Budget impact analysis of 8 hormonal contraceptive options.

Science.gov (United States)

Crespi, Simone; Kerrigan, Matthew; Sood, Vipan

2013-07-01

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

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

Directory of Open Access Journals (Sweden)

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

Advances in male hormonal contraception.

Science.gov (United States)

Costantino, Antonietta; Gava, Giulia; Berra, Marta; Meriggiola Maria, Cristina

2014-11-01

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

Advances in male hormonal contraception

Directory of Open Access Journals (Sweden)

Costantino Antonietta

2014-01-01

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

Long-acting reversible hormonal contraception | Dahan-Farkas ...

African Journals Online (AJOL)

Long-acting reversible hormonal contraceptives are effective methods of birth control that provide contraception for an extended period without requiring user action. Long-acting reversible hormonal contraceptives include progesterone only injectables, subdermal implants and the levonorgestrel intrauterine system.

Hormonal Approaches to Male contraception

Science.gov (United States)

Wang, Christina; Swerdloff, Ronald S.

2010-01-01

Purpose of review Condoms and vasectomy are male controlled family planning methods but suffer from limitations in compliance (condoms) and limited reversibility (vasectomy); thus many couples desire other options. Hormonal male contraceptive methods have undergone extensive clinical trials in healthy men and shown to be efficacious, reversible and appear to be safe. Recent Findings The success rate of male hormonal contraception using injectable testosterone alone is high and comparable to methods for women. Addition of progestins to androgens improved the rate of suppression of spermatogenesis. Supported by government or non-government organizations, current studies aim to find the best combination of testosterone and progestins for effective spermatogenesis suppression and to explore other delivery methods for these hormones. Translation of these advances to widespread use in the developed world will need the manufacturing and marketing skills of the pharmaceutical industry. Availability of male contraceptives to the developing world may require commitments of governmental and non-governmental agencies. In a time when imbalance of basic resources and population needs are obvious, this may prove to be a very wise investment. Summary Male hormonal contraception is efficacious, reversible and safe for the target population of younger men in stable relationships. Suppression of spermatogenesis is achieved with a combination of an androgen and a progestin. Partnership with industry will accelerate the marketing of a male hormonal contraceptive. Research is ongoing on selective androgen and progesterone receptor modulators that suppress spermatogenesis, minimize potential adverse events while retaining the androgenic actions. PMID:20808223

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

[Male hormonal contraception: past, present, future].

Science.gov (United States)

Pásztor, Norbert; Hegyi, Borbála Eszter; Badó, Attila; Németh, Gábor

2017-11-01

In certain regions of the world the enormous rate of population growth raises economic and public health concerns and widely accessible contraceptive methods would be desired. In contrast, in other countries the use of effective contraception is a question of individual preferences. Today, most of the reliable contraceptive methods are applied by women, while the options for male methods are quite limited. It is well known that significant portion of pregnancies are still unplanned and several data revealed men's willingness to take part in family planning. Based on these needs, remarkable efforts have been made to develop a suitable hormonal contraceptive agent for men. With the exogenous suppression of follicle stimulating hormone and luteinizing hormone secretion, the inhibition of the testicular testosterone production and the spermatogenesis can be achieved. In the beginning, testosterone-derivatives, or testosterone-progestin combinations were administered, later synthetic androgen agents were developed. Despite of these efforts, unfortunately, there is no safe, widely feasible male hormonal contraception to date, but in the future this goal can be achieved by solving the key hurdles. Orv Hetil. 2017; 158(46): 1819-1830.

Male Hormonal Contraception: Looking Back and Moving Forward

OpenAIRE

Roth, Mara Y.; Page, Stephanie T.; Bremner, William J.

2015-01-01

Despite numerous contraceptive options available to women, approximately half of all pregnancies in the United States and worldwide are unplanned. Women and men support the development of reversible male contraception strategies, but none have been brought to market. Herein we review the physiologic basis for male hormonal contraception, the history of male hormonal contraception development, currents agents in development, as well as the potential risks and benefits of male hormonal contrace...

Male hormonal contraception: looking back and moving forward.

Science.gov (United States)

Roth, M Y; Page, S T; Bremner, W J

2016-01-01

Despite numerous contraceptive options available to women, approximately half of all pregnancies in the United States and worldwide are unplanned. Women and men support the development of reversible male contraception strategies, but none have been brought to market. Herein we review the physiologic basis for male hormonal contraception, the history of male hormonal contraception development, currents agents in development as well as the potential risks and benefits of male hormonal contraception for men. © 2015 American Society of Andrology and European Academy of Andrology.

Long-acting reversible hormonal contraception

African Journals Online (AJOL)

Abstract. Long-acting reversible hormonal contraceptives are effective methods of birth control that provide contraception for an extended ... The World Health Organization (WHO) has online tools available .... trials and marketing experience.

Emergency Contraception Website

Science.gov (United States)

Text Only Full media Version Get Emergency Contraception NOW INFO about Emergency Contraception Q&A about Emergency Contraception Español | Arabic Find a Morning After Pill Provider Near You This website ...

Association of Hormonal Contraception With Suicide Attempts and Suicides

DEFF Research Database (Denmark)

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

2017-01-01

OBJECTIVE: The purpose of this study was to assess the relative risk of suicide attempt and suicide in users of hormonal contraception. METHOD: The authors assessed associations between hormonal contraceptive use and suicide attempt and suicide in a nationwide prospective cohort study of all women...... in Denmark who had no psychiatric diagnoses, antidepressant use, or hormonal contraceptive use before age 15 and who turned 15 during the study period, which extended from 1996 through 2013. Nationwide registers provided individually updated information about use of hormonal contraception, suicide attempt......, suicide, and potential confounding variables. Psychiatric diagnoses or antidepressant use during the study period were considered potential mediators between hormonal contraceptive use and risk of suicide attempt. Adjusted hazard ratios for suicide attempt and suicide were estimated for users of hormonal...

Hormonal contraception and female pain, orgasm and sexual pleasure.

Science.gov (United States)

Smith, Nicole K; Jozkowski, Kristen N; Sanders, Stephanie A

2014-02-01

Almost half of all pregnancies in the United States are unintentional, unplanned, or mistimed. Most unplanned pregnancies result from inconsistent, incorrect, or nonuse of a contraceptive method. Diminished sexual function and pleasure may be a barrier to using hormonal contraception. This study explores sexual function and behaviors of women in relation to the use of hormonal vs. nonhormonal methods of contraception. Data were collected as part of an online health and sexuality study of women. Main outcomes variables assess frequencies in two domains: (i) sexual function (proportion of sexual events with experiences of pain or discomfort, arousal, contentment and satisfaction, pleasure and enjoyment, lubrication difficulty, and orgasm) and (ii) sexual behavior (number of times engaged in sexual activity, proportion of sexual events initiated by the woman, and proportion of sexual events for which a lubricant was used). Sociodemographic variables and contraceptive use were used as sample descriptors and correlates. The recall period was the past 4 weeks. The sample included 1,101 women with approximately half (n = 535) using a hormonal contraceptive method exclusively or a combination of a hormonal and nonhormonal method, and about half (n = 566) using a nonhormonal method of contraception exclusively. Hierarchical regression analyses were conducted to examine the relation of hormonal contraceptive use to each of the dependent variables. Women using a hormonal contraceptive method experienced less frequent sexual activity, arousal, pleasure, and orgasm and more difficulty with lubrication even when controlling for sociodemographic variables. This study adds to the literature on the potential negative sexual side effects experienced by many women using hormonal contraception. Prospective research with diverse women is needed to enhance the understanding of potential negative sexual side effects of hormonal contraceptives, their prevalence, and possible mechanisms

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...

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...

Clinical trials in male hormonal contraception.

Science.gov (United States)

Nieschlag, Eberhard

2010-11-01

Research has established the principle of hormonal male contraception based on suppression of gonadotropins and spermatogenesis. All hormonal male contraceptives use testosterone, but only in East Asian men can testosterone alone suppress spermatogenesis to a level compatible with contraceptive protection. In Caucasians, additional agents are required of which progestins are favored. Clinical trials concentrate on testosterone combined with norethisterone, desogestrel, etonogestrel or depot-medroxyprogesterone acetate. The first randomized, placebo-controlled clinical trial performed by the pharmaceutical industry demonstrated the effectiveness of a combination of testosterone undecanoate and etonogestrel in suppressing spermatogenesis in volunteers. Copyright © 2010 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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.

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.

Concordance of self-reported hormonal contraceptive use and presence of exogenous hormones in serum among African women.

Science.gov (United States)

Pyra, Maria; Lingappa, Jairam R; Heffron, Renee; Erikson, David W; Blue, Steven W; Patel, Rena C; Nanda, Kavita; Rees, Helen; Mugo, Nelly R; Davis, Nicole L; Kourtis, Athena P; Baeten, Jared M

2018-04-01

Studies that rely on self-report to investigate the relationship between hormonal contraceptive use and HIV acquisition and transmission, as well as other health outcomes, could have compromised results due to misreporting. We determined the frequency of misreported hormonal contraceptive use among African women with and at risk for HIV. We tested 1102 archived serum samples from 664 African women who had participated in prospective HIV prevention studies. Using a novel high-performance liquid chromatography-mass spectrometry assay, we quantified exogenous hormones for injectables (medroxyprogesterone acetate or norethisterone), oral contraceptives (OC) (levonorgestrel or ethinyl estradiol) and implants (levonorgestrel or etonogestrel) and compared them to self-reported use. Among women reporting hormonal contraceptive use, 258/358 (72%) of samples were fully concordant with self-report, as were 642/744 (86%) of samples from women reporting no hormonal contraceptive use. However, 42/253 (17%) of samples from women reporting injectable use, 41/66 (62%) of samples from self-reported OC users and 3/39 (8%) of samples from self-reported implant users had no quantifiable hormones. Among self-reported nonusers, 102/744 (14%) had ≥1 hormone present. Concordance between self-reported method and exogenous hormones did not differ by HIV status. Among African women with and at risk for HIV, testing of exogenous hormones revealed agreement with self-reported contraceptive use for most women. However, unexpected exogenous hormones were identified among self-reported hormonal contraceptive users and nonusers, and an important fraction of women reporting hormonal contraceptive use had no hormones detected; absence of oral contraceptive hormones could be due, at least in part, to samples taken during the hormone-free interval. Misreporting of hormonal contraceptive use could lead to biased results in observational studies of the relationship between contraceptive use and health

Hot issues in female and male hormonal contraception.

Science.gov (United States)

Gava, Giulia; Lantadilla, Claudia; Martelli, Valentina; Fattorini, Anna; Seracchioli, Renato; Meriggiola, Maria C

2016-02-01

In recent years a number of significant developments in the field of female hormonal contraception have been made which have produced new formulations and delivery systems providing high efficacy, safety and important non-contraceptive benefits. In particular long-acting reversible contraception (LARC) formulations have been demonstrated to ensure extremely high efficacy in typical use, minimal contraindications, optimal safety in all women thereby representing the best option for most women of all ages. Their effectiveness is not reliant upon user adherence and their ability to reduce unintended pregnancies and abortions has been proven. Unfortunately the same considerations cannot be made for male hormonal contraception. Although a large number of men are interested and would welcome the opportunity to use male contraceptive methods, no safe, effective and reversible methods are available on the market. Current methods available for men are limited to condoms and vasectomy. Highly effective prototype regimens have been developed but the pharmaceutical industry is unwilling to pursue further development and market these products. Of all new approaches to male contraception, hormonal methods are the closest to clinical application. These are based on the reversible suppression of luteinizing hormone and follicle stimulating hormone with subsequent reversible inhibition of spermatogenesis and consequent replacement to maintain androgen dependent physiological functions. Most approaches tested combination regimens such as testosterone and a progestin or testosterone and a GnRH analog.

Comparative Effects of Injectable and Oral Hormonal Contraceptives on Lipid Profile

OpenAIRE

Adebayor Adegoke; Pascal C. Eneh; Roseanne Okafor; Benjamin N. Okolonkwo; Solomon A. Braide; Chukwubike U.Okeke; Holy Brown; Ngozika B. Okwandu

2012-01-01

Background and AimsThe continual use of hormonal contraceptives among women within reproductive age has been on the increase. The effects of these contraceptives on lipid metabolism vary depending on the type of hormonal contraceptive. This study was carried out among Nigerian women, to compare theeffects of injectable hormonal contraceptives to that of combined oral contraceptives on lipid profile (triglyceride, total cholesterol, high density lipoprotein-cholesterol and low density lipo-pro...

Progress and prospects in male hormonal contraception

Science.gov (United States)

Amory, John K.

2009-01-01

Purpose of review Testosterone functions as a contraceptive by suppressing the secretion of luteinizing hormone and follicle-stimulating hormone from the pituitary. Low concentrations of these hormones deprive the testes of the signals required for spermatogenesis and results in markedly decreased sperm concentrations and effective contraception in a majority of men. Male hormonal contraception is well tolerated and acceptable to most men. Unfortunately, testosterone-alone regimens fail to completely suppress spermatogenesis in all men, meaning that in some the potential for fertility remains. Recent findings Because of this, novel combinations of testosterone and progestins, which synergistically suppress gonadotropins, have been studied. Two recently published testosterone/progestin trials are particularly noteworthy. In the first, a long-acting injectable testosterone ester, testosterone decanoate, was combined with etonogestrel implants and resulted in 80–90% of subjects achieving a fewer than 1 million sperm per milliliter. In the second, a daily testosterone gel was combined with 3-monthly injections of depot medroxyprogesterone acetate producing similar results. Summary Testosterone-based hormone combinations are able to reversibly suppress human spermatogenesis; however, a uniformly effective regimen has remained elusive. Nevertheless, improvements, such as the use of injectable testosterone undecanoate, may lead to a safe, reversible and effective male contraceptive. PMID:18438174

Long acting injectable hormonal contraceptives.

Science.gov (United States)

Fraser, I S

1982-03-01

Injectable hormonal preparations can be highly effective and satisfactory contraceptives. The two main preparations available today are depot medroxy progesterone acetate (DMPA) and norethisterone oenanthate (NET-OEN), but several other approaches are currently under clinical trial. Injectable contraceptives have some unique advantages which give them justifiably wide appeal amongst many groups of women. However, they do have a number of disadvantages including invariable menstrual disturbance and a delay in the return of fertility. One formulation of DMPA, Depo-Provera, is probably the most extensively investigated single hormonal contraceptive ever made. These studies indicate that it is remarkably safe and does not face any more unresolved issues than the combined pill, intrauterine device or tubal sterilization. However, for a number of disparate emotional and political reasons it has attracted the attention of several consumer and feminist groups, who have waged a prolonged and quite unjustified campaign against it. It is to be hoped that future debate will be conducted on a more informed, rational and less emotional basis. Injectable contraceptives should have an important place in the family planning armamentarium of all countries, and current developments should lead to a decrease in concerns about presently available agents. This should further increase the widespread acceptability of this approach to contraception.

Non-hormonal male contraception: A review and development of an Eppin based contraceptive.

Science.gov (United States)

O'Rand, Michael G; Silva, Erick J R; Hamil, Katherine G

2016-01-01

Developing a non-hormonal male contraceptive requires identifying and characterizing an appropriate target and demonstrating its essential role in reproduction. Here we review the development of male contraceptive targets and the current therapeutic agents under consideration. In addition, the development of EPPIN as a target for contraception is reviewed. EPPIN is a well characterized surface protein on human spermatozoa that has an essential function in primate reproduction. EPPIN is discussed as an example of target development, testing in non-human primates, and the search for small organic compounds that mimic contraceptive antibodies; binding EPPIN and blocking sperm motility. Although many hurdles remain before the success of a non-hormonal male contraceptive, continued persistence should yield a marketable product. Copyright © 2015 Elsevier Inc. All rights reserved.

KNOWLEDGE LEVEL OF UNIVERSITY STUDENTS ABOUT EMERGENCY CONTRACEPTIVE USAGE

Directory of Open Access Journals (Sweden)

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.

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

Hormonal contraceptive use and mate retention behavior in women and their male partners.

Science.gov (United States)

Welling, Lisa L M; Puts, David A; Roberts, S Craig; Little, Anthony C; Burriss, Robert P

2012-01-01

Female hormonal contraceptive use has been associated with a variety of physical and psychological side effects. Women who use hormonal contraceptives report more intense affective responses to partner infidelity and greater overall sexual jealousy than women not using hormonal contraceptives. Recently, researchers have found that using hormonal contraceptives with higher levels of synthetic estradiol, but not progestin, is associated with significantly higher levels of self-reported jealousy in women. Here, we extend these findings by examining the relationship between mate retention behavior in heterosexual women and their male partners and women's use of hormonal contraceptives. We find that women using hormonal contraceptives report more frequent use of mate retention tactics, specifically behaviors directed toward their partners (i.e., intersexual manipulations). Men partnered with women using hormonal contraceptives also report more frequent mate retention behavior, although this relationship may be confounded by relationship satisfaction. Additionally, among women using hormonal contraceptives, the dose of synthetic estradiol, but not of synthetic progesterone, positively predicts mate retention behavior frequency. These findings demonstrate how hormonal contraceptive use may influence behavior that directly affects the quality of romantic relationships as perceived by both female and male partners. Published by Elsevier Inc.

Contemporary Hormonal Contraception and the Risk of Breast Cancer

DEFF Research Database (Denmark)

Mørch, Lina S; Skovlund, Charlotte W; Hannaford, Philip C

2017-01-01

BACKGROUND: Little is known about whether contemporary hormonal contraception is associated with an increased risk of breast cancer. METHODS: We assessed associations between the use of hormonal contraception and the risk of invasive breast cancer in a nationwide prospective cohort study involving...... all women in Denmark between 15 and 49 years of age who had not had cancer or venous thromboembolism and who had not received treatment for infertility. Nationwide registries provided individually updated information about the use of hormonal contraception, breast-cancer diagnoses, and potential...... confounders. RESULTS: Among 1.8 million women who were followed on average for 10.9 years (a total of 19.6 million person-years), 11,517 cases of breast cancer occurred. As compared with women who had never used hormonal contraception, the relative risk of breast cancer among all current and recent users...

Thrombotic stroke and myocardial infarction with hormonal contraception

DEFF Research Database (Denmark)

Lidegaard, Øjvind; Løkkegaard, Ellen; Jensen, Aksel Karl Georg

2012-01-01

Although several studies have assessed the risk of venous thromboembolism with newer hormonal contraception, few have examined thrombotic stroke and myocardial infarction, and results have been conflicting.......Although several studies have assessed the risk of venous thromboembolism with newer hormonal contraception, few have examined thrombotic stroke and myocardial infarction, and results have been conflicting....

Emerging Options for Emergency Contraception

Science.gov (United States)

Koyama, Atsuko; Hagopian, Laura; Linden, Judith

2013-01-01

Emergency post-coital contraception (EC) is an effective method of preventing pregnancy when used appropriately. EC has been available since the 1970s, and its availability and use have become widespread. Options for EC are broad and include the copper intrauterine device (IUD) and emergency contraceptive pills such as levonorgestrel, ulipristal acetate, combined oral contraceptive pills (Yuzpe method), and less commonly, mifepristone. Some options are available over-the-counter, while others require provider prescription or placement. There are no absolute contraindications to the use of emergency contraceptive pills, with the exception of ulipristal acetate and mifepristone. This article reviews the mechanisms of action, efficacy, safety, side effects, clinical considerations, and patient preferences with respect to EC usage. The decision of which regimen to use is influenced by local availability, cost, and patient preference. PMID:24453516

[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.

Emerging Options for Emergency Contraception

Directory of Open Access Journals (Sweden)

Atsuko Koyama

2013-01-01

Full Text Available Emergency post-coital contraception (EC is an effective method of preventing pregnancy when used appropriately. EC has been available since the 1970s, and its availability and use have become widespread. Options for EC are broad and include the copper intrauterine device (IUD and emergency contraceptive pills such as levonorgestrel, ulipristal acetate, combined oral contraceptive pills (Yuzpe method, and less commonly, mifepristone. Some options are available over-the-counter, while others require provider prescription or placement. There are no absolute contraindications to the use of emergency contraceptive pills, with the exception of ulipristal acetate and mifepristone. This article reviews the mechanisms of action, efficacy, safety, side effects, clinical considerations, and patient preferences with respect to EC usage. The decision of which regimen to use is influenced by local availability, cost, and patient preference.

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.

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.

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

Science.gov (United States)

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.

Influence of hormonal contraceptives and the occurrence of stroke: integrative review

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Adman Câmara Soares Lima

Full Text Available ABSTRACT Objective: To identify scientific evidence regarding the influence of hormonal contraceptive use and the occurrence of stroke. Method: Integrative review of the literature, through database search using the descriptors "contraceptive agents", "contraceptive devices", "contraceptives, Oral" and "Stroke". Original studies in Portuguese, Spanish and English, published in full and available online were included. Studies that did not answer our guiding questions and duplicated studies were excluded. Results: Women using combined oral contraceptives have higher risk of stroke, even with a lower hormonal dosage and different types of progestogen, regardless of the duration of use. The use of contraceptives associated with smoking, hypertension, migraine, hypercholesterolemia, obesity and sedentary lifestyle increases the chance of stroke. Contraceptive patch and vaginal ring are associated to increased risk. Conclusion: Use of combined hormonal contraceptives, except for the injectable and the transdermal ones, increases the chance of occurrence of the event. Progestogen-only contraceptives were considered safe.

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

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I. B. Gridina

2015-12-01

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

Interactions between hormonal contraception and antiepileptic drugs

DEFF Research Database (Denmark)

Reimers, Arne; Brodtkorb, Eylert; Sabers, Anne

2015-01-01

Antiepileptic drugs (AEDs) and hormonal contraceptives may affect each other's metabolism and clinical efficacy. Loss of seizure control and unplanned pregnancy may occur when these compounds are used concomitantly. Although a large number of available preparations yield a plethora of possible drug...... combinations, most of these drug interactions are predictable and, thus, avoidable. Unfortunately, there is a substantial lack of data regarding the newer AEDs. Detailed understanding of these issues is necessary for those who prescribe AEDs and/or hormonal contraception to women with epilepsy, as well...

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.

