group-2 (combined oral contraceptive users) and group-3 (injectable contraceptive users). History and examination of subjects were recorded on proforma. Levels of serum serotonin were measured using standard ELISA kits. Results were analysed by one way anova and a p-value 0.05 percentage was taken as significant, using SPSS 16.0. Results: The mean age of the patients in group-1 was 30.4±6.1 years, group-2 was 28.9±4.9 and in group-3 was 2.5±6.8 years. For subjects in group-1, group-2 and group 3 the mean±SD concentration of serum serotonin was 160.68±53.27 ng/dl, 227.3±63.98 ng/dl and 118.19±31.32 ng/dl. A significant (p=0.00) difference was seen among three groups, i.e., group-1, group-2 and group-3. After applying Post HOC Tukey HSD, there was statistically no significant difference between group-1 and group-2 (p=0.956). Difference was seen between group-2 and group-3 (p=0.00), it was also significant between group-3 and group-1 (p=0.00). Conclusion: It was concluded that hormonal contraceptives affect the levels of serum serotonin.Background: Many types of hormonal contraceptives are in use nowadays for example oral pills, emergency contraceptive pills, vaginal rings, implantable rods and injectable contraceptives (combined and progestogens only). The purpose of this study was to determine and compare serum serotonin levels in married fertile females of reproductive age group using hormonal contraceptives with non-contraceptive

Influence of structured counseling on women's selection of hormonal contraception in Israel: results of the CHOICE study

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Yeshaya A

2014-08-01

Full Text Available Arie Yeshaya,1 Amos Ber,2 Daniel S Seidman,3 Bjorn J Oddens41Department of Obstetrics and Gynecology, Rabin Medical Center, Petah Tikva, 2Maccabi Health Services, Tel Aviv, Israel; 3Department of Obstetrics and Gynecology, Sacker School of Medicine, Tel Hashomer, Israel; 4Global Medical Affairs, MSD, Oss, the NetherlandsBackground: The multinational CHOICE (Contraceptive Health Research Of Informed Choice Experience study evaluated the effects of structured counseling on women's contraceptive decisions, their reasons for making those decisions, and their perceptions of combined hormonal contraceptive (CHC methods in eleven countries. The aim of this paper to present data from the 1,802 women participating in Israel's CHOICE program.Methods: Women (aged 17–40 years who consulted their health care providers about contraception and who would consider a CHC method qualified to participate. After indicating their intended CHC method, the women received counseling about the daily pill, weekly patch, and monthly vaginal ring. After counseling, the women completed a questionnaire about their contraceptive decisions.Results: Before counseling, 67%, 6%, and 5% of women (mean age 27 years intended to use the pill, patch, or ring, respectively. Counseling significantly influenced the women's CHC choice, with 56%, 12%, and 23% of women selecting the pill, patch, or ring (P<0.0001 for all contraceptive methods versus before counseling. Logistic regression analysis suggested that age significantly increased the probability of switching from the pill to the ring.Conclusion: Although the pill was the most popular choice overall, counseling appeared to influence Israeli women's contraceptive decisions, with significantly more women selecting the patch. More than four times as many women selected the ring after counseling than before counseling.Keywords: combined hormonal contraceptive, counseling, contraceptive ring, contraceptive patch, oral contraceptive pill

The provision of emergency contraception in Kinshasa's private sector pharmacies: experiences of mystery clients.

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Hernandez, Julie H; Mbadu, Muanda Fidèle; Garcia, Mélissa; Glover, Annie

2018-01-01

Recent programmatic and research efforts on addressing gaps in health systems of low-income countries increasingly see task shifting, i.e. the provision of healthcare by non-medically trained personnel, as a possible solution to increase the availability of specific services and commodities. In Kinshasa, private-sector pharmacies are the primary and preferred provider of family planning (FP) methods, and thus constitute a potential resource for expanding access to specific contraceptives. The objective of this study is to explore selected pharmacies' readiness to serve women seeking emergency contraception (EC). This study used a mystery client (MC) methodology to visit 73 pharmacies in Kinshasa, Democratic Republic of Congo (DRC). Trained interviewers posed as novice EC users and asked specific questions to evaluate the pharmacy staff's technical knowledge of EC and their attitudes towards EC clients. The results of the MC visit were recorded immediately after the MC left the pharmacy. Findings indicate that more than two-thirds of EC providers were knowledgeable about EC dosage, timeframe, and side effects, and 90% were deemed helpful towards novice EC users. Rare but glaring misconceptions about EC timeframe (20% of providers) and long-term side effects (4% of providers), as well as frequent stock-out (22%) and cost issues highlight priorities for programmatic improvements. As new service delivery strategies are explored to complement the uneven network of health structures in DRC, this study suggests that, given proper training and integration in FP programming, private-sector pharmacies have the potential to meet specific contraceptive needs for women living in Kinshasa. Private pharmacies included in study sample in Kinshasa (DRC) have adequate family planning (FP) service skills to provide clients with emergency contraceptive pills. These higher-end outlets constitute an opportunity for expanding access to FP, although, under total market approaches, a more

Morning-After Pill

Science.gov (United States)

... of emergency birth control (contraception). The purpose of emergency contraception is to prevent pregnancy after a woman has ... wall and has already begun to develop. Risks Emergency contraception is an effective option for preventing pregnancy after ...

[Emergency oral contraception policy: the Peruvian experience].

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Pretell-Zárate, Eduardo A

2013-07-01

Emergency oral contraception is part of the sexual and reproductive rights of women. In 2001, this health policy was incorporated into the Rules of the National Family Planning Program of the Ministry of Health, primarily to prevent unwanted pregnancy and its serious consequences, induced abortion and the high associated maternal mortality rate, which are major public health problems. Scientific research has confirmed that the main mechanism of action of levonorgestrel, component of emergency oral contraception (EOC) is to inhibit or delay ovulation, preventing fertilization of the egg; additionally, it increases the thickening of the cervical mucus, making the sperm migration more difficult. No study has found endometrial abnormalities that may interfere with the implantation of the fertilized egg or embryo development of an implanted egg. However, despite the support of medical science and legal backing, the EOC is available only to users with economic resources, but its use has not been fully implemented in public sector services, due to obstacles created by groups opposed to contraception under claim of an alleged abortive effect that has already been ruled out scientifically. This article describes the administrative experience and legal confrontations between groups of power that prevent the proper implementation of an emergency contraception policy in Peru.

The copper intrauterine device for emergency contraception: an opportunity to provide the optimal emergency contraception method and transition to highly effective contraception.

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Dermish, Amna I; Turok, David K

2013-07-01

Worldwide, 40% of all pregnancies are unintended. Widespread, over-the-counter availability of oral emergency contraception (EC) has not reduced unintended pregnancy rates. The EC visit presents an opportunity to initiate a highly effective method of contraception in a population at high risk of unintended pregnancy who are actively seeking to avoid pregnancy. The copper intrauterine device (IUD), the most effective method of EC, continues to provide contraception as effective as sterilization for up to 12 years, and it should be offered as the first-line method of EC wherever possible. Increased demand for and supply of the copper IUD for EC may have an important role in reducing rates of unintended pregnancy. The EC visit should include access to the copper IUD as optimal care but should ideally include access to all highly effective methods of contraception.

Contraception containing estradiol valerate and dienogest--advantages, adherence and user satisfaction.

Science.gov (United States)

Graziottin, A

2014-10-01

The contraceptive pill containing estradiol valerate and dienogest meets women's requests for: a more natural contraceptive, that is reliable and easy to use, with positive cosmetic effects; less intense and shorter bleeding, reduced anaemia and increased vital energy; reduced dysmenorrhoea and all the specific cycle-related symptoms linked to a drop in oestrogen and the related systemic inflammation, the result of a hormone free interval (HFI) of just two days; with a good impact on sexuality and overall well-being, all associated with a high level of efficacy: (uncorrected Pearl Index: 0.79; corrected: 0.42). Women would prefer more natural hormonal contraception, with high reliability, good tolerability, a simple dosing schedule and possibly some health advantages. To evaluate what the pill containing estradiol valerate and dienogest can offer women and the best way to communicate this opportunity, after 4 years of growing clinical use. A review of literature plus the Author's clinical experience. The new pill containing estradiol valerate and dienogest may satisfy women's need for: a more natural hormonal contraceptive with a low hormone dosage, high reliability and good tolerability; a simple dosing schedule (one pill per day for 28 days); a positive cosmetic effect on the skin; lighter and shorter withdrawal bleeding, improved anaemia, less fatigue and higher vital energy; reduced dysmenorrhoea and a dramatic reduction in all symptoms thanks to a shorter Hormone Free Interval (HFI) of just two days. The new pill is an option for all women taking hormonal contraception who would like a more natural choice; for those who have never used hormonal contraception and may consider this new opportunity positively, for those who suffer from various menstrual symptoms, related inflammation ("a shorter HFI means much fewer or no symptoms") and, possibly for pre-menopausal women, an opportunity to combine excellent contraception with a definite improvement in their well

Improving access to emergency contraception pills through strengthening service delivery and demand generation: a systematic review of current evidence in low and middle-income countries.

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Angela Dawson

Full Text Available Emergency contraception pills (ECP are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP.A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013 from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping.Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs.There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP.

Improving Access to Emergency Contraception Pills through Strengthening Service Delivery and Demand Generation: A Systematic Review of Current Evidence in Low and Middle-Income Countries

Science.gov (United States)

Dawson, Angela; Tran, Nguyen-Toan; Westley, Elizabeth; Mangiaterra, Viviana; Festin, Mario

2014-01-01

Objectives Emergency contraception pills (ECP) are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC) including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP. Methods A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013) from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping. Findings Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs. Conclusion There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP. PMID:25285438

Pharmacy Access to Emergency Contraception in Rural and Frontier Communities

Science.gov (United States)

Bigbee, Jeri L.; Abood, Richard; Landau, Sharon Cohen; Maderas, Nicole Monastersky; Foster, Diana Greene; Ravnan, Susan

2007-01-01

Context: Timely access to emergency contraception (EC) has emerged as a major public health effort in the prevention of unintended pregnancies. The recent FDA decision to allow over-the-counter availability of emergency contraception for adult women presents important rural health implications. American women, especially those living in rural and…

Change to Either a Nonandrogenic or Androgenic Progestin-Containing Oral Contraceptive Preparation is Associated with Improved Sexual Function in Women with Oral Contraceptive-Associated Sexual Dysfunction

DEFF Research Database (Denmark)

Davis, Susan R; Bitzer, Johannes; Giraldi, Annamaria

2013-01-01

It is a commonly held belief that combined oral contraceptive (COC) pills containing an androgenic progestin may be less likely to impair sexual function than COCs containing an anti-androgenic progestin.......It is a commonly held belief that combined oral contraceptive (COC) pills containing an androgenic progestin may be less likely to impair sexual function than COCs containing an anti-androgenic progestin....

THE KNOWLEDGE OF THE NIŠ UNIVERSITY STUDENTS ABOUT EMERGENCY CONTRACEPTION

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Milena Veljković

2014-03-01

Full Text Available Emergency contraception is a treatment that used as an emergency procedure to prevent unwanted pregnancy after an unprotected sexual intercourse or contraception failure regardless of the point in the menstrual cycle. The most common method is the treatment with sexual steroids and the second-line form is the copper intrauterine device. A considerable number of female students of Nis were informed about the existence of emergency contraception. Younger generations (I/II years of sudy were better informed than older generations (III/IV years of study: 81.6% vs. 57.5%. The difference was statistically significant (χ2 =7.91;p<0.005. The students of medicine were better informed than the students of art and science: 87.9% vs. 78.2% vs. 70.0% but there was not statistical difference. It is expected that adequate usage of emergency contraception will significantly reduce the number of unwanted pregnancies. It is only emergency treatment and is not a substitution for regular contraception. Students are very important in the population of youth and it is expected that they could be optimally informed about this method of fertility control.

The use of a written assessment checklist for the provision of emergency contraception via community pharmacies: a simulated patient study

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Schneider CR

2013-09-01

Full Text Available Background: The Pharmaceutical Society of Australia recommends use of a written assessment checklist prior to supply of emergency contraception by pharmacists. Objective: The aim of this research was to determine the prevalence of use of a written assessment checklist by community pharmacists and secondly, to ascertain the effect of the checklist on appropriate assessment and supply.Methods: Three female simulated patients visited 100 randomly selected pharmacies requesting supply of ‘the morning after pill’. Information provided when assessed by the pharmacist was that she had missed one inactive pill of her regular hormonal contraception. The amount of assessment provided and the appropriateness of supply were used as comparative outcome measures.Results: Eighty-three pharmacies used a written assessment checklist. Twenty-four of the pharmacies visited provided the appropriate outcome of non-supply. Pharmacies that used a written assessment checklist provided a greater quantity and consistency of assessment (11.3 ±2.5 v. 6.5 ±3.8 questions, p<0.0001 but this did not result in an improved frequency of an appropriate outcome (20%, n=16 v. 23%, n=3. Conclusions: While a written patient assessment checklist improved the quantity and consistency of patient assessment, it did not improve the advice provided by community pharmacies when handling requests for emergency contraception.

KNOWLEDGE OF EMERGENCY CONTRACEPTIVES AMONG WOMEN OF REPRODUCTIVE AGE GROUP

OpenAIRE

Singh; Himabindu; Shrivastava

2016-01-01

BACKGROUND As per data from WHO, 21.6 million unsafe abortions occurred globally in 2008, out of which 47,000 women died from abortionrelated complications, contributing to 13% of global maternal mortality. (1) Emergency contraceptive can be used after intercourse to prevent pregnancy in case of unprotected intercourse, contraceptive failure or sexual assault. A considerable proportion of these abortions can be prevented by the timely use of emergency contraception. OBJECTIVE...

Emergency Contraceptives and the Beginning of Human Animals.

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Paez, Eze

2016-07-01

Emergency contraceptives may sometimes prevent implantation, thereby causing the death of the embryo. According to some positions contrary to abortion, because the embryo is a human animal, there are usually decisive moral reasons not to use them. In this article, I will show that objecting to the use of emergency contraceptives on those grounds is unjustified. If organisms are real existents, then according to the most plausible conception of what is required for a group of cells to compose one, the embryo cannot qualify as a single organism. On the other hand, if organisms are virtual objects, then whether or not the embryo qualifies as one is morally irrelevant. I conclude that even if those positions are right about the morality of abortion, they are not entitled to oppose the use of emergency contraceptives. © 2016 John Wiley & Sons Ltd.

Emergency contraception: ¿how, when and with what?

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Álvaro Monterrosa Castro

2006-04-01

Full Text Available Emergency contraception is a valid birth-control strategy that articulated and immers d in its real dimension makes a good influenceover the negative social-demographic, biological and economicreverberations that unwanted pregnancy and abortions in riskconditions generate. Due to all the implications that this has, it isimportant that professionals that attend sexual and reproductivehealth, have a clear level of theoretical knowledge based on scientific concepts, be convinced of its advantages and have a serious compromise with the society. Because the abortion is not legal in Colombia, even in rape cases, incest, life risk and woman health, and because the provoked abortion and its complications is the third cause of maternal death, all the actions, including emergency contraception, that prevent unwanted pregnancy and abortion have great importance. Every health professional must know when, with what tools and how administrate emergency contraception.

Knowledge, attitude and practice of emergency contraceptives among adama university female students.

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Tilahun, Dejene; Assefa, Tsion; Belachew, Tefera

2010-11-01

Unwanted pregnancy followed by unsafe abortion is one of the major worldwide health problems, which has many negative consequences on the health and well-being of women. Information about women's knowledge, attitude and practice of emergency contraceptives plays a major role in the reduction of unwanted pregnancy; however, there are no studies about this issue in the study area. This study assessed Adama University female students' knowledge, attitude and practice of emergency contraceptives. A cross-sectional study design was employed from February 1 to 30/2009, on 660 regular undergraduate female students of Adama University. Data were entered and analyzed using SPSS for windows version 16.0. Logistic regression was used to identify the association between variables and emergency contraceptive knowledge, attitude and practice. P-value less than 0.05 at 95% CI was taken for statistical significance. Of the total, 660 respondents, 194(29.4%) were sexually active, 63(9.4%) had history of pregnancy and 49(7.4%) had history of abortion. About 309 (46.8%) of the students had heard about emergency contraceptives and from those who heard emergency contraceptives, 27.2% had good knowledge. Majority, four hundred fifteen (62.9%) of the students had positive attitude towards it. However, only 31(4.7%) had used emergency contraceptive methods. This study demonstrated lack of awareness, knowledge and utilization of emergency contraceptives among Adama University female students. Hence behavioral change strategies should be considered by responsible bodies to improve knowledge and bring attitudinal change on use of emergency contraception.

Study of Contraceptives Used in Unwanted Pregnancies

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S Aghababaei

2010-09-01

Full Text Available Introduction: Unintended pregnancy is a worldwide problem that affects women, their families, and society. Unintended pregnancy can result from contraceptive failure, non-use or use mistake of contraceptive Methods: This study examined the Frequency and pattern of contraceptive method use in unintended pregnancy women reffering to health and medical center of Hamadan medical science university in Iran. Design and setting: A descriptive study was conducted at health and medical center of Hamadan medical science in Iran. Data were collected using a questionnaire in 2006 from a convenience sample of 900 unintended pregnancy women . The survey included measures of demographic variables, type and pattern of contraceptive method use. Data were analyzed by Chi square and t-test using SPSS. Results: Of the 900 participants, 93.9% had used contraceptive methods. The most common contraceptive method use in unintended pregnancy women were oral contraceptive pills 38.1% , natural method 31.9%, condom 19.8%, breastfeeding 4.4%, IUD 3.6%, emergency 1.9% and rhythm 0.4%. The most common problem in contraceptive use were irregular and incorrectly use in hormonal methods and condom users, no control in IUD users and mistake in date calculation in rhythmic users. Conclusion: The majority of participants had used contraceptive methods but have unintended pregnancy. More education is needed in this subject.

One-year contraceptive continuation and pregnancy in adolescent girls and women initiating hormonal contraceptives.

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Raine, Tina R; Foster-Rosales, Anne; Upadhyay, Ushma D; Boyer, Cherrie B; Brown, Beth A; Sokoloff, Abby; Harper, Cynthia C

2011-02-01

To assess contraceptive discontinuation, switching, factors associated with method discontinuation, and pregnancy among women initiating hormonal contraceptives. This was a 12-month longitudinal cohort study of adolescent girls and women (n=1,387) aged 15 to 24 years attending public family planning clinics who did not desire pregnancy for at least 1 year and selected to initiate the patch, ring, depot medroxyprogesterone acetate, or pills. Participants completed follow-up assessments at 3, 6, and 12 months after baseline. Life table analysis was used to estimate survival rates for contraceptive continuation. Cox proportional hazards models were used to estimate factors associated with method discontinuation. The continuation rate (per 100 person-years) at 12 months was low for all methods; however, it was lowest for patch and depot medroxyprogesterone acetate initiators, 10.9 and 12.1 per 100 person years, respectively (P≤.003); continuation among ring initiators was comparable to pill initiators, 29.4 and 32.7 per 100 person-years, respectively (P=.06). Discontinuation was independently associated with method initiated and younger age. The only factors associated with lower risk of discontinuation were greater intent to use the method and being in school or working. The pregnancy rate (per 100 person-years) was highest for patch and ring initiators (30.1 and 30.5) and comparable for pill and depot medroxyprogesterone acetate initiators (16.5 and 16.1; Pcontraceptive continuation, education about longer-acting methods, and developing new contraceptives that women may be more likely to continue. II.

