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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↗
PubMed1986

The practical aspects of clinical trials of contraceptive methods.

Although setting up a clinical trial to test the efficacy of a method of contraception may appear to be a simple exercise, in practice, unless the aim is well delineated, the trial carefully designed, and the staff participating in the trial carefully briefed, problems will arise which prevent a successful outcome. Possible areas of bias such as selection of participants and staff prejudices must be eliminated, otherwise the value of the results may be diminished. Ethical considerations must be addressed regarding voluntary participation, information for participants, delineation of risk to participants and informed consent.

Clinical Trials as Topic↗
PubMed1980

[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↗
PubMed1994

Contraceptive methods and risk of pelvic endometriosis.

The relation between contraceptive methods and risk of pelvic endometriosis has been analyzed in a case-control study. Cases were 376 women with laparoscopically or laparotomically confirmed pelvic endometriosis admitted to a network of Obstetrics and Gynecology Clinics in Lombardy, Northern Italy. Controls were 522 women admitted for acute non-gynecological and non-obstetrics conditions to the same hospitals where cases had been identified. A total 153 women (40.3%) out of the 377 cases and 154 (29.7%) out of the 522 controls reported ever oral contraceptive (OC) use: the corresponding relative risk (RR) was 1.6 (95% confidence interval, CI, 1.2-2.2). The risk was restricted to ex-OC users (RR 1.7, 95% CI 1.3-2.4), the estimated RR for current users being 0.9 (95% CI 0.5-1.9). No clear relation emerged with duration, recency and latency of OC use and risk of endometriosis. In comparison with never IUD users, the risk for ever users was 1.3 (95% CI 0.6-2.8), and no clear relation emerged with duration of use. Likewise, no association was observed between barrier method of contraception and risk of endometriosis (RR ever vs never users 0.5, 95% CI 0.3-1.4). The role of selection and other biases should be considered in the interpretation of epidemiological data on the role of OC on the risk of endometriosis.

Adult↗
PubMed1991

Escherichia coli bacteriuria and contraceptive method.

We evaluated the effects of contraceptive method on the occurrence of bacteriuria and vaginal colonization with Escherichia coli in 104 women who were evaluated prior to having sexual intercourse, the morning after intercourse, and 24 hours later. After intercourse, the prevalence of E coli bacteriuria increased slightly in oral contraceptive users but dramatically in both foam and condom users and diaphragm-spermicide users. Twenty-four hours later, the prevalence of bacteriuria remained significantly elevated only in the latter two groups. Similarly, vaginal colonization with E coli was more dramatic and persistent in users of diaphragm-spermicide and foam and condoms. Vaginal colonization with Candida species, enterococci, and staphylococci also increased significantly in diaphragm-spermicide users after intercourse. We conclude that use of the diaphragm with spermicidal jelly or use of a spermicidal foam with a condom markedly alters normal vaginal flora and strongly predisposes users to the development of vaginal colonization and bacteriuria with E coli.

Adult↗
PubMed1995

Contraceptive methods and the risk of Chlamydia trachomatis infection in young women.

To evaluate the relation between contraceptive methods and cervical Chlamydia trachomatis infection, the authors studied a population-based sample of 1,779 nonpregnant women aged 15-34 years who underwent cell culture diagnostic testing for the detection of C. trachomatis at a health maintenance organization. Barrier contraceptive method users were classified as those who reported using one of the following methods at time of testing: condom, diaphragm, cervical cap, spermicidal sponge, foam, or vaginal spermicidal suppositories. Barrier methods were associated with a reduction in the risk of chlamydial infection in women aged 25 years or older when compared with all other women in the same age category (adjusted prevalence odds ratio = 0.15, 95% confidence interval (CI) 0.04-0.66). When compared with only noncontracepting women, the adjusted prevalence odds ratio was 0.34 (95% CI 0.06-1.99). The protective effect of barrier methods was not evident in women younger than age 25 years. Oral contraceptive use was not associated with the risk of C. trachomatis infection using either referent group; the adjusted prevalence odds ratio was 0.99 (95% CI 0.57-1.73) compared with all other women, and 0.88 (95% CI 0.44-1.79) compared with noncontracepting women. These findings suggest that present patterns of use of barrier methods differ by age and afford only selective protection against cervical C. trachomatis infections.

Adolescent↗
PubMed2003

[Male participation in contraceptive methods use].