Effect of Oral and Vaginal Hormonal Contraceptives on Inflammatory Blood Biomarkers

Directory of Open Access Journals (Sweden)

Afshin A. Divani

2015-01-01

Full Text Available The use of combined hormonal contraceptives has been reported to increase the level of C-reactive protein (CRP. We assessed the effect of hormonal contraceptive use on inflammatory cytokines including CRP, monocyte chemotactic protein-1, soluble tumor necrosis factor (sTNF, interleukin-6 (IL-6, and soluble CD40 ligand. We used 79 female subjects (19 to 30 years old who were combined oral contraceptives users (n=29, combined vaginal contraceptive users (n=20, and nonusers (n=30 with CRP values of ≤1 (n=46 or ≥3 (n=33. Information on medical history, physical activities, and dietary and sleeping habits were collected. Both oral and vaginal contraceptive users had higher levels of CRP (P<0.0001, compared to nonusers. Only oral contraceptive users exhibited elevated sCD40L (P<0.01. When comparing the groups with CRP ≤ 1 and CRP ≥ 3, levels of IL-6 and sTNF-RI were positively correlated with CRP among oral contraceptive users. We did not observe the same elevation for other inflammatory biomarkers for the CRP ≥ 3 group among vaginal contraceptive users. The clear cause of elevation in CRP level due to the use of different hormonal contraceptive formulations and methods is not well understood. Longitudinal studies with larger sample size are required to better assess the true cause of CRP elevation among hormonal contraceptive users.

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

Science.gov (United States)

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.

Tear secretion and tear stability of women on hormonal contraceptives

Directory of Open Access Journals (Sweden)

Faustina Kemdinum Idu

2013-01-01

Conclusions: Injectable hormonal contraceptives had no significant effects on tear secretion and tear stability of healthy women of childbearing age. Further studies may be required to determine the effects of hormonal contraceptives on tear volume and stability of women with dry eyes.

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

Science.gov (United States)

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.

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.

[Forgetting hormonal contraceptive methods: expert opinion about their daily management in clinical routine practice].

Science.gov (United States)

Jamin, C; André, G; Audebert, A; Christin-Maître, S; Elia, D; Harvey, T; Letombe, B; Lopes, P; Moreau, C; Nisand, I; Pélissier, C

2011-11-01

Many guidelines regarding the daily management of regular oral hormonal contraceptive methods have been proposed worldwide. Some of them may even appear to be conflicting. The search for the maximal contraceptive protection leads to a low acceptance of these guidelines, probably because of their complexity and their apparent discrepancy. We are deeply convinced that simplicity and pragmatism of guidelines should pave the way to both their better acceptance and compliance and, consequently, to their improved real-life effectiveness. We have considered physiology and pharmacodynamics before proposing the following rules for an effective management of hormonal contraceptive failures. We conclude that the risk of unwanted pregnancy is higher in case of a unique contraception misuse/a delayed start during the first week of the contraceptive cycle (or in case of multiple days of contraceptive misuses during the following weeks) for a combined contraception or at every cycle day for a non anti-ovulatory progestin only contraception. In such risky situations, we firmly recommend the restart of the regular contraceptive method and the use of condoms for the following 72 hours, provided no sexual intercourse has occurred during the past 5 days before the contraceptive failure. If sexual intercourse has occurred during the past 5 days before the contraceptive failure, we firmly recommend the intake of an emergency contraception, ulipristal acetate, the restart the regular contraceptive method and in this case, the use of condoms for, at least, the following 7 days. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Physical examination prior to initiating hormonal contraception: a systematic review.

Science.gov (United States)

Tepper, Naomi K; Curtis, Kathryn M; Steenland, Maria W; Marchbanks, Polly A

2013-05-01

Provision of contraception is often linked with physical examination, including clinical breast examination (CBE) and pelvic examination. This review was conducted to evaluate the evidence regarding outcomes among women with and without physical examination prior to initiating hormonal contraceptives. The PubMed database was searched from database inception through March 2012 for all peer-reviewed articles in any language concerning CBE and pelvic examination prior to initiating hormonal contraceptives. The quality of each study was assessed using the United States Preventive Services Task Force grading system. The search did not identify any evidence regarding outcomes among women screened versus not screened with CBE prior to initiation of hormonal contraceptives. The search identified two case-control studies of fair quality which compared women who did or did not undergo pelvic examination prior to initiating oral contraceptives (OCs) or depot medroxyprogesterone acetate (DMPA). No differences in risk factors for cervical neoplasia, incidence of sexually transmitted infections, incidence of abnormal Pap smears or incidence of abnormal wet mount findings were observed. Although women with breast cancer should not use hormonal contraceptives, there is little utility in screening prior to initiation, due to the low incidence of breast cancer and uncertain value of CBE among women of reproductive age. Two fair quality studies demonstrated no differences between women who did or did not undergo pelvic examination prior to initiating OCs or DMPA with respect to risk factors or clinical outcomes. In addition, pelvic examination is not likely to detect any conditions for which hormonal contraceptives would be unsafe. Published by Elsevier Inc.

Psychological, social, and spiritual effects of contraceptive steroid hormones.

Science.gov (United States)

Klaus, Hanna; Cortés, Manuel E

2015-08-01

Governments and society have accepted and enthusiastically promoted contraception, especially contraceptive steroid hormones, as the means of assuring optimal timing and number of births, an undoubted health benefit, but they seldom advert to their limitations and side effects. This article reviews the literature on the psychological, social, and spiritual impact of contraceptive steroid use. While the widespread use of contraceptive steroid hormones has expanded life style and career choices for many women, their impact on the women's well-being, emotions, social relationships, and spirituality is seldom mentioned by advocates, and negative effects are often downplayed. When mentioned at all, depression and hypoactive sexual desire are usually treated symptomatically rather than discontinuing their most frequent pharmacological cause, the contraceptive. The rising incidence of premarital sex and cohabitation and decreased marriage rates parallel the use of contraceptive steroids as does decreased church attendance and/or reduced acceptance of Church teaching among Catholics. Lay summary: While there is wide, societal acceptance of hormonal contraceptives to space births, their physical side effects are often downplayed and their impact on emotions and life styles are largely unexamined. Coincidental to the use of "the pill" there has been an increase in depression, low sexual desire, "hook-ups," cohabitation, delay of marriage and childbearing, and among Catholics, decreased church attendance and reduced religious practice. Fertility is not a disease. Birth spacing can be achieved by natural means, and the many undesirable effects of contraception avoided.

Psychological, social, and spiritual effects of contraceptive steroid hormones

Science.gov (United States)

Klaus, Hanna; Cortés, Manuel E.

2015-01-01

Governments and society have accepted and enthusiastically promoted contraception, especially contraceptive steroid hormones, as the means of assuring optimal timing and number of births, an undoubted health benefit, but they seldom advert to their limitations and side effects. This article reviews the literature on the psychological, social, and spiritual impact of contraceptive steroid use. While the widespread use of contraceptive steroid hormones has expanded life style and career choices for many women, their impact on the women's well-being, emotions, social relationships, and spirituality is seldom mentioned by advocates, and negative effects are often downplayed. When mentioned at all, depression and hypoactive sexual desire are usually treated symptomatically rather than discontinuing their most frequent pharmacological cause, the contraceptive. The rising incidence of premarital sex and cohabitation and decreased marriage rates parallel the use of contraceptive steroids as does decreased church attendance and/or reduced acceptance of Church teaching among Catholics. Lay summary: While there is wide, societal acceptance of hormonal contraceptives to space births, their physical side effects are often downplayed and their impact on emotions and life styles are largely unexamined. Coincidental to the use of “the pill” there has been an increase in depression, low sexual desire, “hook-ups,” cohabitation, delay of marriage and childbearing, and among Catholics, decreased church attendance and reduced religious practice. Fertility is not a disease. Birth spacing can be achieved by natural means, and the many undesirable effects of contraception avoided. PMID:26912936

Association of Hormonal Contraception with depression in the postpartum period.

Science.gov (United States)

Roberts, Timothy A; Hansen, Shana

2017-12-01

Studies have demonstrated an association between hormonal contraception use with subsequent depression and antidepressant use. This association has not been assessed among postpartum women. This study is a secondary analysis of insurance records from 75,528 postpartum women enrolled in the US military medical system, who delivered between October 2012 and September 2014. Our analyses excluded women who used antidepressants or had a diagnosis of depression in the 24months prior to delivery. We assessed the relationship of hormonal contraception use with subsequent antidepressant use or diagnosis with depression in the first 12months postpartum using Cox proportional hazards regression, with a time dependent covariate measuring exposure to hormonal contraception. Antidepressants were prescribed to 7.8% of women and 5.0% were diagnosed with depression. In multivariable analysis adjusting for demographics, both antidepressant use and diagnosis with depression were associated with: younger age, lower socioeconomic status, and a history of military service. Compared to women with no hormonal contraceptive use, use of etonogestrel containing contraception was associated with a higher risk of antidepressant use (Implant: adjHR:1.22(95%CI:1.06-1.41), pdepression diagnosis (0.56(0.49-0.64), pdepression diagnoses (0.65(0.52-0.82), pdepression diagnosis and antidepressant use in the postpartum period varies with the type of hormonal contraception used. Further research is required to describe the mechanisms of these relationships. Published by Elsevier Inc.

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.

Hormonal contraceptive use lowers female intrasexual competition in pair-bonded women

NARCIS (Netherlands)

Cobey, Kelly D.; Klipping, Christine; Buunk, Abraham P.

The purpose of this study was to test the influence of hormonal contraceptive use on levels of female intrasexual competition. Twenty-eight women completed a scale for intrasexual competition on three occasions: when using hormonal contraceptives and when regularly cycling at a fertile and a

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.

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.

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.

Factors Associated With Interest in Same-Day Contraception Initiation Among Females in the Pediatric Emergency Department.

Science.gov (United States)

Miller, Melissa K; Randell, Kimberly A; Barral, Romina; Sherman, Ashley K; Miller, Elizabeth

2016-02-01

The purposes were to describe interest in hormonal contraception initiation among female adolescent in the emergency department (ED) and to assess for associations with factors known to increase pregnancy risk such as violence victimization. We used a computerized survey to assess sexual and dating practices, pregnancy history/likelihood, contraception use (including long-acting reversible contraception [LARC]) and concerns, contraception initiation interest, violence victimization, medical utilization, and demographics among sexually experienced females aged 14-19 years in our ED. The primary outcome was interest in contraception initiation. We compared responses between subgroups using the chi-square test. A total of 168 adolescents participated (82% of approached; mean age 16.6 years; 41% white; 48% black; 21% commercial insurance). Interest in contraception initiation was high: 60% overall and 70% among those not using hormonal contraception (n = 96). Among those using non-LARC contraception (n = 59), 29% were interested in LARC initiation. Contraception/LARC interest was positively associated with lack of recent well care (p contraception (p contraception at last intercourse. One third (36%) reported violence victimization. Most (70%) reported ≥1 concern about contraception (most commonly cost). Many reported behaviors and exposures, including violence victimization, that increase their risk for pregnancy and most expressed interest in same-day initiation of hormonal contraception, including LARC. These findings may inform novel strategies for increased adolescent access to contraception and pregnancy prevention through use of nontraditional sites such as EDs. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Hormonal contraception and physiology: a research-based theory of discontinuation due to side effects.

Science.gov (United States)

Vitzthum, Virginia J; Ringheim, Karin

2005-03-01

Side effects influence the acceptability and continuation of hormonal contraceptives. Counseling the client about the management of side effects is a principal approach advocated for increasing continuation. Evidence of a biological basis for variation in women's tolerance of hormonal contraceptives argues, however, that greater attention should be given to altering the product rather than principally attempting to alter a woman's ability to deal with the product. Discontinuation rates for hormonal contraceptives, largely attributable to side effects and health concerns, are high in nearly all less-developed countries for which Demographic and Health Survey data are available. Oral contraceptives appear to be particularly problematic for Latin American women, most notably in Bolivia. Clinical trials suggest substantial variation in the physiological response to exogenous hormones, and new evidence confirms the hypothesis that the normal hormonal profiles of Bolivian women are significantly lower than those of women in the United States. These findings suggest a need for more population-specific physiological research linked to analyses of the possible association between endogenous hormone differences and contraceptive continuation. Appropriately adjusting the level of the steroid delivered may benefit women's health and improve the acceptability and continuation of hormonal contraceptives.

Influence of hormonal contraceptives and the occurrence of stroke: integrative review.

Science.gov (United States)

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

2017-01-01

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

Emergency contraception: different bioethical perspectives

Directory of Open Access Journals (Sweden)

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.

Male hormonal contraception: a double-blind, placebo-controlled study.

NARCIS (Netherlands)

Mommers, E.; Kersemaekers, W.M.; Elliesen, J.; Kepers, M.; Apter, D.; Behre, H.M.; Beynon, J.; Bouloux, P.M.; Costantino, A.; Gerbershagen, H.P.; Gronlund, L.; Heger-Mahn, D.; Huhtaniemi, I.; Koldewijn, E.L.; Lange, C.; Lindenberg, S.; Meriggiola, M.C.; Meuleman, E.J.H.; Mulders, P.F.A.; Nieschlag, E.; Perheentupa, A.; Solomon, A.; Vaisala, L.; Wu, F.C.; Zitzmann, M.

2008-01-01

BACKGROUND: This study was performed to assess spermatogenesis suppression and safety of a new combination of an etonogestrel (ENG) implant combined with testosterone undecanoate (TU) injections for male contraception. This is the first large placebo-controlled study for male hormonal contraception.

Do the emotional side-effects of hormonal contraceptives come from pharmacologic or psychological mechanisms?

Science.gov (United States)

Robinson, Stephen A; Dowell, Matt; Pedulla, Dominic; McCauley, Larry

2004-01-01

Hormonal preparations have become one of the most popular methods used for controlling fertility. The literature over the last 40 years continues to reveal how their numerous side effects negatively impact many users and even society at large. Three large cohort trials were the first to demonstrate, on a grand scale, certain emotional and behavioral associations with contraceptive use. Current contraceptive use was associated with an increase rate in depression, divorce, tranquilizer use, sexual dysfunction, and suicide and other violent and accidental deaths. Despite the advent of more "user friendly" contraceptives, the discontinuation rate secondary to side effects has changed little through the years. While in rare cases hormonal preparations can be deadly to the user, there is substantial evidence that their negative effect issues more from their emotional and behavioral properties. This paper reviews the results of over seven studies which further characterize these prominent associations, particularly with hormonal contraception, in an attempt to demonstrate their association with the intrinsic pharmacologic properties of hormonal preparations. Hormonal contraceptive users, in contrast with non users, were found to have higher rates of depression, anxiety, fatigue, neurotic symptoms, sexual disturbances, compulsion, anger, and negative menstrual effects. The question of whether the association of these maladies is directly due to the effect of taking exogenous hormones versus the psychological impact of the contraceptive behavior itself had yet to be studied. Seven small randomized-controlled trials were found in a review of the literature which studied this hypothesis in a direct way. They do not support the origination of these side effects being from the pharmacological properties of hormones. No association was found between hormone levels and emotional functioning in females. Psychiatric evaluations among IUD and oral contraceptive pill (OCP) users

Decreased susceptibility to false memories from misinformation in hormonal contraception users.

Science.gov (United States)

Petersen, Nicole; Patihis, Lawrence; Nielsen, Shawn E

2015-01-01

Sex hormones are increasingly implicated in memory formation. Recent literature has documented a relationship between hormones and emotional memory and sex differences, which are likely related to hormones, have long been demonstrated in a variety of mnemonic domains, including false memories. Hormonal contraception (HC), which alters sex hormones, has been associated with a bias towards gist memory and away from detailed memory in women who use it during an emotional memory task. Here, we investigated whether HC was associated with changes in susceptibility to false memories, which may be related to the formation of gist memories. We tested false memory susceptibility using two well-validated false memory paradigms: the Deese-Roediger-McDermott (DRM) task, and a story-based misinformation task. We found that hormonal contraceptive users were less susceptible to false memories compared to non-users in the misinformation task, and no differences were seen between groups on the DRM task. We hypothesise that the differences in false memories from the misinformation task may be related to hormonal contraceptive users' memory bias away from details, towards gist memory.

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 ...

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.

Comparative description of the use of modern methods of hormonal contraception for women with excessive body mass

Directory of Open Access Journals (Sweden)

I. B. Gridina

2016-04-01

Full Text Available Maintenance of reproductive health of women with excessive weight is the actual problem of nowadays and is an important direction of modern medicine. Aim. To analyze the efficiency and acceptability of oral, іntravaginal and transdermal hormonal contraceptives among women with excessive body mass. Methods and results. The tolerability and ease of use of different types of hormonal contraception have been studied in 72 women with excessive body mass to determine the reliability and acceptability of modern hormonal contraceptives. It has been investigated that the effectiveness of hormonal contraceptives according to our data is 100%, none patient was registered with an unwanted pregnancy. The total subjective evaluation of all hormonal contraceptives use were positive: 78.6% of women with excessive body mass who used oral contraceptives, were satisfied with the chosen contraceptive method, 81,8% – were satisfied with intravaginal method, 59,1% – transdermal contraceptive. Conclusions. It has been found that intravaginal contraceptive is most suitable as the drug of first choice for women with overweight compared with oral and transdermal hormonal methods of contraception. This suggests that women with excessive body mass can successfully use modern methods of hormonal contraception. But it is necessary to carry out clinical supervision, during which further clarification on the use of hormonal contraception in women with excessive body mass is possible.

Hormonal contraception usage is associated with altered memory for an emotional story.

Science.gov (United States)

Nielsen, Shawn E; Ertman, Nicole; Lakhani, Yasmeen S; Cahill, Larry

2011-09-01

Substantial evidence now documents sex-related influences on the neurobiology of emotional memory. Robust sex influences exist, for example, on the amygdala's role in emotional memory formation, as well as on retention of central information (gist) and detail for an emotional event. Evidence also suggests that the well-documented effects of stress hormones on memory depend upon sex hormone levels. Since hormonal contraception alters sex hormone levels, and must by extension alter sex/stress hormone interactions in memory, we examined whether the use of hormonal contraception also alters memory for an emotional story. Two groups of healthy female subjects--one naturally cycling, one using hormonal contraception--viewed either a brief, emotionally arousing story, or a closely matched, but more emotionally neutral story. Each subject's eye movements and pupil dilation changes were recorded as they viewed the story. Additionally, saliva samples were taken throughout the experimental session to examine salivary alpha-amylase, a biomarker for norepinephrine. A surprise free recall test one week later measured story memory in all subjects. Naturally cycling women exhibited enhanced memory of story details, but not of central information (gist), in the emotional compared with neutral story conditions. In contrast, women using hormonal contraception exhibited enhanced memory of gist, but not story details, in the emotional compared with neutral story conditions. Analysis of eye movements made while watching the stories indicated that the differences in memory could not be attributed either to a differential attention focus or to the degree of arousal induced by the stories in the two groups. These findings suggest that the use of hormonal contraception alters memory for an emotional event, perhaps by altering sex/stress hormone interactions in memory formation. They also suggest that further investigation of the mnemonic effects of these very widely used treatments is

Contraception and Hormones within Interaction Design

DEFF Research Database (Denmark)

Homewood, Sarah

2017-01-01

investigating the implications of the new form of contraception from an interaction design perspective before introducing my current research area; hormones within interaction design and describes how this research is relevant to the workshop Hacking Women’s Health. Finally, this paper describes my personal...

Assessment of dietary choices of young women in the contexts of hormonal contraceptives

Science.gov (United States)

Friedrich, Mariola; Junak, Magdalena

Metabolic changes caused by hormonal contraception combined with unbalanced diet may pose many threats, and deficiency or excess of nutrients may increase the risk of using such contraceptives. The purpose of the survey was to assess the dietary choices of young women using hormonal contraceptives, taking into account their general knowledge about the contraception and its impact on their bodies. The survey comprised 67 women aged from 18 to 25 years. In of three-day menus (201 daily food rations) of the women under research the content of energy and most of nutritious ingredients wandered away from recommended values in Poland. Each respondent additionally filled in a questionnaire concerning her: anthropometric data, education, place of residence; the type, name and time of taking contraceptives; purpose for using hormonal contraception along with its determinants; duration of use, breaks in contraceptive practice; occurrence of side effects during contraceptive use; stimulants used; physical activity, incidence of diarrhoea and vomiting, and dietary supplements use. The assessment of nutritional status of young women taking hormonal contraceptives has shown a number of nonconformities. The survey has revealed insufficient energy value of the menus, and incorrect proportions of basic nutrients, from recommended values, what was reflected in insufficient intake of vitamins (A, D, E, C, B1, B3, B6, and folates) and minerals (K, Ca, Mg, Fe). An excessive consumption of proteins, animal-based in particular, and insufficient consumption of lipids and carbohydrates, polysaccharides in particular, what resulted in insufficient consumption of dietary fibre. Nutritional choices of the respondents were typical to their gender and age, but were not adjusted to the use of hormonal contraceptives. Side effects observed by the respondents, mainly weight gain, may have been a summary result of improper eating behaviors that facilitated accumulation of body fat and water.

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.

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.

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.

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

Science.gov (United States)

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.

Hormonal contraceptive use and risk of glioma among younger women a nationwide case-control study

DEFF Research Database (Denmark)

Andersen, Lene; Friis, Søren; Hallas, Jesper

2015-01-01

AIM: Oral contraceptive use influences the risk for certain cancers; however, few studies have examined any link with risk of central nervous system tumors. We investigated the association between hormonal contraceptive use and glioma risk among premenopausal women in a population-based setting...... risk set sampling. Based on prescription data, exposure until 2 years prior to the index date was categorized according to hormonal contraceptive type, i.e., combined estrogen-progestagen or progestagen-only, and duration of use (... to compute odds ratios (ORs) with 95% confidence intervals (CIs) for glioma associated with hormonal contraceptive use, adjusting for potential confounders. RESULTS: We identified 317 cases and 2,126 controls. Ever use of hormonal contraceptive was associated with an OR of 1.5 (95% CI: 1...

Is there any association between hormonal contraceptives and cervical neoplasia in a poor Nigerian setting?