Knowledge of, beliefs about, and perceived barriers to the use of the emergency contraception pill among women aged 18-51 in Nova Scotia

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Whelan AM

2011-09-01

Full Text Available Objectives: To investigate women in Nova Scotia (NS, Canada with respect to their knowledge of, beliefs about, and perceptions of barriers to accessing emergency contraception pills (ECP.Methods: A random digit dialing approach was used to survey a representative sample of NS women aged 18-51. Analyses described the knowledge, beliefs, and perceived barriers associated with ECP access among participants. Particular focus was given to differences between younger (age 18-31 and older (age 32-51 women.Results: The survey response rate of 49% achieved the desired sample size of 770. Overall, women in NS appeared to be poorly informed about ECP with regards to effectiveness, proper timing of administration, how it works, as well as how to access Plan B®. Younger women (age 18-31 were significantly more likely than older women (age 32-51 to know that ECP does not always prevent pregnancy (p<0.01, that it can be taken more than 12 hours after unprotected intercourse (p<0.01, and that it is available without a prescription in pharmacies (p<0.01. Thirty percent of women agreed that ECP will cause an abortion, with older women (p<0.01 being more likely than younger women to agree. Cost and lack of privacy in pharmacies were identified as potential barriers to access.Conclusions: Lack of knowledge and the perception that ECP causes an abortion may influence a woman’s ability to consider ECP as an option should she find herself at risk of an unplanned pregnancy. To address this, efforts should be made to educate women (including older women about ECP and its availability in pharmacies.

Post-coital contraception.

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Ashton, J R; Chambers, J; Hall, D J

1984-03-01

137,000 British women chose to have an abortion in 1981 and about 25% were teenagers. A recent estimate noted that 10% of unintended pregnancies could have been avoided if postcoital contraception had been obtainable. The availability of postcoital contraception is limited and few doctors have much knowledge of or interest in this contraceptive method. 2 questions that arise are why have doctors been so slow to adopt this effective method of birth control and what are the chances of its availability in the National Health Service (NHS) improving. Postcoital contraception is a comparatively new and until recently unpublicized fertility control method, and there was little knowledge of it among the general population or the medical profession. Doctors' ignorance and reluctance to provide the method may have been due in part to the fact that the pharmaceutical firms have been hesitant to recommend oral contraceptive (OC) pills for this use. There is no specially packaged product, and it is necessary for a patient to be given 4 pills from a 21-pill pack. This has meant that the method has not been advertized, as most new methods would be, in the medical magazines. Hopefully, this lack of knowledge has been rectified by the Family Planning Association. As part of its campaign to launch the method, it has sent details to all general practitioners. Attitudes to postcoital contraception are important, and clearly there are strong parallels with the abortion issues and legal and moral undercurrents as well. Many doctors might have been put off providing postcoital contraception by the experience of the 2 clinics (BPAS in Sheffield and the Caithorpe Nursing Home in Birmingham) which had been reported by Life, an antiabortion pressure group, to the Director of Public Prosecutions under the Offences Against the Persons Act 1863. But on May 10, 1983 the Attorney General announced that the provisionof postcoital contraception is not a criminal offense. This statement may not be

Oral contraceptives induce lamotrigine metabolism: evidence from a double-blind, placebo-controlled trial

DEFF Research Database (Denmark)

Christensen, Jakob; Petrenaite, Vaiva; Attermann, Jørn

2007-01-01

and taking combination-type oral contraceptives, were randomized to treatment with placebo or a standard combination-type contraceptive pill. The dose-corrected trough plasma concentration of LTG and the ratio of N-2-glucuronide/unchanged LTG on urine after 21 days of concomitant placebo treatment...... was analyzed versus those after 21 days of concomitant treatment with the oral contraceptive pill. RESULTS: The mean dose-corrected LTG concentration after placebo treatment was 84%[95% confidence interval (CI), 45-134%] higher than after oral contraceptives, signifying an almost doubling of the concentration...

Developing emergency department-based education about emergency contraception: adolescent preferences.

Science.gov (United States)

Mollen, Cynthia J; Miller, Melissa K; Hayes, Katie L; Wittink, Marsha N; Barg, Frances K

2013-11-01

The objective was to identify adolescent preferences for emergency department (ED)-based education about emergency contraception. This was a cross-sectional computerized survey, using adaptive conjoint analysis (ACA). Patients were eligible if they were females ages 14 through 19 years old and were seeking care in one of two urban EDs. Patients were excluded if they were too ill to participate in the survey or if they were non-English speaking. Participants completed a computerized survey that used ACA, a technique that can be used to assess patients' relative preferences for services. ACA uses the individual's answers to update and refine questions through trade-off comparisons, so that each respondent answers a customized set of questions. The survey assessed preferences for the following attributes of emergency contraception education: who should deliver the education, if anyone (e.g., nurse, doctor); how the education should be delivered (e.g., by a person or via video); how often the education should be offered if patients were to frequent the ED (e.g., every time or only when asking for it); length (e.g., 5 minutes, 10 minutes); and chief complaint that would trigger the education (e.g., headache or stomach pain). A total of 223 patients were enrolled (37.2% at Hospital 1 and 62.8% at Hospital 2). The mean (±SD) age of the participants was 16.1 (±1.3) years. Just over half (55%) reported a history of sexual activity; 8% reported a history of pregnancy. Overall, the participants preferred education that was delivered by a person, specifically a doctor or nurse. They preferred a slightly longer education session and preferred education directed at patients seeking care in the ED for complaints potentially related to sexual activity. Adolescents have specific preferences for how education about emergency contraception would best serve their needs. This information can inform clinicians as they work to improve adolescents' knowledge about pregnancy prevention

Safety, efficacy, actions, and patient acceptability of drospirenone/ethinyl estradiol contraceptive pills in the treatment of premenstrual dysphoric disorder

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Lesley L Breech

2009-08-01

Full Text Available Lesley L Breech, Paula K BravermanDivision of Adolescent Medicine, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USAAbstract: Premenstrual dysphoric disorder (PMDD is estimated to affect 3%–8% of reproductive age women. Multiple therapeutic modalities have been evaluated with varying efficacy for the associated somatic and mood symptoms. The majority of older studies had shown that oral contraceptive pills (OCs were most effective for the physical symptoms. However, newer OCs containing a novel progestin, drospirenone, have shown promise in alleviating both the somatic and affective/behavioral symptoms. This progestin, which is a derivative of spironolactone, has both antimineralocorticoid and antiandrogenic activity. A 24/4 formulation containing 20 µg of ethinyl estradiol has been found effective in randomized double-blind placebo-controlled trials utilizing established scales documenting symptoms associated with PMDD. Multiple studies have shown that drospirenone-containing OCs are safe without evidence of clinically adverse effects on carbohydrate metabolism, lipids, blood pressure, weight, serum potassium or increased thrombotic events compared to other low dose OCs. In addition, significant improvements have been demonstrated in acne, hirsutism, and fluid retention symptoms. Several open label studies demonstrated good patient compliance and reported satisfaction with the method. Because of the significant placebo effect demonstrated in the blinded placebo-controlled trials, additional large randomized placebo-controlled trials are needed to confirm the efficacy of the drospirenone OCs in the treatment of PMDD. However, this OC formulation appears to be a promising therapeutic modality.Keywords: drospirenone, premenstrual dysphoric disorder, premenstrual syndrome, oral contraceptive pill

Contraceptive sales in the setting of the Zika virus epidemic

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

2017-01-01

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

Contraceptive sales in the setting of the Zika virus epidemic.

Science.gov (United States)

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

2017-01-01

Has there been any influence of the Zika virus (ZIKV) outbreak on the sales of contraceptive methods in Brazil? Contraceptive sales in the 24 months of evaluation showed little variation and no significant change has been observed since the ZIKV outbreak. 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. 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. 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. Monthly sales of COC, POP, patches and vaginal rings represent the major sales segment of the market, i.e. 12.7-13.8 million cycles/units per month (90%). The second largest group of sales was injectables, representing 0.8-1.5 million ampoules per month (9.5%). Following this

Amygdala reactivity to negative stimuli is influenced by oral contraceptive use.

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Petersen, Nicole; Cahill, Larry

2015-09-01

The amygdala is a highly interconnected region of the brain that is critically important to emotional processing and affective networks. Previous studies have shown that the response of the amygdala to emotionally arousing stimuli can be modulated by sex hormones. Because oral contraceptive pills dramatically lower circulating sex hormone levels with potent analogs of those hormones, we performed a functional magnetic resonance imaging experiment to measure amygdala reactivity in response to emotional stimuli in women using oral contraceptives, and compared their amygdala reactivity with that of naturally cycling women. Here, we show that women who use oral contraceptive pills have significantly decreased bilateral amygdala reactivity in response to negatively valenced, emotionally arousing stimuli compared with naturally cycling women. We suggest that by modulating amygdala reactivity, oral contraceptive pills may influence behaviors that have previously been shown to be amygdala dependent-in particular, emotional memory. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Oral contraceptive use in women changes preferences for male facial masculinity and is associated with partner facial masculinity.

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Little, Anthony C; Burriss, Robert P; Petrie, Marion; Jones, Benedict C; Roberts, S Craig

2013-09-01

Millions of women use hormonal contraception and it has been suggested that such use may alter mate preferences. To examine the impact of oral contraceptive (pill) use on preferences, we tested for within-subject changes in preferences for masculine faces in women initiating pill use. Between two sessions, initiation of pill use significantly decreased women's preferences for male facial masculinity but did not influence preferences for same-sex faces. To test whether altered preference during pill use influences actual partner choice, we examined facial characteristics in 170 age-matched male partners of women who reported having either been using or not using the pill when the partnership was formed. Both facial measurements and perceptual judgements demonstrated that partners of women who used the pill during mate choice have less masculine faces than partners of women who did not use hormonal contraception at this time. Our data (A) provide the first experimental evidence that initiation of pill use in women causes changes in facial preferences and (B) documents downstream effects of these changes on real-life partner selection. Given that hormonal contraceptive use is widespread, effects of pill use on the processes of partner formation have important implications for relationship stability and may have other biologically relevant consequences. Copyright © 2013 Elsevier Ltd. All rights reserved.

Is the faculty of family planning and reproductive health care guidance on emergency contraception being followed in general practice? An audit in the West Midlands, UK.

Science.gov (United States)

Bannister, Lisa; Macve, Joanna; Pinkey, Benjamin; Webberley, Helen

2007-07-01

In 2003, the Faculty of Family Planning and Reproductive Health Care (FFPRHC) of the Royal College of Obstetricians and Gynaecologists published guidance on emergency contraception (EC). A literature search revealed no published work describing doctors' actions when prescribing EC. In order to assess the extent to which the FFPRHC Guidance is being followed in general practice, an audit of the medical notes of women requesting EC between January 2003 and December 2004 in six general practice surgeries located in the West Midlands, UK was conducted. From the medical notes, discussions between health care professionals and patients requesting EC regarding ongoing contraceptive needs, the risk of sexually transmitted infections (STIs) and the availability of the emergency intrauterine device (IUD) were recorded. A total of 718 emergency contraceptive pill consultations were analysed. The median age for presentation was 24 years. The 20-24 years age group accounted for the most consultations (30.9%). In 40% of consultations there was no evidence of future contraceptive needs having been discussed. Only 20 (2.8%) consultation notes contained evidence that STIs had been discussed. Chlamydia tests were undertaken in only 15/718 (1.7%) consultations. In only 10 (1.4%) of the consultations was the IUD discussed with the patient as an alternative form of EC. This audit suggests that the FFPRHC Guidance on EC is not being followed in general practice, and therefore patients requesting EC may not be receiving the highest standard of care.

Developing Emergency Department–based Education About Emergency Contraception: Adolescent Preferences

Science.gov (United States)

Mollen, Cynthia J.; Miller, Melissa K.; Hayes, Katie L.; Wittink, Marsha N.; Barg, Frances K.

2014-01-01

Objectives The objective was to identify adolescent preferences for emergency department (ED)-based education about emergency contraception. Methods This was a cross-sectional computerized survey, using adaptive conjoint analysis (ACA). Patients were eligible if they were females ages 14 through 19 years old and were seeking care in one of two urban EDs. Patients were excluded if they were too ill to participate in the survey or if they were non-English speaking. Participants completed a computerized survey that used ACA, a technique that can be used to assess patients’ relative preferences for services. ACA uses the individual’s answers to update and refine questions through trade-off comparisons, so that each respondent answers a customized set of questions. The survey assessed preferences for the following attributes of emergency contraception education: who should deliver the education, if anyone (e.g., nurse, doctor); how the education should be delivered (e.g., by a person or via video); how often the education should be offered if patients were to frequent the ED (e.g., every time or only when asking for it); length (e.g., 5 minutes, 10 minutes); and chief complaint that would trigger the education (e.g., headache or stomach pain). Results A total of 223 patients were enrolled (37.2% at Hospital 1 and 62.8% at Hospital 2). The mean (±SD) age of the participants was 16.1 (±1.3) years. Just over half (55%) reported a history of sexual activity; 8% reported a history of pregnancy. Overall, the participants preferred education that was delivered by a person, specifically a doctor or nurse. They preferred a slightly longer education session and preferred education directed at patients seeking care in the ED for complaints potentially related to sexual activity. Conclusions Adolescents have specific preferences for how education about emergency contraception would best serve their needs. This information can inform clinicians as they work to improve

Arkansas pharmacists’ perceptions toward emergency contraception and nonprescription Plan B

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Hopkins D

2008-06-01

Full Text Available Objective: This study describes Arkansas pharmacists’ knowledge, attitudes, and beliefs regarding emergency contraception. Methods: A cross-sectional survey was conducted among a convenience sample of pharmacists prior to a continuing education lecture. The 16-item survey included multiple choice and true/false questions to assess knowledge in addition to Likert-type scale questions regarding attitudes and beliefs. Frequency and descriptive statistics were calculated for all variables.Results: Eighty-eight pharmacists completed the survey. A majority (73% knew that Plan B had been FDA-approved for nonprescription use yet 42% believed that it works by disrupting a newly implanted ovum. On a scale from 1-5 where 5=strongly agree, the mean item score was 3.2 for whether emergency contraception should be available for nonprescription use with counseling and 1.6 for nonprescription use without counseling. When asked what they would do if presented with a request for emergency contraception, 45.8% indicated they would dispense the drug, 22.9% would refer the patient to another pharmacist or pharmacy, 3.6% would refuse to dispense, and 27.7% were not sure. Almost half (48.6% did not believe they were competent instructing patients on the use of emergency contraception. Conclusions: The results show that pharmacists could benefit from additional training on emergency contraception.

Routine counseling about intrauterine contraception for women seeking emergency contraception.

Science.gov (United States)

Schwarz, E Bimla; Papic, Melissa; Parisi, Sara M; Baldauf, Erin; Rapkin, Rachel; Updike, Glenn

2014-07-01

To compare contraceptive knowledge and use among women seeking emergency contraception (EC) before and after an inner-city clinic began providing structured counseling and offering same-day intrauterine device (IUD) or implant placement to all women seeking EC. For 8 months before and 21 months after this change in clinic policy, women aged 15-45 who wanted to avoid pregnancy for at least 6 months were asked to complete surveys immediately, 3 and 12 months after their clinic visit. In addition, we abstracted electronic medical record (EMR) data on all women who sought EC (n=328) during this period. We used chi-squared tests to assess pre/post differences in survey and EMR data. Surveys were completed by 186 women. After the clinic began offering structured counseling, more women had accurate knowledge of the effectiveness of IUDs, immediately and 3 months after their clinic visit. In addition, more women initiated IUD or implant use (survey: 40% vs. 17% preintervention, p=0.04; EMR: 22% vs. 10% preintervention, p=0.01), and fewer had no contraceptive use (survey: 3% vs. 17% preintervention, pcontraceptives with the option of same-day contraceptive placement. Copyright © 2014 Elsevier Inc. All rights reserved.

Drug interactions between non-rifamycin antibiotics and hormonal contraception: a systematic review.

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

2018-01-01

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, clinicaltrials.gov, 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.

The impact of religion on the contraceptive choice among women in ...

African Journals Online (AJOL)

The impact of religion on the contraceptive choice among women in the south ... methods of contraception were Oral contraceptive pills 5.5% and implant, 1.2% respectively. Least accepted was the male condom by only 0.2% of the clients.

Deep vein thrombosis and the oestrogen content in oral contraceptives. An epidemiological analysis.

Science.gov (United States)

Kierkegaard, A

1985-01-01

Epidemiological studies have pointed to a correlation between the oestrogen content of oral contraceptives and the risk of deep vein thrombosis (DVT). The correlation has been strongest in studies which partially consisted of adverse drug reaction reports to the Swedish Adverse Drug Reaction Advisory Committee (SADRAC). The present study analyzes the epidemiological basis of the adverse drug reaction reports on DVT in women on oral contraceptives to SADRAC. It verifies the reported correlation between the oestrogen content of the pills and the risk of DVT but it also demonstrates that this correlation probably was secondary to differences in the diagnostic standard of DVT, to differences in reporting policies to SADRAC and to an age difference between women on low-oestrogen-pills and those on high-oestrogen pills and is thus due to bias. It is concluded that adverse drug reaction reporting on oral contraceptives has been very unreliable, for which reason it cannot support any epidemiological conclusion concerning the relative thrombogenicity of high-oestrogen pills compared with that of low-oestrogen pills.

Knowledge and use of emergency contraception among students of public secondary schools in Ilorin, Nigeria.

Science.gov (United States)

Babatunde, Oluwole Adeyemi; Ibirongbe, Demilade Olusola; Omede, Owen; Babatunde, Olubukola Oluwakemi; Durowade, Kabir Adekunle; Salaudeen, Adekunle Ganiyu; Akande, Tanimola Makanjuola

2016-01-01

Unintended pregnancy and unsafe abortion pose a major reproductive health challenge to adolescents. Emergency contraception is safe and effective in preventing unplanned pregnancy. The objective of this study was to assess the student's knowledge and use of emergency contraception. This cross-sectional study was carried out in Ilorin, Nigeria, using multi-stage sampling method. Data was collected using pre-tested semi-structured self-administered questionnaire. Knowledge was scored and analysed. SPSS version 21.0 was used for data analysis. A p-value emergency contraception. Majority of respondents (87.2%) had never used emergency contraception. Majority of those who had ever used emergency contraception (85.7%) used it incorrectly, using it more than 72 hours after sexual intercourse (p=0.928). Knowledge about Emergency contraception and prevalence of use were low. Contraceptive education should be introduced early in the school curriculum for adolescents.

Racial and ethnic differences in men's knowledge and attitudes about contraception.

Science.gov (United States)

Borrero, Sonya; Farkas, Amy; Dehlendorf, Christine; Rocca, Corinne H

2013-10-01

Little is known about racial/ethnic differences in men's contraceptive knowledge and attitudes. We used multivariable logistic regression to examine racial/ethnic differences in contraceptive knowledge and attitudes among 903 men aged 18-29 in the 2009 National Survey of Reproductive and Contraceptive Knowledge. Black and Hispanic men were less likely than Whites to have heard of most contraceptive methods, including female and male sterilization, and also had lower knowledge about hormonal and long-acting reversible methods. They were less likely to know that pills are ineffective when 2-3 pills are missed [Blacks: adjusted odds ratio (aOR)=0.42; Hispanics: aOR=0.53] and that fertility was not delayed after stopping the pill (Blacks: aOR=0.52; Hispanics: aOR=0.27). Hispanics were less likely to know that nulliparous women can use the intrauterine device (aOR=0.47). Condom knowledge was similar by race/ethnicity, but Blacks were less likely to view condoms as a hassle than Whites (aOR=0.46). Efforts to educate men, especially men of color, about contraceptive methods are needed. Published by Elsevier Inc.

