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Spontaneous foetal losses in women using different contraceptives around the time of conception.

Spontaneous losses between the 5th and 27th weeks of pregnancy were measured in a prospective study of 32 123 women whose contraceptive history around the time of conception was known. Diaphragm use prior to conception was associated with a significant reduction in second-trimester losses, after taking into account the effects of age, parity, race, marital status, alcohol use, and previous spontaneous or induced abortions. Women who used oral contraceptives and stopped them more than one month prior to their LMP experienced a deficit of first-trimester losses but conceptions occurring immediately after stopping the pill were followed by a small but nonsignificant increase in spontaneous abortions. After oral contraceptive failures there was an increase in first-trimester losses, but no change in the incidence of second-trimester ones. IUD failures were followed by a significant two-fold increase in the risk of both first and second-trimester losses: no differences were detected between the different brands.

Abortion, Spontaneous↗

[Which contraceptive methods are suitable for adolescents].

Because of the extreme difficult problems in teen-age pregnancy the doctor should recommend only safe or nearly safe methods for contraception. In case of stabile cycles (intervals not shorter than 25 days and not longer than 35 days) the recommendation is primarily oral contraceptives. This recommendation concerns mainly preparations of low hormone-dosage and step-up preparations. Among conventional contraceptives only the condom is recommendable with the same safety like the IUCD but without any side effects and risk.

Adolescent↗

Methods of contraception and rates of genital infections.

Bacterial vaginosis, trichomoniasis and candidiasis are the most common genital infection. The aim of this study was to evaluate the various methods of contraception with regard to the prevalence of bacterial vaginosis and vulvo-vaginitis over a period of four years. We also evaluated in the same period the rates of trichomoniasis, candidiasis, bacterial vaginosis and vulvo-vaginitis between users and non users of contraceptional methods and the relationship between ages of patients and types of contraceptives. Finally we considered the change of contraceptive use with regard to age among two different periods. The IUD users showed a significant increase of B.V., T.v. and other bacteria and a decrease of the negatives compared to OC users. Barrier contraceptive users had a reduction (0.01 > p > 0.001) of B.V. and an increase (p < 0.001) of the negatives compared to IUD users. OC users had a significant (p < 0.05) increase in candidiasis, B.V. together with a reduction of the negatives compared to non users group. IUD users had a significant (p < 0.001) increase of B.V. and vulvo-vaginitis from other bacteria, and the reduction of the negatives. Teenagers use OC much more than adults, but less IUD (p < 0.001). The use of OC has increased and the use of IUD decreased among adults (p < 0.001). The barrier methods were seen to be statistically reduced.

Adult↗

Cabbages and condoms: packaging and channels of distribution.

Contraception is only rarely a therapy for disease. Usually, contraceptives help adults implement informed choices. Therefore, wider channels of distribution and promotion are possible and necessary than in the case of curative therapies. The more channels of distribution that are available for the same method of contraception, the higher the prevalence of use. Establishing new channels of distribution can be as important as developing new methods of contraception. Family planning is an important element in public health, and active promotion enhances the health of individuals and physicians. Other health professionals need to understand the role of non-medical skills and channels of contraceptive distribution.

Contraception↗

Contraception and ectopic pregnancy risk.

Studies of the association of ectopic pregnancy with contraception have generated a conflicting array of results because of methodologic differences between studies. We estimated the absolute incidence rates of ectopic pregnancy for various contraceptives by multiplying the pregnancy rate by the proportion of pregnancies with ectopic implantation for each method. Our results indicated a more than 500-fold difference in ectopic pregnancy incidence, from a low of 0.005 ectopic pregnancies per 1000 women years of oral contraception or vasectomy to a high of 2.6 per 1000 women years of no contraception. These estimated incidence rates should be useful for clinicians and patients seeking to better understand the risks and benefits of contraceptives.

Adult↗

The prophylaxis of gonorrhea.

The current level of the gonorrhea epidemic supports the need for additional measures for gonorrhea control. In the absence of evidence that prophylactic availability enhances promiscuity, a strong case can be made for venereal disease prophylaxis. This paper reviews the efficacy and acceptability of prophylactic techniques. In the military, acceptability and efficacy have been demonstrated for systemic antibiotics, and probably a postcoital prophylactic kit. These measures are either inappropriate or unavailable for general civilian use. The condom and vaginal spermicides offer promise of partial protection; further studies of efficacy and utilization are needed.

Administration, Topical↗

Contraception in the perimenopause.

Pregnancy in women aged 40 and above is frequently unplanned and the legal abortion rate is high in this age group. Contraception and fertility are shrouded in popular mythology and many women do not appreciate either their risk of conception or the range of methods available to prevent conception. Either hormonal or non-hormonal methods of contraception may be appropriate.

Contraception↗

The oral pill in the Indonesian Population/Family Planning Program.

The oral pill is the most extensively used contraceptive in Indonesia. Of new users, 64% use the pill, 20% IUDs, 8% injectables, 6% condoms and 2% voluntary sterilization. Since the continuation rate of pill use is low as compared to the other non-permanent methods, i.e. the IUD and the injectables, special steps must be taken in order to reach the goal of the program, i.e. the reduction of the crude birth rate (CBR) to 22/1000 by the year 1990. These special steps involve selecting the best pill for Indonesian women, and determining the best contraceptive combination for each region and for new pill acceptors. The role of the oral pill in the program is also discussed.

Contraceptive Devices, Male↗

Fertility control services for adolescents: access and utilization.

More than one million teenagers get pregnant each year; six in 10 pregnancies end in live births--the rest in induced or spontaneous abortions. More than one-third of the births are out of wedlock. Yet, two-thirds of teenage pregnancies and half of the births are not intended. Some two million teenagers at risk of unintended pregnancy are now using effective birth control methods; but two millions are still denied them.

Abortion, Induced↗