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Ajah LO

2015-07-01

Full Text Available Leonard Ogbonna Ajah,1,2 Chibuike Ogwuegbu Chigbu,2 Benjamin Chukwuma Ozumba,2 Theophilus Chimezie Oguanuo,2 Paul Olisaemeka Ezeonu1 1Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Nigeria; 2Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria Background: The association between hormonal contraception and cervical cancer is controversial. These controversies may hamper the uptake of hormonal contraceptives. Objective: To determine the association between hormonal contraceptives and cervical neoplasia. Materials and methods: This was a case-control study in which Pap-smear results of 156 participants on hormonal contraceptives were compared with those of 156 participants on no form of modern contraception. Modern contraception is defined as the use of such contraceptives as condoms, pills, injectables, intrauterine devices, implants, and female or male sterilization. Those found to have abnormal cervical smear cytology results were subjected further to colposcopy. Biopsy specimens for histology were collected from the participants with obvious cervical lesions or those with suspicious lesions on colposcopy. The results were analyzed with descriptive and inferential statistics at a 95% level of confidence. Results: A total of 71 (45.5%, 60 (38.5%, and 25 (16.0% of the participants on hormonal contraceptives were using oral contraceptives, injectable contraceptives, and implants, respectively. Cervical neoplasia was significantly more common among participants who were ≥35 years old (6% versus 1%, P<0.0001, rural dwellers (6% versus 3.5%, P<0.0001, unmarried (7.6% versus 3.5%, P<0.0001, unemployed (6.8% versus 3.5%, P<0.0001, less educated (6% versus 3.8%, P<0.0001, and had high parity (6.8% versus 3.6%, P<0.0001. There was no statistical significant difference in cervical neoplasia between the two groups of participants (7 [4.5%] versus 6 [3.8%], P=1.0. Conclusion

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.

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.

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 ...

Sex hormone-binding globulin as a marker for the thrombotic risk of hormonal contraceptives.

NARCIS (Netherlands)

Raps, M.; Helmerhorst, F.; Fleischer, K.; Thomassen, S.; Rosendaal, F.; Rosing, J.; Ballieux, B.; Vliet, H. van

2012-01-01

BACKGROUND: It takes many years to obtain reliable values for the risk of venous thrombosis of hormonal contraceptive users from clinical data. Measurement of activated protein C (APC) resistance via thrombin generation is a validated test for determining the thrombogenicity of hormonal

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.

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

Emergency Contraception: Do Your Patients Have a Plan B?

Science.gov (United States)

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.

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.

Emergency contraceptives bring a little peace of mind.

Science.gov (United States)

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.

A review of global access to emergency contraception.

Science.gov (United States)

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.

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

Directory of Open Access Journals (Sweden)

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.

Use of hormonal contraceptives among immigrant and native women in Norway: data from the Norwegian Prescription Database

Science.gov (United States)

Omland, G; Ruths, S; Diaz, E

2014-01-01

Objective To examine the use of hormonal contraceptives among immigrant and native women in Norway. Design Nationwide registry-based study based on merged data from the Norwegian Prescription Database, the Norwegian Population Registry, the Regular General Practitioner Database and the Medical Birth Registry. Setting Norway. Sample All women born abroad to two foreign-born parents (immigrants), or born in Norway to two Norwegian-born parents (natives) aged 16–45 years, who lived in Norway in 2008. Methods Data on all collected supplies of hormonal contraceptives in 2008 were merged with demographic, socio-economic and immigration data, information on any delivery and women's general practitioners. Main outcome measures User rates of hormonal contraception and predictors of contraceptive use. Results A total of 893 073 women were included, of whom 130 080 were immigrants. More native women (38%) used hormonal contraceptives compared with all immigrant groups (15–24%). The odds ratios for any use of hormonal contraceptives for immigrants compared with Norwegian-born women were; Nordic countries 0.53, South and Central America 0.53, Western countries 0.39, Asia 0.30, Eastern Europe 0.29, Africa 0.29. Work, education, long stay in Norway and young age of immigration predicted the use of hormonal contraceptives among immigrants. Conclusions The use of hormonal contraceptives varies between natives and immigrant groups. Further work is needed to ascertain whether these differences can be explained by higher desires for fertility, preferential use of non-hormonal contraceptives or other reasons identified through qualitative research. PMID:24931487

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.

Sexual life impact evaluation of different hormonal contraceptives on the basis of their methods of administration.

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Guida, Maurizio; Cibarelli, Francesca; Troisi, Jacopo; Gallo, Alessandra; Palumbo, Anna Rita; Di Spiezio Sardo, Attilio

2014-12-01

The aim of this study is to evaluate and compare sexual satisfaction with the use of three types of hormonal contraceptives. We have evaluated the sexological profile of 23 patients, treated with a subdermal hormonal contraceptive containing 68 mg etonogestrel. We have compared this profile to that of other two groups of previously studied patients: one consisting of 26 women treated with a vaginal ring releasing 120 µg/day of etonogestrel and 15 µg/day of ethinylestradiol (EE) and one consisting of 25 women treated with an oral contraceptive containing 20 µg of EE and 150 µg of desogestrel. A further group of 25 women, not in treatment with any type of hormonal contraceptive, has been studied as control group. The Interviewer Rating of Sexual Function (IRSF) has been completed by the patients at the beginning of the study and after cycles of 3 and 6 months of contraceptive usage. All three types of hormonal contraceptives have increased positive indicators of patients' sexual life (sexual interest and fantasies, of orgasm number and intensity and satisfaction) and decreased negative ones (anxiousness, discomfort). Subdermal contraception is slower than both intravaginal and oral hormonal contraceptives in giving these effects, but is more effective after a cycle of 6 months of usage.

Male hormonal contraception: concept proven, product in sight?

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Matthiesson, Kati L; McLachlan, Robert I

2006-01-01

Current male hormonal contraceptive (MHC) regimens act at various levels within the hypothalamic pituitary testicular axis, principally to induce the withdrawal of the pituitary gonadotrophins and in turn intratesticular androgen production and spermatogenesis. Azoospermia or severe oligozoospermia result from the inhibition of spermatogonial maturation and sperm release (spermiation). All regimens include an androgen to maintain virilization, while in many the suppression of gonadotrophins/spermatogenesis is augmented by the addition of another anti-gonadotrophic agent (progestin, GnRH antagonist). The suppression of sperm concentration to 1 x 10(6)/ml appears to provide comparable contraceptive efficacy to female hormonal methods, but the confidence intervals around these estimates remain relatively large, reflecting the limited number of exposure years reported. Also, inconsistencies in the rapidity and depth of spermatogenic suppression, potential for secondary escape of sperm into the ejaculate and onset of fertility return not readily explainable by analysis of subject serum hormone levels, germ cell number or intratesticular steroidogenesis, are apparent. As such, a better understanding of the endocrine and genetic regulation of spermatogenesis is necessary and may allow for new treatment paradigms. The development of an effective, consumer-friendly male contraceptive remains challenging, as it requires strong translational cooperation not only between basic scientists and clinicians but also between public and private sectors. At present, a prototype MHC product using a long-acting injectable testosterone and depot progestin is well advanced.

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

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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

Hormonal contraception in women with polycystic ovary syndrome: choices, challenges, and noncontraceptive benefits.

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de Melo, Anderson Sanches; Dos Reis, Rosana Maria; Ferriani, Rui Alberto; Vieira, Carolina Sales

2017-01-01

Polycystic ovary syndrome (PCOS) is an endocrine disorder among women of reproductive age characterized by chronic anovulation and polycystic ovary morphology and/or hyperandrogenism. Management of clinical manifestations of PCOS, such as menstrual irregularities and hyperandrogenism symptoms, includes lifestyle changes and combined hormonal contraceptives (CHCs). CHCs contain estrogen that exerts antiandrogenic properties by triggering the hepatic synthesis of sex hormone-binding globulin that reduces the free testosterone levels. Moreover, the progestogen present in CHCs and in progestogen-only contraceptives suppresses luteinizing hormone secretion. In addition, some types of progestogens directly antagonize the effects of androgens on their receptor and also reduce the activity of the 5α reductase enzyme. However, PCOS is related to clinical and metabolic comorbidities that may limit the prescription of CHCs. Clinicians should be aware of risk factors, such as age, smoking, obesity, diabetes, systemic arterial hypertension, dyslipidemia, and a personal or family history, of a venous thromboembolic event or thrombophilia. This article reports a narrative review of the available evidence of the safety of hormonal contraceptives in women with PCOS. Considerations are made for the possible impact of hormonal contraceptives on endocrine, metabolic, and cardiovascular health.

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)

Hormone Use for Therapeutic Amenorrhea and Contraception During Hematopoietic Cell Transplantation

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Chang, Katherine; Merideth, Melissa A.; Stratton, Pamela

2015-01-01

There is a growing population of women who have or will undergo hematopoietic stem cell transplant for a variety of malignant and benign conditions. Gynecologists play an important role in addressing the gynecologic and reproductive health concerns for these women throughout the transplant process. As women undergo cell transplantation, they should avoid becoming pregnant and are at risk of uterine bleeding. Thus, counseling about and implementing hormonal treatments such as gonadotropin-releasing hormone agonists, combined hormonal contraceptives, and progestin-only methods help to achieve therapeutic amenorrhea and can serve as contraception during the peritransplant period. In this commentary, we summarize the timing, risks and benefits of the hormonal options just prior, during and for the year after hematopoietic stem cell transplantation. PMID:26348182

Male contraception

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Mathew, Vivek; Bantwal, Ganapathi

2012-01-01

Contraception is an accepted route for the control of population explosion in the world. Traditionally hormonal contraceptive methods have focused on women. Male contraception by means of hormonal and non hormonal methods is an attractive alternative. Hormonal methods of contraception using testosterone have shown good results. Non hormonal reversible methods of male contraception like reversible inhibition of sperm under guidanceare very promising. In this article we have reviewed the curren...

Hormonal contraceptives and cerebral venous thrombosis risk: A systematic review and meta-analysis

Directory of Open Access Journals (Sweden)

Farnaz eAmoozegar

2015-02-01

Full Text Available Objectives: Use of oral contraceptive pills (OCP has previously been shown to increase the risk of cerebral venous sinus thrombosis (CVST. Whether this risk varies by type of OCP use, duration of use and other forms of hormonal contraceptives is largely unknown. This systematic review and meta-analysis updates the current state of knowledge on these issues.Methods: We performed a search to identify all published studies on the association between hormonal contraceptive use and risk of CVST in women aged 15-50, using MEDLINE, EMBASE, Cochrane systematic review, the Cochrane Center for Clinical Trials and CINAHL. Risk of CVST was estimated using random effects models. Stratification and meta-regression were used to assess heterogeneity. Results: Of 861 studies reviewed for eligibility, quality, and data extraction, 11 were included in the final systematic review. The pooled odds of developing CVST in women of reproductive age taking oral contraceptives was over 7 times higher compared to women not taking oral contraceptives (OR=7.59, 95% CI 3.82 – 15.09. There is some indication that third generation OCPs may confer a higher risk of CVST than second generation OCPs, but this remains controversial. Data is insufficient to make any conclusions about duration of use and other forms of hormonal contraceptives and risk of CVST. Conclusions: OCP use increases the risk of developing CVST in women of reproductive age. Better studies are needed to determine if duration and type of hormonal contraceptive use modifies this risk.

Hormonal contraception in women with polycystic ovary syndrome: choices, challenges, and noncontraceptive benefits

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de Melo AS

2017-02-01

Full Text Available Anderson Sanches de Melo, Rosana Maria dos Reis, Rui Alberto Ferriani, Carolina Sales Vieira Department of Gynecology and Obstetrics, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil Abstract: Polycystic ovary syndrome (PCOS is an endocrine disorder among women of reproductive age characterized by chronic anovulation and polycystic ovary morphology and/or hyperandrogenism. Management of clinical manifestations of PCOS, such as menstrual irregularities and hyperandrogenism symptoms, includes lifestyle changes and combined hormonal contraceptives (CHCs. CHCs contain estrogen that exerts antiandrogenic ­properties by triggering the hepatic synthesis of sex hormone-binding globulin that reduces the free testosterone levels. Moreover, the progestogen present in CHCs and in progestogen-only ­contraceptives suppresses luteinizing hormone secretion. In addition, some types of progestogens directly antagonize the effects of androgens on their receptor and also reduce the activity of the 5α reductase enzyme. However, PCOS is related to clinical and metabolic comorbidities that may limit the prescription of CHCs. Clinicians should be aware of risk factors, such as age, smoking, obesity, diabetes, systemic arterial hypertension, dyslipidemia, and a personal or family history, of a venous thromboembolic event or thrombophilia. This article reports a narrative review of the available evidence of the safety of hormonal contraceptives in women with PCOS. Considerations are made for the possible impact of hormonal contraceptives on endocrine, metabolic, and cardiovascular health. Keywords: polycystic ovary syndrome, hormonal contraceptive, lipid metabolism, carbohydrate metabolism, hyperandrogenism, thrombosis

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.

Emergency contraception – a neglected option for birth control

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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

The fox and the grapes: an Anglo-Irish perspective on conscientious objection to the supply of emergency hormonal contraception without prescription.

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Gallagher, Cathal T; Holton, Alice; McDonald, Lisa J; Gallagher, Paul J

2013-10-01

Emergency hormonal contraception (EHC) has been available from pharmacies in the UK without prescription for 11 years. In the Republic of Ireland this service was made available in 2011. In both jurisdictions the respective regulators have included 'conscience clauses', which allow pharmacists to opt out of providing EHC on religious or moral grounds providing certain criteria are met. In effect, conscientious objectors must refer patients to other providers who are willing to supply these medicines. Inclusion of such clauses leads to a cycle of cognitive dissonance on behalf of both parties. Objectors convince themselves of the existence of a moral difference between supply of EHC and referral to another supplier, while the regulators must feign satisfaction that a form of regulation lacking universality will not lead to adverse consequences in the long term. We contend that whichever of these two parties truly believes in that which they purport to must act to end this unsatisfactory status quo. Either the regulators must compel all pharmacists to dispense emergency contraception to all suitable patients who request it, or a pharmacist must refuse either to supply EHC or to refer the patient to an alternative supplier and challenge any subsequent sanctions imposed by their regulator.

Hormonal contraceptive congruency : Implications for relationship jealousy

NARCIS (Netherlands)

Cobey, Kelly D.; Roberts, S. Craig; Buunk, Abraham P.

Research shows that women who use hormonal contraceptives (HCs) differ in their mate preferences from women who have regular cycles. It has been proposed that when a partnered woman either begins to use or ceases to use HCs, she may experience changes in her relationship since her preferences become

Hormonal contraception and HPV: a tale of differing and overlapping mechanisms

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Marks MA

2011-11-01

Full Text Available Morgan A Marks1, Sabra L Klein2,3, Patti E Gravitt1,21Department of Epidemiology, 2W Harry Feinstone Department of Molecular Microbiology and Immunology, 3Department of Biochemistry and Molecular Biology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USAAbstract: Hormonal contraceptive use is an identified co-factor that modifies cervical cancer risk. The mechanisms by which sex steroid hormones affect the multi-stage natural history of human papillomavirus (HPV infection and cervical carcinogenesis are still unclear, with no consistent evidence in support of a single biological hypothesis. Understanding the means by which hormonal contraception affects HPV infection and cervical cancer risk may provide critical information to guide future secondary interventions for cancer prevention.Keywords: hormones, human papillomavirus, cervical cancer

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.

Incidence of ovarian endometrioma among women with peritoneal endometriosis with and without a history of hormonal contraceptive use.

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Kavoussi, Shahryar K; Odenwald, Kate C; As-Sanie, Sawsan; Lebovic, Dan I

2017-08-01

To determine if, among women with peritoneal endometriosis, the incidence of ovarian endometrioma at first laparoscopy differs between those with and without a history of hormonal contraceptive use. Retrospective case-control study of women who were patients at a fertility center and had first laparoscopy from 2009 through 2015 showing, at minimum, evidence of peritoneal endometriosis (n=136). Chart review was conducted for history of prior birth control use as well as operative and pathology notes of surgeries. Study subjects were grouped as follows: women with peritoneal endometriosis diagnosed by laparoscopy who had a history of hormonal contraceptive use (n=93) and women with peritoneal endometriosis diagnosed by laparoscopy who had never used hormonal contraceptives (n=43). The main outcome measure was the incidence of ovarian endometrioma among women with peritoneal endometriosis who had a history of hormonal contraceptive use as compared to women with peritoneal endometriosis who had a history of no hormonal contraceptive use. Among women with peritoneal endometriosis who had a history of hormonal contraceptive use, 17/93 (18.3%) were found to have endometriomas. Among women with peritoneal endometriosis who had a history of no hormonal contraceptive use, 21/43 (48.8%) were found to have endometriomas. The chi-square statistic was 13.6 (P-valueendometriosis, those with a history of hormonal contraceptive use had a lower incidence of ovarian endometrioma than those with a history of no hormonal contraceptive use. Possible mechanisms of action include reducing the risk of a corpus luteum formation and subsequent transformation into an ovarian endometrioma or reducing the risk of ectopic endometrium implantation into the ovary via the diminution of retrograde menstruation. Although larger, prospective studies are needed, the findings of this study suggest that the use of hormonal contraception may decrease the likelihood of ovarian endometrioma formation among

[Combined hormonal contraception in cycles artificially extended].

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

2010-01-01

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

Cost-effectiveness of emergency contraception options over 1 year.

Science.gov (United States)

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

Canadian Contraception Consensus (Part 1 of 4).

Science.gov (United States)

Black, Amanda; Guilbert, Edith; Costescu, Dustin; Dunn, Sheila; Fisher, William; Kives, Sari; Mirosh, Melissa; Norman, Wendy V; Pymar, Helen; Reid, Robert; Roy, Geneviève; Varto, Hannah; Waddington, Ashley; Wagner, Marie-Soleil; Whelan, Anne Marie; Ferguson, Carrie; Fortin, Claude; Kielly, Maria; Mansouri, Shireen; Todd, Nicole

2015-10-01

To provide guidelines for health care providers on the use of contraceptive methods to prevent pregnancy and on the promotion of healthy sexuality. Guidance for Canadian practitioners on overall effectiveness, mechanism of action, indications, contraindications, non-contraceptive benefits, side effects and risks, and initiation of cited contraceptive methods; family planning in the context of sexual health and general well-being; contraceptive counselling methods; and access to, and availability of, cited contraceptive methods in Canada. Published literature was retrieved through searches of Medline and The Cochrane Database from January 1994 to January 2015 using appropriate controlled vocabulary (e.g., contraception, sexuality, sexual health) and key words (e.g., contraception, family planning, hormonal contraception, emergency contraception). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies published in English from January 1994 to January 2015. Searches were updated on a regular basis and incorporated in the guideline to June 2015. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of the evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table). Chapter 1: Contraception in Canada Summary Statements 1. Canadian women spend a significant portion of their lives at risk of an unintended pregnancy. (II-2) 2. Effective contraceptive methods are underutilized in Canada, particularly among vulnerable populations. (II-2) 3. Long-acting reversible contraceptive methods, including contraceptive implants and intrauterine contraception (copper-releasing and levonorgestrel

Canadian Contraception Consensus (Part 2 of 4).

Science.gov (United States)

Black, Amanda; Guilbert, Edith; Costescu, Dustin; Dunn, Sheila; Fisher, William; Kives, Sari; Mirosh, Melissa; Norman, Wendy V; Pymar, Helen; Reid, Robert; Roy, Geneviève; Varto, Hannah; Waddington, Ashley; Wagner, Marie-Soleil; Whelan, Anne Marie; Ferguson, Carrie; Fortin, Claude; Kielly, Maria; Mansouri, Shireen; Todd, Nicole

2015-11-01

To provide guidelines for health care providers on the use of contraceptive methods to prevent pregnancy and on the promotion of healthy sexuality. Guidance for Canadian practitioners on overall effectiveness, mechanism of action, indications, contraindications, non-contraceptive benefits, side effects and risks, and initiation of cited contraceptive methods; family planning in the context of sexual health and general well-being; contraceptive counselling methods; and access to, and availability of, cited contraceptive methods in Canada. Published literature was retrieved through searches of Medline and The Cochrane Database from January 1994 to January 2015 using appropriate controlled vocabulary (e.g., contraception, sexuality, sexual health) and key words (e.g., contraception, family planning, hormonal contraception, emergency contraception). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies published in English from January 1994 to January 2015. Searches were updated on a regular basis and incorporated in the guideline to June 2015. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of the evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table). Chapter 1: Contraception in Canada Summary Statements  1. Canadian women spend a significant portion of their lives at risk of an unintended pregnancy. (II-2)  2. Effective contraceptive methods are underutilized in Canada, particularly among vulnerable populations. (II-2)  3. Long-acting reversible contraceptive methods, including contraceptive implants and intrauterine contraception (copper-releasing and levonorgestrel

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.

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 ...

The impact of genetics and hormonal contraceptives on the steroid profile in female athletes

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Jenny Erkander Mullen

2014-04-01

Full Text Available The steroid module of the Athlete Biological Passport (ABP, the newest innovation in doping testing, is currently being finalized for implementation. Several factors, other than doping, can affect the longitudinal steroid profile. In this study we investigated the effect of hormonal contraceptives as well as the effect of three polymorphisms on female steroid profiles in relation to doping controls.The study population consisted of 79 female elite athletes between the ages of 18 to 45. Hormonal contraceptives were used by 32 % of the subjects. A full urinary steroid profile was obtained using World Anti-Doping Agency accredited methods. In addition all subjects were genotyped for copy number variation of UGT2B17 and SNPs in UGT2B7 and CYP17.Subjects using hormonal contraceptives excreted 40 % less epitestosterone as compared to non-users (p = 0.005 but showed no difference in testosterone excretion. When removing individuals homozygous for the deletion in UGT2B17, the testosterone to epitestosterone (T/E ratio was 29 % higher in the hormonal contraceptives group (p = 0.016. In agreement with previous findings in men, copy number variation of UGT2B17 had significant effect on female urinary testosterone excretion and therefore also the T/E ratio. Subjects homozygous for the T allele of CYP17 showed a lower urinary epitestosterone concentration than the other CYP17 genotypes. It is of great importance that the athlete’s steroidal passport can compensate for all possible normal variability in steroid profiles from women. Therefore, considering the large impact of hormonal contraceptives on female steroid profiles, we suggest that the use of hormonal contraceptives should be a mandatory question on the doping control form.

University Students Seeking Hormonal Emergency Contraception: Why Do They Not Want Pregnancy Now? When is it Suitable to Have Children?

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Aira Virtala

2004-01-01

Full Text Available University students who sought hormonal emergency contraception (EC in the Tampere Student Health Station during the period 1.9.2000-31.12.2001 received a questionnaire on their use of it. Of the total, 114 responded (67%. The aim of this study was to ascertain why the respondents did not want to get pregnant now and when it would be suitable for them to get children. Free answers to these questions were analysed using a collective consensus method. The main reasons for not wanting pregnancy now were un? nished studies and the non-steady character of the relationship. Almost all planned to become pregnant some day in the future when their life situation was appropriate, usually at the age of about 30 years.

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.

Pre-exposure prophylaxis for HIV-1 prevention does not diminish the pregnancy prevention effectiveness of hormonal contraception.