EFFECTS OF ORAL CONTRACEPTIVES ON COAGULATING FACTORS

Directory of Open Access Journals (Sweden)

H.R. Sadeghipour Roudsari.

1997-06-01

Full Text Available Thirty young, healthy, nonsmoking women (mean age approximately 28 years taking low-dose oral contraceptive pills were recruited for the study of the effects of these pills on coagulating factors. Twenty subjects were taking LD pill (Ethinyl estradiol 0.03 mg, levonorgestrel 0.15 mg and 10 others were taking Cilest (Ethinyl estradiol 0.035 mg, Norgestimate 0.25 mg for six months. The control subjects did not receive any oral contraceptives or other medications. Our results showed that:"n1. There is no significant difference between the effects of LD and Cilest (with a different progestin content on coagulating factors."n2. No significant changes were observed between both LD users and controls in PT, APTT, and fibrinogen levels."n3. No significant changes were observed between both Cilest users and controls in PT, APTT, and fibrinogen levels."n

Herbal Weight Loss Pill Overdose: Sibutramine Hidden in Pepper Pill

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Gul Pamukcu Gunaydin

2015-01-01

Full Text Available Supposedly herbal weight loss pills are sold online and are widely used in the world. Some of these products are found to contain sibutramine by FDA and their sale is prohibited. We report a case of a female patient who presented to the emergency department after taking slimming pills. 17-year-old female patient presented to the emergency room with palpitations, dizziness, anxiety, and insomnia. She stated that she had taken 3 pills named La Jiao Shou Shen for slimming purposes during the day. Her vital signs revealed tachycardia. On her physical examination, she was restless, her oropharynx was dry, her pupils were mydriatic, and no other pathological findings were found. Sibutramine intoxication was suspected. She was given 5 mg IV diazepam for restlessness. After supportive therapy and observation in emergency department for 12 hours there were no complications and the patient was discharged home. Some herbal pills that are sold online for weight loss have sibutramine hidden as an active ingredient, and their sale is prohibited for this reason. For people who use herbal weight loss drugs, sibutramine excessive intake should be kept in mind at all times.

Does the knowledge of emergency contraception affect its use among high school adolescents?

Science.gov (United States)

Chofakian, Christiane Borges do Nascimento; Borges, Ana Luiza Vilela; Sato, Ana Paula Sayuri; Alencar, Gizelton Pereira; Santos, Osmara Alves dos; Fujimori, Elizabeth

2016-01-01

This study aimed to test how knowledge on emergency contraception (according to age at sexual initiation, type of school, and knowing someone that has already used emergency contraception) influences the method's use. This was a cross-sectional study in a probabilistic sample of students 15-19 years of age enrolled in public and private middle schools in a medium-sized city in Southeast Brazil (n = 307). Data were collected in 2011 using a self-administered questionnaire. A structural equations model was used for the data analysis. Considering age at sexual initiation and type of school, knowledge of emergency contraception was not associated with its use, but knowing someone that had used the method showed a significant mean effect on use of emergency contraception. Peer group conversations on emergency contraception appear to have greater influence on use of the method than knowledge itself, economic status, or sexual experience.

Measuring and reporting of the treatment effect of hormonal emergency contraceptives.

Science.gov (United States)

Leung, Vivian W Y; Soon, Judith A; Levine, Marc

2012-03-01

To derive summary estimates of observed pregnancy rates in women who used the Yuzpe or levonorgestrel emergency contraceptive regimen and identify the various ways in which data related to regimen effectiveness were reported, to discuss the limitations of the effectiveness estimates as they are currently reported, and to propose alternative reporting methods that are less susceptible to misinterpretation. Analysis of pooled data from 34 experimental or observational studies that had an explicit method of follow-up to systematically evaluate pregnancy outcome after a single course of emergency contraception treatment within a given menstrual cycle. Women who took either the Yuzpe or levonorgestrel emergency contraceptive regimen to prevent pregnancy. We searched the MEDLINE and EMBASE databases for clinical studies that systematically evaluated pregnancy outcomes of women who used the Yuzpe or levonorgestrel regimen for emergency contraception. The effectiveness of these regimens is typically reported in relative terms as the reduction of pregnancy risk from a theoretical baseline risk. We reported the effectiveness using absolute risk reductions and numbers needed to treat. We pooled relevant data by using the β-binomial method to derive observed pregnancy rates. The pooled observed pregnancy rates for studies of the Yuzpe and levonorgestrel regimens were 2.0% (95% confidence interval [CI] 1.5-2.5%) and 1.7% (95% CI 1.2-2.2%), respectively. Against expected pregnancy rates of 4-8%, relative emergency contraceptive effectiveness ranges were 50.0-75.0% and 57.5-78.8% for the Yuzpe and levonorgestrel regimens, respectively. Absolute risk reductions were 2.0-6.0% and 2.3-6.3%, respectively. This means that 17-50 women would need to have received the Yuzpe regimen and 16-43 women the levonorgestrel regimen to prevent one pregnancy. Emergency contraception effectiveness data are susceptible to misinterpretation when data are reported in relative terms without the

Differences between users and non-users of emergency contraception after a recognized unprotected intercourse

DEFF Research Database (Denmark)

Sørensen, M B; Pedersen, B L; Nyrnberg, L E

2000-01-01

Knowledge of emergency contraception is crucial but might not transform into use. Factors influencing decision-making related to use of emergency contraception after an unprotected intercourse and the characteristics of users of emergency contraception (EC) were assessed. In an abortion clinic...... setting, 217 women referred for termination of pregnancy were asked to fill in a questionnaire. Of the 217 women, 139 (64%) were aware of pregnancy risk but only 9 (4%) had used EC after the unprotected intercourse. 42% were estimated to have sufficient knowledge to use hormonal emergency contraception...

New developments in oral contraception: clinical utility of estradiol valerate/dienogest (Natazia® for contraception and for treatment of heavy menstrual bleeding: patient considerations

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Nelson AL

2012-12-01

Full Text Available Anita L NelsonObstetrics and Gynecology, David Geffen School of Medicine at UCLA, Harbor UCLA Medical Center, Torrance, California, USAAbstract: Natazia® is a new oral contraceptive with estradiol valerate and dienogest in a unique multiphasic formulation that includes a shortened hormone-free interval. This new formulation has been approved for both contraception and also as a treatment for heavy menstrual bleeding in women who desire to use oral contraceptives as their method of birth control. It is marketed in the US as Natazia® and elsewhere as Qlaira®. This article will review the properties of each of the major new features of this pill: estradiol used in place of ethinyl estradiol, dienogest as the progestin, and the unique dosing pattern of this product. It will also summarize the results of the pivotal clinical trials of contraceptive effectiveness, bleeding patterns, safety and tolerability. The lessons learned from the clinical trials about the effectiveness of this formulation in the treatment of excessive menstrual bleeding will be summarized. Also, results of trials comparing this new pill to other popular formulations for "menstrually-related" symptoms and for potential female sexual dysfunction related to use of oral contraceptives will be presented. This review will suggest how all this information might be used to counsel women about how to use this pill most successfully.Keywords: oral contraceptives, estradiol valerate, dienogest, heavy menstrual bleeding, menorrhagia, dynamic dosing

Effect of Exposure to Pill Contraceptive Low-dose Levels of Homocysteine and Nitric Oxide in Healthy Women

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A Dehghani

2016-07-01

Full Text Available Introduction: Cardiovascular disease is one of the public health priorities. Consumption of oral contraceptives increase the risk of cardiovascular disease and it still remains a concern. This study aimed to investigate the effect of exposure on pill contraceptive low-dose  levels on homocysteine and nitric oxide. methods: In this cohort ( retrospective+ prospective study, 100 women with normal menstrual cycle aged betwen 20-35 years old refered to health care centers of Yazd, Iran in 2015.  This study was conducted through face to face interviews by the researcher who asked for demographic and anthropometric characteristics. Anthropometic indices  was measured and the levels of homosysteine and nitric oxide was determined. The data were analyzed using t-test, chi- square test and ANOVA by SPSS 21. Results: The mean and standard deviation of homocysteine levels in the exposed group acompared to non-exposed group were (3/848±2/357 μmol/L and (3/284±1/616 μmol/L as well as the mean and standard deviation of nitric oxide in the exposed group were (p-value=0/41 and (181/360±90/44μM and in the non-exposed group were (162/654±90/913 μM and (p-value=0/29 , respectively.According to these results, there was not found any statistical significant  difference among these results. Conclusion: Taking low dose oral contraceptives in healthy women did not change any differences in homocysteine and nitric oxide levels as a modifiable risk factors for cardiovascular disease.

Missed hormonal contraceptives: new recommendations.

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Guilbert, Edith; Black, Amanda; Dunn, Sheila; Senikas, Vyta

2008-11-01

To provide evidence-based guidance for women and their health care providers on the management of missed or delayed hormonal contraceptive doses in order to prevent unintended pregnancy. Medline, PubMed, and the Cochrane Database were searched for articles published in English, from 1974 to 2007, about hormonal contraceptive methods that are available in Canada and that may be missed or delayed. Relevant publications and position papers from appropriate reproductive health and family planning organizations were also reviewed. The quality of evidence is rated using the criteria developed by the Canadian Task Force on Preventive Health Care. This committee opinion will help health care providers offer clear information to women who have not been adherent in using hormonal contraception with the purpose of preventing unintended pregnancy. The Society of Obstetricians and Gynaecologists of Canada. SUMMARY STATEMENTS: 1. Instructions for what women should do when they miss hormonal contraception have been complex and women do not understand them correctly. (I) 2. The highest risk of ovulation occurs when the hormone-free interval is prolonged for more than seven days, either by delaying the start of combined hormonal contraceptives or by missing active hormone doses during the first or third weeks of combined oral contraceptives. (II) Ovulation rarely occurs after seven consecutive days of combined oral contraceptive use. (II) RECOMMENDATIONS: 1. Health care providers should give clear, simple instructions, both written and oral, on missed hormonal contraceptive pills as part of contraceptive counselling. (III-A) 2. Health care providers should provide women with telephone/electronic resources for reference in the event of missed or delayed hormonal contraceptives. (III-A) 3. In order to avoid an increased risk of unintended pregnancy, the hormone-free interval should not exceed seven days in combined hormonal contraceptive users. (II-A) 4. Back-up contraception should

Does the knowledge of emergency contraception affect its use among high school adolescents?

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Christiane Borges do Nascimento Chofakian

2016-01-01

Full Text Available Abstract This study aimed to test how knowledge on emergency contraception (according to age at sexual initiation, type of school, and knowing someone that has already used emergency contraception influences the method’s use. This was a cross-sectional study in a probabilistic sample of students 15-19 years of age enrolled in public and private middle schools in a medium-sized city in Southeast Brazil (n = 307. Data were collected in 2011 using a self-administered questionnaire. A structural equations model was used for the data analysis. Considering age at sexual initiation and type of school, knowledge of emergency contraception was not associated with its use, but knowing someone that had used the method showed a significant mean effect on use of emergency contraception. Peer group conversations on emergency contraception appear to have greater influence on use of the method than knowledge itself, economic status, or sexual experience.

EFFECT OF HORMONAL CONTRACEPTIVES ON SERUM SEROTONIN IN FEMALES OF REPRODUCTIVE AGE GROUP.

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Faryal, Uzma; Rashid, Shazia; Hajra, Bibi; Hassan, Mukhtiar; Saqib, Javeria; Ali, Muhammad Afaq

2016-01-01

Many types of hormonal contraceptives are in use nowadays for example oral pills, emergency contraceptive pills, vaginal rings, implantable rods and injectable contraceptives (combined and progestogens only). The purpose of this study was to determine and compare serum serotonin levels in married fertile females of reproductive age group using hormonal contraceptives with non-contraceptive users. A total of 300 women were selected in the study. This cross sectional study included three groups; Group-1 (control), group-2 (combined oral contraceptive users) and group-3 (injectable contraceptive users). History and examination of subjects were recorded on pro forma. Levels of serum serotonin were measured using standard ELISA kits. Results were analysed by one way ANOVA and a p-value 0.05% was taken as significant, using SPSS 16.0. The mean age of the patients in group-1 was 30.4 ± 6.1 years, group-2 was 28.9 ± 4.9 and in group-3 was 2.5 ± 6.8 years. For subjects in group-1, group-2 and group 3 the mean ± SD concentration of serum serotonin was 160.68 ± 53.27 ng/dl, 227.3 ± 63.98 ng/dl and 118.19 ± 31.32 ng/dl. A significant (p = 0.00) difference was seen among three groups, i.e., group-1, group-2 and group-3. After applying Post HOC Tukey's HSD, there was statistically no significant difference between group-1 and group-2 (p = 0.956). Difference was seen between group-2 and group-3 (p = 0.00), it was also significant between group-3 and group-1 (p = 0.00). It was concluded that hormonal contraceptives affect the levels of serum serotonin.

Young women's accounts of factors influencing their use and non-use of emergency contraception: in-depth interview study

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Free, Caroline; Lee, Raymond M; Ogden, Jane

2002-01-01

Objectives To explore young women's accounts of their use and non-use of emergency contraception. Design Qualitative study using in-depth interviews. Participants 30 women aged 16-25; participants from socially deprived inner city areas were specifically included. Setting Community, service, and educational settings in England. Results Young women's accounts of their non-use of emergency contraception principally concerned evaluations of the risk conferred by different contraceptive behaviours, their evaluations of themselves in needing emergency contraception, and personal difficulties in asking for emergency contraception. Conclusions The attitudes and concerns of young women, especially those from disadvantaged backgrounds, may make them less able or willing than others to take advantage of recent increases in access to emergency contraception. Interventions that aim to increase the use of emergency contraception need to address the factors that influence young women's non-use of emergency contraception. What is already known on this topicLimited knowledge of, or poor access to, emergency contraception, and concerns about side effects and moral issues may reduce the use of emergency contraception in women at riskYoung people can be embarrassed about using contraception servicesInterventions to increase knowledge of and access to emergency contraception have had limited success among teenagersWhat this study addsPerceptions of low vulnerability to pregnancy, negative self evaluations about the need for such contraception, and concerns about what others think deter young women from using emergency contraceptionThese women find it difficult to ask for emergency contraceptionThe attitudes and concerns of young women, especially those from deprived inner city areas, may render them least willing and able to obtain emergency contraception PMID:12480855

Adherence to the oral contraceptive pill: a cross-sectional survey of modifiable behavioural determinants

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Molloy Gerard J

2012-10-01

Full Text Available Abstract Background Poor adherence to the oral contraceptive pill (OCP is reported as one of the main causes of unintended pregnancy in women that rely on this form of contraception. This study aims to estimate the associations between a range of well-established modifiable psychological factors and adherence to OCP. Method A cross-sectional survey of 130 female University students currently using OCP (Mean age: 20.46 SD: 3.01, range 17–36 was conducted. An OCP specific Medication Adherence Report Scale was used to assess non-adherence. Psychological predictor measures included necessity and concern beliefs about OCP, intentions, perceived behavioural control (pbc, anticipated regret and action and coping planning. Multiple linear regression was used to analyse the data. Results Fifty-two per cent of participants reported missing their OCP once or more per month and 14% twice or more per month. In bivariate analysis intentions (r = −0.25, perceived behavioural control (r= −0.66, anticipated regret (r=0.20, concerns about OCP (r =0.31, and action (r= −0.25 and coping (r= −0.28 planning were all significantly associated with adherence to OCP in the predicted direction. In a multivariate model almost half (48% of the variation in OCP adherence could be explained. The strongest and only statistically significant predictors in this model were perceived behavioural control (β=−0.62, p Conclusion The present data point to a number of key modifiable psychological determinants of OCP use. Future work will establish whether changing these variables results in better adherence to the OCP.

Attitude toward contraception and abortion among Curaçao women. Ineffective contraception due to limited sexual education?

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Meyboom-de Jong Betty

2011-06-01

Full Text Available Abstract Background In Curaçao is a high incidence of unintended pregnancies and induced abortions. Most of the induced abortions in Curaçao are on request of the woman and performed by general practitioners. In Curaçao, induced abortion is strictly prohibited, but since 1999 there has been a policy of connivance. We present data on the relevance of economic and socio-cultural factors for the high abortion-rates and the ineffective use of contraception. Methods Structured interviews to investigate knowledge and attitudes toward sexuality, contraception and abortion and reasons for ineffective use of contraceptives among women, visiting general practitioners. Results Of 158 women, 146 (92% participated and 82% reported that their education on sexuality and about contraception was of good quality. However 'knowledge of reliable contraceptive methods' appeared to be - in almost 50% of the cases - false information, misjudgements or erroneous views on the chance of getting pregnant using coitus interruptus and about the reliability and health effects of oral contraceptive pills. Almost half of the interviewed women had incorrect or no knowledge about reliability of condom use and IUD. 42% of the respondents risked by their behavior an unplanned pregnancy. Most respondents considered abortion as an emergency procedure, not as contraception. Almost two third experienced emotional, physical or social problems after the abortion. Conclusions Respondents had a negative attitude toward reliable contraceptives due to socio-cultural determined ideas about health consequences and limited sexual education. Main economic factors were costs of contraceptive methods, because most health insurances in Curaçao do not cover contraceptives. To improve the effective use of reliable contraceptives, more adequate information should be given, targeting the wrong beliefs and false information. The government should encourage health insurance companies to reimburse

[Emergency contraception in Brazil: facilitators and barriers].

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Hardy, E; Duarte, G A; Osis, M J; Arce, X E; Possan, M

2001-01-01

A multi-centered qualitative study was conducted in Brazil, Chile, and Mexico to assess the acceptability of emergency contraception both among potential users and possible providers, authorities, and opinion-makers, and to identify (according to participants' perceptions) factors facilitating or hindering the method's use and the most appropriate strategies to disseminate information and provide the method. Data were collected through semi-structured interviews, group interviews, and discussion groups, which were tape-recorded and transcribed. A thematic analysis of this material was conducted. Acceptability of emergency contraception was high among participants, who also felt that there were no barriers towards its acceptance by the population. Participants felt that the method's acceptability would be greater if it were included in reproductive health programs, emphasizing its prescription for emergency situations. Participants highlighted that strategic components in Brazil would be training of providers and inclusion of the method in family planning services.

Emergency contraception: Knowledge and practice among women and the spouses seeking termination of pregnancy.

Science.gov (United States)

Kathpalia, S K

2016-04-01

India was one of the first countries to launch a formal family planning program. Initially, the main thrust of the program was on sterilization but subsequently it has got evolved and now the stress is to bring about awareness of contraception and make informed choices. Emergency contraception has been included in its armamentarium. This study was conducted to find out about the awareness among the cases who report for induced abortion. A total of 784 willing cases were enrolled in the study; there were no exclusion criteria except unwillingness. A parallel group was also included consisting of their spouses. Information that was being sought about Emergency Contraception (EC) included its knowledge, details of administration, and availability. Of the 784 cases, a large number, 742 (94.6%), underwent first trimester abortion and only 42 (5.3%) underwent second trimester abortion. 286 (36.4%) patients had not used any contraceptive. A large number had used natural methods (35.3%), like lactation, abstinence, or coitus interruptus, and 25.7% had used barrier contraception inconsistently. A very small percentage in both the groups knew about EC; more number of men knew about EC than women. Awareness about emergency contraception is low, as reported in many other studies, though it is available for many years. Awareness about contraceptives needs to be improved and emergency contraceptive should be advocated as a backup method. More efforts are required to generate awareness about regular use of effective contraception and emergency contraception if required.