This study aimed to evaluate male participation in the use of contraceptive methods and to identify relevant variables. A secondary data analysis was conducted, and the sample size was estimated at 175 men using contraceptives methods that require male participation. The study used the qui-square test to evaluate differences between groups, as well as multiple logistic regression analysis. Some 38% of interviewees used some birth control method that required male participation. Higher level of schooling was associated with the use of some form of contraception requiring male participation, i.e., condom use or vasectomy. Considering the sample's characteristics, the study concluded that it is possible for important changes to take place in Brazilian society with regard to the male perspective on contraception. For these changes to be possible it is necessary to invest in education for both men and women, shown to be an important factor for a balance in gender relations.

Adult↗
PubMed1989

Sociodemographic determinants of contraceptive method choice in Sri Lanka: 1975-82.

The determinants of contraceptive method choice in Sri Lanka are examined during a period in which contraceptive prevalence increased by over 60% and involved substantial use of sterilization and traditional methods. Data are from the 1975 World Fertility and 1982 Contraceptive Prevalence Surveys. Polytomous logistic regression is used to model four current contraceptive choices: non-use, use of a traditional method, use of a modern temporary method and use of sterilization. The analysis shows, in 1975 and 1982, strong socioeconomic as well as demographic effects on whether any method is used. However, in both years the type of method chosen is primarily a function of demographic considerations related to the couple's family-building stage rather than social status, implying that in Sri Lanka there are few socioeconomic barriers limiting access to different contraceptive methods. The family planning programme, however, has emphasized sterilization rather than birth spacing methods.

Age Factors↗
PubMed2004

Systematic review of the literature on postpartum care: selected contraception methods, postpartum Papanicolaou test, and rubella immunization.

BACKGROUND: The postpartum period is a time when many routine interventions are provided to mothers. This review examined the published evidence for the effectiveness of selected contraceptive methods, Papanicolaou (Pap) tests, and rubella immunization. METHODS: MEDLINE, Cinahl, PsycINFO, and the Cochrane Library were searched for randomized controlled trials of interventions initiated from immediately after birth to 1 year in postnatal women. The initial literature search was done in 1999, and was enhanced in 2003. Studies were categorized and reviewed by topic areas. Data were extracted in a systematic method, and the quality of each study was reviewed. RESULTS: In the 1999 search, 140 studies were randomized controlled trials that met the selection criteria: 5 related to postpartum contraception, 1 to timing of the postpartum Pap test, and 2 to postpartum rubella immunization. In the 2003 searches, 1 additional study related to postpartum contraception was identified. From the published literature on selected contraceptive methods, the intrauterine devices examined were effective in preventing pregnancy and had comparable side effect profiles. No clear recommendation can be made because insertion timing was not randomized in the included trials. Although delaying the postpartum Pap smear until 8 weeks reduces the proportion of inflammatory smears, it is uncertain whether a Pap smear is of benefit to postpartum women. The RA 27/3 postpartum rubella vaccine appears to be more effective than the Cendehill vaccine, but a small proportion of women may develop acute and chronic joint manifestations. CONCLUSIONS: Some evidence is available to support selected postpartum contraceptive methods and the postpartum rubella vaccine, but data are lacking on the effectiveness and optimal timing of the postpartum Pap smear.

Contraception↗
PubMed1991

[Contraceptive methods and their efficiency].

On the basis of the present investigations concerning the employment of contraceptive methods in Denmark and the knowledge of the efficacies of these methods, the annual number of legal terminations of pregnancy performed in Denmark are assessed. A considerable proportions of the unwanted pregnancies may be explained by defective high efficacy of the contraceptive methods employed.

Abortion, Legal↗
PubMed1994

Cost-effectiveness of levonorgestrel subdermal implants. Comparison with other contraceptive methods available in the United States.

The objective of this analysis was to evaluate and compare the cost-effectiveness of eight contraceptive methods: condoms, diaphragms, oral contraceptives, intrauterine devices, medroxyprogesterone acetate suspension, levonorgestrel subdermal implants, tubal ligation and vasectomy. Based on a comprehensive review of the literature and various additional data sources, this analysis identified, measured and compared direct costs of the methods, physician visits, treatment of adverse effects and cost of failure (i.e., mean cost for all types of deliveries or first-trimester abortion). Medical benefits (if any) resulting from each contraceptive method were calculated and considered in the analysis as cost savings. The cost of method failure proved to be the greatest influence on cost-effectiveness. Sterilization was identified as the most cost-effective method overall. Of the reversible methods, the intrauterine device was found to be the most cost-effective, followed by levonorgestrel implants.

Adult↗
PubMed2002

Assessing the cost-effectiveness of contraceptive methods in Shiraz, Islamic Republic of Iran.