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Murnane, Pamela M; Heffron, Renee; Ronald, Allan; Bukusi, Elizabeth A; Donnell, Deborah; Mugo, Nelly R; Were, Edwin; Mujugira, Andrew; Kiarie, James; Celum, Connie; Baeten, Jared M

2014-07-31

For women at risk of HIV-1, effective contraception and effective HIV-1 prevention are global priorities. In a clinical trial of pre-exposure prophylaxis (PrEP) for HIV-1 prevention in HIV-1-serodiscordant couples, we estimated the effectiveness of hormonal contraceptives (oral contraceptive pills, injectable depot medroxyprogesterone acetate, and hormonal implants) for pregnancy prevention relative to no contraception among 1785 HIV-1-uninfected women followed up to 36 months. We compared the effectiveness of each method among women assigned PrEP versus placebo. Contraception was not required for participation, but was offered on-site and was recorded monthly; incident pregnancy was determined by monthly urine testing. For women using no contraception, overall pregnancy incidence was 15.4% per year. Women reporting oral contraceptive use had comparable pregnancy incidence to women using no contraception, and this lack of contraceptive effectiveness was similar for those assigned PrEP and placebo (17.7 and 10.0% incidence per year, respectively; P-value for difference in effect by PrEP use = 0.24). Women reporting injectable contraception had reduced pregnancy incidence compared to those reporting no contraception, which did not differ by arm (PrEP 5.1%, placebo 5.3% per year; P-value for difference = 0.47). Contraceptive effectiveness was highest among women using implants (pregnancy incidence <1% per year in both arms). PrEP had no adverse impact on hormonal contraceptive effectiveness for pregnancy prevention. As seen previously in similar populations, women reporting contraceptive pill use had little protection from pregnancy, possibly due to poor adherence. Injectable or implantable hormonal contraception and PrEP provide effective prevention for pregnancy and HIV-1.

The safety of hormonal contraceptives for women living with HIV and their sexual partners.

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Phillips, Sharon J; Polis, Chelsea B; Curtis, Kathryn M

2016-01-01

Hormonal contraceptives are important for the health and well-being of some women living with HIV, so evaluation of evidence regarding their safety vis-à-vis HIV-related risks is important. We updated two prior systematic reviews on the impact of hormonal contraception (HC) on HIV disease progression and female-to-male HIV transmission. One new study finds no increased risk for HIV disease progression or death associated with oral contraceptive use [adjusted (adj) hazard ratio (HR) 0.83, confidence interval [CI] 0.48-1.44] or injectables (adj HR 0.72, CI 0.53-0.98). Three new studies did not find significantly increased risks for measures of female-to-male HIV transmission with HC use. Hormonal contraceptive methods do not appear to accelerate HIV disease progression. More research is needed to clarify whether HC impacts HIV transmissibility. Copyright © 2016. Published by Elsevier Inc.

Unmarried Mother's Knowledge and Attitudes toward Emergency Contraceptive Pills

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Gyeong Mi Lee

2013-06-01

Full Text Available PurposeThis study was conducted to identify relationships among knowledge and attitudes of unmarried mothers toward emergency contraceptive pills.MethodsData were collected through structured questionnaires from 135 unmarried mothers enrolled in 7 single mothers' facilities nationwide. Data were analyzed using the SPSS/WIN 17.0 program for descriptive statistics, t-test, ANOVA, Scheffe-test, and Pearson correlation coefficients.ResultsFor knowledge about emergency contraceptive pills, there were significant differences among who live with her before pregnancy, experience of past pregnancies, state of present pregnancy and preparation in using contraceptives. For attitude toward emergency contraceptive pills, there were significant differences according to age, education level and religion. There were significant positive relationships between knowledge and attitudes toward emergency contraceptive pills.ConclusionThe results of this study suggest that unmarried women should be better informed about emergency contraceptive pills, and reassured about their safety. Efforts are needed to disseminate up-to-date information to experts in sex education including nurses.

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

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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…

Search for an Emergency Contraception Provider in the United States

Science.gov (United States)

... 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 ...

Gravidez ectópica após uso de contracepção de emergência: relato de caso Ectopic pregnancy after use of hormonal emergency contraception: a case report

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Renato Monteiro Zucchi

2004-10-01

Full Text Available Gravidez ectópica é a implantação e o desenvolvimento do ovo fora da cavidade uterina; impõe diagnóstico precoce e assistência de urgência. Gravidez ectópica com corpo lúteo contralateral presume ocorrência de transmigração do zigoto para a tuba uterina do lado oposto, o que pode ser responsável pela sua ocorrência. Em 1994, o levonorgestrel teve sua eficácia comprovada como superior à dos outros métodos para contracepção de emergência. É relatado caso de paciente de 27 anos que apresentou gravidez ectópica, de localização tubária, com corpo lúteo contralateral, após uso de contracepção de emergência por falha do método anticoncepcional de escolha (preservativo masculino. Foi realizado tratamento cirúrgico conservador por videolaparoscopia, com boa evolução após a cirurgia.Ectopic pregnancy is the implantation and development of the ovum outside the uterine cavity; it needs a quick diagnosis and an urgent treatment. The presence of the corpus luteum in the ovary that is contralateral to the ectopic pregnancy is presumptive evidence for ovum transmigration, which may be the cause of ectopic pregnancy. In 1994, a multinational clinical trial proved the superiority of levonorgestrel over the existing emergency contraceptive products. In the present study, we describe the case of a 27-year-old woman with ectopic pregnancy and a contralateral corpus luteum after use of hormonal emergency contraception (levonorgestrel, because of failure of the used contraception method (condom. The patient was treated with laparoscopic surgery that was successful.

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.

Vulvo-vaginal candidosis in a cohort of hormonal contraceptive ...

African Journals Online (AJOL)

Results: There were 116 women using hormonal contraceptive methods who ... HIV (12.1%), trichomoniasis (10.3%), chlamydia cervicitis (7.8%), syphilis (5.2%), ... Younger age of sexual debut influenced the decision of selecting various ...

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

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Kazi Yasmeen

2012-08-01

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

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.

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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.

Investigational hormone receptor agonists as ongoing female contraception: a focus on selective progesterone receptor modulators in early clinical development.

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Nelson, Anita L

2015-01-01

As efforts are made to continue to increase the safety of contraceptive methods, those without estrogen have attracted new attention. Progestin-only options are available in many delivery systems, but most cause disturbed bleeding patterns. For gynecologic patients, selective progesterone receptor modulators (SPRMs) have been approved for medical abortion, for ovulation suppression in emergency contraception, and for the treatment of heavy menstrual bleeding due to leiomyoma. This article discusses the role of SPRMs in controlling fertility on an ongoing basis with particular emphasis on mifepristone and ulipristal acetate (UPA), since none of the other compounds has progressed out of early Phase I - II testing. It also discusses important information about the mechanisms of action and safety of these two SPRMs. Of all the investigational hormone agonist/antagonists, SPRMs have demonstrated the greatest potential as ongoing female contraceptives. They have the ability to suppress ovulation after initiation of the luteinizing hormone (LH) surge without affecting ovarian production of estrogen or inducing any significant metabolic changes. SPRMs may well be able to provide longer term contraception as oral agents, vaginal rings, and perhaps even intrauterine devices. UPA has the greatest promise. Current research needs to be expanded.

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

Breast Cancer Risk Analysis by the Use of Hormonal Contraceptives and Age of Menarche

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Gusti Ayu Triara Dewi

2016-01-01

Full Text Available The number of cases of breast cancer is increasing every year and it’s a serious health problem in the world, including in Indonesia. Breast cancer is type of cancer that is most dominant in Indonesia. High estrogen exposure is one of factor that can increase the risk of breast cancer in women. This study was conducted to determine the relationship of estrogen exposure through the use of hormonal contraceptives and age of menarche with breast cancer incidence in women. Type of this study is observational analytic and use case control design. All of women breast cancer patients of Dr. Soetomo Hospital in 2013 were the population of case. All of woman non breast cancer patients who done breast examination at Dr Soetomo Hospital in 2013 were the population of control. The number of respondents in this study were 90 respondents were drawn from population using simple random sampling method. The variables studied were the use of hormonal contraceptives and age of menarche. The results of the analysis used binary logistic regression (α = 5% indicated that the use of hormonal contraceptives (p = 0,028; OR = 3,266 and age of menarche (p =0,031; OR = 3,492 has an significant correlation with incidence of breast cancer in women at Dr. Soetomo Hospital in 2013. It is expected that the community can be more accurate in determining the duration of hormonal contraception usage and avoid lifestyle can accelerate the occurrence of menarche. Keywords: breast cancer, risk factor, hormonal contraceptives, age of menarche, estrogen

The conscientious objection: debate on emergency contraception.

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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.

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

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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.

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)

Mechanistic and "natural" body metaphors and their effects on attitudes to hormonal contraception.

Science.gov (United States)

Walker, Susan

2012-01-01

A small, self-selected convenience sample of male and female contraceptive users in the United Kingdom (n = 34) were interviewed between 2006 and 2008 concerning their feelings about the body and their contraceptive attitudes and experiences. The interviewees were a sub-sample of respondents (n = 188) who completed a paper-based questionnaire on similar topics, who were recruited through a poster placed in a family planning clinic, web-based advertisements on workplace and university websites, and through direct approaches to social groups. The bodily metaphors used when discussing contraception were analyzed using an interpretative phenomenological analytical approach facilitated by Atlas.ti software. The dominant bodily metaphor was mechanistic (i.e.,"body as machine"). A subordinate but influential bodily metaphor was the "natural" body, which had connotations of connection to nature and a quasi-sacred bodily order. Interviewees drew upon this "natural" metaphorical image in the context of discussing their anxieties about hormonal contraception. Drawing upon a "natural," non-mechanistic body image in the context of contraceptive decision-making contributed to reluctance to use a hormonal form of contraception. This research suggests that clinicians could improve communication and advice about contraception by recognizing that some users may draw upon non-mechanistic body imagery.

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.

Acceptability of a transdermal gel-based male hormonal contraceptive in a randomized controlled trial☆, ☆☆, ★

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Roth, Mara Y.; Shih, Grace; Ilani, Niloufar; Wang, Christina; Page, Stephanie T.; Bremner, William J.; Swerdloff, Ronald S.; Sitruk-Ware, Regine; Blithe, Diana L.; Amory, John K.

2014-01-01

Objective Fifty percent of pregnancies in the United States are unintended despite numerous contraceptive methods available to women. The only male contraceptive methods, vasectomy and condoms, are used by 10% and 16% of couples, respectively. Prior studies have shown efficacy of male hormonal contraceptives in development, but few have evaluated patient acceptability and potential use if commercially available. The objective of this study is to determine if a transdermal gel-based male hormonal contraceptive regimen, containing testosterone and Nestorone® gels, would be acceptable to study participants as a primary contraceptive method. Study Design As part of a three-arm, 6-month, double-blind, randomized controlled trial of testosterone and nestorone gels at two academic medical centers, subjects completed a questionnaire to assess the acceptability of the regimen. Of the 99 men randomized, 79 provided data for analysis. Results Overall, 56% (44/79) of men were satisfied or extremely satisfied with this gel-based method of contraception, and 51% (40/79) reported that they would recommend this method to others. One third of subjects (26/79) reported that they would use this as their primary method of contraception if it were commercially available today. However, men with concerns about sexually transmitted disease were significantly less satisfied than men without such concerns (p=0.03). Conclusions A majority of the men who volunteered to participate in this trial of an experimental male hormonal contraceptive were satisfied with this transdermal male hormonal contraceptive. If commercially available, a combination of topical nesterone and testosterone gels could provide a reversible, effective method of contraception that is appealing to men. Implications A substantial portion of men report they would use this transdermal male contraceptive regimen if commercially available. This method would provide a novel, reversible method of contraception for men, whose

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.

'Stratified Contraception': Emergency Contraceptive Pills and Women's Differential Experiences in Contemporary India.

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Sheoran, Nayantara

2015-01-01

Available without prescriptions in India since 2005, emergency contraceptive pills (ECPs) and their advertisements have provided women with increased contraceptive options and a vocabulary to talk about their reproductive lives. I draw on long-term fieldwork with women in urban India about ECPs, demonstrating a new form of 'stratified contraception' enabled by these pills and their advertisements. I posit that there are within India spaces that replicate the luxuries and privileges of the global North. These material conditions, I suggest, are replicated when it comes to contraception as there are hubs of women consumers of contraception and contraceptive advertising that participate in an 'imagined cosmopolitanism' within the global South in close proximity to 'contraceptive ghettos.' Moving beyond simplistic binaries, I outline three major stratifications along which women experience this medical technology and outline the implications for women and their contraceptive choices when notions of northern privilege exist in the 'South.'

Combined hormonal contraception and risk of venous thromboembolism within the first year following pregnancy

DEFF Research Database (Denmark)

Petersen, Jesper Friis; Bergholt, T; Nielsen, A. K.

2014-01-01

Estimating the risk of venous thromboembolism (VTE) associated with combined hormonal contraceptives following early terminated pregnancies or birth, a Danish nationwide retrospective cohort observing a one-year follow-up was defined using three unique registries. All Danish women with confirmed...... pregnancies aged 15-49 during the period of 1995-2009 were included. The main outcomes were relative and absolute risks of first time venous thromboembolism in users as well as non-users of combined hormonal contraceptives. In 985,569 person-years, 598 venous thromboembolisms were recorded. After early...... terminated pregnancies and births, respectively, 113 and 485 events occurred in 212,552 and 773,017 person-years. After early terminated pregnancies, the crude VTE incidence ratios were similar, and the numbers needed to harm were equal between groups that did or did not use combined hormonal contraceptives...

Contraception Initiation in the Emergency Department: A Pilot Study on Providers' Knowledge, Attitudes, and Practices.

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Liles, Iyanna; Haddad, Lisa B; Lathrop, Eva; Hankin, Abigail

2016-05-01

Almost half of all pregnancies in the United States are unintended; these pregnancies are associated with adverse outcomes. Many reproductive-age females seek care in the emergency department (ED), are at risk of pregnancy, and are amenable to contraceptive services in this setting. Through a pilot study, we sought to assess ED providers' current practices; attitudes; and knowledge of emergency contraception (EC) and nonemergency contraception (non-EC), as well as barriers with respect to contraception initiation. ED physicians and associate providers in Georgia were e-mailed a link to an anonymous Internet questionnaire using state professional databases and contacts. The questionnaire included Likert scales with multiple-choice questions to assess study objectives. Descriptive statistics were generated as well as univariate analyses using χ(2) and Fisher exact tests. A total of 1232 providers were e-mailed, with 119 questionnaires completed. Participants were predominantly physicians (80%), men (59%), and individuals younger than 45 years (59%). Common practices were referrals (96%), EC prescriptions (77%), and non-EC prescriptions (40%). Common barriers were perceived as low likelihood for follow-up (63%), risk of complications (58%), and adverse effects (51%). More than 70% of participants correctly identified the highly effective contraceptive methods, 3% identified the correct maximum EC initiation time, and 42% correctly recognized pregnancy as a higher risk than hormonal contraception use for pulmonary embolism. Most ED providers in this pilot study referred patients for contraception; however, there was no universal contraceptive counseling and management. Many ED providers in this study had an incorrect understanding of the efficacy, risks, and eligibility associated with contraceptive methods. This lack of understanding may affect patient access and be a barrier to patient care.

Contracepção hormonal e anti-retrovirais em mulheres infectadas pelo HIV Hormonal contraception and antiretroviral therapy among HIV-infected women

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Eliana Amaral

2006-11-01

Full Text Available Há controvérsia sobre a relação entre o uso de contraceptivos hormonais e o risco de adquirir o vírus da imunodeficiência humana (HIV, e pouco se sabe sobre os efeitos da contracepção hormonal em mulheres infectadas (efeitos colaterais, distúrbios menstruais, progressão da doença, interações com terapias anti-retrovirais. O objetivo deste artigo foi revisar os dados disponíveis quanto à vulnerabilidade ao HIV e à sua transmissibilidade na vigência do uso de contraceptivos hormonais bem como as conseqüências potenciais do uso desses contraceptivos por mulheres HIV-positivas sob terapia anti-retroviral (TARV, com ênfase nas interações medicamentosas. Concluiu-se que ainda não é possível elaborar recomendações, baseadas em evidências, sobre a contracepção hormonal em mulheres portadoras do HIV sob TARV. Assim, os infectologistas e os ginecologistas devem estar atentos às interações potenciais que possam representar aumento de efeitos adversos, individualizando a orientação sobre os esteróides contraceptivos, suas doses e vias de administração, considerando a TARV em uso.There is much controversy regarding the realtionship between the use of hormonal contraceptives and the risk of acquiring human immunodeficiency virus (HIV, and little is known about the effects of hormonal contraception in HIV-infected women (adverse events, menstrual disorders, disease progression, antiretroviral therapy interactions. The aim of the present study was to review available data regarding HIV vulnerability and transmission associated with hormonal contraceptives and the use of these contraceptives by women on antiretroviral therapy, with emphasis on drug interactions. In conclusion, it was not possible to offer evidence-based recommendations for the use of hormonal contraceptives among HIV-infected women under antiretroviral therapy. Infectious disease specialists and gynecologists providing care should be cautious about potential

Knowledge, attitude and practice of emergency contraceptives ...

African Journals Online (AJOL)

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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.

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.

Developments in contraception.

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Weisberg, Edith

2014-02-01

Although the contraceptive options for women have expanded considerably in the last decade, these methods are often not being offered to women as choices because clinicians are not well informed, limiting the ability of women to control their fertility. Areas covered include the use of oestradiol instead of ethinyl oestradiol and improved progestogens utilised in hormonal contraceptives, and new delivery systems have enabled the development of long-acting methods, which require less action on the part of the user, and thereby, reduce failure rates. Effective emergency contraceptive methods have become more readily available over the counter. However, male contraception, despite much research, still remains elusive. This manuscript will provide an assessment of recent advances and controversies in contraception and make suggestions about improved availability.

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: ...

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

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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.

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

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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.

Improving access to emergency contraceptive pills.

Science.gov (United States)

1999-09-01

This article focuses on the accessibility of emergency contraceptive pills (ECPs). The ECPs are safe, simple, and effective contraceptive agent that can reduce a woman's chance of becoming pregnant by 75%. It works by preventing or delaying ovulation, interfering with fertilization, or blocking implantation of a fertilized egg, depending on when in the menstrual cycle the pills are taken. The Population Council takes a multifaceted approach to expanding access to and knowledge on emergency contraception. Studies on innovations in service delivery are being conducted. In Mexico, one-tenth of women aged 13-55 who reported being raped during the 9-month study were counseled about ECPs. Results showed that pregnancies from reported rapes declined from 9.8% to 7.4% during the study. In Ho Chi Minh City, Vietnam, practitioners approved of the use of emergency contraception and desired more accurate knowledge so that they could provide it effectively. Moreover, in Zambia, researchers found out that giving women packages of ECPs in advance greatly reduced the length of time between having unprotected intercourse and beginning ECP treatment. Council researchers have also addressed the safety of offering ECPs without prescription. They have collaborated with leaders in the health care industry to increase method availability.

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

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.

Novel effects of hormonal contraceptive use on the plasma proteome.

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Andrea R Josse

Full Text Available Hormonal contraceptive (HC use may increase cardiometabolic risk; however, the effect of HC on emerging cardiometabolic and other disease risk factors is not clear.To determine the association between HC use and plasma proteins involved in established and emerging disease risk pathways.Concentrations of 54 high-abundance plasma proteins were measured simultaneously by LC-MRM/MS in 783 women from the Toronto Nutrigenomics and Health Study. C-reactive protein (CRP was measured separately. ANCOVA was used to test differences in protein concentrations between users and non-users, and among HC users depending on total hormone dose. Linear regression was used to test the association between duration (years of HC use and plasma protein concentrations. Principal components analysis (PCA was used to identify plasma proteomic profiles in users and non-users.After Bonferroni correction, 19 proteins involved in inflammation, innate immunity, coagulation and blood pressure regulation were significantly different between users and non-users (P<0.0009. These differences were replicated across three distinct ethnocultural groups. Traditional markers of glucose and lipid metabolism were also significantly higher among HC users. Neither hormone dose nor duration of use affected protein concentrations. PCA identified 4 distinct proteomic profiles in users and 3 in non-users.HC use was associated with different concentrations of plasma proteins along various disease-related pathways, and these differences were present across different ethnicities. Aside from the known effect of HC on traditional biomarkers of cardiometabolic risk, HC use also affects numerous proteins that may be biomarkers of dysregulation in inflammation, coagulation and blood pressure.

Noncontraceptive use of oral combined hormonal contraceptives in polycystic ovary syndrome-risks versus benefits.

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Dokras, Anuja

2016-12-01

The use of steroid sex hormones for noncontraceptive benefits has been endorsed by several medical societies. In women with polycystic ovary syndrome (PCOS), hormonal contraceptives are first-line therapy for concurrent treatment of menstrual irregularity, acne, and hirsutism. The association of PCOS with obesity, diabetes, and dyslipidemia frequently brings up the debate regarding risks versus benefits of hormonal contraceptives in this population. In women with PCOS, the lack of large-scale studies evaluating the risks with varying doses of ethinyl estradiol, types of progestins, and presence of confounding factors such as obesity, smoking, and other cardiometabolic comorbidities is a significant limitation in these deliberations. Although it is important to assess the absolute risk for major morbidities including cardiovascular events, currently, there are a paucity of long-term data for these outcomes in PCOS. Most of the current studies do not suggest an increase in risk of prediabetes/diabetes, clinically significant dyslipidemia, inflammatory changes, or depressive/anxiety symptoms with oral contraceptive pill use. Screening of women with PCOS for cardiometabolic and psychiatric comorbidities is routinely recommended. This information should be used by health care providers to individualize the choice of hormonal contraceptive treatment, adequately counsel patients regarding risks and benefits, and formulate an appropriate follow-up plan. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

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.

Ectopic Pregnancy and Emergency Contraceptive Pills: A Systematic Review

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Cleland, Kelly; Raymond, Elizabeth; Trussell, James; Cheng, Linan; Zhu, Haoping

2014-01-01

Objective To evaluate the existing data to estimate the rate of ectopic pregnancy among emergency contraceptive pill treatment failures. Data Sources Our initial reference list was generated from a 2008 Cochrane review of emergency contraception. In August 2009, we searched Biosys Previews, the Cochrane Database of Systematic Reviews, Medline, Global Health Database, Health Source: Popline, and Wanfang Data (a Chinese database). Methods of Study Selection This study included data from 136 studies which followed a defined population of women treated one time with emergency contraceptive pills (either mifepristone or levonorgestrel), and in which the number and location of pregnancies were ascertained. Results Data from each article were abstracted independently by two reviewers. In the studies of mifepristone, 3 out of 494 (0.6%) pregnancies were ectopic; in the levonorgestrel studies, 3 out of 307 (1%) were ectopic. Conclusion The rate of ectopic pregnancy when treatment with emergency contraceptive pills fails does not exceed the rate observed in the general population. Since emergency contraceptive pills are effective in lowering the risk of pregnancy, their use should reduce the chance that an act of intercourse will result in ectopic pregnancy. PMID:20502299

Sexual and Contraceptive Behaviors among Adolescents Requesting Emergency Contraception.