Non-enzymatic antioxidant status of women using four different methods of contraception

International Nuclear Information System (INIS)

Akinloye, O.; Oyabiyi, S.A.; Oguntibeju, O.O.; Arowojolu, A.O.

2010-01-01

Objective: To investigate antioxidant status of women on four different methods of contraception. Methodology: Sixty non-pregnant women aged 16-45 years on oral contraceptive pills, injectables, Norplant and intra-uterine contraceptive devices (IUD) attending the Family Planning Clinics of the University College Hospital (UCH) and Adeoyo Maternity Hospital, Ibadan were recruited for the study. Fifty-eight apparently healthy women aged 16-45 years who were not on any contraceptive served as a control group. The body mass index (BMI) of all participants (subjects and controls) was determined following standard protocol. Serum levels of ascorbic acid, tocopherol, malondialdehyde, bilirubin, creatinine, uric acid, total protein and albumin were determined using standard spectrophotometric methods. Progesterone was estimated by the chemilumiscence method while selenium was determined by atomic absorption spectrophotometry (AAS). Results: The BMI was significant in women on oral contraceptive pills (OCP) when compared to the control group (P 0.05) in intra-uterine device (IUD), injectables and Norplant users. The mean serum ascorbic acid (P 0.05) in users of other contraceptive methods. Serum levels of malondialdehyde was significantly elevated in women on OCP (P 0.05) in users of other contraceptive methods. There was no significant association between progesterone and antioxidants in women on OCP, IUD, injectables and Norplant. Conclusion: Oral contraceptive pills showed a significant decreasing effect on the antioxidant status of its users while IUD, injectables and Norplant did not indicate any significant effect. Routine monitoring of the antioxidant status of women on different methods of contraceptive particularly those on OCP is recommended. (author)

Oral contraceptive pills: A risk factor for retinal vascular occlusion in in-vitro fertilization patients

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Rohina S Aggarwal

2013-01-01

Full Text Available Retinal vascular occlusion is the most common cause of retinopathy leading to severe visual loss in all age groups. Central retinal vein occlusion (CRVO is usually seen in older age group and is often associated with systemic vascular diseases. Although the exact cause and effect relationship has not been proven, central retinal vein occlusion has been associated with various systemic pathological conditions, hence a direct review of systems toward the various systemic and local factors predisposing the central retinal vein occlusion is advocated. We describe the development of central retinal venous occlusion with associated cystoid macular edema (CME in two healthy infertile women who were recruited for in vitro fertilization cycle for infertility. Predisposing risk factors associated with central retinal vein occlusion are obesity, sedentary life style, smoking, and some systemic diseases such as hyperlipidemia, hypertension, associated autoimmune disorders e.g., antiphospholipid antibody syndrome, lupus, diabetes mellitus, cardiovascular disorders, bleeding or clotting disorders, vasculitis, closed-head trauma, alcohol consumption, primary open-angle glaucoma or angle-closure glaucoma.In our patients, they were ruled out afterdoing allpertaining investigations. The cases were managed with further avoidance of oral contraceptives and intra-vitreal injections of Bevacizumab (Avastin, an anti-vascular endothelial growth factor (anti-VEGF drug and Triamcinolone acetonide (a long acting synthetic steroid. Hence, even if no systemic diseases are detected. Physical examinations are recommended periodically for young women on oral contraceptive pills.

The interaction between legalization of abortion and contraception in Denmark.

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Matthiessen, P C

1979-01-01

Trends in fertility, abortion, and contraceptive practice in Denmark were analyzed, using previously compiled official statistics; the conclusion was drawn that easy access to abortion may contribute toward a decline in contraceptive practice depending on the level of contraceptive practice in the population and on the degree of confidence the population has in available contraceptive methods. In October 1973 Denmark passed a law permitting women to obtain free abortion on demand. The number of legal abortions increased from 16,500 in 1973 to 28,000 in 1975. This marked increase was not attributable to a decline in illegal abortion since that annual number had declined from 5,000 to 1,000 prior to the passage of the 1973 abortion on demand law. The increase in abortion observed from 1973-1975 was accompanied by a marked decrease in the number of oral contraceptive cycles sold. Annual sales decreased from 3.9 million cycles to 2.6 million. It was difficult to access the factors responsible for this decline. Although IUD insertions increased during this period, the increase could not adequately compensate for the reduction in oral contraceptive sales. The decline in oral contraceptive sales occurred at about the time the negative side effects associated with the pill received widespread news coverage. Some of the decline in pill usage was probably due to fear of side effects, but abortion availability also encouraged women to be more lax about taking the pill and encouraged them to rely on less effective methods of contraception. Tables provide data for Denmark in reference to: 1) number of legal abortions and the abortion rates for 1940-1977; 2) distribution of abortions by season, 1972-1977; 3) abortion rates by maternal age, 1971-1977; 4) oral contraceptive and IUD sales for 1977-1978; and 5) number of births and estimated number of abortions and conceptions, 1960-1975.

Emergency contraception use is correlated with increased condom use among adolescents: results from Mexico.

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Walker, Dilys M; Torres, Pilar; Gutierrez, Juan Pablo; Flemming, Kendra; Bertozzi, Stefano M

2004-10-01

To evaluate the association between knowledge about, or experience with, emergency contraception (EC), and condom use among school-attending adolescents in the state of Morelos, Mexico. We analyzed data from anonymously self-administered questionnaires (n = 10,918), from a cluster-randomized controlled trial among first year students from 40 (75%) public high schools in Morelos, Mexico. The survey included specific questions about EC knowledge and experience as well as questions about perceived ability to negotiate and condition sexual relations on condom use; and condom use at first and last sexual intercourse. Overall, 61% (6384) of students had heard of EC, and 36% (1964) of girls and 39% (1997) of boys had correct knowledge about EC. Correct knowledge was based upon knowing that EC is pills taken up to 3 days after unprotected sex to prevent pregnancy. Of 1695 (15.6%) reporting lifetime sexual activity, 16.4 % (275) reported they had tried to obtain EC and almost of all them (263) reported having used EC. The probability of a student reporting he/she is capable of interrupting sexual intercourse to use a condom was significantly higher for those who had correct EC knowledge, and a history of EC use was strongly correlated with condom use at last sexual intercourse. Experience with emergency contraception has no adverse effects on condom use, but rather is associated with an increased probability of condom use and an increased perceived capacity to negotiate condom use. Despite concern that information about, and access to EC may encourage sexual risk taking, our results suggest the reverse is true. These data support the position that there is no justification to withhold EC information or access from adolescents.

A tiered analytical approach for investigating poor quality emergency contraceptives.

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María Eugenia Monge

Full Text Available Reproductive health has been deleteriously affected by poor quality medicines. Emergency contraceptive pills (ECPs are an important birth control method that women can use after unprotected coitus for reducing the risk of pregnancy. In response to the detection of poor quality ECPs commercially available in the Peruvian market we developed a tiered multi-platform analytical strategy. In a survey to assess ECP medicine quality in Peru, 7 out of 25 different batches showed inadequate release of levonorgestrel by dissolution testing or improper amounts of active ingredient. One batch was found to contain a wrong active ingredient, with no detectable levonorgestrel. By combining ultrahigh performance liquid chromatography-ion mobility spectrometry-mass spectrometry (UHPLC-IMS-MS and direct analysis in real time MS (DART-MS the unknown compound was identified as the antibiotic sulfamethoxazole. Quantitation by UHPLC-triple quadrupole tandem MS (QqQ-MS/MS indicated that the wrong ingredient was present in the ECP sample at levels which could have significant physiological effects. Further chemical characterization of the poor quality ECP samples included the identification of the excipients by 2D Diffusion-Ordered Nuclear Magnetic Resonance Spectroscopy (DOSY 1H NMR indicating the presence of lactose and magnesium stearate.

Emergency contraception: a survey of 1773 women.

Science.gov (United States)

Bastianelli, Carlo; Rosato, Elena; Farris, Manuela; Benagiano, Giuseppe

2016-12-01

The aim of the study was to retrieve data on the characteristics and profile of women attending an emergency service (ES) to receive a prescription (mandatory until May 2015) for emergency contraception (EC). In a retrospective study the following data were collected for all women requesting EC between January 2014 and June 2015: demographic characteristics, time between unprotected sexual intercourse (USI) and arrival at the ES, time between the last menstrual period and the USI, and type of EC prescribed. In a prospective study starting January 2015, a questionnaire was administered requesting the following information: reasons for requiring EC, previous EC use, source of knowledge about EC, prior contraception and age at first intercourse. During the whole study period, 1773 women requested EC: their mean age was 26.0 years; 78.5% were Italian; 91.5% were unmarried; 55.2% were still studying and 51.9% had high school education; 61.2% reached the ES within 12 h of the USI; and 42.4% had a USI during days 9-16 of their menstrual cycle. Levonorgestrel was prescribed in 81.4% of women and ulipristal acetate in 17.7%. In the prospective part of the study (382 women), the majority (57.9%) requested EC for condom rupture; 49.5% reported previous use of EC; and 41.6% received information on the subject through friends. The vast majority (83.8%) reported prior use of contraception; in 25.4% the reason for not using it was the absence of a relationship. An exact profile of women requesting EC can help women in their choice of permanent contraception, and help clinicians in counselling women on appropriate contraception.

The effects of contraception on female poverty.

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Browne, Stephanie P; LaLumia, Sara

2014-01-01

Poverty rates are particularly high among households headed by single women, and childbirth is often the event preceding these households' poverty spells. This paper examines the relationship between legal access to the birth control pill and female poverty. We rely on exogenous cross-state variation in the year in which oral contraception became legally available to young, single women. Using census data from 1960 to 1990, we find that having legal access to the birth control pill by age 20 significantly reduces the probability that a woman is subsequently in poverty. We estimate that early legal access to oral contraception reduces female poverty by 0.5 percentage points, even when controlling for completed education, employment status, and household composition.

Emergency Contraceptive Knowledge And Practice Among ...

African Journals Online (AJOL)

With a high incidence of unwanted pregnancies and unsafe abortion especially among unmarriedwomen in developing countries, there is need to promote emergency contraception (EC). To assess the unmarriedwomen\\'s knowledge, attitude and practice ofEC. A random sample of a cross-section of 594 unmarried women ...

Pills on the World Wide Web: reducing barriers through technology.

Science.gov (United States)

Gawron, Lori M; Turok, David K

2015-10-01

Oral contraceptive pills are safe, effective, and available without a prescription in most countries. Despite support from the American Congress of Obstetricians and Gynecologists to provide oral contraceptives as an over-the-counter medication, US women are still required to have a prescription to obtain them. Use of online applications and the Internet has made most things easier to obtain in our society and this includes contraceptive methods. Several online ventures are now underway to enable US women to obtain oral contraceptives without visiting a medical provider's office. Women's health care professionals should encourage these novel approaches, as they will improve contraceptive access. As US women experiment with innovative health care models, providers will need to lead, follow, or be left behind. Copyright © 2015 Elsevier Inc. All rights reserved.

Emergency Contraception: Awareness, Perception and Practice among Female Undergraduates in Imo State University, Southeastern Nigeria.

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Ojiyi, Ec; Anolue, Fc; Ejekunle, Sd; Nzewuihe, Ac; Okeudo, C; Dike, Ei; Ejikem, Ce

2014-11-01

Limited knowledge and practice of contraception is a global public health problem. Unintended pregnancies are the primary cause of induced abortion. When safe abortions are not available, as in Nigeria with restricted abortion laws, abortion can contribute significantly to maternal mortality and morbidity. Adequate information on the awareness and the use of emergency contraception is necessary for planning interventions in groups vulnerable to unwanted pregnancy. The aim of the following study is to access the awareness, perception and practice of emergency contraception among female undergraduates in Imo State University, South Eastern Nigeria. A questionnaire based cross-sectional survey using female undergraduates selected randomly from Imo State University, Owerri. A total of 700 students participated in the study. Awareness of emergency contraception was very high (85.1%) (596/700). The awareness was significantly higher amongst students in health related faculties than in the non-health related faculties (P = 0.01). The main sources of information were through friends (43.1%) (317/700) and lectures (22.1%) (192/700). High dose progestogen (postinor-2) was the most commonly known type of emergency contraception (70.8%) (422/596). Only 58.1% (346/596) of those who were aware of emergency contraception approved of their use. The major reasons given by the 41.9% (250/596) who disapproved of their use were religious reasons (50.4%) (126/250) and that they were harmful to health (49.2%) (123/250). Two-third (67%) (46 9/700) of the students were sexually active and only 39.9% (187/469) of them used emergency contraception. High dose progestogen (postinor-2) was again the most commonly used method (70.8%) (422/596). The most common situation in which emergency contraception was used was following unprotected sexual intercourse (45.5%) (85/144). Only 34.6% (206/596) of those who were aware of emergency contraception identified correctly the appropriate time interval

Awareness and utilization of emergency contraception among ...

African Journals Online (AJOL)

students were aware of emergency contraception, and 211 (71.5%) had utilized them. Among those who had .... Maiduguri has been a centre of learning and commercial activity since the .... magazines, television and movies.[31] In particular ...

Emergency contraception amongst female college students – knowledge, attitude and practice

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Wendwosen T. Nibabe

2014-03-01

Full Text Available Background: Unwanted teenage pregnancies have a notable detrimental impact on the learners’ trajectory and have been associated with jeopardising the students’ educational progress and future career prospects. These pregnancies are mostly unplanned and unintended and many are terminated, either legally or illegally. Aim: The aim of this study was to explore the contributory role played by the knowledge, attitude and practices of female college students with respect to the utilisation of emergency contraceptives. Setting: Three tertiary institutions in Dessie, Ethiopia. Methods: Quantitative self-administered questionnaires were used to collect descriptive data from 352 female college students. Results: The study revealed that there was a high percentage (78.3% of unwanted pregnancies amongst those engaging in sex. Significantly, nearly half (43.3% of these unwanted pregnancies resulted in abortion. Only 10% of the students sampled admitted to ever having used emergency contraception. Even though more than half (69.9% of the students knew about emergency contraception, only 27% of them felt confident that they understood when it was most effective. Conclusion: These and other observed findings confirm the need for improvement of female college students’ knowledge and timely utilisation of emergency contraception.

Emergency contraception amongst female college students – knowledge, attitude and practice

Science.gov (United States)

Nibabe, Wendwosen T.

2014-01-01

Background Unwanted teenage pregnancies have a notable detrimental impact on the learners’ trajectory and have been associated with jeopardising the students’ educational progress and future career prospects. These pregnancies are mostly unplanned and unintended and many are terminated, either legally or illegally. Aim The aim of this study was to explore the contributory role played by the knowledge, attitude and practices of female college students with respect to the utilisation of emergency contraceptives. Setting Three tertiary institutions in Dessie, Ethiopia. Methods Quantitative self-administered questionnaires were used to collect descriptive data from 352 female college students. Results The study revealed that there was a high percentage (78.3%) of unwanted pregnancies amongst those engaging in sex. Significantly, nearly half (43.3%) of these unwanted pregnancies resulted in abortion. Only 10% of the students sampled admitted to ever having used emergency contraception. Even though more than half (69.9%) of the students knew about emergency contraception, only 27% of them felt confident that they understood when it was most effective. Conclusion These and other observed findings confirm the need for improvement of female college students’ knowledge and timely utilisation of emergency contraception. PMID:26245395

Obesity and contraception: metabolic changes, risk of thromboembolism, use of emergency contraceptives, and role of bariatric surgery.

Science.gov (United States)

Gurney, E P; Murthy, A S

2013-06-01

Rates of obesity are increasing worldwide. Due to the medical consequences of obesity, routine health care like family planning becomes complicated. Conflicting data exists regarding efficacy of hormonal contraceptives in obese women, while little data on efficacy of emergency contraception in obese women exists. Much of what is available suggests lower serum hormonal levels in obese women with little effect on ovulation inhibition. Contraceptive steroids can cause a number of deteriorating metabolic changes, particularly in obese women; whether these changes are clinically significant is unknown. Venous thromboembolic risk is increased with both obesity and use of hormonal contraceptives; however the question remains if the risk is additive or multiplicative. Bariatric surgery can lead to digestive changes which may affect absorption of contraceptive hormones. While long acting reversible contraceptives may be the best option in the post operative obese patient, little data, beyond a simple recommendation to avoid pregnancy for at least one year, exists to help guide appropriate contraceptive choice.

Maintenance of ovulation inhibition with a new progestogen-only pill containing drospirenone after scheduled 24-h delays in pill intake

DEFF Research Database (Denmark)

Duijkers, Ingrid J M; Heger-Mahn, Doris; Drouin, Dominique

2016-01-01

by four placebo tablets. A previous study showed that this new drospirenone-only pill effectively inhibited ovulation. Clinical efficacy, however, can be affected by compliance, and delayed or forgotten pill intake often occurs in daily life. The aim of this study was to investigate if inhibition.......8%; only one subject in Group A fulfilled the ovulation criteria in Cycle 2. Follicular diameters in the regular-intake and the delayed-intake cycles were similar. CONCLUSION: Despite the 4-day hormone-free period and multiple intentional 24-h delays in tablet intake, ovulation inhibition was maintained...... inhibition by the new-generation oestrogen-free pill, containing 4-mg drospirenone for 24 days followed by a 4-day treatment-free period, was maintained despite four 24-h delays in tablet intake, so the impact of delayed intake on contraceptive reliability will be low....

Pharmacists' knowledge and interest in developing counseling skills relating to oral contraceptives.

Science.gov (United States)

Amin, Mohamed E K

2016-04-01

Possessing correct therapeutic information on oral contraceptives is an important prerequisite for the provision of sound advice to women who are using these products. This study examines Egyptian pharmacists' knowledge of pharmacotherapeutic aspects of oral contraceptives as well as interest in developing skills in providing counseling on oral contraceptive pills. Community pharmacies throughout Alexandria, Egypt. A cross-sectional survey was self-administered by a random sample of community pharmacists in Alexandria, Egypt. Five multiple choice questions likely to arise when counseling women on oral contraceptives were constructed. Questions covered compatibility with breastfeeding, precautions, health risks and managing missed pills of oral contraceptives. Using ordered logistic regression, a model was estimated to predict pharmacists' interest in developing skills in providing counseling on oral contraceptives. Pharmacists' aggregate scores for knowledge questions and pharmacists' interest in developing skills in providing counseling on oral contraceptive pills. Of the 181 approached pharmacists, 92 % participated. Twenty one pharmacists (13 %) did not know the correct answer to any question, 122 (73 %) answered one-two correctly, 23 (14 %) answered three-four correctly. No pharmacist answered all five questions correctly. For pharmacists' interest in developing skills in providing counseling on oral contraceptives, the percentage values for answers were: not interested at all (10.2 %), slightly interested (27.0 %), somewhat interested (23.4 %), interested (30.0 %) and extremely interested (9.6 %). Pharmacists' interest in developing skills in providing counseling on oral contraceptives was significantly associated with the number of women who requested advice from the pharmacists on oral contraceptives (OR 1.54, CI 1.24-1.91). In terms of the learning method of preference, percentage values for answers were: attending a workshop (4 %), online course (18

Knowledge and Practice of Emergency Contraception Among ...

