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PubMed1985

Barrier contraception in the teenager: a comparison of four methods in adolescent girls.

The use-effectiveness and continuation rates of 4 methods of contraception were studied during a 2 year follow-up period in a group of 405 teenage girls. Results were compared in 2 groups of adolescents, 1 of highly motivated, high socioeconomic status girls (A) and 1 of poorly motivated, low socioeconomic status adolescent clinic patients (B). The method of contraception was selected by the girls, who were instructed in their proper use. Results showed good rates of continuation among girls of the 1st group as compared to those of the 2nd group. Pregnancy rates after 24 months of use, as calculated by Pearl's formula, was 3.6 and 5.4 respectively with the use of a condom, and 5.8 and 10.8 when the diaphragm was used. When using vaginal foam alone, the rates were 4.2 and 12.3 and with the rhythm method, 8.5 and 13.1. The foam-alone method was unpopular in both groups. No serious side effects or complications were recorded. The study demostrated a reasonable acceptability and use-effectiveness for barrier contraceptives. It is suggested that these harmless and complication-free methods, especially the condom and diaphragm, may be reasonable alternatives for the more modern methods in teens of all socioeconomic strata; an effort must be made to educate and instruct the poorly motivated and encourage them to present themselves for regular follow-up.

Adolescent↗
PubMed1993

A field trial of Billings' ovulation method for spacing and limitation of birth.

In spite of constant efforts by health and social workers, existing family planning measures are not used by a vast majority of eligible couples. This is because of the fear that the method may affect their health and happiness. Billings' ovulation method is based on the scientific observation that by noting the changes in cervical mucus, which is clear, slippery and copious in periovulatory period, it is possible to prevent pregnancy by avoiding intercourse during this period. As this method does not require the use of drugs or devices it was decided to promote this method in the urban areas and slums of Patna, Bihar where couples were not using other methods. This is not a comparative study of the cost-effectiveness of Billings' ovulation method versus other contraceptive measures at all. An analysis of 501 cases (267 in urban and 234 in slums) over a period of 2 1/2 years has been presented and it is gratifying to note that the couples from all religions and strata of the society (nearly 47% were slum dwellers) agreed to continue this method.

Adult↗
PubMedDate not supplied

Using an ovarian monitor as an adjunct to natural family planning.

The need to identify a reliable ovulation predictor has received attention by the scientific community in recent years. For couples practicing natural family planning, a more precise identification of the fertile phase would be a welcome adjunct to their method. A home ovarian monitor invented by Professor J. B. Brown of Melbourne, Australia, enables couples to measure the principal urinary metabolite of ovarian estrogen and progesterone. The charted results reveal the hormonal pattern of the menstrual cycle and thus identify the beginning, peak, and end of the fertile period. A study involving 21 couples was conducted with the purpose of assessing overall acceptability, including ease of use, motivation, and client satisfaction. At the completion of the study, 12 couples indicated a high degree of motivation and satisfaction with the monitor. None reported difficulty with the test procedure. Increased confidence in natural family planning was cited as the most positive evaluation and the time required to perform the test, as the most negative.

Adult↗
PubMed1981

A prospective multicentre trial of the ovulation method of natural family planning. I. The teaching phase.

The percentage of 869 women in five countries capable of being taught to recognize the periovulatory cervical mucus symptom of the fertile period was determined in a prospective multicentre trial of the ovulation method of natural family planning. The women were ovulating, of proven fertility, represented a spectrum of cultures and socioeconomic levels, and ranged from illiteracy to having postgraduate education. In the first of three standard teaching cycles, 93% recorded on interpretable ovulatory mucus pattern. Eighty-eight per cent of subjects successfully completed the teaching phase; 7% discontinued for reasons other than pregnancy, including 1.3% who failed to learn the method. Forty-five subjects (5%) became pregnant during the average 3.1-cycle teaching phase. The average number of days of abstinence required by the rules of the method was 17 in the third teaching cycle (58.2% of the average cycle length). To what extent the findings of this study can be extended to other couples remains to be demonstrated.

Adult↗
PubMed1993

Natural regulation of fertility.