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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.

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.

Do hormonal contraceptives stimulate growth of neurofibromas? A survey on 59 NF1 patients

International Nuclear Information System (INIS)

Lammert, Marge; Mautner, Victor-Felix; Kluwe, Lan

2005-01-01

Neurofibromas are benign tumors of the peripheral nerves and hallmark of neurofibromatosis type 1 (NF1), a tumor suppressor gene syndrome. Neurofibromas mostly start developing at puberty and can increase in size and number during pregnancy. Expression of progesterone receptors has been found in 75% of the tumors. Many female NF1 patients are thus concerned about the possibility that hormonal contraceptives may stimulate the growth of their neurofibromas. A survey was carried out on 59 female NF1 patients who are practicing or have practiced hormonal contraception to examine the effect of the various contraceptives on the growth of neurofibromas. Majority (53 out of 58) of patients who received oral estrogen-progestogen or pure progestogen preparations reported no associated tumor growth. In contrast, significant tumor growth was reported by two patients who received depot contraceptive containing high dose of synthetic progesterone. Oral contraceptives do not seem to stimulate the growth of neurofibromas in NF1 patients. High doses of progesterone might stimulate the growth of neurofibromas and deserve more caution

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

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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.

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.

Influence of Hormonal Contraceptive Use and Health Beliefs on Sexual Orientation Disparities in Papanicolaou Test Use

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Corliss, Heather L.; Missmer, Stacey A.; Frazier, A. Lindsay; Rosario, Margaret; Kahn, Jessica A.; Austin, S. Bryn

2014-01-01

Objectives. Reproductive health screenings are a necessary part of quality health care. However, sexual minorities underutilize Papanicolaou (Pap) tests more than heterosexuals do, and the reasons are not known. Our objective was to examine if less hormonal contraceptive use or less positive health beliefs about Pap tests explain sexual orientation disparities in Pap test intention and utilization. Methods. We used multivariable regression with prospective data gathered from 3821 females aged 18 to 25 years in the Growing Up Today Study (GUTS). Results. Among lesbians, less hormonal contraceptive use explained 8.6% of the disparities in Pap test intention and 36.1% of the disparities in Pap test utilization. Less positive health beliefs associated with Pap testing explained 19.1% of the disparities in Pap test intention. Together, less hormonal contraceptive use and less positive health beliefs explained 29.3% of the disparities in Pap test intention and 42.2% of the disparities in Pap test utilization. Conclusions. Hormonal contraceptive use and health beliefs, to a lesser extent, help to explain sexual orientation disparities in intention and receipt of a Pap test, especially among lesbians. PMID:23763393

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 ...

Absorption and metabolization of sex hormones and their transformation into contraceptive technologies: the paths taken by medical thought in Brazil.

Science.gov (United States)

Bonan, Claudia; Teixeira, Luiz Antonio; Nakano, Andreza Rodrigues

2017-01-01

The article analyses knowledge assimilation and the development of clinical and research practices relating to sex hormones among Brazilian gynaecologists. It discusses the paths taken by medical thought from the reception of the hormones to their transformation into contraceptives. Our objective is to comprehend styles of introducing and disseminating medical technologies in the area of reproductive health in Brazil. It uses methods of historical analysis and takes as its source the Anais Brasileiros de Ginecologia, a journal published between 1936 and 1970. From the outset, the accompaniment of scientific breakthroughs in relation to sex hormones and their use to treat diverse female illnesses played a key role in the rapid medical acceptance of hormonal contraception. Scientific and technical questions (side effects, dosages) and the demographic issue formed part of the majority of the debates. Objections from the Catholic Church were considered but did not set the agenda of medical thought on contraceptives. The quest to consolidate gynaecology as a scientific, modern and cosmopolitan area of expertise, along with sanitary and demographic motives that allowed contraceptives to be classed as ethical drugs, are identified as processes underlying the assimilation and metabolization of sex hormones as hormonal contraceptives.

Reimbursement of hormonal contraceptives and the frequency of induced abortion among teenagers in Sweden.

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Sydsjö, Adam; Sydsjö, Gunilla; Bladh, Marie; Josefsson, Ann

2014-05-29

Reduction in costs of hormonal contraceptives is often proposed to reduce rates of induced abortion among young women. This study investigates the relationship between rates of induced abortion and reimbursement of dispensed hormonal contraceptives among young women in Sweden. Comparisons are made with the Nordic countries Finland, Norway and Denmark. Official statistics on induced abortion and numbers of prescribed and dispensed hormonal contraceptives presented as "Defined Daily Dose/thousand women" (DDD/T) aged 15-19 years were compiled and related to levels of reimbursement in all Swedish counties by using public official data. The Swedish numbers of induced abortion were compared to those of Finland, Norway and Denmark. The main outcome measure was rates of induced abortion and DDD/T. No correlation was observed between rates of abortion and reimbursement among Swedish counties. Nor was any correlation found between sales of hormonal contraceptives and the rates of abortion. In a Nordic perspective, Finland and Denmark, which have no reimbursement at all, and Norway all have lower rates of induced abortion than Sweden. Reimbursement does not seem to be enough in order to reduce rates of induced abortion. Evidently, other factors such as attitudes, education, religion, tradition or cultural differences in each of Swedish counties as well as in the Nordic countries may be of importance. A more innovative approach is needed in order to facilitate safe sex and to protect young women from unwanted pregnancies.

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

Science.gov (United States)

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.

Hormonal contraception and regulation of menstruation: a study of young women's attitudes towards 'having a period'.

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Newton, Victoria Louise; Hoggart, Lesley

2015-07-01

Irregular bleeding is one of the most common side effects of hormonal contraception and a key reason for the discontinuation of hormonal methods. A qualitative study in which 12 young women volunteered to be interviewed in depth, along with six focus group discussions (23 participants). The study had two main research objectives: to document and investigate what young women think and feel about menstruation and contraception, and to explore young women's preferences regarding the intersection of contraceptives and bleeding patterns. Although participants held a broad view that menstruation can be an inconvenience, they did ascribe positive values to having a regular bleed. Bleeding was seen as a signifier of non-pregnancy and also an innate part of being a woman. A preference for a 'natural' menstruating body was a strong theme, and the idea of selecting a hormonal contraceptive that might stop the bleeding was not overly popular, unless the young woman suffered with painful natural menstruation. Contraceptives that mimicked the menstrual cycle were acceptable to most, suggesting that cyclic bleeding still holds a symbolic function for women. When counselling young women about the effect of different contraceptive modalities on their bleeding, practitioners should explore how the women feel about their bleeding, including how they might feel if their bleeding stopped or if they experienced erratic bleeding patterns. Practitioners also need to recognise the subjective understanding of the 'natural body' as held by some women, and in these cases to support them in their seeking out of non-hormonal methods of contraception. 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.

Provision of hormonal and long-acting reversible contraceptive services by general practices in Scotland, UK (2004-2009).

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Reddy, Anusha; Watson, Margaret; Hannaford, Philip; Lefevre, Karen; Ayansina, Dolapo

2014-01-01

In the UK, a large proportion of contraceptive services are provided from general practice. However, little is known about which contraceptive services are provided and to whom. Descriptive serial cross-sectional study of women aged 12-55 years, registered with 191 general practices in Scotland, UK between 2004 and 2009. Annual incidence of provision of hormonal and long-acting reversible contraceptives (LARCs) increased from 27.7% in 2004 to 30.1% in 2009. Amongst those women registered with a general practice for the full 5-year period the provision of LARCs increased from 8.8% to 12.5% (pemergency hormonal contraception (EHC) decreased from 5.2% to 2.6% (pcontraceptives and LARCs from general practices. It is important that a full range of contraceptive options remains easily available to women.

Emergency contraception: potential role of ulipristal acetate

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Kristina Gemzell-Danielsson

2010-04-01

Full Text Available Kristina Gemzell-Danielsson, Chun-Xia MengDepartment of Women’s and Children’s Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, SwedenAbstract: Unintended pregnancy is a global reproductive health problem. Emergency contraception (EC provides women with a safe means of preventing unwanted pregnancies after having unprotected intercourse. While 1.5 mg of levonorgestrel (LNG as a single dose or in 2 doses with 12 hours apart is the currently gold standard EC regimen, a single dose of 30 mg ulipristal acetate (UPA has recently been proposed for EC use up to 120 hours of unprotected intercourse with similar side effect profiles as LNG. The main mechanism of action of both LNG and UPA for EC is delaying or inhibiting ovulation. However, the ‘window of effect’ for LNG EC seems to be rather narrow, beginning after selection of the dominant follicular and ending when luteinizing hormone peak begins to rise, whereas UPA appears to have a direct inhibitory effect on follicular rupture which allows it to be also effective even when administered shortly before ovulation, a time period when use of LNG is no longer effective. These experimental findings are in line with results from a series of clinical trials conducted recently which demonstrate that UPA seems to have higher EC efficacy compared to LNG. This review summarizes some of the data available on UPA used after unprotected intercourse with the purpose to provide evidence that UPA, a new type of second-generation progesterone receptor modulator, represents a new evolutionary step in EC treatment.Keywords: emergency contraception, ulipristal acetate, levonorgestrel

Hormonal contraception in obesity, the metabolic syndrome, and diabetes

DEFF Research Database (Denmark)

Skouby, S.O.

2010-01-01

The rate of obesity worldwide is currently at epidemic proportions. As part of obesity, the metabolic syndrome describes a clustering of metabolic abnormalities that increase the cardiovascular and diabetes risk. In particular, women from developing countries have diabetes in the reproductive age...... diabetes, hormonal contraception should therefore be part of the highly needed preconception care and metabolic control...

Hormonal Contraception in obestiy, the metabolic syndrome, and diabetes

DEFF Research Database (Denmark)

Skouby, Sven O.

2010-01-01

The rate of obesity worldwide is currently at epidemic proportions. As part of obesity, the metabolic syndrome describes a clustering of metabolic abnormalities that increase the cardiovascular and diabetes risk. In particular, women from developing countries have diabetes in the reproductive age...... diabetes, hormonal contraception should therefore be part of the highly needed preconception care and metabolic control...

Associations of hormonal contraceptive use with measures of HIV disease progression and antiretroviral therapy effectiveness.

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Whiteman, Maura K; Jeng, Gary; Samarina, Anna; Akatova, Natalia; Martirosyan, Margarita; Kissin, Dmitry M; Curtis, Kathryn M; Marchbanks, Polly A; Hillis, Susan D; Mandel, Michele G; Jamieson, Denise J

2016-01-01

To examine the associations between hormonal contraceptive use and measures of HIV disease progression and antiretroviral treatment (ART) effectiveness. A prospective cohort study of women with prevalent HIV infection in St. Petersburg, Russia, was conducted. After contraceptive counseling, participants chose to use combined oral contraceptives (COCs), depot-medroxyprogesterone acetate (DMPA), a copper intrauterine device (IUD) or male condoms for pregnancy prevention. Among participants not using ART at enrollment, we used multivariate Cox regression to assess the association between current (time-varying) contraceptive use and disease progression, measured by the primary composite outcome of CD4 decline to contraceptive method. During a total of 5233 months follow-up among participants not using ART with enrollment CD4 ≥350 cells/mm(3) (n=315), 97 experienced disease progression. Neither current use of COCs [adjusted hazard ratio (aHR) 0.91, 95% confidence interval (CI) 0.56-1.48] nor DMPA (aHR 1.28, 95% CI 0.71-2.31) was associated with a statistically significant increased risk for disease progression compared with use of nonhormonal methods (IUD or condoms). Among participants using ART at enrollment (n=77), we found no statistically significant differences in the predicted mean changes in CD4 cell count comparing current use of COCs (p=.1) or DMPA (p=.3) with nonhormonal methods. Hormonal contraceptive use was not significantly associated with measures of HIV disease progression or ART effectiveness among women with prevalent HIV infection. Hormonal contraceptive use was not significantly associated with measures of HIV disease progression or ART effectiveness among women with prevalent HIV infection. Published by Elsevier Inc.

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

Science.gov (United States)

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.

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...

Does hormone replacement therapy and use of oral contraceptives increase the risk of non-melanoma skin cancer?

DEFF Research Database (Denmark)

Birch-Johansen, Fatima; Jensen, Allan; Olesen, Anne Braae

2012-01-01

We aimed to examine whether use of hormone replacement therapy (HRT) and oral contraceptives (OC) affect the risk of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in women.......We aimed to examine whether use of hormone replacement therapy (HRT) and oral contraceptives (OC) affect the risk of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in women....

[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.

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…

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

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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 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.

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

Science.gov (United States)

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

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?

Directory of Open Access Journals (Sweden)

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.

Sexual orientation differences in teen pregnancy and hormonal contraceptive use: an examination across 2 generations.

Science.gov (United States)

Charlton, Brittany M; Corliss, Heather L; Missmer, Stacey A; Rosario, Margaret; Spiegelman, Donna; Austin, S Bryn

2013-09-01

To examine whether sexual orientation is associated with disparities in teen pregnancy and hormonal contraception use among adolescent females in 2 intergenerational cohorts. Data were collected from 91,003 women in the Nurses' Health Study II (NHSII), born between 1947-1964, and 6463 of their children, born between 1982-1987, enrolled in the Growing Up Today Study (GUTS). Log-binomial models were used to estimate risk ratios for teen pregnancy and hormonal contraception use in sexual minorities compared with heterosexuals and metaanalysis techniques were used to compare the 2 cohorts. Overall, teen hormonal contraception use was lower and teen pregnancy was higher in NHSII than GUTS. In both cohorts, lesbians were less likely, whereas the other sexual minorities were more likely, to use hormonal contraception as teenagers compared with their heterosexual peers. All sexual minority groups in both cohorts, except NHSII lesbians, were at significantly increased risk for teen pregnancy, with risk ratios ranging from 1.61 (95% confidence interval, 0.40-6.55) to 5.82 (95% confidence interval, 2.89-11.73). Having an NHSII mother who was pregnant as a teen was not associated with teen pregnancy in GUTS participants. Finally, significant heterogeneity was found between the 2 cohorts. Adolescent sexual minorities have been, and continue to be, at increased risk for pregnancy. Public health and clinical efforts are needed to address teen pregnancy in this population. Copyright © 2013 Mosby, Inc. All rights reserved.

Sexual orientation differences in teen pregnancy and hormonal contraceptive use: An examination across two generations

Science.gov (United States)

Charlton, Brittany M.; Corliss, Heather L.; Missmer, Stacey A.; Rosario, Margaret; Spiegelman, Donna; Austin, S. Bryn

2013-01-01

Objectives To examine whether sexual orientation is associated with disparities in teen pregnancy and hormonal contraception use among adolescent females in two intergenerational cohorts. Study Design Data were collected from 91,003 women in the Nurses’ Health Study II (NHSII),born between 1947–1964, and 6,463 of their children, born between 1982–1987, enrolled in the Growing Up Today Study (GUTS). Log-binomial models were used to estimate risk ratios (RR) for teen pregnancy and hormonal contraception use in sexual minorities compared to heterosexuals and meta-analysis techniques were used to compare the two cohorts. Results Overall, teen hormonal contraception use was lower and teen pregnancy was higher in NHSII than GUTS. In both cohorts, lesbians were less likely, whereas the other sexual minorities were more likely, to use hormonal contraception as teenagers compared to their heterosexual peers. All sexual minority groups in both cohorts, except NHSII lesbians, were at significantly increased risk for teen pregnancy, with RRs ranging from 1.61 (95%CI 0.40, 6.55) to 5.82 (95%CI 2.89, 11.73). Having a NHSII mother who was pregnant as a teen was not associated with teen pregnancy in GUTS participants. Finally, significant heterogeneity was found between the two cohorts. Conclusions Adolescent sexual minorities have been, and continue to be, at increased risk for pregnancy. Public health and clinical efforts are needed to address teen pregnancy in this population. PMID:23796650

A socio-ecological approach for examining factors related to contraceptive use among recent Latina immigrants in an emerging Latino state.

Science.gov (United States)

White, Kari; Ocampo, Michelle; Scarinci, Isabel C

2017-08-01

Using the Social Ecological Model, the individual, partner, social, and structural factors related to recent Latina immigrants' contraceptive use in an emerging immigrant community were explored. During September 2013-January 2014, door-to-door sampling was used in Birmingham, Alabama to recruit Latina immigrants who had lived in the United States (U.S.) for less than 5 years. Ten women with foreign-born children and 10 with only U.S.-born children completed in-depth interviews about their contraceptive use following migration. Women's narratives revealed interrelated barriers to using highly effective contraception after migrating to the U.S. Women had nuanced concerns about using hormonal contraception, which, when combined with other factors, led them to rely on condoms and withdrawal. Limited partner communication was a barrier to effective method use for some women, but partner attitudes that women should be responsible for contraception were less important. Weak female networks made it difficult for immigrants to learn about the U.S. health-care system, especially those with only U.S.-born children. Even once women accessed services, a full range of highly effective methods was not available or affordable. In emerging communities, integrated strategies that address immigrants' need for information and ensure access to affordable contraception would help women achieve their reproductive life goals.

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

Contracepção hormonal e sistema cardiovascular Contracepción hormonal y sistema cardiovascular Hormonal contraception and cardiovascular system

Directory of Open Access Journals (Sweden)

Milena Bastos Brito

2011-04-01

Full Text Available A contracepção hormonal é o método mais utilizado para prevenção de gestações não planejadas. A literatura tem demonstrado associação entre risco cardiovascular e uso de hormonioterapia. A fim de melhorar a orientação contraceptiva para mulheres com fatores de risco para doença cardiovascular, realizamos uma revisão da literatura em relação ao assunto. Esta revisão descreve os dados mais recentes da literatura científica acerca da influência dos contraceptivos hormonais em relação a trombose venosa, arterial e hipertensão arterial sistêmica, doenças cada dia mais prevalentes na população feminina jovem.La contracepción hormonal es el método más utilizado para la prevención de los embarazos no planificados. La literatura ha venido demostrando la asociación que existe entre el riesgo cardiovascular y el uso de la hormonoterapia. Con el objetivo de mejorar la orientación en la contracepción en mujeres con factores de riesgo para el desarrollo de enfermedad cardiovascular, realizamos una revisión de la literatura con relación a ese asunto. Esa revisión describe los datos más recientes de la literatura científica acerca de la influencia de los anticonceptivos hormonales con relación a la trombosis venosa, arterial e hipertensión arterial sistémica, enfermedades cada día más prevalentes en la población femenina joven.Hormonal contraception is the most widely used method to prevent unplanned pregnancies. The literature has shown an association between cardiovascular risk and use of hormone therapy. With the purpose of providing better guidelines on contraception methods for women with risk factors for cardiovascular disease, we have reviewed the literature on the subject. This review describes the latest data from the scientific literature concerning the influence of hormonal contraceptives on arterial thrombosis, venous thrombosis and systemic high blood pressure, which are diseases that have become

Emergency contraceptive pills: knowledge and attitudes of pharmacy personnel in Managua, Nicaragua.

Science.gov (United States)

Ehrle, Nina; Sarker, Malabika

2011-06-01

As abortion is illegal in Nicaragua, postcoital contraception is an important option for preventing pregnancy. Emergency contraceptive pills are available in Nicaraguan pharmacies over the counter, but pharmacy personnel's knowledge and attitudes about this method can affect access. A cross-sectional survey was conducted in Managua, Nicaragua's capital. Interviewers administered a semistructured questionnaire to 93 pharmacy employees to determine their knowledge of and attitudes toward emergency contraceptive pills. Descriptive statistics and cross-tabulations were used to examine responses of and differences between male and female employees. All participants knew about emergency contraceptive pills and reported experience selling them. The majority sold them at least once a week (92%), usually without a prescription (97%). Of participants who were aware that emergency contraceptive pills should be taken only after sexual intercourse, 45% knew that the pills can be taken up to three days afterward; none knew that the pills are effective up to five days afterward. More than one-third of all respondents (39%) thought the pills can induce abortion, and most overestimated contraindications and side effects. Large majorities believed the availability of emergency contraceptive pills discourages use of ongoing methods (75%), encourages sexual risk-taking (82%) and increases transmission of HIV and other STIs (76%). Sixty-three participants (68%) thought emergency contraceptive pills are necessary to reduce unwanted and unplanned pregnancy; 65% were willing to provide them to all women in need, although only 13% would provide them to minors. Managuan pharmacy personnel frequently dispense emergency contraceptive pills, but need additional education to accurately counsel women about the method.

Sex hormone studies by radioimmunoassay in pregnant and non-pregnant women and in women treated with hormonal contraceptives

International Nuclear Information System (INIS)

Tafurt, C.A.

1980-12-01

Blood concentration profiles for follicle-stimulating hormone, luteinizing hormone, chorionic gonadotropin, testosterone, estradiol, estriol, progesterone, cortisol and sex hormonebinding globulin throughout a menstrual cycle were derived from measurements by radioimmunoassay and related procedures on serial blood samples from 16 normal women as controls. Similar studies were then performed on 9 normal women receiving a low-dose oral contraceptive combination of D-norgestrel and ethynlestradiol. Further studies were performed on 9 out of 16 normal women in whom progestational contraception was carried out with orally administered lynestrenol or intramuscularly administered norethindrone enathate and on 12 normal pregnant women from the 28th to the 38th week of pregnancy. Additional studies embracing chorionic gonadotropin progesterone and 17-hydroxyprogesterone were performed on 10 normal pregnant women from the 6th to the 12th week of pregnancy. Detailed results are presented and their significance discussed

Barriers to and Enablers of Contraceptive Use among Adolescent Females and their Interest in an Emergency Department-based Intervention

Science.gov (United States)

Chernick, Lauren S; Schnall, Rebecca; Higgins, Tracy; Stockwell, Melissa; Castaño, Paula; Santelli, John; Dayan, Peter S

2015-01-01

Objective Over 15 million adolescents, many at high risk for pregnancy, use emergency departments (ED) in the United States annually, but little is known regarding reasons for failure to use contraceptives in this population. The purpose of this study was to identify the barriers to and enablers of contraceptive use among adolescent females using the ED and determine their interest in an ED-based pregnancy prevention intervention. Study Design We conducted semi-structured, open-ended interviews with females in an urban ED. Eligible females were 14-19 years old, sexually active, presenting for reproductive health complaints, and at risk for pregnancy, defined as non-use of effective (per the World Health Organization) contraception. Interviews were recorded, transcribed, and coded based on thematic analysis. Enrollment continued until no new themes emerged. A modified Health Belief Model guided the organization of the data. Results Participants (n=14) were predominantly Hispanic (93%), insured (93%), and in a sexual relationship (86%). The primary barrier to contraceptive use was perceived health risk, including effects on menstruation, weight, and future fertility. Other barriers consisted of mistrust in contraceptives, ambivalent pregnancy intentions, uncertainty about the future, partner's desire for pregnancy, and limited access to contraceptives. Enablers of past contraceptive use included the presence of a school-based health clinic and clear plans for the future. All participants were receptive to ED-based pregnancy prevention interventions. Conclusions The identified barriers and enablers influencing hormonal contraceptive use can be used to inform the design of future ED-based adolescent pregnancy prevention interventions. PMID:25499588

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

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.