African Journals Online (AJOL)

Subjects and Methods: In this cross sectional observational study, 675 female non medical undergraduates were interviewed using pretested semi structured questionnaire to assess their knowledge and experience with emergency contraception. Data was analysed using SPSS version 17 (SPSS, Chicago, IL, USA).

KNOWLEDGE LEVEL OF UNIVERSITY STUDENTS ABOUT EMERGENCY CONTRACEPTIVE USAGE

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L. F. Camargo

2016-11-01

Full Text Available The emergency contraception is a hormonal measure adopted to prevent undesired pregnancy after unprotected sexual relation or when it occurs a flaw in the conventional method. The method is inserted in the policy of Sexual and Reproductive Rightsof Brazilian Health Ministry since 1996 with the purpose of preventing undesired pregnancy and consequently reducing the illegal abortion rate and maternal mortality. This study has as objective to seek the degree of knowledge of women, female health care college students of Centro Universitário Padre Anchieta, Jundiaí-SP, who make use of this contraceptive method. To perform the survey a questionnaire was elaborated and approved by the Human Ethics Committee, number 30407014.9.0000.5386. A survey of 11 closed questions and 3 open questions were applied to the volunteers after they had signed the TCLE. Sixty- five (65 women ranging from 18 to 35 years old were interviewed, of those 76,92% have active sexual life and 33,85% are married. The most cited contraceptive method was the hormonal contraceptive (46.15% and 43.08% have used emergency contraceptive. Among the respondents 49.23 % said they did not know the side effects of the EC. The results allowed us to evaluate that this method of contraception is not used by fully satisfactory way with these students that will be future health professionals, this is a worrying fact because many do not know how to use in yourself, which may reflect in the information provided to their future patients.

The knowledge of emergency contraception and dispensing practices of Patent Medicine Vendors in South West Nigeria.

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Fayemi, Mojisola M; Oduola, Olufemi L; Ogbuji, Queen C; Osinowo, Kehinde A; Oyewo, Adejoke E; Osiberu, Olabimpe M

2010-09-01

Patent Medicine Vendors (PMVs) can play a critical role in increasing access to emergency contraceptive pills (ECPs) in developing countries, but few studies have examined their knowledge and dispensing practices. Using cluster sampling, the authors selected and interviewed 97 PMVs (60.8 per cent female) in Oyo and Ogun States of Nigeria to assess their knowledge, dispensing practices, and referral for ECPs. About one-third (27.8 per cent) of respondents were not aware of ECPs, and only half knew that ECPs could prevent pregnancy. Forty per cent had ever dispensed ECPs. Reasons proffered by those who do not dispense ECPs included barriers from the State Ministry of Health, police, other regulatory agencies, and religious beliefs. Only 50.5 per cent have referral arrangements for clients. Strategies to increase access to ECPs through PMVs include training on counseling techniques and referral, effective government regulation, and community involvement. Where unsafe abortion is a major cause of maternal mortality, these strategies offer protection for many women in the future.

Using the theory of reasoned action to explain physician intention to prescribe emergency contraception.

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Sable, Marjorie R; Schwartz, Lisa R; Kelly, Patricia J; Lisbon, Eleanor; Hall, Matthew A

2006-03-01

Although research has examined providers' knowledge, attitudes and prescribing behaviors with regard to emergency contraception, none has used a theory-based approach to understanding the interplay of these factors. A cross-sectional survey of 96 faculty physicians from one Southern and three Midwestern universities was conducted in 2004 to assess factors associated with intention to prescribe emergency contraception. The theory of reasoned action guided the study hypotheses and survey design. Correlation and regression analyses were used to examine the data. Only 42% of respondents strongly intended to prescribe emergency contraception for teenagers, but 65-77% intended to do so for all other specified groups (women who ask for the method, who have had a method problem, who have experienced rape or incest, and who have had unprotected sex). Consistent with the theory of reasoned action, high intention to prescribe emergency contraception was associated with positive attitudes toward doing so and with the perception that specific colleagues or professional groups support prescribing it; however, the perception of support by colleagues or professional groups in general did not predict intention. Also consistent with the theory, physicians' knowledge about emergency contraception and their demographic characteristics were not significant. Interventions to encourage physicians to provide emergency contraception should take into account their attitudes toward the method and the components of those attitudes.

Awareness and practice of emergency contraception among ...

African Journals Online (AJOL)

Unprotected sexual exposure leading to unwanted pregnancy and unsafe abortion contributes significantly to reproductive ill health, especially in developing countries. Promotion of emergency contraception (EC) has been advocated as a way of reducing these problems. Our youth, the most vulnerable group, should ...

Contraception awareness and practice among antenatal attendees in Uyo, Nigeria

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Augustine Vincent Umoh

2011-12-01

Full Text Available INTRODUCTION: Contraception is major component of reproductive health. The study aims to document the awareness of contraception and its use in Uyo, South-south Nigeria and provide useful information for future intervention strategies. METHODS: A cross-sectional study using pretested questionnaires among antenatal attendees in a tertiary and a secondary health facility in Uyo. RESULTS: A total of 550 women took part in the study. Majority of respondents (92.4% were aware of contraception while 52.6% had ever used any form of contraception. The condom (60.3% and the pill (49.9% were the most common forms of contraception that the women had heard of, mostly from the doctor (36.9%, radio (33.8% and nurse (28.5%. The condom (46.7%, withdrawal method (14.1% and the pills (13.3% were the most commonly used forms of contraception. Majority of the women (70.5% planned to use contraception in the future and this intention was significantly related to the woman's educational status (p<0.05 but not to religion or occupation. Fear of side effects, uncertainty about its need, partner objection and previous side effects were the common reasons given for unwillingness to use contraception in the future. CONCLUSION: Our study has shown that while there is good contraceptive awareness in Uyo, Nigeria, this is not matched by commensurate contraceptive prevalence but prospects for improvement exist. There�s need to tackle known obstacles to contraceptive uptake. Also targeted campaigns and every available opportunity should be used to provide reproductive counseling to women especially on contraception.

New low-dose, extended-cycle pills with levonorgestrel and ethinyl estradiol: an evolutionary step in birth control.

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Nelson, Anita

2010-08-09

To review milestones in development of oral contraceptive pills since their introduction in the US 50 years ago in order to better understand how a new formulation with low-dose estrogen in an extended-cycle pattern fits into the evolution of birth control pills. This is a review of trends in the development of various birth controls pills and includes data from phase III clinical trials for this new formulation. The first birth control pill was a very high-dose monophasic formulation with the prodrug estrogen mestranol and a first-generation progestin. Over the decades, the doses of hormones have been markedly reduced, and a new estrogen and several different progestins were developed and used in different dosing patterns. The final element to undergo change was the 7-day pill-free interval. Many of these same changes have been made in the development of extended-cycle pill formulation. The newest extended-cycle oral contraceptive formulation with 84 active pills, each containing 20 μg ethinyl estradiol and 100 μg levonorgestrel, represents an important evolution in birth control that incorporates lower doses of estrogen (to reduce side effects and possibly reduce risk of thrombosis), fewer scheduled bleeding episodes (to meet women's desires for fewer and shorter menses) and the use of low-dose estrogen in place of placebo pills (to reduce the number of days of unscheduled spotting and bleeding). Hopefully, this unique formation will motivate women to be more successful contraceptors.

[Hormonal (levonorgestrel) emergency contraception--effectiveness and mechanism of action].

Science.gov (United States)

Medard, Lech M; Ostrowska, Lucyna

2010-07-01

Periodic abstinence and coitus interruptus are the most popular methods of contraception in Poland. Recent studies have provided us with evidence that the so-called "menstrual calendar" may be much less effective than it was believed. In these circumstances, promotion and use of safe and truly effective contraceptives is very important for Polish women. Emergency contraception (EC) is a method which could be used even in cases when other contraception methods have failed. Mechanism of action of levonorgestrel used for EC and possible disturbances in the process of implantation of the blastocyst in the endometrium, remain the source of heated discussion among medical professionals. The latest publications provide us with evidence that the use of levonorgestrel in EC neither alters endometrial receptivity nor impedes implantation. Hormonal EC effectiveness is another hot topic of gynecological endocrinology and statistics. There is, however, no better, safer, and more ethically accepted method of preventing unwanted pregnancy for patients in need of postcoital contraception.

[Induced abortion and use of contraceptive methods among prostitutes in Almería (Spain)].

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Cabrerizo Egea, María Jesús; Barroso García, María Pilar; Rodríguez-Contreras Pelayo, Rafael

2015-01-01

To analyze the performance of induced abortion (IA) in prostitutes in Almería (Spain) and its association with the use of contraceptive methods. A cross-sectional study was conducted in 110 women. A bivariate analyses using either the χ(2) test or Fisher's exact test was carried out (significance level <0.05), with calculation of odds ratios and 95% confidence intervals. A total of 52.7% of women had undergone at least one IA. All of these women used condoms and 35.5% of them also used another contraceptive method. No statistically significant association was found between condom breakage and the performance of IA or in the use of other contraceptive methods. A high percentage of this group of women had undergone IA, despite widespread condom use. However, there was a high percentage of condom breakage and a low percentage of use of emergency contraceptive pills after risky sexual relationships. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Brief Report: Dapivirine Vaginal Ring Use Does Not Diminish the Effectiveness of Hormonal Contraception.

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Balkus, Jennifer E; Palanee-Phillips, Thesla; Reddy, Krishnaveni; Siva, Samantha; Harkoo, Ishana; Nakabiito, Clemensia; Kintu, Kenneth; Nair, Gonasangrie; Chappell, Catherine; Kiweewa, Flavia Matovu; Kabwigu, Samuel; Naidoo, Logashvari; Jeenarain, Nitesha; Marzinke, Mark; Soto-Torres, Lydia; Brown, Elizabeth R; Baeten, Jared M

2017-10-01

To evaluate the potential for a clinically relevant drug-drug interaction with concomitant use of a dapivirine vaginal ring, a novel antiretroviral-based HIV-1 prevention strategy, and hormonal contraception by examining contraceptive efficacies with and without dapivirine ring use. A secondary analysis of women participating in MTN-020/ASPIRE, a randomized, double-blind, placebo-controlled trial of the dapivirine vaginal ring for HIV-1 prevention. Use of a highly effective method of contraception was an eligibility criterion for study participation. Urine pregnancy tests were performed monthly. Pregnancy incidence by arm was calculated separately for each hormonal contraceptive method and compared using an Andersen-Gill proportional hazards model stratified by site and censored at HIV-1 infection. Of 2629 women enrolled, 2310 women returned for follow-up and reported using a hormonal contraceptive method at any point during study participation (1139 in the dapivirine arm and 1171 in the placebo arm). Pregnancy incidence in the dapivirine arm versus placebo among women using injectable depot medroxyprogesterone acetate was 0.43% vs. 0.54%, among women using injectable norethisterone enanthate was 1.15% vs. 0%, among women using hormonal implants was 0.22% vs. 0.69%, and among women using oral contraceptive pills was 32.26% vs. 28.01%. Pregnancy incidence did not differ by study arm for any of the hormonal contraceptive methods. Use of the dapivirine ring does not reduce the effectiveness of hormonal contraceptives for pregnancy prevention. Oral contraceptive pill use was associated with high pregnancy incidence, potentially because of poor pill adherence. Injectable and implantable methods were highly effective in preventing pregnancy.

Misconception of emergency contraception among tertiary school ...

African Journals Online (AJOL)

Objective: To assess the degree of awareness and use of emergency contraception among tertiary school students in Akwa Ibom State, Nigeria. Design: A self-administered questionnaire survey. Setting: The Akwa Ibom State Polytechnic, Ikot Osurua, located on the outskirts of Ikot Ekpene local government area between ...

Investigation of the Relationship between Myocardial Infarction, Angina Pectoris, and Venous Thrombosis and Some Risk Factors in the Women Suffering from Cardiovascular Diseases with a History of Contraceptive Pills Consumption

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Marzieh Akbarzade

2016-06-01

Full Text Available Background: Cardiovascular diseases have various etiologies. Previous studies have come to contradictory results regarding the effects of Oral Contraceptive Pills (OCPs on the risk of myocardial infarction, angina pectoris, and venous thrombosis. Thus, further investigation is required in this area. Objectives: This study aimed to determine the relationship between cardiovascular diseases and some risk factors in the women with a history of contraceptive pills consumption. Patients and Methods: The present case-control study was conducted on 317 women with cardiovascular diseases (myocardial infarction, angina pectoris, and deep venous thrombosis selected through simple purposive sampling from CCU, ICU, post-ICU, and neurology departments of Nemazee, Faghihi, and Al-Zahra heart hospitals. Also, 371 controls were selected among 20 – 60 year-old women without cardiac diseases. The data were collected through questionnaires, interviewing the patients and their first-degree relatives, and the patients’ medical records. The main variables studied in both groups included the history of OCPs consumption, weight gain, blood sugar level, and hypertension. Then, the data were analyzed using chi-square test, correlation coefficient, and odds ratio. Besides, P < 0.05 was considered to be statistically significant. Results: The mean age of the study population was 49.2 ± 13.4 years. Besides, 10.6%, 4%, and 2.7% of the women had used OCPs for 6 - 10, 11 - 15, and more than 16 years, respectively. There were no significant differences between the two groups in terms of history of using OCPs (47.3% vs. 51.5%, P = 0.8. In addition, no significant relationship was observed between consumption of OCPs and incidence of myocardial infarction (P = 0.202, angina pectoris (P = 0.260, and thrombosis (P = 0.389. However, a significant difference was found between the two groups regarding the frequency of hyperlipidemia, hyperglycemia, and hypertension (P < 0

Hormonal contraception, thrombosis and age

DEFF Research Database (Denmark)

Lidegaard, Øjvind

2014-01-01

: 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......INTRODUCTION: This paper reviews the risk of thrombosis with use of different types of hormonal contraception in women of different ages. AREAS COVERED: Combined hormonal contraceptives with desogestrel, gestodene, drospirenone or cyproterone acetate (high-risk products) confer a sixfold increased...

Correlates of women's cancer screening and contraceptive knowledge among female emergency department patients

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Bock Beth C

2007-05-01

Full Text Available Abstract Background Lack of knowledge regarding preventive health services for women might impede campaigns to expand these services in the emergency department setting. For 18–55-year-old English-speaking women visiting an urban emergency department, we aimed to: (1 Ascertain their knowledge regarding the applicability, purpose, and recommended intervals of three women's cancer screening and three contraceptive methods; and (2 Determine if patient age, race/ethnicity, medical insurance status, and current or recent usage of these methods are associated with greater or lesser knowledge about them. Methods Emergency department-based survey on recent or current usage and knowledge about Pap smears, breast self-examinations, mammograms, condoms, birth control, and emergency contraception. Analyses included calculation of summary statistics and creation of multivariable logistic regression models. Results Of 1,100 patients eligible for the study, 69.9% agreed to participate. Most of the participants were Conclusion Although these female ED patients demonstrated strong knowledge on some women's cancer screening and contraceptive methods, there were several areas of knowledge deficit. Women without private medical insurance and those who have not used a particular cancer screening or contraceptive method demonstrated less knowledge. Reduced knowledge about women's cancer screening and contraceptive methods should be considered during clinical encounters and when instituting or evaluating emergency department-based initiatives that assess the need for these methods.

[Place of persistence trouble during oral contraception and subsequent use of emergency contraception].

Science.gov (United States)

Jamin, C; Lachowsky, M

2015-10-01

In order to improve the understanding of hormonal contraceptive failures, this study evaluates the persistence of oral contraception and the use of emergency contraception (EC) during persistence incidents. We made the hypothesis of the existence of a strong link between the risk of unplanned pregnancies and these two parameters. In this study, we also evaluated women's perception of EC in order to elucidate the reasons of EC insufficient use. One survey was carried out on Internet on a representative sample of women, aged 16-45. In this survey, 3775 French women were interviewed (source-population). We defined a target population of 2415 fertile women who had heterosexual intercourse during the last 12 months, and a population of 760 women at risk of unintended pregnancy who had unprotected sexual intercourse during the last 12 months(risk-population). A little more than 30% of the target population, meaning 20% of the source-population (n=745) stopped their contraceptive method temporarily for an average time of two months. Almost 60% of women had a risk of unwanted pregnancy during this period without contraception, which is 59% of the risk-population. Only 20% of women among the population at risk used EC. The main reasons given for EC insufficient use were the misperception of the risk of pregnancy, the lack of knowledge about EC and its way of use. For the first time, this survey shows that 13% of women (of the source population) decide to stop temporarily their contraceptive method for an average time of two months per year. Fifty-nine percent of unplanned pregnancy situations are due to this poor contraception persistence. Although there is a need to reduce the risk of women being at risk, it seems also highly desirable to overcome the consequences of this poor persistence. Giving information about EC and a systematic prescription during contraception consultations would lead to an increased use of EC. Copyright © 2014 Elsevier Masson SAS. All rights

Emergency contraception use and counseling after changes in United States prescription status.

Science.gov (United States)

Kavanaugh, Megan L; Williams, Sanithia L; Schwarz, E Bimla

2011-06-30

Analysis of data from the 2006-2008 National Survey of Family Growth indicates that use of emergency contraception in the United States has increased after changes in its prescription status in 2006. However, clinicians continue to play a pivotal role in ensuring that women have accurate information about emergency contraception. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Knowledge, attitudes and practice of emergency contraception ...

African Journals Online (AJOL)

Background: Emergency contraceptives (EC) play a very important role in the prevention of unwanted pregnancies when there are user failures with the regular devices. It is an integral part of the treatment of cases of sexual assaults and other unprotected sexual intercourse in susceptible subjects. Aims & Objectives: This ...

Community pharmacists providing emergency contraception give little advice about future contraceptive use: a mystery shopper study.

Science.gov (United States)

Glasier, Anna; Manners, Rachel; Loudon, Joanna C; Muir, Aileen

2010-12-01

UK women increasingly prefer to attend a pharmacy for emergency contraception (EC) rather than a doctor. Most women who use EC do not conceive and remain at risk of pregnancy unless they start regular contraception. We undertook a study to evaluate the quality of service provision in community pharmacies in Lothian, Scotland, and to determine what advice is given about contraception after EC use. Mystery shopper study. EC was unobtainable from 5/40 pharmacies (12.5%), refused because of "contraindications" in 7 (17.5%) and offered in 28 (70%). Most pharmacists appeared nonjudgemental, over 75% asked appropriate questions about eligibility, and over 90% gave appropriate advice about use. EC was universally refused beyond 72 h after sex but universally provided when the date of the last menstrual period was uncertain. Ongoing contraception after EC use was discussed in only 32.5% of all pharmacies and only 43% of those issuing EC. The quality of consultations for EC in pharmacies is generally good but only a minority discuss ongoing contraception after EC use. The implications for contraceptive use and unintended pregnancy rates are worrying. Copyright © 2010 Elsevier Inc. All rights reserved.

Use of emergency contraception in Nigeria: An exploration of related factors among sexually active female university students.

