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Comparison of the metabolic effects of two hormonal contraceptive methods: an oral formulation and a vaginal ring. I. Carbohydrate metabolism and liver function.

A prospective, long-term study was undertaken to compare the metabolic effects of a contraceptive vaginal ring releasing levonorgestrel (about 290 microgram per day) and estradiol (about 180 microgram per day) and a combined oral contraceptive containing 30 microgram ethinylestradiol and 150 microgram levonorgestrel in two groups of women (n = 22 and 20, respectively). An intravenous glucose tolerance test, including determination of the insulin response to glucose, and liver function tests were performed. Both the glucose tolerance and fasting values of glucose were unaltered. The early insulin response to glucose increased by 50 percent in the contraceptive ring roup after one year of treatment, but not in the oral contraceptive group. All other insulin values were unchanged. All liver function values remained within the normal range in all subjects. There was a small significant decrease in alkaline phosphatases in both groups, which is in contrast to the effects of the early combined pills, which could cause an elevation. It is concluded that neither of these two contraceptive methods, the effects of which are predominantly gestagenic, seems to cause impairment of glucose tolerance or hepatic function.

Blood Glucose↗

[Contraceptive methods and epilepsy. Consideration on its physiopathogenesis].

The authors present six cases of patients with catamenial epilepsy, that use contraceptive methods (hormonal and intrauterine device). A critical report of the physiopathogenic aspects of hormones and epilepsy is also made. The authors conclude that: 1 - It seems there is no doubt about the influence of sexual hormones in epilepsy. 2 - There is no previsibility about the consequence of the use of contraceptives (hormonal and IUD) in patients with catamenial epilepsy. 3 - Further studies are still necessary to demonstrate the risk factors of contraceptive methods in epileptic patients.

Contraceptives, Oral↗

The effect of sexual behavior and a pregnancy on contraceptive method switching among black female teens.

Little is known about determinants of contraceptive method switching and few reports use data that can link events that occur close in time. Using retrospective information from the sexual calendars of black female teens who attended a reproductive health clinic, determinants of method switching in four areas were investigated. Method switchers, those who switched from an unprepared to a prepared method (n = 62) and those who switched from a prepared to an unprepared method (n = 18), were matched with nonswitchers who used the same initial method. Associations between switching and changes in the frequency of intercourse, sexual abstinence, and pregnancy were found. It is suggested that abstinence may have a different role in switching from each type of method. Counselors need to emphasize the importance of method continuation, even when sex has not occurred for a short period of time.

Adolescent↗

Characteristics of adolescents' sexual partners and their association with use of condoms and other contraceptive methods.

CONTEXT: While a number of studies have examined the association between individuals' characteristics and their contraceptive use, few studies have examined the influence of partners' characteristics on individuals' contraceptive use. METHODS: Using nationally representative data from the National Longitudinal Study of Adolescent Health, multiple logistic analyses were conducted to identify associations between the demographic characteristics of adolescents' heterosexual partners and adolescents' use of condoms or other contraceptive methods. RESULTS: The partners of white and black adolescents were likely to be similar to them, while the partners of Latino adolescents and of adolescents of "other" race or ethnicity were more likely to be of a different racial or ethnic group. Differences in age between adolescents and their partners were notable in all racial and ethnic groups. As adolescents age, the characteristics of their partners become more heterogeneous. The less similar adolescents and their partners are to one another--whether because of a difference in age, grade or school--the less likely adolescents are to use condoms and other contraceptive methods. CONCLUSIONS: Many adolescents have relationships with partners whose characteristics differ from theirs and with whom they are less likely to use condoms or other contraceptive methods. This behavior is more common as adolescents grow older. To provide appropriate counseling, sexuality educators and family planning providers need to consider the ways in which adolescents' relationships change as they age and discuss with them the dynamics of relationships involving partners who differ in age or other characteristics.

Adolescent↗

Contraceptive methods in the McCune-Albright syndrome.

We describe the case of a woman with McCune-Albright syndrome who had a pathological bone fracture while being treated with an oral contraceptive. In this syndrome the bone lesions contain estrogen and progesterone receptors. The possibility of progression of the bone lesions during pregnancy is well-known. We judge the use of oral contraceptives to be dangerous in this syndrome; the affected women must be orientated towards alternative contraceptive methods.

Adult↗

[Male views of contraceptive methods in a rural community in Bahia State, Brazil].

Family planning programs have traditionally concentrated on women. This study aimed to determine men's knowledge of contraceptive methods in a rural community in Bahia State, Brazil. Mean age of interviewees was 40.0 (+/-17.6) years. Avoiding unwanted pregnancy was reported as a responsibility of the couple by 39.7% of the male interviewees (n = 71) and as the man's responsibility by 26.8% (n = 48). The most widely known methods were condoms (98.9%) and the pill (96.6%). Condoms (22.9%), female sterilization (21.2%), and the pill (12.8%) were the most widely used methods. The majority of the interviewees (56.4%) reported that they "always" use some method. The men chose the method in 45.6% of the couples. The results indicate that more options for contraceptive methods should be offered, thereby facilitating the best choice of methods by the couple. Still, since in this study men chose the method in nearly half of the cases, it is necessary to prioritize couples' participation in family planning programs.