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.

Recent methodological advances in male hormonal contraception.

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Liu, Peter Y; Swerdloff, Ronald S; Wang, Christina

2010-11-01

Landmark WHO-sponsored trials showed decades ago that male hormonal contraception (MHC) is an effective male-directed contraceptive approach. Considerable progress has been made particularly in the last 5 years, establishing for the first time the reversibility of MHC and its short-term safety. Methodological advances in recent years include the pooling of information and individual-level integrated analysis; the first-time use of centralized semen analysis and fluorescence to detect low sperm concentrations; the establishment of sperm quality reference ranges in fertile men; the measurement of blood steroid concentrations by gas chromatography/mass spectrometry; and the inclusion of placebo groups to delineate clearly possible adverse effects of androgens and progestins in men. We report integrated analyses of factors that are important in predicting suppression and recovery of spermatogenesis after MHC clinical trials for the past 15 years. These are the best data available and will provide guidance and reassurance for the larger-scale Phase III specific regimen efficacy studies that will be required to bring MHC to the population (market). Copyright © 2010 Elsevier Inc. All rights reserved.

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.

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

Science.gov (United States)

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

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.

Adolescents' Knowledge, Attitude and Utilization of Emergency Contraceptive Pills in Nigeria's Niger Delta Region.

Science.gov (United States)

Onasoga, Olayinka A; Afolayan, Joel Adeleke; Asamabiriowei, Tariebi Florence; Jibril, Umar Nda; Imam, Abubakar Ayinla

2016-01-01

Risky sexual activity among adolescents is on the increase and contraceptive prevalence rate is low which is evidenced by high rate of teenage pregnancy in Bayelsa state, Nigeria. This study assesses the adolescents' knowledge, attitude and utilization of emergency contraceptive pills (ECP) in Amassoma Community, Bayelsa State, in the Niger Delta region of Nigeria. The study was a descriptive cross-sectional research design. A purposive sampling technique was used to select a sample of 220 respondents from the target population. Data were collected using a self-structured questionnaire. Descriptive and inferential statistics were used to analyze the data generated. Majority of the respondents had high level of knowledge and positive attitude towards emergency contraceptive pills but had low level of utilization. Concerns about what others may say, parental attitude, contraceptive availability, contraceptive accessibility, and peer influences were the major factors that influenced the utilization of contraceptive pills. There was no significant relationship between knowledge and utilization of emergency contraceptive pills, as well as level of knowledge and their utilization of emergency contraceptive pills. Adolescents in the study were more likely to use emergency contraceptive pills, if parents and others reaction to adolescents' contraceptive use were positive about those. Health care professionals, especially nurses, should organize enlightenment programs to educate adolescents, parents and the public on the benefits of adolescents' contraceptives use, especially ECP.

Hormonal contraception use alters stress responses and emotional memory

OpenAIRE

Nielsen, Shawn E.; Segal, Sabrina K.; Worden, Ian V.; Yim, Ilona S.; Cahill, Larry

2012-01-01

Emotionally arousing material is typically better remembered than neutral material. Since norepinephrine and cortisol interact to modulate emotional memory, sex-related influences on stress responses may be related to sex differences in emotional memory. Two groups of healthy women – one naturally cycling (NC women, N = 42) and one using hormonal contraceptives (HC women, N = 36) – viewed emotionally arousing and neutral images. Immediately after, they were assigned to Cold Pressor Stress (CP...

How do levonorgestrel-only emergency contraceptive pills prevent pregnancy? Some considerations.

Science.gov (United States)

Mozzanega, Bruno; Cosmi, Erich

2011-06-01

Controversial opinions exist about the possible mechanisms throughout emergency contraception prevents pregnancy. Recently, the International Federation of Gynaecology and Obstetrics and the International Consortium for Emergency Contraception released a Joint Statement declaring that 'inhibition or delay of ovulation should be their primary and possibly only mechanism of action'. They still added that 'Review of the evidence suggests that LNG-ECPs cannot prevent implantation'. Concerning levonorgestrel-only emergency contraceptive pills effects on ovulation, the Statement based on seven reference papers which considered a total of only 142 patients, divided into still different subgroups. Basing on their same references we got quite different conclusions.

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

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

Science.gov (United States)

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

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.

Emergency contraceptive pills: what you need to know. Brochure for programs providing combined ECPs.

Science.gov (United States)

1998-01-01

This informational brochure was prepared for potential users of emergency contraceptive pills. In question-and-answer format, it presents facts on the mechanism of action, effectiveness, safety, and side effects of emergency contraception. It then outlines the regimen for method use. The brochure notes that emergency contraceptive pills cannot offer protection against HIV and other sexually transmitted diseases. Finally, two other emergency contraceptive regimens--the copper T IUD and progestin-only pills--are discussed. The brochure may be reproduced by family planning and other health programs.

Simultaneous quantitation of multiple contraceptive hormones in human serum by LC-MS/MS.

Science.gov (United States)

Blue, Steven W; Winchell, Andrea J; Kaucher, Amy V; Lieberman, Rachel A; Gilles, Christopher T; Pyra, Maria N; Heffron, Renee; Hou, Xuanlin; Coombs, Robert W; Nanda, Kavita; Davis, Nicole L; Kourtis, Athena P; Herbeck, Joshua T; Baeten, Jared M; Lingappa, Jairam R; Erikson, David W

2018-04-01

The objective was to develop a method to simultaneously quantify five commonly used hormonal contraceptives (HCs) and two endogenous sex steroids by liquid chromatography-tandem triple quadrupole mass spectrometry (LC-MS/MS) and apply this method to human serum samples. We developed a method to simultaneously analyze ethinyl estradiol (EE2), etonogestrel (ENG), levonorgestrel (LNG), medroxyprogesterone acetate (MPA) and norethisterone (NET), along with estradiol (E2) and progesterone (P4), in human serum for a Shimadzu Nexera-LCMS-8050 LC-MS/MS platform. We analyzed serum collected from women self-reporting use of oral contraceptives, contraceptive implants or injectable contraceptives (n=14) and normally cycling women using no HC (n=15) as well as pooled samples from women administered various HCs (ENG, n=6; LNG, n=14; MPA, n=7; NET, n=5). Limits of quantitation were 0.010ng/mL for E2, EE2 and P4; 0.020ng/mL for ENG, LNG and MPA; and 0.040ng/mL for NET. Precisions for all assays, as indicated by coefficient of variation, were less than or equal to 12.1%. Accuracies for all assays were in the range of 95%-108%. Endogenous hormone values obtained from analysis of human serum samples are in agreement with levels previously reported in the literature for normally cycling women as well as for women taking the appropriate HC. We have developed a robust, accurate and sensitive method for simultaneously analyzing commonly used contraceptive steroids and endogenous sex steroids in human serum. This analytical method can be used for quantitating contraceptive steroid levels in women for monitoring systemic exposure to determine drug interactions, nonadherence, misreporting and proper dosing. Copyright © 2018 Elsevier Inc. All rights reserved.

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

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Prabhudas R. Palan

2010-01-01

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

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

Directory of Open Access Journals (Sweden)

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.

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

Directory of Open Access Journals (Sweden)

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.

Beyond the Condom: Frontiers in Male Contraception.

Science.gov (United States)

Roth, Mara Y; Amory, John K

2016-05-01

Nearly half of all pregnancies worldwide are unplanned, despite numerous contraceptive options available. No new contraceptive method has been developed for men since the invention of condom. Nevertheless, more than 25% of contraception worldwide relies on male methods. Therefore, novel effective methods of male contraception are of interest. Herein we review the physiologic basis for both male hormonal and nonhormonal methods of contraception. We review the history of male hormonal contraception development, current hormonal agents in development, as well as the potential risks and benefits of male hormonal contraception options for men. Nonhormonal methods reviewed will include both pharmacological and mechanical approaches in development, with specific focus on methods which inhibit the testicular retinoic acid synthesis and action. Multiple hormonal and nonhormonal methods of male contraception are in the drug development pathway, with the hope that a reversible, reliable, safe method of male contraception will be available to couples in the not too distant future. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

Science.gov (United States)

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.

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

Science.gov (United States)

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

[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.

Knowledge-attitude-practice survey among Portuguese gynaecologists regarding combined hormonal contraceptives methods.

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

2012-04-01

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

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

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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.

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

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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

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.

Emergency contraception: a survey of 1773 women.

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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.

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

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 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 ...

Repeat use of emergency contraceptive pills in urban Kenya and Nigeria.

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Chin-Quee, Dawn; L'Engle, Kelly; Otterness, Conrad; Mercer, Sarah; Chen, Mario

2014-09-01

Little is known about the frequency and patterns of use of emergency contraceptive pills among women in urban Kenya and Nigeria. To recruit women who had used emergency contraceptive pills, individuals aged 18-49 were intercepted and interviewed at shopping venues in Nairobi, Kenya, and Lagos, Nigeria, in 2011. Information was collected on 539 Nairobi and 483 Lagos respondents' demographic and behavioral characteristics, attitudes toward the method, and frequency of use. Multinomial logistic regression analyses were used to identify associations between these characteristics and frequency of pill use. Eighteen percent of the women interviewed in Nairobi and 17% in Lagos had ever used emergency contraceptive pills. On average, these respondents had used the pills less than once per month, but greater use and acceptance were seen in Lagos. In multivariate analysis, women who had sex at least once in a typical week were generally more likely than others to have used the pills 2-5 times in the last six months, rather than once or never, or to have used them six or more times. Furthermore, Lagos respondents who said their main contraceptive method was the condom, the pill or injectable, or a natural method were generally less likely than those who did not report these methods to have used the emergency pills multiple times in the last six months. Repeated use of emergency contraceptive pills was not common in this sample.

Adolescents’ Knowledge, Attitude and Utilization of Emergency Contraceptive Pills in Nigeria’s Niger Delta Region

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Onasoga, Olayinka A.; Afolayan, Joel Adeleke; Asamabiriowei, Tariebi Florence; Jibril, Umar Nda; Imam, Abubakar Ayinla

2016-01-01

Background and Objective: Risky sexual activity among adolescents is on the increase and contraceptive prevalence rate is low which is evidenced by high rate of teenage pregnancy in Bayelsa state, Nigeria. This study assesses the adolescents’ knowledge, attitude and utilization of emergency contraceptive pills (ECP) in Amassoma Community, Bayelsa State, in the Niger Delta region of Nigeria. Methods: The study was a descriptive cross-sectional research design. A purposive sampling technique was used to select a sample of 220 respondents from the target population. Data were collected using a self-structured questionnaire. Descriptive and inferential statistics were used to analyze the data generated. Results: Majority of the respondents had high level of knowledge and positive attitude towards emergency contraceptive pills but had low level of utilization. Concerns about what others may say, parental attitude, contraceptive availability, contraceptive accessibility, and peer influences were the major factors that influenced the utilization of contraceptive pills. There was no significant relationship between knowledge and utilization of emergency contraceptive pills, as well as level of knowledge and their utilization of emergency contraceptive pills. Conclusions and Global Health Implications: Adolescents in the study were more likely to use emergency contraceptive pills, if parents and others reaction to adolescents’ contraceptive use were positive about those. Health care professionals, especially nurses, should organize enlightenment programs to educate adolescents, parents and the public on the benefits of adolescents’ contraceptives use, especially ECP. PMID:28058193

Ethical, religious and factual beliefs about the supply of emergency hormonal contraception by UK community pharmacists.

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Cooper, Richard J; Bissell, Paul; Wingfield, Joy

2008-01-01

Community pharmacists' role in the sale and supply of emergency hormonal contraception (EHC) represents an opportunity to increase EHC availability and utilise pharmacists' expertise but little is known about pharmacists' attendant ethical concerns. Semi-structured qualitative interviews were undertaken with 23 UK pharmacists to explore their views and ethical concerns about EHC. Dispensing EHC was ethically acceptable for almost all pharmacists but beliefs about selling EHC revealed three categories: pharmacists who sold EHC, respected women's autonomy and peers' conscientious objection but feared the consequences of limited EHC availability; contingently selling pharmacists who believed doctors should be first choice for EHC supply but who occasionally supplied and were influenced by women's ages, affluence and genuineness; non-selling pharmacists who believed EHC was abortion and who found selling EHC distressing and ethically problematic. Terminological/factual misunderstandings about EHC were common and discussing ethical issues was difficult for most pharmacists. Religion informed non-selling pharmacists' ethical decisions but other pharmacists prioritised professional responsibilities over their religion. Pharmacists' ethical views on EHC and the influence of religion varied and, together with some pharmacists' reliance upon non-clinical factors, led to a potentially variable supply, which may threaten the prompt availability of EHC. Misunderstandings about EHC perpetuated lay beliefs and potentially threatened correct advice. The influence of subordination and non-selling pharmacists' dispensing EHC may also lead to variable supply and confusion amongst women. Training is needed to address both factual/terminological misunderstandings about EHC and to develop pharmacists' ethical understanding and responsibility.

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.

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

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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.

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

Contribution of estradiol levels and hormonal contraceptives to sex differences within the fear network during fear conditioning and extinction.

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Hwang, Moon Jung; Zsido, Rachel G; Song, Huijin; Pace-Schott, Edward F; Miller, Karen Klahr; Lebron-Milad, Kelimer; Marin, Marie-France; Milad, Mohammed R

2015-11-18

Findings about sex differences in the field of fear conditioning and fear extinction have been mixed. At the psychophysiological level, sex differences emerge only when taking estradiol levels of women into consideration. This suggests that this hormone may also influence sex differences with regards to activations of brain regions involved in fear conditioning and its extinction. Importantly, the neurobiological correlates associated with the use of hormonal oral contraceptives in women have not been fully contrasted against men and against naturally cycling women with different levels of estradiol. In this study, we begin to fill these scientific gaps. We recruited 37 healthy men and 48 healthy women. Of these women, 16 were using oral contraceptives (OC) and 32 were naturally cycling. For these naturally cycling women, a median split was performed on their serum estradiol levels to create a high estradiol (HE) group (n = 16) and a low estradiol (LE) group (n = 16). All participants underwent a 2-day fear conditioning and extinction paradigm in a 3 T MR scanner. Using the 4 groups (men, HE women, LE women, and OC users) and controlling for age and coil type, one-way ANCOVAs were performed to look at significant activations within the nodes of the fear circuit. Using post-hoc analyses, beta-weights were extracted in brain regions showing significant effects in order to unveil the differences based on hormonal status (men, HE, LE, OC). Significant main effect of hormonal status group was found across the different phases of the experiment and in different sub-regions of the insular and cingulate cortices, amygdala, hippocampus, and hypothalamus. During conditioning, extinction and recall, most of the observed differences suggested higher activations among HE women relative to men. During the unconditioned response, however, a different pattern was observed with men showing significantly higher brain activations. Our data further support the important contribution

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 ...

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

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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.

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

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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

Hormonal contraception does not increase women's HIV acquisition risk in Zambian discordant couples, 1994-2012.

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Wall, Kristin M; Kilembe, William; Vwalika, Bellington; Htee Khu, Naw; Brill, Ilene; Chomba, Elwyn; Johnson, Brent A; Haddad, Lisa; Tichacek, Amanda; Allen, Susan

2015-06-01

To determine the impact of hormonal contraceptive methods on risk of HIV acquisition among HIV-negative women cohabiting with HIV-positive male partners. From 1994-2012, HIV discordant couples recruited from a couples' voluntary HIV counseling and testing center in Lusaka, Zambia were followed longitudinally. HIV-negative partners were tested quarterly. This analysis is restricted to couples in which the man was HIV-positive and the woman was HIV-negative at enrollment and the man was not on antiretroviral treatment. Multivariate Cox models evaluated associations between time-varying contraceptive methods and HIV acquisition among women. Sensitivity analyses explored exposure misclassification and time-varying confounder mediation. Among 1393 couples, 252 incident infections occurred in women over 2842 couple-years (8.9 infections per 100 couple-years; 95% CI, 7.8-10.0). Multivariate Cox models indicated that neither injectable [adjusted hazard ratio (aHR)=1.2; 95% CI, 0.8-1.7], oral contraceptive pill (OCP, aHR=1.3; 95% CI, 0.9-1.8), or implant (aHR=1.1; 95% CI, 0.5-2.2) use was significantly associated with HIV acquisition relative to non-hormonal contraception controlling for woman's age, literacy and time-varying measures of genital ulceration/inflammation. This remained true when only looking at the subset of infections acquired from the spouse (82% of infections) and additionally controlling for baseline HIV viral load of the male partner, pregnancy status, and time-varying measures of sperm on a vaginal swab wet prep and self-reported unprotected sex. OCP and injectable users reported more unprotected sex (pcontraception and HIV acquisition risk in women. Condom use and reinforced condom counseling should always be recommended for HIV discordant couples. HIV testing of sex partners together is critical to establish HIV risk, ascertain couple fertility intentions and counsel appropriately. These findings add to a controversial literature and uniquely address

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 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.

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

Science.gov (United States)

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 ...

Population-based evaluation of the effectiveness of two regimens for emergency contraception.

Science.gov (United States)

Leung, Vivian W Y; Soon, Judith A; Lynd, Larry D; Marra, Carlo A; Levine, Marc

2016-06-01

To estimate and compare the effectiveness of the levonorgestrel and Yuzpe regimens for hormonal emergency contraception in routine clinical practice. A retrospective population-based study included women who accessed emergency contraceptives for immediate use prescribed by community pharmacists in British Columbia, Canada, between December 2000 and December 2002. Linked administrative healthcare data were used to discern the timings of menses, unprotected intercourse, and any pregnancy-related health services. A panel of experts evaluated the compatibility of observed pregnancies with the timing of events. The two regimens were compared with statistical adjustments for potential confounding. Among 7493 women in the cohort, 4470 (59.7%) received levonorgestrel and 3023 (40.3%) the Yuzpe regimen. There were 99 (2.2%) compatible pregnancies in the levonorgestrel group and 94 (3.1%) in the Yuzpe group (P=0.017). The estimated odds ratio for levonorgestrel compared with the Yuzpe regimen after adjusting for potential confounders was 0.64 (95% confidence interval 0.47-0.87). Against an expected pregnancy rate of approximately 5%, the relative and absolute risk reductions were 56.0% and 2.8%, respectively, for levonorgestrel and 36.7% and 1.8% for the Yuzpe regimen. The levonorgestrel regimen is more effective than the Yuzpe regimen in routine use. The data suggest that both regimens are less effective than has been observed in randomized trials. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Gender and the use of hormonal contraception in women are not associated with cerebral cortical 5-HT 2A receptor binding

DEFF Research Database (Denmark)

Frokjaer, V G; Erritzoe, D; Madsen, J

2009-01-01

to frontolimbic 5-HT(2A) receptor binding and to be more pronounced in women, again, the effect of gender was not significant (P=0.42, n=127). Also, the use of hormonal contraception (n=14) within the group of pre-menopausal women (total n=29) was not associated with cortical 5-HT(2A) receptor binding (P=0.......31). In conclusion, neither gender, nor the use of hormonal contraception in premenopausal women was associated with cortical 5-HT(2A) receptor binding....... binding it is not clear if gender or use of hormonal contraception exhibits associations with 5-HT(2A) receptor binding. We found no significant effect of gender on cortical 5-HT(2A) receptor binding (P=0.15, n=132). When adjusting for the personality trait neuroticism, known to be positively correlated...

"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.

Awareness and Perceptions of Emergency Contraceptive Pills Among Women in Kinshasa, Democratic Republic of the Congo.

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Hernandez, Julie H; Muanda, Mbadu; Garcia, Mélissa; Matawa, Grace

2017-09-01

Despite the commitment of the Democratic Republic of the Congo (DRC) to expand the family planning method mix and increase access to services, awareness of emergency contraception is low among women, and the method remains underused and poorly integrated in family planning programming. Data from 15 focus group discussions conducted in 2016 among women aged 15-35 were used to examine awareness and perceptions of, and attitudes toward, emergency contraceptives. After facilitators explained emergency contraceptive pills' mechanism of action and other characteristics, participants were asked about the potential benefits and risks of making the method more widely available. Transcripts were analyzed using an iterative approach. Women reported employing a wide range of postcoital contraceptive behaviors, albeit often using inappropriate products, and generally agreed that emergency contraceptive pills seemed to be a potentially effective solution to their family planning needs. Perceived benefits and limitations of the method were almost always framed in reference to other, better-known contraceptives, and women expressed strong preferences for pharmacy-based provision that aligned with their usual behaviors for obtaining contraceptives. Participants were reluctant to see the method available for free. Emergency contraceptive pills have the potential to address gaps in the family planning method mix in the DRC. Assessing whether women have incomplete or erroneous information about family planning methods can provide better understanding of women's contraceptive choices in low-income countries.

Contraceptive Practices Among Female Cancer Survivors of Reproductive Age.

