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PubMed1987

Contraceptive usage during lactation in the United States: an update.

National Surveys of Family Growth data showed that as of 1982, most lactating women who were sexually active used a contraceptive method; barrier methods were most frequently used. Black women and women of higher parity and lower educational level were more likely to be sexually active and not using a method.

Adolescent↗
PubMed1988

Oral contraceptive agents: current status.

Oral contraceptives are the most widely prescribed and ingested drug in human history. The difficulty in establishing their clear-cut side effects is compounded by the rarity of these side effects and their occurrence with multiple other factors and cofactors that may be etiologically more important. For the prudent surgeon, suffice it to say that should operation require bedrest postoperatively, oral contraceptives should be stopped at least 2 weeks preoperatively and barrier methods begun. Barrier methods should also be used when drugs that interfere with oral contraceptives are prescribed. Oral contraceptives and anticoagulants should not be given together because of the chemical changes in the blood caused by the steroid content of the contraceptive. As surgeons, we must remember the contraindications noted herein and become familiar with the current literature as new developments unfold in the dynamic field of conception control.

Contraceptives, Oral↗
PubMed1991

Barrier contraceptive methods and preeclampsia.

Recent investigations have suggested that women who use barrier methods of contraception may be at increased risk for preeclampsia. We used data from two prospective pregnancy studies to examine the relationship between contraceptive use before conception and preeclampsia. The preeclampsia rates among women using barrier contraceptives were not significantly higher than the rates in women using nonbarrier contraceptives or the rates in women using no contraceptives in either study. The odds ratios for preeclampsia in barrier contraceptive users in the two studies were 0.89 (95% confidence interval [Cl], 0.71 to 1.12) and 0.85 (95% Cl, 0.49 to 1.45) compared with nonbarrier contraceptive users and 0.91 (95% Cl, 0.71 to 1.16) and 0.81 (95% Cl, 0.48 to 1.35) compared with women using no contraceptives. After adjusting for other risk factors, we found no association between preeclampsia and barrier contraceptive use. Additional studies are needed to resolve this issue; however, we would recommend that women not be advised to avoid barrier contraceptives unless more data linking their use to preeclampsia appear.

Adolescent↗
PubMed1985

Infection with Chlamydia trachomatis in female college students.

Chlamydia trachomatis was isolated from genital specimens from 21 (4.9%) of 431 female college students. Antibody to C. trachomatis was found in the genital secretions of 52 (11.9%) of 437 women. Multiple logistic regression analysis showed race, number of sexual partners, and use of barrier methods of contraception to be predictive of infection with C. trachomatis. Logistic regression analysis found race, number of sexual partners, use of barrier methods of contraception, and presence of cervical erythema to be predictive of local chlamydial antibody. White participants were infected less often (12 of 388 (3.1%)) than black participants (9 of 43 (20.9%)) (p less than 0.001) and were less likely to have local chlamydial antibody. None of the sexually inexperienced women were infected or had local antibody. Among the sexually experienced women, chlamydial infection and local chlamydial antibody increased with increasing number of sexual partners only for women who were not using barrier methods of contraception. Sexually experienced women who used barrier methods of contraception (condom, diaphragm) were less likely to be infected (one of 105 (1.0%)) than were sexually experienced women who used other contraceptive measures or who did not use contraception (20 of 276 (7.2%)) (p = 0.031). Women who used barrier methods of contraception also were less likely to have local chlamydial antibody. Women with cervical erythema were more likely to have local chlamydial antibody (4 of 11 (36.4%)) than women without cervical erythema (48 of 426 (11.3%)). Vaginal colonization with other sexually transmitted microorganisms (Mycoplasma hominis, Ureaplasma urealyticum, Trichomonas vaginalis) was noted more often among women with chlamydial infection than among uninfected women.

Adult↗
PubMed1990

[Evaluation of cutaneous risks of the Pill].

Despite the fact that about 150 millions women must have taken hormonal contraceptives all over the world since the 1960s, the risk/benefit ratio of this birth control method has yet not been reliably assessed. The side effects of the pill on the skin do not pertain, in general, to those (like thrombo-embolism or, perhaps, breast cancer) which might be life-threatening, but they are probably more frequent and may have a potential to alter the quality of life of women who use it. The aim of this paper is to review the dermatological effects of hormonal contraceptives from the point of view of everyday prescribing, with the emphasis on the quality of life of patients. The reported side effects of the pill are therefore classified according to their real or probable frequency, not to their severity or the theoretical importance of their mechanisms. As it would be unwise to speak of the risks without consideration for the benefits, an attempt is made to compare the dermatological safety profile of oral contraceptives to that of other birth control methods (barrier contraceptive methods, intrauterine devices, etc.) on the one hand; on the other hand, one insists upon the fact that the pill in itself may have health benefits, general (reduction in the incidence of some cancers) or dermatological (e. g. an effect on acne).