Adolescent↗

Guidelines No. 100 on the provision of information concerning contraceptive methods, 8 September 1986.

These Guidelines set down detailed provisions in accordance with which general physicians and clinics may provide advice on contraceptive methods. Annex 1 is entitled "Guidelines on counselling on contraception," and deals with the mode of operation, effectiveness, contraindications and side-effects of, and medical follow-up to the following methods of contraception: hormonal contraceptives; intrauterine devices; diaphragms; condoms; chemical agents (foam, jell, cream, etc.); and sterilization.

Ambulatory Care Facilities↗

Contraceptive methods used and preferred by men and women.

In 1997, a random sample of Finnish men (n = 395) and women (n = 393) aged 18-50 years received a postal questionnaire concerning family planning, in which they were asked which contraceptive methods they had ever used and which three methods they considered to be best. Men's contraceptive preferences were compared to those of women. The response rate for men was 45% and for women 56%. The majority of both men and women had used, together with their partners, condom, oral contraceptives (OCs) and intrauterine devices (IUDs). The use of diaphragm, Norplant, Depo Provera and postcoital IUDs was not common. Among the men, 2-11% did not know whether their partner/partners had used the contraceptives in question. Concerning the three best contraceptive methods, men placed the condom first and women OCs. No male or female respondents rated postcoital emergency pills a superior method. Both men and women appreciated the most reliable means.

Adolescent↗

Use of contraceptive methods in Spain: results of a national survey.

We conducted a personal interview of 2136 Spanish women aged 15 to 49 years with the aim of determining the contraceptive attitudes of this population. A stratified random sampling was performed to select the women who were to be interviewed, and this sampling design ensured adequate representation of the sample in Spain. At the time of the survey, only 1296 of the 2136 women used some type of contraceptive method (60.6%); the most commonly used method was the condom. The major reason given by the 840 women not using contraceptive methods was the absence of sexual intercourse. Nearly 25% of the Spanish women aged 15-49 years reported that they have no sexual relations.

Adolescent↗

Trends and determinants of contraceptive method choice in Kenya.

This study uses data from the 1989, 1993, and 1998 Kenya Demographic and Health Surveys to examine trends and determinants of contraceptive method choice in Kenya. The analysis, based on two-level multinomial regression models, shows that, over time, the use of modern contraceptive methods, especially long-term methods, is higher in urban than in rural areas, whereas the pattern is reversed for traditional methods. Use of barrier methods among unmarried women is steadily rising, but the levels remain disappointingly low, particularly in view of the HIV/AIDS epidemic in Kenya. One striking result from this analysis is the dramatic rise in the use of injectables. Of particular program relevance is the notably higher levels of use of injectables among rural women, women whose partners disapprove of family planning, uneducated women, and those less frequently exposed to family planning media messages, compared with their counterparts who have better access to services and greater exposure to family planning information.

Adolescent↗

[The acceptability of current contraceptive methods to adolescents].

The authors analyze the admissibility of present-day contraception methods in 107 adolescent girls who used oral anteovin and trisiston and in 128 ones who used copper-containing IUDs. Analysis has not revealed noticeable differences in the incidence of side effects in adolescents and a control group of women of a reproductive age. Spontaneous menses recovery occurred in all young patients within 26 to 36 days after the drugs were discontinued, and basal temperature biphasic pattern recovered in 70.2% of girls by the third month after IUD contraception discontinuation. Short courses (up to 6-12 months) of hormonal contraception are advisable for adolescents. IUD contraception complications presenting as expulsions and menstrual cycle disorders were 1.5-2 times more incident in the adolescents than in control women despite the preventive measures taken.

Adolescent↗

Determinants of contraceptive method among young women at risk for unintended pregnancy and sexually transmitted infections.

The objective of this study was to examine the relationship between contraceptive method choice, sexual risk and various demographic and social factors. Data were collected on 378, 15- to 24-year-old women, recruited from health clinics and through community outreach in Northern California. Logistic regression analysis was used to estimate the association of predictors with contraceptive method used at last sex. Asian and Latina women were less likely to use any method. Women who were raised with a religion, or thought they were infertile, were also less likely to use any method. Women with multiple partners were generally less likely to use any method, but were more likely to use barrier methods when they did use one. Few women (7%) were dual method users. Women appear to act in a rational fashion within their own social context and may use no methods at all or use methods that are less effective for pregnancy prevention but offer more protection from sexually transmitted infections.

Adolescent↗

Motivational antecedents to contraceptive method change following a pregnancy scare: a couple analysis.