To determine the cost-effectiveness of seven contraceptive methods from the providers' perspective, the cost per adjusted couple-years of protection (ACYP) was calculated for each method based on region-specific conversion factors. More than 74,800 ACYPs were provided during March 1999 to February 2000. Intrauterine devices and implants offered the highest and lowest ACYP respectively. Condom was the single most expensive contraceptive method. Vasectomy was the most cost-effective method and implant provided the highest cost per ACYP.

Adult↗
PubMed1986

[Contraception and informatics. SELF, a system to aid medical decisions applied to the prescription of contraceptive methods].

SELF (systeme en logique floue = system in soft discware), developed by the Computer Sciences Laboratory of the Faculté de Médecine in Nancy, is, by comparison to many systems of assistance in medical decisions already existing, a comprehensive and simple unit enabling the construction and modification of basic knowledge as well as its questioning. The first application of SELF concerned the field of gynecology, by producing a system of assistance applied to the prescription of a contraceptive method. The systematic use of this computer program along with the traditional prescription of a contraceptive method, was tested for three months in the Regional Maternity Hospital by several physicians in the Gynecology Clinic. The system was extremely well accepted and the responses have generated numerous discussions between physicians leading to an improvement of SELF and a better rationalization of the prescription. The medical and paramedical personnel in training at the hospital found SELF to be a teaching tool which, on the basis of simulated cases, permits an easier and more concrete explanation of the practical management in advising or prescribing a contraceptive method.

Contraceptive Agents, Female↗
PubMed1990

Adolescent contraceptive method choices.

This article analyzes determinants of contraceptive method choices among adolescent women in the United States. By using data from the 1982 National Survey of Family Growth, we examined factors that differentiate users of various methods early in the sexual careers of teenaged women. We find that patterns of method choice not only vary by race and region within the United States but also change over the teenager's life course. In addition, among teenagers who did not use a method at first sex, the likelihood of adopting a method soon thereafter was low for both whites and blacks and was unaffected by social structural characteristics.

Adolescent↗
PubMedDate not supplied

[Impact of contraceptive methods on women's lives: the case of tubal ligation].

This study focused on the long-term consequences of tubal ligation on women's lives. Women 30 to 49 years old living in Campinas, State of São Paulo (Brazil), were interviewed: 236 sterilized at least five years prior to the interview and 236 non-sterilized women. Their experiences with the currently used contraceptive methods were compared with regard to satisfaction, benefits, and damage attributed to the method, feelings of regret, and perception of effects on their health, body, menstruation, sex, affective and family life, job, studies, economic status, and self-esteem. Scores were created to compare the groups in relation to self-esteem, well-being/quality of life, relationship with partner, and gender issues. Satisfaction with the currently used contraceptive method was significantly higher among sterilized women, although they more frequently reported having regretted being sterilized at some moment in time. Relatively more sterilized women felt that the contraceptive method had improved their sex lives and economic status, while producing a negative effect on their menstruation. No significant difference was observed between the groups with regard to the scores studied.

Adult↗
PubMedDate not supplied

Women's barrier contraceptive methods: poised for change.

Over the past 20 years, the number of women in the United States choosing a cervical barrier contraceptive method has dramatically declined. By 2002, fewer than 3% of women reported using any woman-initiated barrier method, including the diaphragm, female condom, or cervical cap. At the same time, however, research in infectious diseases indicates that cervical barriers may effectively prevent the transmission of several sexually transmitted infection. This possibility has fueled the recent development of two novel devices. This article examines the seven devices currently available in the United States, comparing their characteristics, efficacy, benefits, and drawbacks. Compared to the diaphragm, the new devices do not offer improved odds of pregnancy prevention, and evidence for their efficacy is sparse. Reasons for the limited acceptance of these methods as contraceptives on one hand-and for interest in their potential for limiting sexually transmitted infections on the other-will also be reviewed. Despite the limited acceptance of cervical barrier methods, midwives and other clinicians should promote their availability as an alternative to other reversible contraceptives.

Contraception, Barrier↗
PubMed1994

The potential of mild testicular heating as a safe, effective and reversible contraceptive method for men.

A preliminary assessment of the contraceptive efficacy of a daily mild increase (1-2 degrees C) in testicular temperature during waking hours is reported in nine couples using two techniques of non-surgical fixation of the testes close to the inguinal canal. With technique 1, immobilization was achieved by passing the penis and the empty scrotum through a hole made in close-fitting underwear; there was one pregnancy, from a man who stopped the heating after 7 weeks, for 42 cycles of exposure in three couples. With technique 2, immobilization was achieved by adding a ring of soft material surrounding the hole in the underwear; there was no pregnancy for 117 cycles of exposure in six couples. Reversibility and safety were assessed. These preliminary results suggest that a daily mild increase in testicular temperature could be a potential contraceptive method for men.

Adult↗