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Abiodun, Olumide

2016-03-01

Unsafe abortions account for nearly one-third of maternal deaths among young people. Women who have an induced abortion are usually literate and less than 30 years old; usually undergraduates with unintended pregnancies. Many of these pregnancies could have been prevented by contraception. The aim of this study was to determine the correlates of uptake of emergency contraception among university students. A cross-sectional study was conducted among 1328 sexually active, never married female university students. Self-administered questionnaire was used to assess knowledge, perception and practice of emergency contraception. Multivariate logistic regression was used to identify the predictors of emergency contraception. Majority of the participants were aware of emergency contraception (72.6%), had good knowledge (56.0%), and had the perception that it is effective (74.6%) and easy to use (72.4%). The main sources of information about emergency contraception were friends (32.9%) and the media (20.0%). About 52.0% of the participants had unprotected sex in the preceding six months, while 718 (54.1%) had ever used emergency contraception. The main sources of the commodities were sexual partners (46.2%) and medicine stores (35.4%). The uptake of emergency contraception was predicted by being ≤19 years (AOR = 3.193), rural dwelling (AOR = 4.247), perceptions that it is effective (AOR = 2.229E11) and easy to use (AOR = 6.680E8). Use of contraception among sexually active female Nigerian university students is predicted by the perception about its effectiveness and ease of use. Sexual and reproductive health programmes should focus on improving knowledge and addressing misconception in order to improve perception about emergency contraception. Copyright © 2015 Elsevier B.V. All rights reserved.

Students' perceptions of contraceptives in university of ghana.

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Nana Nimo Appiah-Agyekum

2013-03-01

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.

[Five hundred females from Guadeloupe and their attitudes to contraception (author's transl)].

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Gadras, P

1982-01-01

Notwithstanding the fact that family planning counseling and services are absolutely free in Basse-Terre, Guadeloupe, requests for induced abortion are increasing. A survey was conducted among 500 women to discover the areas of resistance to contraception. Most women were between 18-32; 38% had at least 1 abortion, and of these 28% had at least 2. 67% of women with parity 6 or over would have liked a smaller family; no woman wanted more than 5 children and ideal family size was considered to be 3. 1 out of 4 women did not disucss contraception with their partner; 3 out of 4 had tried the pill, but 1 out of 4 thought it to be dangerous; only 13% of women who had taken or were taking the pill were satisfied; only 1 out of 2 women took the pill duringly breast feeding. 1 out of 3 women interviewed had tried the IUD. 23% relied on coitus interruptus and 18% on the condom for protection. Sterilization was not very popular and it was requested mainly by women aged 30-44 with parity 3 and over. Only 1 out of 4 knew about vasectomy. All women stated to prefer contraception to induced abortion, and only 68% knew that abortion was legal. The results indicate poor information and comprehension of contraceptive methods. The role of physicians, nurses, and midwives remains paramount in informing couples about their responsibilities in contraception.

Providers′ knowledge, attitude and dispensing practices of E-Pills in government dispensaries of south district in Delhi, India

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Kishore Vertika

2010-01-01

Full Text Available Background: South Delhi is one of the well developed districts in the capital with best public health care facilities. Knowledge, attitude and dispensing practices of emergency contraceptive pills (E-pills were assessed among health care providers of government dispensaries in South Delhi. Study Design: A descriptive epidemiological study. Materials and Methods: Both medical and paramedical (n = 428 providers in 63 government health care facilities were interviewed between August to December 2007 using a semi-structured interview schedule. Results: Among the different categories of the providers, medical officers were observed to be most knowledgeable about E-pills and the pharmacists were the least. The correct prescribed dose of E-pill was known only to 32% of the providers while 49% knew about its right time of intake. Misconceptions and apprehensions for promoting its use were very much prevalent even among medical officers as majority felt that open access to E-pills would increase promiscuity. The dispensing practice of providers was found positively ( P < 0.05 correlated with their knowledge. Training resulted a significant ( P < 0.05 improvement in knowledge, attitude and dispensing practice of the providers. Knowledge and training combined together contributed 35% to the dispensing practice (R 2 = 0.35. Conclusion: Besides knowledge, behavior change communication strategies should form a part of the training curricula of health care providers that would help to improve the dispensing practice of E-pills.

Randomized clinical trial evaluating metformin versus oral contraceptive pills in the treatment of adolescents with polycystic ovarian syndrome.

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Al-Zubeidi, Hiba; Klein, Karen O

2015-07-01

Polycystic ovarian syndrome (PCOS) is characterized by irregular menses, elevated androgens, and insulin resistance. Little information is published about the treatment of adolescent PCOS. The aim of this study was to evaluate metformin versus oral contraceptive pills (OCP) in treating adolescent PCOS. Twenty-two girls were randomized to either treatment for 6 months. The outcomes variables included body mass index (BMI) and free testosterone (FT). BMI decreased in all patients (metformin p=0.004, OCP p=0.045). FT decreased significantly only with OCP. Insulin resistance measures decreased in all patients but did not reach significance. The only significant difference in any of the variables between the two groups was number of menses. BMI and FT remained less than baseline for 3 months off treatment. Metformin and OCP have a positive effect on BMI, which persists after treatment is discontinued. FT decreased with both treatments, but only reached significance with OCP.

Interventions for emergency contraception.

Science.gov (United States)

Shen, Jie; Che, Yan; Showell, Emily; Chen, Ke; Cheng, Linan

2017-08-02

Emergency contraception (EC) is using a drug or copper intrauterine device (Cu-IUD) to prevent pregnancy shortly after unprotected intercourse. Several interventions are available for EC. Information on the comparative effectiveness, safety and convenience of these methods is crucial for reproductive healthcare providers and the women they serve. This is an update of a review previously published in 2009 and 2012. To determine which EC method following unprotected intercourse is the most effective, safe and convenient to prevent pregnancy. In February 2017 we searched CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, Popline and PubMed, The Chinese biomedical databases and UNDP/UNFPA/WHO/World Bank Special Programme on Human Reproduction (HRP) emergency contraception database. We also searched ICTRP and ClinicalTrials.gov as well as contacting content experts and pharmaceutical companies, and searching reference lists of appropriate papers. Randomised controlled trials including women attending services for EC following a single act of unprotected intercourse were eligible. We used standard methodological procedures recommended by Cochrane. The primary review outcome was observed number of pregnancies. Side effects and changes of menses were secondary outcomes. We included 115 trials with 60,479 women in this review. The quality of the evidence for the primary outcome ranged from moderate to high, and for other outcomes ranged from very low to high. The main limitations were risk of bias (associated with poor reporting of methods), imprecision and inconsistency. Comparative effectiveness of different emergency contraceptive pills (ECP)Levonorgestrel was associated with fewer pregnancies than Yuzpe (estradiol-levonorgestrel combination) (RR 0.57, 95% CI 0.39 to 0.84, 6 RCTs, n = 4750, I 2 = 23%, high-quality evidence). This suggests that if the chance of pregnancy using Yuzpe is assumed to be 29 women per 1000, the chance of pregnancy using levonorgestrel would be between

[Individualization of low-dose oral contraceptives. Pharmacological principles and practical indications for oral contraceptives].

Science.gov (United States)

Cianci, A; De Leo, V

2007-08-01

The contraceptive pill has been a revolution of the last 40 years. In Italy, however, it is much less widely used than in other countries. Explanations for this phenomenon range from religious implications and customs to misinformation and word-of-mouth communication of negative experiences. The oral contraceptive pill is often used to correct menstrual disorders, leading to poor results and side-effects. Recent advances in oral contraception have led to a substantial reduction in doses and side-effects. Low-dose pills contain minimal doses of progesterones and estrogens and ensure good control of the menstrual cycle. Although reduction of ethinyl estradiol (EE) concentrations has reduced the incidence of negative systemic side effects such as water retention, edema and swollen breasts, the low estrogen dose may be associated with spotting and hypomenorrhea or amenorrhea in the long term, as well as dyspareunia due to reduced vaginal trophism, which may induce women to suspend use of the drug. It is also true that only one type of estrogen is used in the pill, albeit at different doses, whereas the progesterone may differ and in many cases is the cause of common side-effects. The choice of progesterone therefore involves not only its effect on the endometrium in synergy with estrogen, but also possible residual androgenic activity which may have negative metabolic repercussions. Indeed, addition of a progesterone, especially androgen-derived, attenuates the positive metabolic effects of estrogen. Two new monophasic oral contraceptives were recently released. They contain 30 microg (Yasmin) or 20 muicrog (Yasminelle) EE and a new progesterone, drospirenone, derived from spirolactone, which has antiandrogenic and antimineralcorticoid activity similar to endogenous progesterone. Like progesterone, the drospirenone molecule is an aldosterone antagonist and has a natriuretic effect that opposes the sodium retention effect of EE. It may, therefore, help to prevent the

Safety, efficacy and patient satisfaction with continuous daily administration of levonorgestrel/ethinylestradiol oral contraceptives

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Giuseppe Benagiano

2009-04-01

Full Text Available Giuseppe Benagiano, Sabina Carrara, Valentina FilippiDepartment of Gynaecology and Obstetrics, Sapienza University, Rome, ItalyAbstract: The progestational steroid norgestrel was synthesized and tested between 1960 and 1965 through an international cooperation between Wyeth, USA and Schering, Berlin. It is a mixture of two “enantiomers,” with only one form (designated as levonorgestrel biologically active. When taken orally, it is rapidly absorbed, not subjected to a “first-pass” effect and is approximately 90% bioavailable, with a circulating half-life around 15 hours. Its contraceptive action is exerted at the central (hypothalamic and peripheral (cervical mucus and endometrium levels. Levonorgestrel (LNG, alone or in combination with ethinyl estradiol (EE, is the most widely employed contraceptive progestin: it is used in combined oral contraceptives, progestogen-only pills, long-acting contraceptive implants, intrauterine contraceptive systems and in emergency contraception. It is also the steroid of choice for new oral contraceptive regimens aimed at reducing the frequency of bleeding episodes. This novel approach, already tried more than 30 years ago, gained interest around the year 2000 when surveys of women’s attitudes toward monthly menstrual bleeding started to show a major change: more and more women declared that they would welcome a hormonal contraceptive method that reduced bleeding episodes to 4, 2 or even 1 per year. At this point, while the debate on the significance and “usefulness” of menstruation went on, attention focused on new regimens. The first new modality consisted of changing the 7-day medication-free interval, either shortening it to fewer than 7 days, or by the administration of low-dose estrogens during the interval between packages. Then, continuous administration regimens started to be investigated. This, however, did not happen suddenly, since, in specific situations, doctors had for years

A randomised study comparing the effect on ovarian activity of a progestogen-only pill (POP) containing desogestrel and a new POP containing drospirenone in a 24/4 regimen

DEFF Research Database (Denmark)

Duijkers, Ingrid J M; Heger-Mahn, Doris; Drouin, Dominique

2015-01-01

OBJECTIVES: Progestogen-only pills (POPs) are safer with respect to cardiovascular risks than contraceptives containing estrogens. Despite the increased contraceptive efficacy of a desogestrel-only pill compared with a traditional POP, POPs are still not widely used due to an unpredictable bleeding...... pattern. A new POP containing 4 mg drospirenone has been developed with a 24/4 intake regimen which may improve the bleeding pattern. The objectives of this study were to investigate ovulation inhibition with the new drospirenone-only pill in comparison with the desogestrel-only pill and, in addition......, to assess the effects on cervical mucus permeability and bleeding. METHODS: Sixty-four healthy volunteers with proven ovulatory cycles were randomised and treated with either the drospirenone-only or the desogestrel-only pill during two 28-day cycles. Follicular diameter, endometrial thickness, and serum...

Increasing access to emergency contraception through online prescription requests.

Science.gov (United States)

Averbach, Sarah; Wendt, Jacqueline Moro; Levine, Deborah K; Philip, Susan S; Klausner, Jeffrey D

2010-01-01

To describe a pilot program, Plan B Online Prescription Access, to provide easy access to prescriptions for emergency contraception via the Internet. We measured electronic prescriptions for Plan B (Duramed Pharmaceuticals, Cincinnati, Ohio) by month over time. Pharmacists faxed patient-generated prescriptions back to the Department of Public Health for confirmation. Despite no marketing, within the first 18 months of the program, 152 electronic prescriptions for Plan B were requested by 128 female San Francisco residents. Seventy-eight prescriptions were filled (51%) by pharmacists. If correctly marketed, online prescriptions for Plan B have the potential to be an effective means of increasing emergency contraception access in both urban and rural settings across the United States. Further user-acceptability studies are warranted.

International survey to assess women's attitudes regarding choice of daily versus nondaily female hormonal contraception

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Mansour D

2014-04-01

Full Text Available Diana Mansour New Croft Centre, Newcastle Hospitals Community Health, Newcastle upon Tyne, UK Background: The availability of reliable contraception tailored to suit women's needs and lifestyles is an essential step in addressing unintended pregnancy and its substantial human and financial costs. The daily combined oral contraceptive pill has been the short-acting hormonal contraceptive of choice for the last 50 years. However, for some women, this may be neither suitable nor optimal. Methods: Here we report the findings of a large, online, questionnaire-based study conducted in Brazil, France, Germany, Italy, and the USA. The study was designed to assess women's attitudes, beliefs, and unmet needs regarding current hormonal contraceptive options via an anonymous online survey. Women eligible for contraception were required to respond to questions using either a binary (yes/no or seven-point scale (1, complete disagreement; 7, complete agreement. Women were also asked about other relevant issues, such as lifestyle, perception of menstruation and pregnancy, level of education, and relationship with their health care professional. Results: In total, 12,094 women were questioned, of whom 68% required contraception. Overall, 28% of women expressed an interest in novel contraceptive products, and 49% stated that they would prefer a nondaily method. Although many women expressed satisfaction with the pill, daily intake was thought to be burdensome, resulting in irregular and ineffective usage. However, many women continued to choose the pill due to lack of consideration of and education about other options. Approximately half of the women wished to conceive in the near future. Conclusion: The findings indicate that nearly half of respondents would prefer a nondaily form of contraception. Furthermore, approximately half of respondents wished to conceive in the near future, suggesting that they are unlikely to favor long-acting options. Effective

The COX-2 inhibitor meloxicam prevents pregnancy when administered as an emergency contraceptive to nonhuman primates.

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McCann, Nicole C; Lynch, Terrie J; Kim, Soon Ok; Duffy, Diane M

2013-12-01

Cyclooxygenase-2 (COX-2) inhibitors reduce prostaglandin synthesis and disrupt essential reproductive processes. Ultrasound studies in women demonstrated that oral COX-2 inhibitors can delay or prevent follicle collapse associated with ovulation. The goal of this study was to determine if oral administration of a COX-2 inhibitor can inhibit reproductive function with sufficient efficacy to prevent pregnancy in primates. The COX-2 inhibitor meloxicam (or vehicle) was administered orally to proven fertile female cynomolgus macaques using one emergency contraceptive model and three monthly contraceptive models. In the emergency contraceptive model, females were bred with a proven fertile male once 2±1 days before ovulation, returned to the females' home cage, and then received 5 days of meloxicam treatment. In the monthly contraceptive models, females were co-caged for breeding with a proven fertile male for a total of 5 days beginning 2±1 days before ovulation. Animals received meloxicam treatment (1) cycle days 5-22, or (2) every day, or (3) each day of the 5-day breeding period. Female were then assessed for pregnancy. The pregnancy rate with meloxicam administration using the emergency contraception model was 6.5%, significantly lower than the pregnancy rate of 33.3% when vehicle without meloxicam was administered. Pregnancy rates with the three monthly contraceptive models (75%-100%) were not consistent with preventing pregnancy. Oral COX-2 inhibitor administration can prevent pregnancy after a single instance of breeding in primates. While meloxicam may be ineffective for regular contraception, pharmacological inhibition of COX-2 may be an effective method of emergency contraception for women. COX-2 inhibitors can interfere with ovulation, but the contraceptive efficacy of drugs of this class has not been directly tested. This study, conducted in nonhuman primates, is the first to suggest that a COX-2 inhibitor may be effective as an emergency contraceptive. �

Socio-Economic Differentials in Contraceptive Discontinuation in India

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Kiran Agrahari

2016-05-01

Full Text Available Fertility divergence amid declining in use of modern contraception in many states of India needs urgent research and programmatic attention. Although utilization of antenatal, natal, and post-natal care has shown spectacular increase in post National Rural Health Mission (NRHM period, the contraceptive use had shown a declining trend. Using the calendar data from the National Family Health Survey–3, this article examines the reasons of contraceptive discontinuation among spacing method users by socio-economic groups in India. Bivariate and multivariate analyses and life table discontinuation rates are used in the analyses. Results suggest that about half of the pill users, two fifths of the condom users, one third of traditional method users, and one fifth of IUD users discontinue a method in first 12 months of use. However, the discontinuation of all three modern spacing methods declines in subsequent period (within 12-36 months. The probability of method failure was highest among traditional method users and higher among poor and less educated that may lead to unwanted/mistimed birth. Although discontinuation of condom declines with economic status, it does not show any large variation for pill users. The contraceptive discontinuation was significantly associated with duration of use, age, parity, contraceptive method, religion, and contraceptive intention. Based on these findings, it is suggested that follow-up services to modern spacing method users, increasing counseling for spacing method users, motivating the traditional method user to use modern spacing method, and improving the overall quality of family planning services can reduce the discontinuation of spacing method.

Understanding of Emergency Contraception among Nursing Staff in ...

African Journals Online (AJOL)

2017-07-20

Jul 20, 2017 ... a Tertiary Care Hospital of Andaman and Nicobar Islands, India ... Context: Emergency contraception (EC) offers women a last chance to prevent pregnancy after unprotected ... to create awareness, improve their understanding and change their attitude towards EC. ..... the right message to the right person.

Knowledge, attitude, practice, and determinants emergency contraceptive use among women seeking abortion services in Dire Dawa, Ethiopia.

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Meskerem Abate

Full Text Available Unplanned pregnancy from casual sex, unplanned sexual activity, and sexual violence are increasing. Emergency Contraceptives (EC are used to prevent unplanned pregnancies thereby preventing the occurrence and consequences of unplanned pregnancy. Emergency contraception is widely available in Ethiopia particularly in major cities. Yet the use of EC is very low and abortion rate in cities is high compared to the national average.To assess knowledge, attitude and practice and determinants on the use of emergency contraception among women obtaining abortion service at selected health institutions in Dire Dawa, Eastern Ethiopia.A facility based cross-sectional study was conducted on 390 women selected by multi-stage random sampling technique. The samples were generated from government and private for non profit health facilities. Participant's knowledge and attitude towards emergency contraception were measured using composite index based on 7 and 9 questions, respectively and analyzed using mean score to classify them as knowledgeable or not, and have positive attitude or not. Practice was assessed if the women reported ever use of emergency contraception. Determinants of use of emergency contraception were analyzed using logistic regression.Out of 390 women interviewed, 162 women (41.5% heard about EC, only 133 (34.1% had good knowledge, and 200 (51.3% of the respondents had positive attitudes towards to EC. Ever use of EC was reported by 38 (9.7%. Age, living arrangement, education, marital status, religion were found to be significantly associated with the use of emergency contraceptives. Women with poor knowledge were less likely to use EC compared to the knowledgeable ones [AOR = 0.027, 95% CI (0.007, 0.105].The study identified that most respondents lack adequate knowledge on the method of EC. In addition ever use of EC is very low.Health professions should give attention in increasing knowledge and uptake of Emergency Contraception.

Negative opinions about cancer screening and contraceptive measures by female emergency department patients.

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Merchant, Roland C; Gee, Erin M; Bock, Beth C; Becker, Bruce M; Clark, Melissa A

2008-11-01

We sought to determine the extent to which adult female emergency department participants viewed two women's cancer screening and two contraceptive measures negatively. The study also explored the relationship between having a negative opinion about these measures and participant demography, lack of knowledge, and lack of usage of these measures. Few women expressed negative opinions about these measures. Lack of knowledge about and lack of use of these measures were associated with having negative opinions on these cancer screening and contraceptive measures. Having any negative opinion about one cancer screening or contraceptive measure was associated with a higher risk of having any negative opinion on another measure. The results suggest that influencing opinion and knowledge about these measures might impact the success of emergency department-based cancer screening and contraceptive health programs. Editors' Strategic Implications: Emergency departments (and primary care settings) provide key opportunities for prevention. Replication is needed, but the authors present important data on knowledge, attitudes, and characteristics that might influence women's receptivity to consent to and engage in behaviors consistent with prevention, screening, and health promotion.