Natural methods play an important part in the overall control of world fertility. Lactational amenorrhoea makes a very large contribution to fertility control in developing countries and recent advances in our understanding of the biology of lactation and fertility have enabled guidelines to be prepared to help nursing mothers who wish to use the natural contraceptive effect of breastfeeding to space their families. Methods to identify more reliably the fertile phase of the menstrual cycle, possibly using home monitoring of hormone levels in the urine, would greatly increase the applicability of NFP methods. If used effectively, natural family planning can have a high effectiveness rate but all methods are extremely unforgiving of risk-taking in the fertile phase. More research is required to identify those factors which could serve to improve the efficacy of NFP methods.

Amenorrhea↗
PubMed1991

Use of the Home Ovarian Monitor in pregnancy avoidance.

The application of the Home Ovarian Hormone Monitor to the avoidance of pregnancy by periodic abstinence has been explored. No woman had difficulty with the daily urine testing, and their results consistently identified the distinctive hormone pattern of the ovulatory cycle and the day of ovulation and correlated closely with the mucus symptoms. The tests gave 4 days or more warning of ovulation in 99% of cycles and allowed intercourse to be resumed 1 to 3 days after ovulation in 88%, giving a mean period of abstinence of 7 days. No pregnancy occurred from intercourse during the late safe days defined by the Monitor, but some early-day pregnancies occurred through long sperm survivals of 6 to 8 days, mostly during the return of fertility after breastfeeding. Rules for the avoidance of pregnancy, with the minimum of testing on the basis of these results, are given.

Adult↗
PubMedDate not supplied

Pattern of menstrual cycle length in south Indian women: a prospective study.

Data on 8,308 menstrual cycles from 1,740 South Indian women prospectively recorded were analyzed to identify the effect of age on menstrual cycle length. The distribution was skewed to the right with the mean (SD) cycle length of 31.8 (6.7) days. The range of 25-40 days constituted 10-82 per cent of menstrual cycle lengths. In no age group did 28-day cycles occur in more than 9 per cent of women. Variability as measured by the standard deviation was high among those below 19 years of age, stabilized during 25-39 years, and then increased in women aged 40 years or more. The findings are discussed in the light of other studies and possible implications in fertility control programs.

Adult↗
PubMedDate not supplied

Breast-feeding and natural family planning.

The record of 50 postpartum women who intended to breast-feed for longer than 6 month were analyzed. Fifty percent of the women breast-feed longer than 12 month, and 50% resumed menses by 40 weeks after childbirth. Fifty-two women record of mucus and basal body temperature (BBT) fort at least 4 week before resumption of menses. Ovulation before menses while fully breast-feeding was probable in only one woman. Fifty percent of the first postpartum cycles had a short luteal phase Thirty-five women chose NFP to avoid pregnancy during the study period. Mucus and BBT proved to be a good marker of ovulation during postpartum cycles. Confidence in NFP during lactational amenorrhoea and first postpartum cycles in analyzed. Finally, research aimed at improving the teaching and use of NP for postpartum breast-feeding women is described.

Adult↗
PubMed1991

The evolution of reference methods to monitor ovulation.

Reference methods to predict or detect ovulation have evolved substantially during the past few decades. The potential use and limitations of such methods are reviewed. The use of transvaginal ultrasonography with color flow mapping to monitor periovulatory changes in the intrafollicular morphology and blood flow is described.

Biomarkers↗
PubMed1998

Factors associated with changes in sex behaviour among drug users in Puerto Rico.

Despite available strategies to prevent sex risk behaviours in Puerto Rico, heterosexual transmission of HIV continues to increase. Since 1990, heterosexual contact has been the fastest growing infection risk category among the island's general population, and the primary transmission route for women and children. To understand change in sex risk behaviours and factors related to change, 911 drug injectors and 359 crack smokers were recruited from the San Juan metropolitan area following a stratified cluster design. This study comprised a total of 1,004 (79.1%) drug users who were assessed at follow-up. Abstinence from sex behaviour increased from 54.6% to 61.1% (p < 0.01), use of condoms during vaginal sex also increased from 26.4% to 36.9% (p < 0.01). In multivariate analysis, significant predictors of abstinence were gender, injection drug use, HIV seropositivity and not having a steady partner. Predictors of using condoms during vaginal sex were HIV seropositivity, STD diagnosis and participation in an HIV preventive programme. These findings indicate that additional HIV preventive efforts are needed to reduce sex risk behaviours among drug users who have a steady sex partner, as well as among drug users who are HIV-negative.

Adult↗