Science.gov (United States)

Dominick, Sally A; McLean, Mamie R; Whitcomb, Brian W; Gorman, Jessica R; Mersereau, Jennifer E; Bouknight, Janet M; Su, H Irene

2015-09-01

To compare rates of contraception between reproductive-aged cancer survivors and women in the general U.S. Among survivors, the study examined factors associated with use of contraception and emergency contraception. This study analyzed enrollment data from an ongoing national prospective cohort study on reproductive health after cancer entitled the Fertility Information Research Study. We compared current contraceptive use in survivors with that of the general population ascertained by the 2006-2010 National Survey for Family Growth. Log-binomial regression models estimated relative risks for characteristics associated with use of contraception, World Health Organization tiers I-II (sterilization and hormonal) contraceptive methods, and emergency contraception in survivors. Data from 295 survivors (mean age 31.6±5.7 years, range 20-44 years) enrolled in this prospective study (85% response rate) were examined. Age-adjusted rates of using tiers I-II contraceptive methods were lower in survivors than the general population (34% [28.8-40.0] compared with 53% [51.5-54.5], Pfamily planning services (counseling, prescription or procedure related to birth control) since cancer diagnosis. In adjusted analysis, receipt of family planning services was associated with both increased use of tiers I-II contraceptive methods (relative risk 1.3, 95% confidence interval [CI] 1.1-1.5) and accessing emergency contraception (relative risk 5.0, 95% CI 1.6-16.3) in survivors. Lower rates of using tiers I-II contraceptive methods were found in reproductive-aged cancer survivors compared with the general population of U.S. women. Exposure to family planning services across the cancer-care continuum may improve contraception use among these women. ClinicalTrials.gov, www.clinicaltrials.gov, NCT01843140. II.

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 ...

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.

Hormonal contraception does not increase women's HIV acquisition risk in Zambian discordant couples, 1994–2012

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Wall, Kristin M.; Kilembe, William; Vwalika, Bellington; Khu, Naw Htee; Brill, Ilene; Chomba, Elwyn; Johnson, Brent A.; Haddad, Lisa; Tichacek, Amanda; Allen, Susan

2015-01-01

Objective To determine the impact of hormonal contraceptive methods on risk of HIV acquisition among HIV-negative women cohabiting with HIV-positive male partners. Study design From 1994–2012, HIV discordant couples recruited from a couples’ voluntary HIV counseling and testing center in Lusaka, Zambia were followed longitudinally. HIV-negative partners were tested quarterly. This analysis is restricted to couples in which the man was HIV-positive and the woman was HIV-negative at enrollment and the man was not on antiretroviral treatment. Multivariate Cox models evaluated associations between time-varying contraceptive methods and HIV acquisition among women. Sensitivity analyses explored exposure misclassification and time-varying confounder mediation. Results Among 1393 couples, 252 incident infections occurred in women over 2842 couple-years (8.9 infections per 100 couple-years; 95% CI, 7.8–10.0). Multivariate Cox models indicated that neither injectable [adjusted hazard ratio (aHR)=1.2; 95% CI, 0.8–1.7], oral contraceptive pill (OCP, aHR=1.3; 95% CI, 0.9–1.8), or implant (aHR=1.1; 95% CI, 0.5–2.2) use was significantly associated with HIV acquisition relative to non-hormonal contraception controlling for woman's age, literacy and time-varying measures of genital ulceration/inflammation. This remained true when only looking at the subset of infections acquired from the spouse (82% of infections) and additionally controlling for baseline HIV viral load of the male partner, pregnancy status, and time-varying measures of sperm on a vaginal swab wet prep and self-reported unprotected sex. OCP and injectable users reported more unprotected sex (pcontraception and HIV acquisition risk in women. Condom use and reinforced condom counseling should always be recommended for HIV discordant couples. HIV testing of sex partners together is critical to establish HIV risk, ascertain couple fertility intentions and counsel appropriately. Implications These findings

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

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 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.

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, 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.

Contraception in HIV-positive female adolescents

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Ananworanich Jintanat

2011-06-01

Full Text Available Abstract Sexual behavior of HIV-positive youths, whether infected perinatally, through risky behavior or other ways, is not substantially different from that of HIV-uninfected peers. Because of highly active antiretroviral therapy, increasing number of children, infected perinatally, are surviving into adolescence and are becoming sexually active and need reproductive health services. The objective of this article is to review the methods of contraception appropriate for HIV-positive adolescents with a special focus on hormonal contraceptives. Delaying the start of sexual life and the use of two methods thereafter, one of which is the male condom and the other a highly effective contraceptive method such as hormonal contraception or an intrauterine device, is currently the most effective option for those who desire simultaneous protection from both pregnancy and sexually transmitted diseases. Health care providers should be aware of the possible pharmacokinetic interactions between hormonal contraception and antiretrovirals. There is an urgent need for more information regarding metabolic outcomes of hormonal contraceptives, especially the effect of injectable progestins on bone metabolism, in HIV-positive adolescent girls.

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.

Emergency contraceptive pills: Exploring the knowledge and attitudes of community health workers in a developing Muslim country.

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Mir, Azeem Sultan; Malik, Raees

2010-08-01

Unsafe abortion is a major Public health problem in developing countries, where women make several unsafe attempts at termination of the unintended pregnancy before turning to health services. Community health workers can act as a bridge between the community and their health facilities and can use Emergency Contraceptive Pills to significantly reduce the mortality and morbidity related to unsafe abortions. This study explores the knowledge, attitudes and practices of the Lady Health Supervisor of the National Program for Family Planning, district Rawalpindi, regarding emergency contraception pills. The cross sectional survey was conducted during the monthly meeting of Lady Health Supervisors. Self administered, anonymous and voluntary questionnaire consisting of 17 items, regarding demographic profile, awareness, knowledge, attitudes and practices, was used. Insufficient knowledge, high misinformation and strongly negative attitudes were revealed. More than half did not know that emergency contraceptive pills do not cause abortion. About four fifths believed that emergency contraceptive pills will lead to 'evil' practices in society. More than four fifths recognized that the clients of National Program for Family Planning need emergency contraceptive pills. The attitudes were significantly associated with knowledge (P=0.034, Fisher's Exact Test). The awareness of emergency contraceptive pills is high. Serious gaps in knowledge have been identified. There is a clear recognition of the need of emergency contraceptive pills for the clients of National Program for Family Planning. However, any strategy to introduce emergency contraceptive pills must cater for the misplaced beliefs of the work force.

Hormonal contraception use alters stress responses and emotional memory.

Science.gov (United States)

Nielsen, Shawn E; Segal, Sabrina K; Worden, Ian V; Yim, Ilona S; Cahill, Larry

2013-02-01

Emotionally arousing material is typically better remembered than neutral material. Since norepinephrine and cortisol interact to modulate emotional memory, sex-related influences on stress responses may be related to sex differences in emotional memory. Two groups of healthy women - one naturally cycling (NC women, n=42) and one using hormonal contraceptives (HC women, n=36) - viewed emotionally arousing and neutral images. Immediately after, they were assigned to Cold Pressor Stress (CPS) or a control procedure. One week later, participants received a surprise free recall test. Saliva samples were collected and later assayed for salivary alpha-amylase (biomarker for norepinephrine) and cortisol. Compared to NC women, HC women exhibited significantly blunted stress hormone responses to the images and CPS. Recall of emotional images differed between HC and NC women depending on noradrenergic and cortisol responses. These findings may have important implications for understanding the neurobiology of emotional memory disorders, especially those that disproportionately affect women. Published by Elsevier B.V.

Are we overestimating the stroke risk related to contraceptive pills?

Science.gov (United States)

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.

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

Science.gov (United States)

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.

Efficacy of contraceptive methods: a review of the literature.

Science.gov (United States)

Mansour, Diana; Inki, Pirjo; Gemzell-Danielsson, Kristina

2010-12-01

To provide a comprehensive and objective summary of contraceptive failure rates for a variety of methods based on a systematic review of the literature. Medline and Embase were searched using the Ovid interface from January 1990 to February 2008, as well as the reference lists of published articles, to identify studies reporting contraceptive efficacy as a Pearl Index or life-table estimate. Reports that recruited less than 400 subjects per study group and those covering less than six cycles/six months were excluded. In addition, unlicensed products or those not internationally available, emergency contraception, and vasectomy studies were excluded. Information was identified and extracted from 139 studies. One-year Pearl Indices reported for short-acting user-dependent hormonal methods were generally less than 2.5. Gross life-table rates for long-acting hormonal methods (implants and the levonorgestrel releasing-intrauterine system [LNG-IUS]) generally ranged between 0-0.6 per 100 at one year, but wider ranges (0.1-1.5 per 100) were observed for the copper intrauterine devices (0.1-1.4 per 100 for Cu-UIDs with surface area ≥ 300 mm2 and 0.6-1.5 per 100 for those with surface area natural methods were the least effective. Our review broadly confirms the hierarchy of contraceptive effectiveness in descending order as: (1) female sterilisation, long-acting hormonal contraceptives (LNG-IUS and implants); (2) Cu-IUDs with ≥ 300 mm2 surface area; (3) Cu-IUDs with natural methods.

A comparative analysis of the modification of sexual desire of users of oral hormonal contraceptives and intrauterine contraceptive devices.

Science.gov (United States)

Martin-Loeches, M; Ortí, R M; Monfort, M; Ortega, E; Rius, J

2003-09-01

To compare the influence of oral hormonal contraceptives (OCs) and the use of intrauterine contraceptive devices (IUDs) on the modification of sexual desire. A prospective observational study of 1073 women using OCs or an IUD at the Family Planning Center 'Marina Alta' in Alicante, Spain. In order to evaluate the relative risk regarding the decrease in libido attributed to each contraceptive method, a logistic regression analysis was undertaken which considered the factors of age adjustment, level of studies, family planning information, relationship with partner, age when sexual relationships were initiated, parity, contraceptive method previously used and the duration of use of the contraceptive method. No differences in the decrease of sexual desire were observed between the use of the OC and IUD (odds ratio (OR) 1.32; 95% confidence interval (CI) 0.70-2.49), yet differences were noted, however, in relation to age (OR 1.05; 95% CI 1.01-1.10). Although these differences were not statistically significant, a high level of awareness regarding family planning was shown to increase sexual desire when compared to a lower level of information on this subject (OR 0.64; 95% CI 0.41-1.01). Sexual desire was seen to decrease if the quality of the relationship with the partner was average (OR 2.24; 95% CI 1.36-3.69) or poor (OR 4.69; 95% CI 1.93-11.4). Nulliparous women showed a greater decrease in sexual desire in relation to women who had already given birth (OR 1.57; 95% CI 1.00-2.47). Sexual desire was greater if the contraceptive method had already been in use for 6-12 months (OR 0.41; 95% CI 0.17-0.98). Sexual desire does not vary in relation to the use of OCs or IUDs, yet it does decrease with age, in nulliparous women and in those with an average or poor relationship with their partner. Furthermore, sexual desire shows an increase between the first 6 and 12 months of contraceptive treatment.

Increasing access to emergency contraception through online prescription requests.

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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.

[Contraception in the future].

Science.gov (United States)

Hamzaoui, R; Boukhris, M

1994-02-01

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

[Emergency contraception in Latin America and the Caribbean].

Science.gov (United States)

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

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

Science.gov (United States)

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. �

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

Science.gov (United States)

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.

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.

Hormonal Contraception, Pregnancy, Breastfeeding, and Risk of HIV Disease Progression Among Zambian Women.

Science.gov (United States)

Wall, Kristin M; Kilembe, William; Haddad, Lisa; Vwalika, Bellington; Lakhi, Shabir; Khu, Naw Htee; Brill, Ilene; Chomba, Elwyn; Mulenga, Joseph; Tichacek, Amanda; Allen, Susan

2016-03-01

Some studies suggest that hormonal contraception, pregnancy, and/or breastfeeding may influence rates of HIV disease progression. From 1994 to 2012, HIV discordant couples recruited at couples' voluntary HIV counseling and testing centers in Lusaka were followed 3-monthly. Multivariate survival analyses explored associations between time-varying contraception, pregnancy, and breastfeeding and 2 outcomes among HIV-positive women: (1) time to death and (2) time to antiretroviral treatment (ART) initiation. Among 1656 female seropositive, male seronegative couples followed for 3359 person-years (PY), 224 women died [6.7/100 PY; 95% confidence interval (CI): 5.8 to 7.6]. After 2003, 290 women initiated ART (14.5/100 PY; 95% CI: 12.9 to 16.2). In a multivariate model of time to death, hormonal implant [adjusted hazard ratio (aHR) = 0.30; 95% CI: 0.10 to 0.98] and injectable (aHR = 0.59; 95% CI: 0.36 to 0.97) were significantly protective relative to nonhormonal method use, whereas oral contraceptive pill (OCP) use was not (aHR = 1.08; 95% CI: 0.74 to 1.57) controlling for baseline HIV disease stage, time-varying pregnancy, time-varying breastfeeding, and year of enrollment. In a multivariate model of time-to-ART initiation, implant was significantly protective (aHR = 0.54; 95% CI: 0.31 to 0.95), whereas OCP (aHR = 0.70; 95% CI: 0.44 to 1.10) and injectable (aHR = 0.85; 95% CI: 0.55 to 1.32) were not relative to nonhormonal method use controlling for variables above, woman's age, and literacy. Pregnancy was not significantly associated with death (aHR = 1.07; 95% CI: 0.68 to 1.66) or ART initiation (aHR = 1.24; 95% CI: 0.83 to 1.86), whereas breastfeeding was protective for death (aHR = 0.34; 95% CI: 0.19 to 0.62) and ART initiation (aHR = 0.49; 95% CI: 0.29 to 0.85). Hormonal implants and injectables significantly predicted lower mortality; implants were protective for ART initiation. OCPs and pregnancy were not associated with death or ART initiation, whereas

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.

Directory of Open Access Journals (Sweden)

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.

The impact of hormonal contraceptives on blood pressure, urinary albumin excretion and glomerular filtration rate

NARCIS (Netherlands)

Atthobari, Jarir; Gansevoort, Ron T.; Visser, Sipke T.; de Jong, Paul E.; de Jong-van den Berg, Lolkje T. W.

Aim In short-term studies, hormonal contraceptives (HC) have been suggested to induce a rise in blood pressure (BP) and urinary albumin excretion (UAE), while the effect of HC in renal function (GFR) is still under debate. Data on long-term and withdrawal effects of HC use on these outcomes are,

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…

Perceived competence and contraceptive use during adolescence.

Science.gov (United States)

Hillman, Jennifer B; Negriff, Sonya; Dorn, Lorah D

2010-03-01

Little is known about psychosocial correlates of different contraceptive methods in adolescence. Cross-sectional analyses of 209 postmenarcheal girls [mean age (years)+/-SD=15.68+/-1.74], primarily Caucasian (62.8%) or African American (32.8%). Competence (activities and social) and rule-breaking behavior were assessed by the Youth Self Report (YSR; adolescent) and the Child Behavior Checklist (CBCL; parent). Three contraceptive-use groups were created: no hormonal contraceptive (n=142), combined oral contraceptives or the transdermal patch (COCs/patch, n=41), and depot medroxyprogesterone acetate (DMPA, n=20). There was a significant effect of contraceptive-use group on competence (p=.003). The DMPA group had lower competence (CBCL activities and social; YSR social) than the no-hormonal-contraceptive and COCs/patch groups. The COCs/patch group scored lower than the no-hormonal-contraceptive group on YSR activities competence, but was not different from the DMPA group. Lastly, there was an effect of contraceptive-use group on CBCL (but not YSR) rule-breaking behavior (p=.029) with the DMPA group having higher rule-breaking behavior than the other groups. Type of contraceptive method was associated with parent and adolescent's perceived competence. For rule-breaking behavior, parental perception may be more relevant to contraceptive use. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Reversible, non-barrier male contraception: status and prospects.

Science.gov (United States)

Hoesl, C E; Saad, F; Pöppel, M; Altwein, J E

2005-11-01

Male, non-barrier, contraceptive options are limited to vasectomy and inadequate methods such as withdrawal and periodic abstinence. Herein we give an overview of current research on male contraception by pharmacological means. Literature search of PubMed documented publications and abstracts from meetings. Cross-cultural surveys show men's willingness to carry contraceptive responsibility. Clinical trials substantiate that hormonal contraception involving suppression of gonadotropins holds the best promise to provide a male pharmacological contraceptive. Androgens have been demonstrated to induce reversible infertility particularly in combination with certain progestins and GnRH antagonists. Advances in non-endocrine contraception include intervention with triptolide derivatives, alkylated imino sugars, and immunization by eppin. The prospect of a pharmacological, male contraceptive has been considerably advanced in recent years. Long-term studies involving a greater number of subjects may result in a safe, reversible and effective means. Asia is likely to be the first market for male, hormonal contraceptive methods. The clinical evaluation of non-endocrine approaches may ultimately lead to an alternative to hormone-based male contraception.

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

Science.gov (United States)

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.

Evaluation of pharmacists' services for dispensing emergency contraceptive pills in Delhi, India: A mystery shopper study

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Pikee Saxena

2016-01-01

Full Text Available Background: Although emergency contraceptive pills are available over the counter, the quality of consultation, including key areas of contraceptive counseling and prevention of sexually transmitted infections (STI, has not been well documented. Objective: To evaluate actual pharmacist services while dispensing emergency contraception through a mystery shopper technique. Material and Methods: This cross-sectional study was conducted in 81 pharmacies situated in Delhi by 4 trained mystery shoppers posed as customers over a period of 6 months. Results: None of the pharmacists asked about the time lapsed since last unprotected sexual intercourse or last menstrual period before deciding the eligibility of the customer. The majority were unclear about side effects associated with emergency contraception (78.57% or with anticipated changes in menstrual flow (78.57%; 85.71% did not know whether subsequent unprotected intercourse would be protected. Only 15.71% counseled shoppers regarding risk of STI on asking leading questions and 88.5% did not provide any contraceptive advice. Conclusion: There is a huge gap in the technical knowledge and mindset of the pharmacists when it comes to checking for the eligibility of the client and providing advice regarding use of regular contraception and barrier for protection from STI, which needs to be addressed in order to realize the full benefit of making emergency contraceptive pills available over the counter.

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.

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 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

Hormonal contraception and risk of cancer

DEFF Research Database (Denmark)

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

2011-01-01

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

Hormonal contraception and risk of cancer

DEFF Research Database (Denmark)

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

2010-01-01

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

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.

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.

Superior Mesenteric Vein Thrombosis Associated with Hormonal Contraceptive Use

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Nobuatsu Koyama

2016-06-01

Full Text Available A 44-year-old woman was admitted with a 7-day history of lower abdominal pain and nausea. Physical examination demonstrated tenderness in the lower abdomen without signs of peritonitis. There were no specific findings in the laboratory evaluation. She had a history of dysmenorrhea for 15 years and was taking a combined hormonal contraceptive containing 0.02 mg ethinyl estradiol and 3 mg drospirenone for 19 months. Contrast-enhanced computed tomography showed superior mesenteric vein thrombosis (SMVT. Systemic anticoagulant infusion was immediately administered and the symptoms disappeared within 2 days. The thrombus disappeared after 3 months. This case report suggests that early diagnosis of SMVT and immediate systemic anticoagulant therapy may reduce the rate of intestinal infarction.

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

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... 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 ...

Acceptability of contraception for men: a review.

Science.gov (United States)

Glasier, Anna

2010-11-01

Methods of contraception for use by men include condoms, withdrawal and vasectomy. Prevalence of use of a method and continuation rates are indirect measures of acceptability. Worldwide, none of these "male methods" accounts for more than 7% of contraceptive use although uptake varies considerably between countries. Acceptability can be assessed directly by asking about intended (hypothetical) use and assessing satisfaction during/after use. Since they have been around for a very long time, there are very few data of this nature on condoms (as contraceptives rather than for prevention of infection), withdrawal or vasectomy. There are direct data on the acceptability of hormonal methods for men but from relatively small clinical trials which undoubtedly do not represent the real world. Surveys undertaken among the male general public demonstrate that, whatever the setting, at least 25% of men - and in most countries substantially more - would consider using hormonal contraception. Although probably an overestimate of the number of potential users when such a method becomes available, it would appear that hormonal contraceptives for men may have an important place on the contraceptive menu. Despite commonly expressed views to the contrary, most women would trust their male partner to use a hormonal method. Copyright © 2010 Elsevier Inc. All rights reserved.

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

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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.

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.

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

OpenAIRE

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...

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

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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.

Non-prescription dispensing of emergency oral contraceptives: Recommendations from the German Federal Chamber of Pharmacists [Bundesapothekerkammer

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Schulz M

2016-09-01

Full Text Available Background: Emergency hormonal contraceptives (EHC are contraceptives used to prevent unintended pregnancy following unprotected sexual intercourse (USI or contraceptive failure. The EHCs available without a prescription include medicines containing levonorgestrel (LNG in more than 80 countries and, recently, based on an EU-switch ellaOne®, which contains ulipristal acetate (UPA. EHCs work by stopping or delaying ovulation. Those containing LNG can be used up to 72 hours after USI or contraceptive failure, while UPA can be used up to 120 hours. In the context of the UPA implementation process, Germany switched LNG to non-prescription status as well. Objectives: To develop recommendations, a protocol, and a continuing education program for pharmacists to assure quality when giving advice and dispensing EHCs in community pharmacies without a medical prescription. Methods: The recommendations were developed by an iterative process of drafting, recognizing, and discussing comments and proposals for amendments as well a seeking agreement with a number of stakeholders such as the Federal Ministry of Health (BMG, Federal Institute for Drugs and Medical Devices (BfArM, Federal Chamber of Physicians (BÄK, Drug Commission of German Physicians (AkdÄ, professional organizations/associations of gynaecologists, pharmaceutical OTC-industry as well as government-controlled, private, and church-based organizations and centres providing advice on sex education and family planning. Results: The recommendations were eventually endorsed by the BMG in consultation with the BfArM. Conclusions: The recommendations were made public, published in the professional journal and used in an uncounted number of continuing education programs based on the curriculum and provided by the State Chambers of Pharmacists.

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...

Weight and body mass index among female contraceptive clients.

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Kohn, Julia E; Lopez, Priscilla M; Simons, Hannah R

2015-06-01

As obesity may affect the efficacy of some contraceptives, we examined weight, body mass index (BMI) and prevalence of obesity among female contraceptive clients at 231 U.S. health centers. A secondary aim was to analyze differences in contraceptive method use by obesity status. Cross-sectional study using de-identified electronic health record data from family planning centers. We analyzed contraceptive visits made by 147,336 females aged 15-44 years in 2013. A total of 46.1% of clients had BMI ≥25. Mean body weight was 154.4 lb (S.D.=41.9); mean BMI was 26.1 (S.D.=6.6). A total of 40% had BMI ≥26, when levonorgestrel emergency contraception may become less effective. Obese clients had higher odds of using a tier 1 or tier 3 contraceptive method and had lower odds of using a tier 2 or hormonal method than non-obese clients. About half of contraceptive clients would be categorized as overweight or obese. Contraceptive method choices differed by obesity status. About half of contraceptive clients in this study population were overweight or obese. Contraceptive method choices differed by obesity status. All women - regardless of body size - should receive unbiased, evidence-based counseling on the full range of contraceptive options so that they can make informed choices. Copyright © 2015 Elsevier Inc. All rights reserved.