In this study we develop and then test a couple model of contraceptive method choice decision-making following a pregnancy scare. The central constructs in our model are satisfaction with one's current method and confidence in the use of it. Downstream in the decision sequence, satisfaction and confidence predict desires and intentions to change methods. Upstream they are predicted by childbearing motivations, contraceptive attitudes, and the residual effects of the couples' previous method decisions. We collected data from 175 mostly unmarried and racially/ethnically diverse couples who were seeking pregnancy tests. We used LISREL and its latent variable capacity to estimate a structural equation model of the couple decision-making sequence leading to a change (or not) in contraceptive method. Results confirm most elements in our model and demonstrate a number of important cross-partner effects. Almost one-half of the sample had positive pregnancy tests and the base model fitted to this subsample indicates less accuracy in partner perception and greater influence of the female partner on method change decision-making. The introduction of some hypothesis-generating exogenous variables to our base couple model, together with some unexpected findings for the contraceptive attitude variables, suggest interesting questions that require further exploration.

Adult↗

[Contraceptive methods used by young women in the township of Lomé (Togo)].

Despite intensive development of reproductive health services among Togolese youth over the past ten years, contraceptive prevalence remains low, particularly among young women. To help understand the reasons for the low rate of use of reproductive health services by young women (adolescents and young adults) and to assess prevalence of their contraceptive use in Lomé. In a cross-sectional study in the five precincts of Lomé township from March 08, 1999, to April 17, 1999, approximately 500 adolescent girls and young women (aged 10-24 years) were interviewed according to a semi-structured questionnaire. The variables studied were: social and demographic characteristics; knowledge about family planning, including whether they had discussed sexual issues with their parents; conditions of contraceptive use (method used by the interviewee or her sexual partner, who made the decision, geographical and financial accessibility of the method); suggestions to improve contraceptive prevalence. Data were analysed with Epi-Info 6.3 and comparisons tested with the chi-square test (significance set at 5%). 63.6% (318 of 500) of the young women and female teenagers lived with a partner; 43.4% discussed some aspects of reproductive health with their parents, especially menstruation and STDs, including AIDS. Although 93.4% of the interviewees knew about condoms and 68.2% about the calendar (rhythm) method, few of them used these (respectively 33.6% and 31.8%). The interviewees decided about contraceptive use with their partners (37%) or alone (28%), and rarely asked their parents (1%). Contraceptives were obtained at a health facility by 3.8% of the subjects, and at the drugstore or market by 20.6%. The main reason for the low rates of use of health facilities (10.4%) and of medical contraceptive methods (11.2% of all contraceptive methods used) were: lack of means, information, and interest (in such facilities and methods), and finally, lack of sexual activity. The condom was essentially the only modern contraceptive method used. The main reason for the low rate of use of reproductive health services may be that apart from the condom, women and female teenagers rarely use modern contraceptive methods. Improving information about reproductive health, creating more "young friendly clinics", and developing peer educators might improve the contraceptive prevalence rate among young women in Togo.

Adolescent↗

Religiosity and contraceptive method choice: the Jewish population of Israel.

The primary purpose of this paper is to explore the relationship between religiosity and contraceptive method choice among users of contraception. The authors analyze a representative sample of 1751 married urban Israeli Jewish women interviewed in 1987-88. The authors' findings indicate that the contraceptive choices of religious women are determined largely by considerations unrelated to religious doctrine. A combination of factors, including the suitability of specific methods to fertility control needs, peer influences, and other cultural effects, appear to modify the acceptance and application of a particular religious theology.

Asia↗

Contraceptive method choices among adolescents in a Nigerian tertiary institution.

This study was undertaken to describe adolescents, use of contraceptive methods and to examine factors that motivate their choice. Face-to-face interview of single, randomly selected 971 males and females aged 18-24 years in a Nigerian tertiary institution was conducted. Among sexually active males and females 72 percent and 81 percent respectively had ever used contraception. The commonest methods ever used by the males and females respectively were the condom (43 percent) and rhythm (31 percent). While females were mainly motivated by pregnancy prevention irrespective of the sexual relationship, the males were more concerned about disease prevention in unstable sexual relationships. However, adolescents whose choice was motivated by disease prevention did not choose the condom significantly more frequently than other methods. The college clinic, complimented by other programmes, should be strengthened for reproductive health services.

Adolescent↗

Contraceptive method choice in the Philippines, 1973-83.

Contraceptive use and method mix were analysed using Philippines national survey data of 1973, 1978, and 1983. The analyses suggest that the reported decline in contraceptive prevalence between 1978 and 1983 was due to under-reporting of use in 1973 and 1983. The shifts in contraceptive method mix were also partly from under-reporting of rhythm and other methods in 1973 and 1983. Nevertheless, the determinants of method choice were similar in all three sets of data. Filipino couples were making rational choices in terms of their contraceptive goals, access, evaluation, and competence. Modifications in the directions and magnitude of the relationships in determining method choice also occurred, partly reflecting the increased use of sterilization by older, higher parity women.

Adult↗

Socio-medical factors affecting the utilization of different contraceptive methods at Al-Azhar rural family health clinic.

"The present study aimed at assessing the patterns of contraceptive use by rural women. 1,781 married, sexually active women, were interviewed.... They were served by the Family Health Clinic in Tokh El-Karamos Centre in El-Sharkia Governorate [Egypt]. They were classified according to the type of contraceptive method used. There were statistically significant differences of method users according to the level of education, occupation, history of pregnancy wastage, time lag between last labour and administration, breast feeding, menstrual characters and the type of last method used."

Abortion, Spontaneous↗