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At least 163 records · Page 9Linked to original sources

PubMed1989

Combined oral contraceptives and liver cancer. The WHO Collaborative Study of Neoplasia and Steroid Contraceptives.

A multi-national, hospital-based, case-control study was conducted to evaluate the possible relationships of steroid contraceptives to 6 neoplasms. Based on data from 122 newly diagnosed cases of primary liver cancer and 802 matched controls, the relative risk of liver cancer in women who had ever used combined oral contraceptives was estimated to be 0.71 (95% CI 0.4-1.2). No consistent trend in risk with months of use or time since first or last use was observed. Separate analyses also revealed no association between use of combined oral contraceptives and hepatocellular carcinoma (RR = 0.60) or cholangiocarcinoma (RR = 1.22). Most women in this study came from areas in which hepatitis B is endemic and rates of liver cancer are relatively high, and in most cases use of oral contraceptives was of short duration. These results provide no evidence that short-term use of oral contraceptives enhances risk of liver cancer in countries where the determinants of this disease are similar to those observed in the countries where this study was conducted.

Adolescent↗

PubMed1996

[Evaluation of sex education and contraception instruction at the contraception clinic in Odense].

The aim of the study was to evaluate 1 1/2 hours of lessons on contraception given to 9. and 10. grade students at the Contraception Clinic in Odense, Denmark. The lessons are a supplement to the traditional sexual education given at the school. The study included 148 pupils in the period from August 1991 to January 1992. The median age was 15 years for both girls and boys. The pupils answered two identical questionnaires; one just before the lessons were given and the other ten to 13 weeks after the visit to the clinic. The article presents the answers given about male and female sexual function, knowledge/own choice of contraception, pregnancy, abortion and HIV. The extra lessons improved the knowledge among the pupils, but there were still some boys with inadequate knowledge. The article gives suggestions for improving the teaching of contraception, such as having both male and female teachers. This would also emphasize that both sexes have a common responsibility. If the pupils answer a simple questionnaire before the lessons, it is possible to goal-direct the education to individual requirements. The pupils are introduced to the Contraception Clinic, where they easily can seek advice in the future.

Adolescent↗

PubMed1990

Microdose intravaginal levonorgestrel contraception: a multicentre clinical trial. I. Contraceptive efficacy and side effects. World Health Organization. Task Force on Long-Acting Systemic Agents for Fertility Regulation.

A multicentre clinical trial, including 19 centres in 13 countries, assessed the contraceptive efficacy and clinical acceptability of a Silastic 382 vaginal ring releasing 20 micrograms of levonorgestrel for at least 90 days. A total of 1005 women entered the study and 8176.74 woman-months of experience was gathered. The rate of intrauterine pregnancy at one year of use was 3.6 per 100 women (95% confidence interval 2.2-5.0), and of ectopic pregnancy, 0.2% (one case). The principal reasons for discontinuation were menstrual disturbances (17.2% at one year), vaginal symptoms (6.0%) and repeated expulsion of the ring (7.1%). The pregnancy rate with this 20 micrograms levonorgestrel-releasing vaginal ring compares favourably with that of a low estrogen combination oral contraceptive tested by WHO and is less than half that of a progestogen-only oral contraceptive in a WHO randomized study. It is concluded that the WHO intravaginal ring releasing an average of 20 micrograms of levonorgestrel per 24 hours is an effective method of contraception for at least one year of use.

Administration, Intravaginal↗

PubMed1999

The safety and contraceptive efficacy of a 24-day low-dose oral contraceptive regimen containing gestodene 60 microg and ethinylestradiol 15 microg.