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

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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

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

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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.

Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK: a prospective study

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O'Brien Karen

2009-03-01

Full Text Available Abstract Background More women are requesting Emergency Hormonal Contraception (EHC at pharmacies where screening for Chlamydia trachomatis is not routinely offered. The objective of this study was to assess the uptake of free postal chlamydia screening by women under 25 years who requested EHC at pharmacies in Manchester, UK. Methods Six Primary Care Trusts (PCTs that had contracted with pharmacies to provide free EHC, requested the largest EHC providers (≥ 40 doses annually to also offer these clients a coded chlamydia home testing kit. Pharmacies kept records of the ages and numbers of women who accepted or refused chlamydia kits. Women sent urine samples directly to the laboratory for testing and positive cases were notified. Audit data on EHC coverage was obtained from PCTs to assess the proportion of clients eligible for screening and to verify the uptake rate. Results 33 pharmacies participated. Audit data for 131 pharmacy months indicated that only 24.8% (675/2718 of women provided EHC were also offered chlamydia screening. Based on tracking forms provided by pharmacies for the whole of the study, 1348/2904 EHC clients (46.4% who had been offered screening accepted a screening kit. 264 (17.6% of those who accepted a kit returned a sample, of whom 24 (9.1% were chlamydia-positive. There was an increase in chlamydia positivity with age (OR: 1.2 per year; 1.04 to 1.44; p = 0.015. Conclusion Chlamydia screening for EHC pharmacy clients is warranted but failure of pharmacists to target all EHC clients represented a missed opportunity for treating a well defined high-risk group.

New frontiers in nonhormonal male contraception.

Science.gov (United States)

Cheng, C Yan; Mruk, Dolores D

2010-11-01

The world's population is nearing 6.8 billion, and we are in need of a male contraceptive that is safe, effective, reversible and affordable. Hormonal approaches, which employ different formulations of testosterone administered in combination with other hormones, have shown considerable promise in clinical trials, and they are currently at the forefront of research and development. However, the long-term effects of using hormones throughout a male's reproductive life for contraception are unknown, and it may take decades before this information becomes available. Because of this, many investigators are aiming to bring a nonhormonal male contraceptive to the consumer market. Indeed, there are several distinct but feasible avenues in which fertility can be regulated without affecting the hypothalamus-pituitary-testis axis. In this review, we discuss several approaches for fertility control involving the testis that one day may lead to the development of a nonhormonal male contraceptive. Copyright © 2010 Elsevier Inc. All rights reserved.

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

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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.

Contraceptive options for women living with HIV.

Science.gov (United States)

Phillips, Sharon; Steyn, Petrus; Temmerman, Marleen

2014-08-01

Women living with HIV are often of reproductive age, and many desire effective contraceptive options to delay or prevent pregnancy. We review the safety of various hormonal and non-hormonal contraceptive methods for women living with human immunodeficiency virus (HIV). Additionally, we discuss drug interactions between contraceptive methods and antiretrovirals and the safety of methods with respect to onward transmission to HIV-negative partners for women in sero-discordant partnerships. In general, most methods are safe for most women living with HIV. An understanding of the reproductive goals of each individual patient, as well as her medical condition and medication, should be taken into account when counselling women on their contraceptive options. Further research is needed to understand drug interactions between contraceptives and antiretrovirals better and how to fulfil the contraceptive needs of HIV-positive women. Copyright © 2014. Published by Elsevier Ltd.

Current Developments In Contraception

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Cem Yaşar Sanhal

2012-06-01

Full Text Available Contraception (birth control prevents pregnancy by interfering with the normal process of ovulation, fertilization, and implantation. There are different kinds of birth control that act at different points in the process. The rapid increase in the world population makes it mandatory to develop new contraceptive methods. According to WHO data, every year 200 billion new pregnancies occur and more than 50 billion of them are classified as unintended. To avoid complications of these unintended pregnancies and abortions, the contraception and kinds of contraceptive methods should be well known and understood. Recently, new hormonal contraceptive choices and regimen were adminestered and studies about male contraception and immunocontraception were performed. In this review, we discussed about the new development and progress on contraception.

Psychobehavioral Effects of Hormonal Contraceptive Use

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Lisa L. M. Welling

2013-07-01

Full Text Available Although female use of hormonal contraceptives (HCs has been associated with a variety of physical side effects, the psychological and behavioral side effects have received comparatively little attention until recently. Indeed, the long-term impact of HC use on human psychology has been vastly under-researched and has only recently become a focus for mainstream scholars. Women who use HCs report higher rates of depression, reduced sexual functioning, and higher interest in short-term sexual relationships compared to their naturally-cycling counterparts. Also, HC use may alter women's ability to attract a mate, as well as the mate retention behaviors in both users and their romantic partners. Some evidence even suggests that HC use alters mate choice and may negatively affect sexual satisfaction in parous women, with potential effects on future offspring. Interestingly, HCs have become a standard method of population control for captive nonhuman primates, opening up exciting avenues for potential comparative research. Here, the existing literature on the psychobehavioral effects of HCs in humans and nonhuman primates is reviewed and discussed. The potential resulting downstream consequences for the path of human evolution and recommendations for how future research could tease apart the underlying causes of these psychobehavioral effects of HC use are discussed, including suggestions for research involving nonhuman primates.

The state-of-the-art of emergency contraception with the cutting edge drug

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Sarkar, Narendra Nath

2011-01-01

Full Text Available The objective of this study is to evaluate and elucidated the potential of selective progesterone receptor modulators (SPRMs to be an effective emergency contraception (EC. The data are extracted from the literature through the MEDLINE database service from 2000–2010. The SPRMs are in fact progesterone receptor ligands that could bind to progesterone receptor (PR and exert antagonistic, agonistic or mixed agonist-antagonistic effects. These SPRMs are mifepristone, onapristone, asoprisnil, ulipristal, proellex among other compounds. Currently developed SPRMs may exert contraceptive effects by inhibiting ovulation and retarding endometrial synchronization. Low-doses of progesterone antagonists retard endometrial maturation without affecting ovulation. Mifepristone being a SPRM is effective for prevention of pregnancy but with prostaglandin acts as an excellent abortifacient; yet could not compete with levonorgestrel as EC. However, a single dose of 30 mg ulipristal acetate, another SPRM with similar effectiveness and side effect profiles as 1.5 mg levonorgestrel EC, has shown wider ‘window of effect’ by inhibition of the LH peak even if administered at the advanced pre-ovulatory phase, a time when use of levonorgestrel EC is no longer effective. Thus, ulipristal acetate goes one-step ahead of levonorgestrel in the field of emergency contraception treatment. Further studies are needed to explore the potential of other SPRMs to be cutting edge emergency contraceptive drugs.

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.

Male contraception: history and development.

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Kogan, Paul; Wald, Moshe

2014-02-01

Although the twentieth century has seen great strides in the development of female contraception, not a single new agent has been introduced as an approved method for common use for male contraception. Condoms (considered uncomfortable by some) and vasectomy (a permanent invasive procedure) are the only options provided to men, leaving an undue burden on women to bear contraceptive responsibility. Significant developments have, however, been made with regard to hormonal and nonhormonal contraception, and minor, reversible, procedural contraception. This article reviews the currently available, soon to be available, and theoretically possible methods of male contraception. Copyright © 2014 Elsevier Inc. All rights reserved.

Acute Mesenteric Venous Thrombosis with a Vaginal Contraceptive Ring

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Wesley Eilbert

2014-07-01

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

Emergency contraception: why can't you give it away? Qualitative findings from an evaluation of advance provision of emergency contraception.

Science.gov (United States)

Fairhurst, Karen; Ziebland, Sue; Wyke, Sally; Seaman, Peter; Glasier, Anna

2004-07-01

The Lothian Emergency Contraception Project (LECP)--a primary care-based intervention to offer advance supplies of emergency contraception (EC) to women aged 16-29 was not associated with a reduction in abortion rates. We undertook case studies, utilizing qualitative and quantitative methods, to evaluate the intervention. In this article we present findings from qualitative interviews with 44 primary care professionals working at case study sites and 22 women who had received advance supplies to explain this failure. Professionals reported that women rarely asked for advance supplies of EC and they were reluctant to offer supplies to women because of concerns about contradictory sexual health messages implied by the offer, a perceived association of EC use with chaotic behavior by women, views about the sort of women suitable for advance supplies and practical difficulties making the offer. Women were reluctant to ask for advance supplies because of misgivings about the appropriateness of offering advance supplies to everybody and concerns about being judged by health professionals as morally inadequate. If advance provision of EC is to be successful in reducing abortion rates, professionals must address their concerns about EC and develop imaginative ways of encouraging women most at risk of unwanted pregnancy to take supplies home.

Contraceptive efficacy of the personal hormone monitoring system Persona.

Science.gov (United States)

Trussell, J

1999-07-01

This is a commentary on the contraceptive effectiveness of the personal hormone-monitoring system Persona; it points out the various errors committed in computing method pregnancy rates. The modifications presented by Bonnar et al. on the incorrect procedure for computing method pregnancy rates are criticized as erroneous because the denominator includes cycles in which there is no risk of a method pregnancy according to the authors' algorithm for classifying pregnancy in an imperfect-use cycle. It is also claimed that the new exercise is a more complicated and less accurate way of computing for pregnancy rates by comparison with the simpler alternative. Since this new algorithm, used in the Persona system, is based on flawed logic, the annual risk of pregnancy is actually higher than the estimated 6% among women using Persona and having intercourse in each cycle except on red days.

Contraception technology: past, present and future.

Science.gov (United States)

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

2013-03-01

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

U.S. Men's Perceptions and Experiences of Emergency Contraceptives.

Science.gov (United States)

Wright, Rachel L; Fawson, Peter R; Frost, Caren J; Turok, David K

2017-05-01

Research suggests that men should be included in reproductive health decision making to help enhance positive health outcomes for their partners. Men affect the use of contraception and what method is used. Men's decisions may be affected by different factors such as gender, education, and the nature of their sexual relationship. A qualitative study was conducted to explore males' experiences and perceptions about emergency contraception (EC), and the meanings males assign to EC. Semistructured in-depth focus groups were held with 15 men who engage in heterosexual activity recruited from a university setting in the United States. Participants expressed egalitarian views of the contraception decision-making processes, a sense of responsibility regarding reproductive decision making, and that society has a negative stigma toward those who use EC. However, there was a lack of knowledge regarding the copper intrauterine device, which was not viewed as a method of EC. Exploring the role and needs of men in reproductive health care discussions and research is an important and growing area. Recommendations are provided for health care practitioners, policy, and future research around men and EC.

The safety of available and emerging options for emergency contraception.

Science.gov (United States)

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.

Gonadotrophin-Releasing Hormone Agonists and Other Contraceptive Medications in Exotic Companion Animals.

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Schoemaker, Nico J

2018-05-01

The use of a gonadotrophin-releasing hormone agonist slow-release implant (GnRH A-SRI) has become increasingly popular as an alternative for surgical contraception in many species. Although these implants have proven to be very effective in some species (eg, ferrets, rats, chicken, psittacines, and iguanas), they have been found less effective in other species (eg, male guinea pigs and rabbits, veiled chameleons, slider turtles, and leopard geckos). This review provides an overview of the available literature on the effects of GnRH A-SRIs in companion exotic animals. Copyright © 2018 Elsevier Inc. All rights reserved.

"EFFECT OF PROGESTOGEN-ONLY CONTRACEPTIVES ON HUMAN MILK COMPOSITION"

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Sh. Ghazizadeh P. Pasalar

2004-08-01

Full Text Available Different contraceptive methods are used by breastfeeding mothers. To investigate the effects of progestogen - only contraceptives on human milk components, a non-randomized, follow-up study was carried out in Iran (Varamin on 140 breastfeeding women, 51 of whom used progestogenonly contraception including progestogen-only pills (POP or depo-medroxyprogesterone acetate (DMPA, and 89 used non-hormonal contraception methods, starting at 6 weeks after delivery. Human milk components were compared between the groups after 26 weeks. There were no statistically significant differences between groups, in terms of protein, sodium, calcium, phosphorus and potassium concentration of milk, but triglycerides in the hormonal group and magnesium in the non-hormonal group were higher than the other group (P< 0.05. It seems that progestogen-only methods (POP and DMPA do not have an adverse effect on human milk composition, and are safe contraceptives during lactation.

Breastfeeding duration related to practised contraception in the Netherlands

NARCIS (Netherlands)

Wouwe, J.P. van; Lanting, C.I.; Dommelen, P. van; Treffers, P.E.; Buuren, S. van

2009-01-01

Aim: The aim of this study was to gain insight into contraception practised and related to breastfeeding duration. Methods: Mothers with infants up to 6 months received a questionnaire on infant feeding (breast or formula feeding) and contraception (hormonal or non-hormonal methods). Estimates of

Consequences of emergency contraceptives: the adverse effects.

Science.gov (United States)

Thomin, Anne; Keller, Valentin; Daraï, Emile; Chabbert-Buffet, Nathalie

2014-07-01

Emergency contraception (EC) offers women an important strategy to prevent unintended pregnancy following intercourse. Despite the constant improvement of availability of different molecules and techniques already existing (Yuzpe regimen, levonorgestrel, intrauterine device) and the emergence of ulipristal acetate, the numbers of unintended pregnancies and unplanned births could still be reduced. This review will evaluate all the information about the potential adverse effects and tolerability of each method of EC by putting them in balance with their safety and effectiveness. A literature search until December 2013 was performed to identify all trials studying the safety data available concerning EC. Different means of EC have been demonstrated to be generally safe and well tolerated. These data support women information in order to improve use and efficacy of EC.

Contracepción de emergencia con Levonorgestrel Emergency contraception with levonorgestrel

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Fernando D. Saraví

2007-10-01

Full Text Available La contracepción de emergencia puede evitar el embarazo luego de un coito sin medidas contraceptivas o cuando éstas fallan. Se recomienda el levonorgestrel, un gestágeno sintético, en dosis única de 1.5 mg (alternativamente en dos dosis de 0.75 mg espaciadas 12 h. Su eficacia es moderada, pues impide aproximadamente 80% de los embarazos. La eficacia es mayor cuanto más precozmente se administre, pero puede darse hasta 5 días post-coito. La tolerancia es similar o superior a la de otros preparados empleados con igual propósito. Los efectos adversos comprenden náuseas, vómitos, cefalea, tensión mamaria y alteraciones transitorias en la siguiente menstruación. Se desconoce si el levonorgestrel aumenta la probabilidad de embarazo ectópico cuando el tratamiento fracasa. No se recomienda su empleo como contraceptivo habitual. Cuando se administra antes del pico preovulatorio de LH, el levonorgestrel generalmente bloquea o retrasa la ovulación. Puede asimismo afectar la migración de los espermatozoides en el tracto genital femenino e, indirectamente, la fertilización. Pese a haberse postulado reiteradamente, no existe evidencia de un efecto antiimplantatorio. El conocimiento del método es muy variable en diferentes sociedades, pero aun donde es bien conocido permanece subutilizado. Se ha propuesto proveer levonorgestrel por adelantado para promover su uso. En ensayos clínicos, tal provisión no afectó adversamente el comportamiento sexual ni el empleo de otros contraceptivos, pero tampoco redujo el número de embarazos o abortos. En consecuencia, el empleo de levonorgestrel debe considerarse un método de respaldo que no reemplaza el uso de contraceptivos más eficaces.Emergency contraception may avoid pregnancy after unprotected intercourse or when regular contraceptive measures fail. Levonorgestrel, a synthetic gestagen, is recommended for emergency contraception as a single 1.5-mg dose or, alternatively, two 0.75-mg doses taken 12

Male contraception: past, present and future.

Science.gov (United States)

Payne, Christopher; Goldberg, Erwin

2014-01-01

Current contraceptive options available to men include withdrawal, condoms, and vasectomy, each of which has its own drawbacks. In this chapter we will describe the pros and cons for each, as well as methodological and product updates. Statistics from the U.S. Centers for Disease Control on acceptance and satisfaction will be included. Advances in vasectomy and reversal will be presented. Methods to develop new contraceptive technologies fall into two categories: hormonal and non-hormonal. Many targets and strategies have been proposed for non-hormonal male contraception within the testis. Targets include structural components in the testis, as well as enzymes, ion channels and other proteins specific to spermatozoa. Here we provide an overview of the spermatogenic mechanisms and proteins that have received research interest to date. We also discuss potential novel targets, such as ubiquitin specific proteases, that warrant greater research emphasis.

Effect of body weight and BMI on the efficacy of levonorgestrel emergency contraception.

Science.gov (United States)

Kapp, Nathalie; Abitbol, Jean Louis; Mathé, Henri; Scherrer, Bruno; Guillard, Hélène; Gainer, Erin; Ulmann, André

2015-02-01

To further evaluate the effect of weight and body mass index (BMI) on the efficacy of levonorgestrel emergency contraception. Data from two large, multicenter, randomized controlled trials designed to assess emergency contraceptive efficacy were pooled to evaluate the effect of weight and BMI on pregnancy rates among women who received levonorgestrel. Descriptive methods (comparison of means and distributions according to pregnancy status and pregnancy rates across weight and BMI categories) as well as cubic spline modeling were used to describe the relationship between pregnancy risk and weight/BMI. The analysis population comprised 1731 women, among whom 38 pregnancies were reported. Women for whom levonorgestrel was not effective in preventing pregnancy had a significantly higher mean body weight and BMI than women who did not become pregnant (76.7 vs. 66.4 kg, p85 kg groups, respectively. Statistical modeling demonstrated a steep increase in pregnancy risk starting from a weight near 70-75 kg to reach a risk of pregnancy of 6% or greater around 80 kg. Similar results were obtained for statistical modeling of BMI as well as when the two studies were analyzed individually. All analyses showed a significant drop in the efficacy of levonorgestrel emergency contraception with increasing body weight, with pregnancy risk in the higher weight categories similar to expected rates in the absence of contraception. Like body weight, increasing BMI was highly correlated with increased pregnancy risk. Copyright © 2015 Elsevier Inc. All rights reserved.

Combined oral contraceptives versus levonorgestrel for emergency contraception.

Science.gov (United States)

Strayer, S M; Couchenour, R L

1998-12-01

A study supported by the World Health Organization's Task Force on Postovulatory Methods of Fertility Control compared the efficacy of the Yuzpe and levonorgestrel-only methods of emergency contraception (EC). Enrolled in this double-blind, randomized trial were 1998 women from 21 centers around the world who requested EC within 72 hours of unprotected intercourse. The pregnancy rate was 1.1% for levonorgestrel alone and 3.2% for the combined ethinyl estradiol-levonorgestrel regimen. The crude relative risk of pregnancy was 0.36 (95% confidence interval, 0.18-0.70) for levonorgestrel compared with the Yuzpe regimen. The former method prevented 85% of expected pregnancies, while the latter prevented only 57%. Finally, side effects such as nausea, vomiting, dizziness, and fatigue were significantly less common in the levonorgestrel group. Although these findings document the superiority of the levonorgestrel regimen for EC, the 0.75 mg tablets are not currently manufactured in the US.

Acesso à anticoncepção de emergência: velhas barreiras e novas questões Access to emergency contraception: old barriers and new questions

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Ney Francisco Pinto Costa

2008-02-01

Full Text Available OBJETIVO: comparar duas estratégias de acesso à anticoncepção de emergência (AE: informação e informação com entrega antecipada do método, e sua relação com o uso deste método e com o uso regular de anticoncepcionais. MÉTODOS: DE AGosto de 2004 a janeiro de 2005, foram recrutadas voluntárias de 18 a 49 anos, atendidas em clínicas de saúde reprodutiva em seis cidades brasileiras. Os sujeitos foram distribuídos aleatoriamente no grupo que recebeu informação (Grupo Controle ou no grupo que recebeu informação e entrega antecipada (Grupo Medicado. Houve visitas de seguimento em quatro e oito meses. Para a análise estatística, foram usados os testes de Person e McNemar. RESULTADOS: dos 823 sujeitos recrutados, 407 completaram os oito meses de observação e constituíram a amostra para análise. A maioria dos sujeitos (61% não usou AE. Os sujeitos do Grupo Medicado usaram mais AE (57% do que os do Grupo Controle (18%, e o fizeram mais precocemente em relação ao tempo desde a relação sexual desprotegida. Houve aumento significativo no uso regular de anticoncepcionais entre os sujeitos que usaram AE do Grupo Medicado (88% versus 97% e uma redução sem significado estatístico no Grupo Controle. CONCLUSÕES: informação e entrega antecipada ampliaram o acesso e uso da AE e não reduziram o uso regular de anticoncepcionais, incluindo preservativos.PURPOSE: to compare two strategies of access to emergency contraception: only information and information with previous delivery of this contraceptive method, and its relationship with the use of this method and the regular use of contraceptives. METHODS: from August 2004 to January 2005, 18 to 49-year-old volunteers, attended at reproductive health clinics from six Brazilian towns were recruited. The subjects were randomly distributed in a group getting information about emergency contraception (Control Group, or in a group getting information about this method and previous

Knowledge, Perception and Practice of Emergency Contraception among Female Adolescent Hawkers in Rigasa Suburban Community of Kaduna State Nigeria

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Abubakar Attahir

2010-03-01

Full Text Available Objective: In Nigeria the rate of contraceptive use among sexually active adolescents is about 30%, considerably lower than the rates reported for developed countries. This study aimed to determine the knowledge, perception and practice of emergency contraception among female adolescent hawkers in Rigasa community, a suburb of Kaduna town.Materials and Methods: A cross sectional descriptive study of 1200 adolescent female hawkers aged 15–29 years was carried out in 2008, using both self and interviewer administered questionnaires. Results: Vast majority of the respondents are divorcees, constituting 92%. About 46% of them have never attended formal school before marriage. Of the 18 participants who were aware of emergency contraception; none correctly identified 72 hours as the time limit for the method’s use. Antibiotics or home remedies such as dye Robin Blue mixed with Coca cola or mixed with lime or lime mixed with potash and salt water were mentioned as unlisted methods of emergency contraception by responders. Conclusion: It is glaring that there exist a yawning gap of information and knowledge on contraception in general and emergency contraception in particular among female adolescent hawkers. The need to inform this target group about reproductive health generally and unwanted pregnancy in particular would not be out of place.  

Hormonal contraception among electronic cigarette users and cardiovascular risk: a systematic review.