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At least 451 records · Page 25Linked to original sources
PubMed1995

Women's knowledge of taking oral contraceptive pills correctly and of emergency contraception: effect of providing information leaflets in general practice.

BACKGROUND: About one third of all pregnancies are unplanned and 20% of all pregnancies end in abortion. More than 170,000 legal abortions are performed in the United Kingdom annually. Nearly all general practitioners provide contraceptive advice; the most commonly used form of reversible contraception is the oral contraceptive pill. AIM: The aim of this study was to determine factors associated with women's knowledge of taking the contraceptive pill correctly and of emergency contraception, and to investigate if their knowledge could be improved in general practice by providing women with Family Planning Association information leaflets. METHOD: An uncontrolled intervention study was performed in one rural and one urban English general practice, using a self-completion questionnaire that was initially administered to women attending their general practitioner for oral contraception over six months from 1 October 1992. The questionnaire asked for: sociodemographic information; knowledge of how late women can be taking an oral contraceptive pill and still be protected against unplanned pregnancy; for how many days after being late with a pill they need to use other precautions; sources and methods of emergency contraception; and for how long the methods are effective after the primary contraceptive failure. After completing the questionnaire women were given two leaflets: one about how to take their prescribed contraceptive pill correctly and one about emergency contraception. Three to 12 months later the same questionnaire was administered in the same manner. RESULTS: Of 449 women completing the first questionnaire, 233 (52%) completed the second questionnaire. Initially 71% of 406 women taking an oestrogen/progestogen combined pill knew about the '12-hour rule' and 17% knew about the 'seven-day rule'; giving women information about the pill they were taking increased the extent of knowledge about these rules among 212 respondents to 82% (P < 0.01) and to 25% (P < 0.05), respectively. The proportion of respondents who knew that they could obtain emergency contraception from their own general practitioner, from any general practitioner and from family planning clinics all increased after they had received the leaflets (from 84% to 92%, from 34% to 47% and from 82% to 90%, respectively, all P < 0.01). There were significant improvements in the proportion of women knowing the duration of effectiveness of emergency contraception. However, after receiving the leaflet on emergency contraception the majority of women still did not know for how long after unprotected intercourse the high-dose combined pill and the intrauterine contraceptive device were effective (80% and 93% of 233 women, respectively). Improvements in knowledge depended upon women's social class, previous use of emergency contraception and with which practice they were registered. CONCLUSION: Providing women with leaflets about taking the contraceptive pill correctly and about emergency contraception appears to improve significantly their extent of such knowledge. If such practice was adopted elsewhere this increased knowledge might reduce the number of unplanned pregnancies in the UK. The effect of general practitioners personally providing such leaflets, with or without verbal instruction, warrants further study.

Adolescent↗
PubMed1987

The relationship of tubal infertility to barrier method and oral contraceptive use.

We studied past contraceptive use in 283 nulliparous infertile women who had a diagnosis of tubal adhesions or occlusion and in 3833 women admitted for delivery at seven collaborating hospitals from 1981 to 1983. The relative risk of tubal infertility associated with barrier contraceptive use or oral contraceptive use was calculated using multivariate logistic regression to control for confounding by region, age, religion, education, smoking, number of sexual partners, time since menarche, and use of other contraceptive methods. Women who had ever used barrier methods of contraception were at a significantly decreased risk of tubal infertility (relative risk = 0.6; 95% confidence limits, 0.5 and 0.8). When type of barrier method used for the longest time was evaluated, those who used the diaphragm or condoms plus spermicides were at lower risk than those who used condoms or spermicides alone. Overall, past use of oral contraceptives neither increased nor decreased a woman's risk of tubal infertility, but there was evidence that the association between oral contraceptives and tubal infertility may vary by the amount of estrogen and type of progestogen in the oral contraceptive used. We conclude that contraceptive users who use barrier methods that combine both a mechanical and chemical barrier, such as diaphragms, cervical caps, and condoms plus spermicides, have the clearest protection against tubal damage.

Adult↗
PubMed1990

Low-dose oral contraceptives and carbohydrate metabolism.

Combined oral contraceptive use has been associated with increased incidence of impaired and diabetic glucose tolerance. Although increased risk of overt symptoms of diabetes has not been associated with oral contraceptive use, increased risk of coronary heart disease has been consistently demonstrated. Diabetes is associated with increased risk of coronary heart disease, especially in women. Elevated plasma glucose and insulin concentrations are also associated with increased risk of coronary heart disease. Studies of the effects of low-dose oral contraceptives on glucose tolerance test plasma glucose and insulin levels are reviewed. Low-dose combined oral contraceptives induced changes in measures of carbohydrate metabolism in directions consistent with increased risk of coronary heart disease. The magnitude of these changes may depend on the dose and type of progestogen. The clinical implications of these changes are unknown, but it would seem advisable to minimize them where possible.

Blood Glucose↗
PubMed1993

Changes in blood levels of proteinase inhibitors, pregnancy zone protein, steroid carriers and complement factors induced by oral contraceptives.

Three low-dose oral contraceptives Trinordiol, Gynatrol, and Marvelon, containing ethinylestradiol (EE) in combination with triphasic levonorgestrel (LNg), monophasic levonorgestrel, and monophasic desogestrel (DGS), respectively, were given to 65 healthy women, n = 21-22 in each group. Blood levels of antithrombin III (AT III), alpha 2-macroglobulin (alpha 2M) alpha 1-antitrypsin (alpha 1at), complement factors (factor B, C3, C4), pregnancy zone protein (PZP), corticosteroid binding globulin (CBG), sex hormone binding globulin (SHBG) and albumin were measured before treatment and during the first and third treatment cycles. AT III levels decreased and alpha 1at levels increased in all three groups during treatment. alpha 2M increased during cycle 3 in the Trinordiol and Gynatrol groups. CBG, PZP and SHBG levels increased in all 3 groups, the CBG and PZP increase being higher in the Marvelon group than in the Gynatrol group. Increases in SHBG levels were found in the order Marvelon > Trinordiol > Gynatrol. Plasma levels of complement factors B, C3 and C4 remained unchanged. It is concluded that the increase in alpha 1at partly compensates for the fall in AT III, that the rise in PZP presumably enhances fibrinolysis, and that LNg has higher anti-estrogenicity and androgenicity than DSG.

Adolescent↗