OBJECTIVE: The safety and contraceptive efficacy of a new 24-day regimen of an oral contraceptive combination containing gestodene (GTD) 60 microg and ethinylestradiol (EE) 15 microg was evaluated in an open-label, multicenter study. METHODS: Adult women received GTD 60 microg/EE 15 microg from day 1 to 24 and 4 days of placebo during a 28-day cycle for either 13 or 19 cycles. RESULTS: Of the 1515 subjects enrolled, 1496 were included in the intent-to-treat analysis. A total of three pregnancies were reported during the 18 194 treatment cycles of the study, yielding a Pearl index of 0.21. Life-table analysis, based on 16 954 cycles, gave an accidental pregnancy rate of 0.0033. The most frequent adverse events were headache (reported in 35% of subjects), absence of bleeding (16%), flu-like syndrome (15%), pharyngitis (15%) and abdominal pain (15%). The most frequent reasons for withdrawal from the study were metrorrhagia, flu syndrome and absence of bleeding. Analyses of withdrawal and intermenstrual bleeding and spotting indicated acceptable cycle control. CONCLUSIONS: The 24-day GTD 60 microg/EE 15 microg regimen appears to be a well-tolerated and effective method for low-dose oral contraception. The current formulation offers an ultra-low steroidal dosage combined with a reduced pill-free interval to improve contraceptive efficacy.

Adult↗

PubMed1998

Emergency contraception use and the evaluation of barrier contraceptives. New challenges for study design, implementation, and analysis.

The availability of emergency contraception (EC) introduces new complexities to barrier contraceptive evaluation. Researchers must determine whether the primary objective of interest is to measure the effectiveness of the barrier plus EC back-up or the effectiveness of the barrier alone. Barrier contraceptive effectiveness study protocols must specify what study volunteers will be told about EC, under what conditions EC will be dispensed, what information about EC use will be collected, and how EC use will be addressed during data analysis.

Contraception↗

PubMed2000

Intrauterine contraception in the year 2001: can intrauterine device use be revived with new improved contraceptive technology?

Intrauterine contraception is the most cost-effective reversible method of contraception today. The method is becoming increasingly attractive to women due to the development of new technologies that not only enhance the performance of the intrauterine device (i.e. efficacy is now close to 100%), but also reduce the rate of expulsion (in the case of the 'frameless' GyneFix intrauterine device (IUD)) and the number of removals for medical reasons. This is important, since the demand for intrauterine devices is likely to increase drastically in the coming years. The size of the intrauterine foreign body with the mini GyneFix has been reduced six-fold since the development of the Lippes Loop, resulting in an almost total absence of incompatibility problems. Furthermore, intrauterine contraception is entering a new phase with the development of intrauterine systems (IUSs) that deliver potent progestins. The Mirena intrauterine system, which releases levonorgestrel, has been shown to drastically reduce menstrual bleeding. The FibroPlant levonorgestrel IUS has been clinically developed since 1997 and is a further development of the 'frameless' anchoring IUD concept. The majority of women presenting with excessive bleeding can be treated by insertion of the IUS, resulting in greatly reduced menstrual blood loss. This is a very important result from both a health and a quality-of-life point of view. The fact that the IUS is also a potent contraceptive is extremely interesting. We believe, therefore, that these new technologies will lead to a re-appraisal of the IUD and could revive the use of intrauterine contraception in all parts of the world, including those regions where IUD use is presently very low.

Female↗

PubMed1991

Failed contraception in Nigerian women: outcome of pregnancy and subsequent contraceptive choice.

The outcome of pregnancy in 56 patients who had contraceptive failure out of the 5,431 new acceptors at the Family Planning Clinic of the Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, between 1 January 1981 and 31 December 1989, were analysed. There were 40 IUD, 6 OC, and 4 injectable failures. Three patients had had voluntary surgical contraception (VSC) and 3 used barrier methods. The mean +/- SD age and parity were 32.2 +/- 4.4 years and 4.4 +/- 1.9, respectively. There were 17 (30.1%) live births, 34 (56.6%) terminations of pregnancy and 3 (5.2%) spontaneous abortions. Two (3.0%) patients were lost to follow-up. There was neither any statistically significant difference in the outcome of pregnancy between patients with 5 or more children and less than 5 children (p greater than 0.05), nor between patients less than 31 years of age and those older. Fifty per cent of the patients who had used the IUD continued with the method. Seven patients subsequently requested VSC. None of the patients using the injectable contraceptive or barrier methods continued with the method (p greater than 0.05).