Adult↗
PubMed1994

Progestogen-only contraceptives during lactation: I. Infant growth. World Health Organization Task force for Epidemiological Research on Reproductive Health; Special Programme of Research, Development and Research Training in Human Reproduction.

Growth, development and health of infants whose mothers used progestogen-only contraceptives during lactation were examined in a prospective, non-randomized study carried out in seven centres in five countries (Egypt, Thailand, Kenya, Chile and Hungary). The results on growth are reported here. Breastfeeding women requesting effective contraception were admitted to the study at six weeks postpartum. Infants of acceptors of progestogen-only methods (pill, DMPA, NET-EN or NORPLANT implants) and non-hormonal methods (IUD, barrier methods or sterilization) formed the study groups. The follow-up was at monthly intervals until the end of the first postpartum year. Participating in the study were 2466 mother-infant pairs. The mean duration of exclusive breastfeeding varied from 68 to 159 days, but did not differ significantly between study groups within centres. In anthropometric measures (weight, arm circumference and triceps skinfold), the mean rates of change varied over time as expected, and across the centres. However, there were very few statistically significant differences in these rates of change between groups within centres. Since a large number of statistical comparisons were made, and there was no consistency either across centres, over time, or in the direction of the differences, we conclude that in this study, the progestogen-only contraceptives used during lactation did not adversely affect infant growth.

Adolescent↗
PubMed1994

Progestogen-only contraceptives during lactation: II. Infant development. World Health Organization, Task Force for Epidemiological Research on Reproductive Health; Special Programme of Research, Development, and Research Training in Human Reproduction.

Growth, development and health of infants whose mothers used progestogen-only contraceptives during lactation were examined in a prospective, non-randomized study that was carried out in seven centres in five countries (Egypt, Thailand, Kenya, Chile and Hungary). The results on development are reported here. Breastfeeding women requesting effective contraception were admitted to the study at six weeks postpartum. Infants of acceptors of progestogen-only methods (pill, DMPA, NET-EN or NORPLANT implants) and non-hormonal methods (IUD, barrier methods or sterilization) formed the study groups. The follow-up was at monthly intervals until the end of the first postpartum year. At each visit, the infant examination included, among other things, a set of developmental tests covering the following areas: gross motor, vision and fine motor, hearing, language and concept development, and self help and social skills. Participating in the study were 2466 mother-infant pairs. The comparisons between the study groups were carried out within centres using life table methods and Cox-model analysis having the time to first passing the test as the criterion. There were altogether 247 comparisons between the study groups. Thirty-two (13%) of these comparisons showed statistically significant differences: 20 differences showed that the infants in the progestogen-only groups passed the tests at an earlier age and 12 at a later age than infants in the non-hormonal groups. Since no consistent trends were observed across the centres, we conclude that in this study the progestogen-only contraceptives used during lactation did not adversely affect infant development.

Adolescent↗
PubMed1988

Postcoital contraception: some characteristics of women who use this method.

This paper describes some of the characteristics of the women who attended a medical clinic requesting postcoital contraception. The information is derived from 871 observations in 653 women who requested this contraception. The mean age of women at the time of first request for this method was older than expected (21.9 years) and the mean time from first coitus to first request for the method was longer than expected (2.7 years). Previous pregnancy with therapeutic abortion was reported by 11.3% of the women. Multiple users of the method were younger at their first visit, and more likely to report a previous pregnancy. The method of contraception used before and after the need for postcoital contraception tended to be the same. Barrier method users have need of this method either for use when they fail to use their barrier method or for use when their barrier method fails. The need for more general availability of this method is discussed.

Abortion, Induced↗
PubMed1977

Penetration of some O-and/or N-methylated norepinephrine derivatives through the rat blood brain barrier.

Methods for the determination of a number of O and/or N-methylated derivatives of norepinephrine were developed. The IP injection of these compounds into rats shows quick absorption and short half-lives in plasma, liver and brain. Most compounds do not cross the Blood-Brain-Barrier (BBB) due to low lipid solubility. However, lipid solubility is not a sole determinant. Compounds which have at least one of the 2 phenolic hydroxyl groups methylated and possess a tertiary amino group do cross the BBB readily.