[Attitude to be taken with the adolescent requesting contraception].

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Wermelinger, R

1983-05-01

A combination of biological factors such as earlier age at puberty and fecundity, and social factors such as the disappearance of the extended family and of rites of passage and the development of a youth culture have encouraged adolescent sexuality at the same time that length of schooling is increasing and adolescents have not yet become socially autonomous. Adolescents employ contraception relatively infrequently and tend to choose less reliable methods. Reasons for this include ignorance of the biology of reproduction and of contraception methods; the fear of secondary effects, encouraged by the mass media; lack of access to family planning facilities or fear that parents will be informed; and the cost of contraceptives. An adolescent requesting contraception should be treated as a adult, taking into account the degree of maturity; the attitude of the medial practitioner will influence motivation and success in using the method. The medical history will indicate cases in which a hormonal contraceptive is contraindicated. The gynecological examination reveals the gynecological age of the patient, which is more important than chronological age. The frequency of sexual realtions should also be considered in the choice. Because motivation of adolescents is less reliable than that of adults, such methods as rhythm and withdrawal are not appropriate. Condoms or diaphragms are disliked because of the necessity of repeated manipulation before each act of intercourse, but may be acceptable to highly motivated individuals. Condoms are indicated when relations are unexpected and infrequent. IUDs are indicated only when hormonal contraceptives cannot be used and when forgetting of pills is likely to occur. Nevertheless, IUD use in adolescents can entail serious problems of expulsion or of infection that may lead to later infertility. Little is known of the effects of oral contraceptive use on sexual maturation and growth of very young adolescents, but because of the growth

Turned On / Turned Off: Speculating on the Microchip-based Contraceptive Implant

DEFF Research Database (Denmark)

Homewood, Sarah; Heyer, Clint

2017-01-01

disruptions of "the pill". Framed as interactive technology, we speculate on the design space of controllable implanted contraceptives. We explored existing implanted contraceptives through a performance ethnography of their implantation. Inspiration from this process informed a speculative video of living...... with controllable implants and a guide for healthcare professionals. These materials, along with expert presentations, backgrounded a design workshop in which participants unpacked issues around controllable contraceptive implants. Participants created and roleplayed physical mock-ups of controllers, manifesting...

Use of effective contraception 6 months after emergency contraception with a copper intrauterine device or ulipristal acetate - a prospective observational cohort study.

Science.gov (United States)

Envall, Niklas; Groes Kofoed, Nina; Kopp-Kallner, Helena

2016-08-01

Emergency contraception must be followed by the use of an effective method of contraception in order to reduce future risk of unintended pregnancies. Provision of long-acting reversible contraception (LARC) is highly effective in this regard. The aim of our study was to compare use of an effective method of contraception 6 months following insertion of a copper intrauterine device (Cu-IUD) or intake of ulipristal acetate (UPA) for emergency contraception (EC). Women (n = 79) presenting with need for EC at an outpatient midwifery clinic chose either Cu-IUD or UPA according to preference. Follow up was 3 and 6 months later through telephone interviews. Primary outcome was use of an effective contraceptive method at the 6-month follow up. Secondary outcomes included use of an effective contraceptive method at 3 months follow up and acceptability of Cu-IUD. A total of 30/36 (83.3%) women who opted for Cu-IUD for EC used an effective contraceptive method 6 months after their first visit compared with 18/31 (58.1%) women who opted for UPA (p = 0.03). In the Cu-IUD group 28/36 (77.8%) were still using Cu-IUD at 6 months and 31/36 (86%) stated that they would recommend the Cu-IUD to others as an EC method. Significantly more women who chose Cu-IUD for EC used an effective method for contraception at the 6-month follow up. The results of this study support increased use of Cu-IUDs for EC. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

The Varied Circumstances Prompting Requests for Emergency Contraception at School-Based Clinics

Science.gov (United States)

Sidebottom, Abbey; Harrison, Patricia A.; Amidon, Donna; Finnegan, Katie

2008-01-01

Background: Little is known about the circumstances that prompt teenagers to request emergency contraception (EC). This evaluation was designed to refine the EC clinical protocol and improve pregnancy prevention efforts in high school-based clinics by analyzing information on EC use and subsequent contraception use of EC patients. Methods: Sites…

Quick starting contraception after emergency contraception: have clinical guidelines made a difference?

Science.gov (United States)

Simpson, Janine; Craik, Julie; Melvin, Louise

2014-07-01

When initiating contraception after emergency contraception (EC), conventional practice had been to wait until the next menses. Since 2010, UK guidelines have endorsed quick starting (QS) contraception, namely offering immediate start when requested. We conducted an audit to assess clinical practice before and after QS guidance publication. A full cycle audit was performed on the clinical notes of women requesting EC during two 2-month periods in 2010 and 2011 in an Integrated Sexual Health Service. All case notes were identified using the National Sexual Health database of sexual health records (Scotland). Information was collated and interpreted using Microsoft Excel and SPSS V.17. During January and February 2010 and 2011, 190 and 180 women, respectively, attended for EC, of whom 96 and 97 were identified as potential quick starters. Between 2010 and 2011, a statistically significant increase in QS practice was noted from 20.8% (n=20) to 37.1% (n=36) (p=0.011), with a corresponding decrease in the percentage of women traditionally started on hormonal contraception (HC): 24% (n=23) and 14.6% (n=14), respectively. There was also a decrease in those advised to return for commencement of HC [55.2% (n=53) vs 49% (n=47)]. Of those advised to return, 26.4% (n=14) and 31.9% (n=15) had no further contact with the service within at least 6 months. QS practice increased after the introduction of clinical guidelines. However, overall provision of HC remained low, with only around half of women prescribed a hormonal method. Published by the BMJ Publishing Group Limited.

Sources of contraceptive commodities for users in Nigeria.

Directory of Open Access Journals (Sweden)

Boniface A Oye-Adeniran

2005-11-01

contraceptive use must take into consideration these identified sources of contraceptives with a view to enhancing the quality, quantity, and variety of methods available, and to building capacity for effective service delivery. There is also a need to encourage the establishment of adolescent-friendly clinics where young people can go for counselling and obtain contraceptives of their choice, including emergency contraceptive pills.

Contraceptive development: why the snail's pace?

Science.gov (United States)

Kaeser, L

1990-01-01

Current contraceptive methods are not well-suited to many Americans. More safe and effective methods would be desirable. A report, "Developing New Contraceptives: Obstacles and Opportunities" was released in January 1990. It summarized 2 years of data collection by the Committee on Contraceptive Development which includes pharmaceutical company executives, physicians, reproductive biologists, public health, legal, and public policy experts, demographers, and economists. Barrier facing the development of new methods in the US were analyzed and ways to speed up research suggested. Particularly ill served are teenagers, young mothers, and comparatively older couples. The health risks of pregnancy, delivery, and labor "may be underrated." The pill is now the most common form of contraception in the US, followed by female sterilization, condoms, and vasectomy. 95% of women, aged 15-44, who have ever had intercourse, have used 1 or more contraceptive methods. Contraceptive discontinuation and failure rates are high, too. No fundamentally new contraceptives have been approved for use since the IUD and the pill in the 60s. Modifications of existing methods are in clinical trials. Obstacles cited were attitudes of the public, federal regulations and product liability, and the organization of and resources available for research. Public attitudes are very conservative. There is no great demand for more products. Since the 1960s, only 1 large pharmaceutical company (Ortho Pharmaceutical Corp.) is still involved in contraceptive research. Activity by small firms, nonprofit organizations, and universities has increased. Federal research funding in reproductive biology has only increased modestly since the mid 1970s. Private foundation support has dramatically declined. The time involved in the great costs of data required for Food and Drug Administration (FDA) approval have reduced research incentives. The average time it takes to get FDA approval has increased in the past 20

Do women's attitudes towards abortion and contraceptive methods influence their option for sterilization?

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Elisabeth Meloni Vieira

Full Text Available This paper analyzes the attitudes of low-income women towards abortion and contraception. A survey was conducted in 1992 with a total of 3,149 childbearing-age women living on the outskirts of the Greater Metropolitan São Paulo Area. The study focuses on a sub-sample of 583 women. Attitudes of sterilized and non-sterilized women are compared. Women, especially those sterilized, found the most important attribute of a contraceptive method to be its effectiveness. Women currently taking the pill were less likely than those sterilized to agree that sterilization was the best method because of its effectiveness. Sterilized women were less likely than non-sterilized women to trust the pill. Sterilized women were more likely than non-sterilized to have reported adverse effects from the pill. Most women found abortion unacceptable except in the case of risk to the woman's life. Women using more effective methods showed stronger negative attitudes towards abortion. The tendency to be sterilized while still young was associated with more negative attitudes towards abortion. Family planning activities in basic health care services should include individual counseling for contraceptive use.

Do women's attitudes towards abortion and contraceptive methods influence their option for sterilization?

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Vieira Elisabeth Meloni

1999-01-01

Full Text Available This paper analyzes the attitudes of low-income women towards abortion and contraception. A survey was conducted in 1992 with a total of 3,149 childbearing-age women living on the outskirts of the Greater Metropolitan São Paulo Area. The study focuses on a sub-sample of 583 women. Attitudes of sterilized and non-sterilized women are compared. Women, especially those sterilized, found the most important attribute of a contraceptive method to be its effectiveness. Women currently taking the pill were less likely than those sterilized to agree that sterilization was the best method because of its effectiveness. Sterilized women were less likely than non-sterilized women to trust the pill. Sterilized women were more likely than non-sterilized to have reported adverse effects from the pill. Most women found abortion unacceptable except in the case of risk to the woman's life. Women using more effective methods showed stronger negative attitudes towards abortion. The tendency to be sterilized while still young was associated with more negative attitudes towards abortion. Family planning activities in basic health care services should include individual counseling for contraceptive use.

The lowest-dose, extended-cycle combined oral contraceptive pill with continuous ethinyl estradiol in the United States: a review of the literature on ethinyl estradiol 20 µg/levonorgestrel 100 µg + ethinyl estradiol 10 µg

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Sheila Krishnan

2010-08-01

Full Text Available Sheila Krishnan, Jessica KileyDepartment of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, USAAbstract: Extended-cycle oral contraceptives (OCs are increasing in popularity in the United States. A new extended-cycle OC that contains the lowest doses of ethinyl estradiol (EE and levonorgestrel (LNG + continuous EE throughout the cycle is now available. It provides 84 days of a low-dose, combined active pill containing levonorgestrel 100 µg and ethinyl estradiol 20 µg. Instead of 7 days of placebo following the active pills, the regimen delivers 7 days of ethinyl estradiol 10 µg. Existing studies reveal a similar efficacy and adverse effect profile compared with other extended-regimen OCs. Specifically, the unscheduled bleeding profile is similar to other extended-cycle OCs and improves with the increase in the duration of use. Although lower daily doses of hormonal exposure have potential benefit, to our knowledge, there are no published studies indicating that this specific regimen offers a lower incidence of hormone-related side effects or adverse events. In summary, this new extended-cycle OC provides patients a low-dose, extended-regimen OC option without sacrificing efficacy or tolerability.Keywords: continuous regimen, ethinyl estradiol, extended cycle, oral contraceptive

Assessment of two emergency contraceptive regimens in Iran ...

African Journals Online (AJOL)

The purpose of this study was to compare the efficacy and tolerability of two emergency contraception (EC)methods, levonorgestrel versus theYuzpe. In a prospective, randomized, comparative study, we included 122 healthy volunteers who in the observed cycle had had only one act of unprotected intercourse within 72h of ...

A study of the effects of oral contraceptives on plasma urea of Wistar ...

African Journals Online (AJOL)

Oral contraceptives such as Microgynon a combined pill (0.15mg levonorgestrel and 0.03mg ethinylestradiol) and Primolut -N a mini pill (5mg norethisterone) were investigated for their in-vivo effects on wistar albino rat rattus rattus plasma urea levels. Test results showed that the drugs had a lowering effect on plasma urea ...

A systematic review of effectiveness and safety of different regimens of levonorgestrel oral tablets for emergency contraception.

Science.gov (United States)

Shohel, Mohammad; Rahman, Mohammad Mahfuzur; Zaman, Asif; Uddin, Mir Muhammad Nasir; Al-Amin, Md Mamun; Reza, Hasan Mahmud

2014-04-04

Unintended pregnancy is a complex phenomenon which raise to take an emergency decision. Low contraceptive prevalence and high user failure rates are the leading causes of this unexpected situation. High user failure rates suggest the vital role of emergency contraception to prevent unplanned pregnancy. Levonorgestrel - a commonly used progestin for emergency contraception. However, little is known about its pharmacokinetics and optimal dose for use. Hence, there is a need to conduct a systematic review of the available evidences. Randomized, double-blind trials were sought, evaluating healthy women with regular menstrual cycles, who requested emergency contraception within 72 h of unprotected coitus, to one of three regimens: 1.5 mg single dose levonorgestrel, two doses of 0.75 mg levonorgestrel given 12 h apart or two doses of 0.75 mg levonorgestrel given 24 h apart. The primary outcome was unintended pregnancy; other outcomes were side-effects and timing of next menstruation. Every trial under consideration successfully established the contraceptive effectiveness of levonorgestrel for preventing unintended pregnancy. Moreover, a single dose of levonorgestrel 1.5 mg for emergency contraception supports its safety and efficacy profile. If two doses of levonorgestrel 0.75 mg are intended for administration, the second dose can positively be taken 12-24 h after the first dose without compromising its contraceptive efficacy. The main side effect was frequent menstrual irregularities. No serious adverse events were reported. The review shows that, emergency contraceptive regimen of single-dose levonorgestrel is not inferior in efficacy to the two-dose regimen. All the regimens studied were very efficacious for emergency contraception and prevented a high proportion of pregnancies if taken within 72 h of unprotected coitus. Single levonorgestrel dose (1.5 mg) can substitute two 0.75 mg doses 12 or 24 h apart. With either regimen, the earlier the treatment is given

Family planning 2011: better use of existing methods, new strategies and more informed choices for female contraception.

Science.gov (United States)

Crosignani, Pier Giorgio; Glasier, Anna

2012-01-01

BACKGROUND This paper explores recent developments in female contraception, using them to illustrate how adaptation of existing methods, improved service delivery and understanding contraceptive behaviour might increase contraceptive uptake and correct and consistent use, and how the development of new methods holds some promise for capitalizing on the potential non-contraceptive benefits. METHODS Searches were performed in Medline and other databases. Selection criteria included high-quality studies and studies relevant to clinical reproductive medicine. Summaries were presented and discussed by the European Society of Human Reproduction and Embryology (ESHRE) Workshop Group. RESULTS The topics discussed include: adapted regimens for combined oral contraceptive pills, non-invasive methods of female sterilization, the need to improve the awareness of pregnancy risk to increase the use of emergency contraception, improvements in the evidence base for the safety and service delivery of intrauterine methods, emphasis on the potential benefits of combined oral contraceptives for women with hirsutism and acne, the potential of female sterilization to prevent ovarian cancer, and the promise of anti-progesterones and new approaches to dual protection. CONCLUSIONS Although great strides have been made in recent years in increasing contraceptive use among women in many countries where contraceptive prevalence is low or there is a high unmet need for contraception, much more can, and needs to, be done.

Parental acceptability of contraceptive methods offered to their teen during a confidential health care visit.

Science.gov (United States)

Hartman, Lauren B; Shafer, Mary-Ann; Pollack, Lance M; Wibbelsman, Charles; Chang, Fay; Tebb, Kathleen P

2013-02-01

To examine parental acceptability of contraceptive methods offered confidentially to their adolescent daughter. A random sample of 261 parents/guardians with a daughter aged 12-17 years completed a telephone survey examining the relationship between parental acceptability of seven contraceptive methods and adolescents' likelihood to have sex, parenting beliefs, parents' sexual health as teens, sexually transmitted infection knowledge, and demographic factors. Acceptability was highest for oral contraceptive pills (59%) and lowest for intrauterine device (18%). Parental acceptance of teens' autonomy was significantly associated with increased acceptability of all methods. Parental knowledge of sexually transmitted infections was poor, and 51% found it acceptable for clinicians to provide their sexually active teen with condoms. Parents were more accepting of oral contraceptive pills and condoms compared with intrauterine devices and implants. Parental recognition of their teen's autonomy was associated with greater parental acceptability of clinicians providing their adolescent with contraceptives (regardless of the specific type of method being offered). Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

The effect of oral contraception on cardiometabolic risk factors in women with elevated androgen levels.

Science.gov (United States)

Krysiak, Robert; Gilowska, Małgorzata; Okopień, Bogusław

2017-02-01

In unselected reproductive-aged women, use of combined estrogen-progestin oral contraceptive pills has been linked with an increased risk of vascular disease. The aim of this study was to investigate the effect of oral contraception on cardiometabolic risk factors in a population of women with hyperandrogenism. The study included 16 untreated women with elevated testosterone levels and 15 matched healthy women who were then treated with oral contraceptive pills containing ethinyl estradiol (30μg) and drospirenone (3mg). Plasma lipids, glucose homeostasis markers, circulating levels of androgens, uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen and homocysteine, as well as urinary albumin-to-creatinine ratio (UACR) were assessed at baseline and after 12 weeks of treatment. Compared to healthy women, women with elevated androgen levels showed increased plasma levels of hsCRP, fibrinogen and homocysteine, as well as a higher value of UACR. Oral contraception reduced androgen levels only in hyperandrogenic women. In healthy women, ethinyl estradiol plus drospirenone increased plasma levels of insulin, hsCRP, fibrinogen and homocysteine, while in women with elevated androgen levels their effect was limited only to a small increase in hsCRP. Our results suggest that a deteriorating effect of oral contraceptive pills containing ethinyl estradiol and drospirenone in hyperandrogenic women is weaker than in healthy young women and that ethinyl estradiol/drospirenone combination therapy may be safely used in the former group of patients. Copyright © 2016. Published by Elsevier Urban & Partner Sp. z o.o.

The advance of the contraceptive revolution.

