Introducing new contraceptive methods: the three-stage research approach.
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Navajo Indian intrauterine contraceptive device (IUD) and oral contraceptive users between 1966 and 1971 were followed up to estimate life table rates of complications and continuation. Because of high rates of dropping out, 41.6 per cent of 291 oral contraceptive users and 18.2 per cent of 534 IUD users, a 26 per cent sample survey of the dropout population was used to collate the dropout population data into the life table analysis. Estimates of the IUD continuation rates for one, two, and three years are similar to rates published elsewhere; however, continuation rates for the oral contraceptive are clearly lower than those for other populations, which only 33 per cent continuing after one year, 23 per cent after two years, and 12 per cent after three years. The IUD user is two to three times more successful than the oral contraceptive user in this population.
During a 9-month period, 84 female patients received post-coital contraception consisting either of an association of ethinyl estradiol/norgestrel or of danazol, in order to compare the safety and any adverse reaction of these 2 treatments. Overall, the patients treated with danazol presented 1/3 as many side effects. Nausea was reduced to 1/3 in frequency and vomiting to 1/9 in this group. 5 pregnancies were confirmed in the ethinyl estradiol/norgesterol group and 2 in the danazol group. Although more cases are needed, it would appear that danazol is characterized by greater efficacy and patient acceptability.
The prevalence rate of vaginal colonization with E. coli was studied prospectively among 495 healthy premenopausal women, and factors associated with vaginal carriage of E. coli were examined. Vaginal colonization with E. coli was found in 12% of women, and was significantly correlated with phase of the menstrual cycle (p less than 0.05), prior use of antibiotics (p less than 0.05), current genital complaints (p less than 0.05), history of previous urinary tract infection (p less than 0.001), and use of diaphragm or cervical cap for contraception (p less than 0.005). The high prevalence rate among diaphragm or cervical cap users remained significant when other confounding factors were kept constant (p less than 0.05). This observation may explain the association of diaphragm use and urinary tract infection demonstrated in previous epidemiologic studies and confirmed in the present study (p less than 0.05).
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