Animals↗
PubMed1990

Pelvic inflammatory disease: the influence of contraceptive, sexual, and social life events.

In order to determine associations between pelvic inflammatory disease (PID) and contraceptive, sexual, and social life events, 620 Danish women aged 15-54 were invited to participate in an in-depth interview. Of 585 participating women, 459 were consecutive gynecological in- or outpatients, and 126 were randomly selected from visitors in general practice. Data were analyzed by multivariate test statistics. The mean number of PIDs thereby retrospectively assessed was 1.0. Two-thirds had never had PID, one third had had on average 3 PIDs. The sexual parameter which had the highest predictive value for later PID was the coital debut. Women with coital debut before the 16th year had double the number of PIDs, as women with sexual debut at age 18 or later. Likewise, the mean coital frequency was positively correlated to the number of PIDs. The number of sexual partners, on the other hand, was merely a risk-indicator without a direct influence on PID. Women who used barrier methods (condom and/or diaphragm) for 2 years or more had 23% fewer PIDs than women who had used barrier methods for less than two years. The small number of PIDs among women at high socioeconomic levels could be explained alone by a later coital debut and longer use of barrier methods than that among women at low socioeconomic levels.

Adolescent↗
PubMed1991

Barrier versus oral contraceptive use: a study of female college students.

Although they provide birth control and are easier to use, oral contraceptives (OCPs) are not the preferred approach to preventing sexually transmitted disease (STD). Do the knowledge, attitudes, and experiences of oral contraceptive users place them at greater risk for STDs than those who employ barrier methods? This study examined differences between sexually active female college students (ie, those who reported ever having had vaginal intercourse) who used OCPs and those who employed barrier methods of contraception at the time of their most recent intercourse. The authors analyzed HIV- and other STD-related knowledge, attitudes, and behaviors from three consecutive annual health surveys of young women about to begin their first year of college. Findings showed barrier and OCP users to be comparable in knowledge about the effectiveness of various contraceptive methods in protecting them against STDs, perceived personal susceptibility to HIV, and experiences with alcohol before sexual intercourse. Oral contraceptive users, compared with those in the group who used barrier methods, reported a greater number of recent partners (p less than .03) and greater perceived vulnerability to STDs (p less than .03). Student healthcare providers must develop creative educational strategies to encourage simultaneous use of both oral contraceptives and barrier methods to protect students against STDs and pregnancy.

Adolescent↗
PubMed1994

Women's knowledge of emergency contraception.

BACKGROUND: More widespread use of emergency contraception could help to reduce the number of unwanted pregnancies. AIM: The objective of this study was to assess women's knowledge of emergency contraception. METHOD: A questionnaire was distributed to 1290 women aged between 16 and 50 years attending 14 general practice surgeries in London over a two-week period in 1990. RESULTS: The response rate was 70%. Over three quarters of the women had heard of emergency contraception; these were mainly women who used contraception, who had higher educational qualifications or who were not Muslim. Women who were the most likely to need and to use emergency contraception--those using barrier methods--had no more accurate knowledge than women using any other method of contraception. Only 53% of barrier method users knew emergency contraception could be used as a backup when other methods failed. Only one fifth of women had heard about this method from their general practitioner or any other health professional, while half had obtained their information from the media. CONCLUSION: These results suggest that including information on emergency contraception in consultations with users of barrier methods of contraception is a small step which general practitioners and practice nurses could take to increase the use of emergency contraception.

Adolescent↗
PubMed1981

Oral contraceptives and postmolar trophoblastic disease.

One hundred patients, managed for molar pregnancy at the New England Trophoblastic Disease Center, were selected at random to determine if the contraceptive method following molar evacuation influenced the incidence of postmolar trophoblastic disease. Following molar evacuation, 58 (58%) patients used oral contraceptives and 42 (42%) patients used barrier methods (foam, condom, and/or diaphragm). Postmolar trophoblastic disease developed in 11 (18.9%) patients using oral contraceptives and in 6 (14.3%) patients using barrier methods (P greater than .10). The mean human chorionic gonadotropin (hCG) regression time after molar evacuation was 7.0 weeks in patients using oral contraceptives and 7.2 weeks in patients using barrier methods. The 2 groups of patients were comparable in age, gravidity, molar histology, pretreatment hCG titers, and exposure to prophylactic chemotherapy. Oral contraceptives do not appear to increase the risk of postmolar trophoblastic tumors and therefore may be safely prescribed after molar evacuation during the entire interval of gonadotropin monitoring.

Adolescent↗