Science.gov (United States)

Shah, I H

1994-01-01

Prior to 1965, the contraceptive prevalence rate (CPR) had been estimated at below 10% for the less developed regions. In contrast, over 50% of couples were using a contraceptive method in 1990. The data from the Contraceptive Prevalence Surveys and the World Fertility Survey during the 1970s provided a global overview of current patterns of contraceptive practice during 1980-81 for 76 countries, with further updates covering 97 countries around 1983, 105 countries around 1987, and 117 countries around 1990. The 105 countries covered by the 1987 update included 85% of the world's population. In China CPR was reported at 70.6% in 1982 and 72.1% in 1988. There was great variation within the subregions: while on average 17% of couples in Africa used any contraceptive method around 1987, such use was reported as 31% in northern Africa and 13% in Sub-Saharan Africa. However, in Sub-Saharan Africa CPR is expected to rise to 26% by the year 2000, corresponding to a projected total fertility rate (TFR) of 5.33 births per woman. In Asia and Oceania 53% of couples were using contraceptives around 1987. However, the CPR was 72% in eastern Asia and 40% in other countries. In Latin America, CPR was estimated at 57% in 1987. Female sterilization (tubectomy) accounted for 38% of all use in the less developed regions in 1990. Nearly 1/2 of all couples using a contraceptive method in the less developed regions undergoes female or male sterilization, as compared to about 1/6 in the more developed regions. The most commonly used methods in the more developed regions in 1990 were the pill (16%), condom (14%), and withdrawal (13%). In the less developed regions, the main methods used in 1990 were tubectomy (20%), IUD (13%), pill (6%), and vasectomy (5%). The trends in family planning will be characterized by rapid growth in the number of contraceptive users in the developing world, from 381 million in 1990 to 567 million in the year 2000. However, to meet the potential requirements of

Knowledge attitudes and practices of health professionals in public health institutions on emergency contraception in Pietermaritzburg KwaZuluNatal Province South Africa

Directory of Open Access Journals (Sweden)

E Sibanda

2017-05-01

Full Text Available Background. Although emergency contraception (EC is widely available, its use is surrounded by many controversies. Overall, it seems to be underutilised worldwide.Objectives. To determine healthcare professionalsá¾½ knowledge, attitudes and perceptions regarding EC, and how frequently they encounter, educate and issue it to patients.Methods. A questionnaire-based survey of doctors and nurses (volunteers working in obstetrics and gynaecology was conducted in 3 public hospitals and 17 clinics in Pietermaritzburg, KwaZulu-Natal Province, South Africa. Data were analysed using SPSS.Results. Sixty-seven (25% doctors and 201 (75% nurses participated in the survey. Awareness of the three ECs available in the public sector overall was 56.4%, and 62.7% of participants could prescribe one EC correctly. Only 39.6% knew that EC pills prevent ovulation. Seventy-six percent thought that the use of EC could lead to high-risk sexual behaviour, high risk of transmission of HIV and non-use of other forms of contraception. Only 7.8% saw patients seeking EC often, 5.6% issued it often and 23.5% educated patients about it often.Conclusion. Participants were familiar with EC, but lacked accurate and detailed knowledge about its mechanism of action and had misperceptions on its social impact. They seldom prescribed it.

Afgreidsla á neydargetnadarvörn í apótekum

DEFF Research Database (Denmark)

Heidarsdóttir, Margrét Lilja; Almarsdóttir, Anna Birna; Geirsson, Reynir Tómas

2009-01-01

OBJECTIVE: Use of the levonorgestrel emergency contraception (EC) pill has become more common after being made formally available in pharmacies without prescription. It was investigated how pharmacists in the capital area of Reykjavik supply EC to clients. MATERIAL AND METHODS: A total of 46...... pharmacists of all working ages and both genders were asked to answer a questionnaire concerning how they sold the emergency contraception pill over the counter (84.8% reply rate). RESULTS: Four of five used discuss emergency contraception with the client, but almost all enquired about time from...

A qualitative exploration of emergency contraception users' willingness to select the copper IUD.

Science.gov (United States)

Wright, Rachel L; Frost, Caren J; Turok, David K

2012-01-01

The copper T intrauterine device (IUD) is an effective but underutilized method of emergency contraception (EC). This study investigates the factors influencing a woman's decision around which method of EC to select. In-depth interviews with 14 IUD and 14 oral EC users aged 18-30 years accessing public health clinics. Emergency contraception users associated long-term methods of contraception with long-term sexual relationships. Women were not aware of the possibility of using the copper IUD for EC. Cost was identified as a major barrier to accessing IUDs. Perceived side effects and impact on future pregnancies further influenced the EC method a participant selected. Women think about contraception in the context of each separate relationship and not as a long-term individual plan. Most women were unaware of the copper IUD for EC. Furthermore, there is little discussion between women and their health-care providers around EC. Copyright © 2012 Elsevier Inc. All rights reserved.

Sometimes You Do Get a Second Chance: Emergency Contraception for Adolescents.

Science.gov (United States)

Rome, Ellen S; Issac, Veronica

2017-04-01

Unplanned or unintended pregnancy remains a significant challenge for adolescents; many teens who plan ahead but opt not to choose long-acting reversible contraceptive methods have high failure rates with condom usage, oral contraceptives, and other less long-acting methods. Emergency contraception (EC) remains a necessity for those adolescents seeking a second chance to prevent the unintended consequences of unplanned sexual activity. At present, 5 postcoital methods remain available as EC globally: intrauterine devices, ulipristal acetate, a selective progesterone modulator, mifepristone; levonorgestrel, and ethinyl estradiol plus levonorgestrel or norgestrel (rarely used now that progestin only methods are more readily available). Copyright © 2017 Elsevier Inc. All rights reserved.

Emergency Contraception

Science.gov (United States)

... contraception include: your primary care doctor’s office college/university and women’s health centers public health departments hospital ... Mental Health Sex and Birth Control Sex and Sexuality Birth Control Family Health Infants and Toddlers Kids ...

Evaluation of smartphone oral contraceptive reminder applications.

Science.gov (United States)

Gal, Noga; Zite, Nikki B; Wallace, Lorraine S

2015-01-01

Oral contraceptives (OCs) are the most widely used contraceptive method among women of reproductive age in the United States (US). Routine download and use of health-related smartphone applications (apps) continues to increase. The purpose of this study was to evaluate the utility of English-language, smartphone-platform OC reminder apps currently available for download in the US. During June-July 2013, official Internet-based, mobile app platforms for the two major smartphone operating systems in the US-Android (Google Play Store) and iPhone (iTunes)-were searched. "Birth control," "the pill," and "contraception" were entered into the search-bar of each Smartphone store. Apps were assessed for the following: cost, health care professionals' involvement in app development, reminder mechanisms, and functionality. Of the 39 unique OC reminder apps meeting inclusion criteria, 7 (18%) did not operate as intended when downloaded. Most apps functioned without an Internet connection (97%) and included pop-up notifications (84%). Certain app features overcome common causes of missing an alarm, and hypothetically, may minimize likelihood of an OC user missing a daily pill. Health care providers should inform users of potential pitfalls and advise them that an OC reminder app should be not be used as a sole reminder method. Copyright © 2015 Elsevier Inc. All rights reserved.

Preferential Cyclooxygenase 2 Inhibitors as a Nonhormonal Method of Emergency Contraception: A Look at the Evidence.

Science.gov (United States)

Weiss, Erich A; Gandhi, Mona

2016-04-01

To review the literature surrounding the use of preferential cyclooxygenase 2 (COX-2) inhibitors as an alternative form of emergency contraception. MEDLINE (1950 to February 2014) was searched using the key words cyclooxygenase or COX-2 combined with contraception, emergency contraception, or ovulation. Results were limited to randomized control trials, controlled clinical trials, and clinical trials. Human trials that measured the effects of COX inhibition on female reproductive potential were included for review. The effects of the COX-2 inhibitors rofecoxib, celecoxib, and meloxicam were evaluated in 6 trials. Each of which was small in scope, enrolled women of variable fertility status, used different dosing regimens, included multiple end points, and had variable results. Insufficient evidence exists to fully support the use of preferential COX-2 inhibitors as a form of emergency contraception. Although all trials resulted in a decrease in ovulatory cycles, outcomes varied between dosing strategies and agents used. A lack of homogeneity in these studies makes comparisons difficult. However, success of meloxicam in multiple trials warrants further study. Larger human trials are necessary before the clinical utility of this method of emergency contraception can be fully appreciated. © The Author(s) 2014.

Might generic OCs create contraceptive price war?

Science.gov (United States)

1987-02-01

Genora 1/35 and 1/50, the 1st generic oral contraceptives (OCs) in the world, are now being marketed in the US. Clinicians interviewed by "Contraceptive Technology Update" (CTU) offer differing opinions as to what this new OC may mean in the marketplace. Products of Rugby Laboratories, the pills are copy products of Ortho Pharmaceutical's ON 1/35 and ON 1/50 formulations. Most clinicians believe that Genora's success or failure in the OC market depends on its eventual retail price. The price difference of $3-$4 may be sufficiently substantial for retailers to charge less for the generic OCs. If that is the case, many doctors may prescribe a pill which will save their patients $4/month. Dr. Mildred Hanson, a Minneapolis gynecologist/obstetrician, feels any cost savings from Genora will have a significant impact on the OC market. She suggests that the less expensive OCs will catch the attention of health maintenance organizations (HMOs) and the business of women who participate in such health plans. Yet James Burns, director of family planning services for the Hartford City Health Department, thinks that even a full-scale retail price war won't have much effect from a clinic standpoint. He reports that clinics are able to obtain contraceptive supplies rather inexpensively through the contracting system. Hanson also expressed doubt over the potential popularity of Genora 1/50 as clinical concerns about the effects of combined OCs on serum lipid levels and carbohydrate metabolism have resulted in a nationwide push toward OCs containing less than 50 micrograms of estrogen. He indicated concern that declines in pharmaceutical house products from pricing competition with generic pills might have a negative impact on contraceptive research and development. Dick Haskitt, director of business planning for Syntex Laboratories, Inc., who will produce the OCs for Rugby, reports that their market research shows that people are very interested in having a generic OC available

Women Saw Large Decrease In Out-Of-Pocket Spending For Contraceptives After ACA Mandate Removed Cost Sharing.

Science.gov (United States)

Becker, Nora V; Polsky, Daniel

2015-07-01

The Affordable Care Act mandates that private health insurance plans cover prescription contraceptives with no consumer cost sharing. The positive financial impact of this new provision on consumers who purchase contraceptives could be substantial, but it has not yet been estimated. Using a large administrative claims data set from a national insurer, we estimated out-of-pocket spending before and after the mandate. We found that mean and median per prescription out-of-pocket expenses have decreased for almost all reversible contraceptive methods on the market. The average percentages of out-of-pocket spending for oral contraceptive pill prescriptions and intrauterine device insertions by women using those methods both dropped by 20 percentage points after implementation of the ACA mandate. We estimated average out-of-pocket savings per contraceptive user to be $248 for the intrauterine device and $255 annually for the oral contraceptive pill. Our results suggest that the mandate has led to large reductions in total out-of-pocket spending on contraceptives and that these price changes are likely to be salient for women with private health insurance. Project HOPE—The People-to-People Health Foundation, Inc.

Emergency contraception. Widely available and effective but disappointing as a public health intervention: a review.

Science.gov (United States)

2015-04-01

Emergency contraception (EC) prevents pregnancy after unprotected sex or contraceptive failure. Use of EC has increased markedly in countries where a product is available over the counter, yet barriers to availability and use remain. Although effective in clinical trials, it has not yet been possible to show a public health benefit of EC in terms of reduction of unintended pregnancy rates. Selective progesterone receptor modulators developed as emergency contraceptives offer better effectiveness than levonorgestrel, but still EC is less effective than use of ongoing regular contraception. Methods which inhibit ovulation whenever they are taken or which act after ovulation to prevent implantation and strategies to increase the uptake of effective ongoing contraception after EC use would prevent more pregnancies. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Digital Pills to Measure Opioid Ingestion Patterns in Emergency Department Patients With Acute Fracture Pain: A Pilot Study.

Science.gov (United States)

Chai, Peter R; Carreiro, Stephanie; Innes, Brendan J; Rosen, Rochelle K; O'Cleirigh, Conall; Mayer, Kenneth H; Boyer, Edward W

2017-01-13

Nonadherence to prescribed regimens for opioid analgesic agents contributes to increasing opioid abuse and overdose death. Opioids are frequently prescribed on an as-needed basis, placing the responsibility to determine opioid dose and frequency with the patient. There is wide variability in physician prescribing patterns because of the lack of data describing how patients actually use as-needed opioid analgesics. Digital pill systems have a radiofrequency emitter that directly measures medication ingestion events, and they provide an opportunity to discover the dose, timing, and duration of opioid therapy. The purpose of this study was to determine the feasibility of a novel digital pill system to measure as-needed opioid ingestion patterns in patients discharged from the emergency department (ED) after an acute bony fracture. We used a digital pill with individuals who presented to a teaching hospital ED with an acute extremity fracture. The digital pill consisted of a digital radiofrequency emitter within a standard gelatin capsule that encapsulated an oxycodone tablet. When ingested, the gastric chloride ion gradient activated the digital pill, transmitting a radiofrequency signal that was received by a hip-worn receiver, which then transmitted the ingestion data to a cloud-based server. After a brief, hands-on training session in the ED, study participants were discharged home and used the digital pill system to ingest oxycodone prescribed as needed for pain for one week. We conducted pill counts to verify digital pill data and open-ended interviews with participants at their follow-up appointment with orthopedics or at one week after enrollment in the study to determine the knowledge, attitudes, beliefs, and practices regarding digital pills. We analyzed open-ended interviews using applied thematic analysis. We recruited 10 study participants and recorded 96 ingestion events (87.3%, 96/110 accuracy). Study participants reported being able to operate all

Emergency contraception: knowledge and use among Danish women requesting termination of pregnancy

DEFF Research Database (Denmark)

Perslev, A; Rørbye, C; Boesen, H C

2002-01-01

as knowledge about both the correct time limit and where to acquire the EC. We found adequate knowledge in 44.7%. These women were typically younger, better educated and more often singles, nulliparae, and users of contraception. No relation was found to the type of contraception used or to previous......The aim of this study was to describe knowledge about and use of emergency contraception (EC) among Danish women requesting termination of pregnancy. The study included 1514 women (response rate 83.7%) referred during the period August 2000 to May 2001. Sufficient knowledge of EC was defined...

The efficacy of intrauterine devices for emergency contraception: a systematic review of 35 years of experience

Science.gov (United States)

Cleland, Kelly; Zhu, Haoping; Goldstuck, Norman; Cheng, Linan; Trussell, James

2012-01-01

BACKGROUND Intrauterine devices (IUDs) have been studied for use for emergency contraception for at least 35 years. IUDs are safe and highly effective for emergency contraception and regular contraception, and are extremely cost-effective as an ongoing method. The objective of this study was to evaluate the existing data to estimate the efficacy of IUDs for emergency contraception. METHODS The reference list for this study was generated from hand searching the reference lists of relevant articles and our own article archives, and electronic searches of several databases: Medline, Global Health, Clinicaltrials.gov, Popline, Wanfang Data (Chinese) and Weipu Data (Chinese). We included studies published in English or Chinese, with a defined population of women who presented for emergency contraception and were provided with an IUD, and in which the number of pregnancies was ascertained and loss to follow-up was clearly defined. Data from each article were abstracted independently by two reviewers. RESULTS The 42 studies (of 274 retrieved) that met our inclusion criteria were conducted in six countries between 1979 and 2011 and included eight different types of IUD and 7034 women. The maximum timeframe from intercourse to insertion of the IUD ranged from 2 days to 10 or more days; the majority of insertions (74% of studies) occurred within 5 days of intercourse. The pregnancy rate (excluding one outlier study) was 0.09%. CONCLUSIONS IUDs are a highly effective method of contraception after unprotected intercourse. Because they are safe for the majority of women, highly effective and cost-effective when left in place as ongoing contraception, whenever clinically feasible IUDs should be included in the range of emergency contraception options offered to patients presenting after unprotected intercourse. This review is limited by the fact that the original studies did not provide sufficient data on the delay between intercourse and insertion of the IUD, parity, cycle day

Contraceptive social marketing in the Philippines. A new initiative.

Science.gov (United States)

Migallos, G; Araneta, A

1994-01-01

By offering contraceptives at subsidized prices through pharmacies, drugstores, grocery shops, and other conveniently-located retail outlets, and promoting them with modern marketing techniques, social marketing programs can do much to reduce the unmet need for family planning. Users obviously benefit, while the family planning program benefits from advertising and marketing skills and some cost recovery. The Philippine Contraceptive Social Marketing Project (PCSMP) was formally launched in the Philippines in 1993 in response to the large unmet need in the country, and initial results are promising. The project was started with funding from the US Agency for International Development to provide affordable, quality contraceptives through the private sector to Filipino couples who choose to practice family planning. A 1988 survey found that only 22.4% of women aged 15-44 years were using modern methods of contraception and 13.8% were using traditional methods; approximately three million women therefore had unmet need for family planning. The PCSMP established an AIDS prevention component and a birth spacing component, enlisting the participation of oral contraceptive manufacturers Wyeth, Organon, and Schering, along with one condom distributor, Philusa. These companies lowered their product prices by 20% for the program. Despite objections from the Catholic church, sales of both oral pills and condoms increased in the first year. In its second year, the program will advertise Sensation condoms and the Couple's Choice Pills via television, through intensive distribution drives, consumer and trade promotions, and the continuous training of health professionals. The contraceptive injectable DMPA will be added to the Couple's Choice product line in April 1994. This method, too, will be heavily promoted.

["Hormone bomb": risks of emergency contraception from the perspective of pharmacy attendants in Rio de Janeiro, Brazil].

Science.gov (United States)

Brandão, Elaine Reis; Cabral, Cristiane da Silva; Ventura, Miriam; Paiva, Sabrina Pereira; Bastos, Luiza Lena; Oliveira, Naira Villas Boas Vidal de; Szabo, Iolanda

2016-09-19

This study focused on views towards emergency contraception among pharmacy attendants in Greater Metropolitan Rio de Janeiro, Brazil. The empirical material came from a socio-anthropological study with 20 semi-structured interviews of pharmacy attendants of both sexes (8 females and 12 males). The interviews showed negative views of emergency contraception, emphasizing its potential health risks. Interviews considered emergency contraception a "hormone bomb" that can harm the female reproductive organs and other organ systems. The pharmacy attendants highlighted the risks of "uncontrolled" or "indiscriminate" use, especially by adolescents and young women. Since they considered it "dangerous" to women's bodies, they assigned the responsibility for orientation and counseling on use of the method to gynecologists rather than to pharmacists. The article discusses the need to expand the public debate on emergency contraception in Brazil to include pharmacists and pharmacy attendants, in addition to health professionals in general and teachers.

Condoms - male

Science.gov (United States)

Prophylactics; Rubbers; Male condoms; Contraceptive - condom; Contraception - condom; Barrier method - condom ... your health care provider or pharmacy about emergency contraception ("morning-after pills"). PROBLEMS WITH CONDOM USE Some ...

Contraception and pregnancy then and now: examining the experiences of a cohort of mid-age Australian women.

Science.gov (United States)

Read, Christine; Bateson, Deborah; Weisberg, Edith; Estoesta, Jane

2009-08-01

More than 50% of women who have an unplanned pregnancy report using a contraceptive method. Since the launch of the pill 50 years ago, a number of cross-sectional surveys have examined contraceptive use in the Australian context. There is, however, little data on contraceptive use and efficacy over a woman's reproductive years. To determine the pattern of contraceptive use of Australian women over their reproductive lifespan, with particular emphasis on the relationship between contraceptive use and pregnancy. One thousand women from the mid-age cohort of the Australian Women's Longitudinal Study were invited to participate in the Family Planning survey by completing a questionnaire about their reproductive histories. Completed questionnaires were received for 812 women. The contraceptive pill was the most commonly ever used contraceptive method at 94% and also the most commonly used method prior to all pregnancies. Contraceptive failure increased with increasing gravidity; 11.4% with the first pregnancy to 23.0% with the fourth pregnancy, while 28.8% of the respondents reported an 'accidental' pregnancy due to stopping contraception for reasons such as concern about long-term effects and media stories. While surveys indicate that 66-70% of Australian women use a contraceptive method, more than half of unplanned pregnancies apparently occur in women using contraception. The modern Australian woman, in common with her predecessors, still faces significant challenges in her fertility management. This survey provides a longitudinal perspective on contraceptive use in relation to pregnancy and highlights the issue of efficacy of contraceptives in real-life situations.