Adult↗

PubMed2005

Effective use of hormonal contraceptives: Part II: Combined hormonal injectables, progestogen-only injectables and contraceptive implants.

Our objective in this systematic review was to evaluate evidence regarding controversial issues in the clinical management of women using injectable and implantable contraceptives. We searched MEDLINE and EMBASE for reports of primary research, published from 1966 through April 2005 in peer-reviewed journals, related to the initiation of combined or progestogen-only injectables and contraceptive implants, the effects of late contraceptive injections or the duration of levonorgestrel implant effectiveness. Results of the studies we reviewed showed that initiating injectable and implantable contraceptives through day 7 of the menstrual cycle suppresses follicular activity. Time to ovulation after study participants discontinued using injectables varied widely: from 4 to 8 weeks after the last administration of combined injectables, from 15 to 49 weeks after the last injection of depot medroxyprogesterone acetate and from 5 to 19 weeks after the last injection of norethisterone enanthate. Norplant implants left in place for up to seven completed years remained effective among women who weighed <70 kg at the time of implant insertion, but their effectiveness decreased among women weighing >or=70 kg.

Contraception↗

PubMed2006

Patterns of oral contraceptive pill-taking and condom use among adolescent contraceptive pill users.

PURPOSE: Imperfect oral contraceptive pill (OCP) regimen adherence may impair contraceptive effectiveness. The purpose of this study was to describe daily adherence patterns of OCP use, to analyze OCP protection on an event level basis, and to examine pill-taking and condom use during method transitions. METHODS: Women (n = 123, ages 14-17 years) completed quarterly interviews to classify OCP method choice into four categories: stable, initiated, stopped, and discordant use. Within each OCP category, daily diaries were used to assess occurrence of coitus, condom use, and patterns of day-to-day OCP use (i.e., consecutive days of OCP use reported with no more than two consecutive days of nonuse). A coital event was OCP protected if pills were used on both the day of the coitus and the day preceding. RESULTS: There were 123 participants who reported at least some OCP use in 210 diary periods (average diary length = 75.5 days). Fifty-three participants categorized as stable users reported 87 diary periods: the average interval of consecutive OCP use in this group was 32.5 days. Among stable users, only 45% of coital events were associated with both OCP and condom use. Over one-fifth of coital events in all groups were protected by no method of contraception. CONCLUSION: Dual use of OCP and barrier contraception remains an elusive goal. The time during OCP adoption or discontinuation is often unprotected by condoms. However, concurrent missed pills and condom nonuse increase pregnancy and infection risk even among stable OCP users. Understanding motivation for method usage may improve education and prevention techniques.

Adolescent↗

PubMed1981

Coagulation factors in women using oral contraceptives or intrauterine contraceptive devices immediately after abortion.

The changes in coagulation parameters were studied in 24 women who started using microdose combined oral contraceptives immediately after first-trimester abortion. Another 24 women who had an intrauterine contraceptive device inserted at the end of the abortion procedure were studied as control subjects. In pill users, a slightly increaed tendency toward hypercoagulability was observed 1 week after abortion in terms of elevated fibrinogen and Factor VIII as well as decreased antithrombin levels. Other studies have shown that the new follicle development after first-trimester abortion starts beyond the first week. It would therefore seem that by postponing oral contraceptive use until 1 week after abortion, no decrease in the effectiveness of contraception occurs and the possible risks of hypercoagulabilty during the postabortal period can be avoided.

Abortion, Induced↗

PubMed2000

Comparative effects of Lunelle monthly contraceptive injection (medroxyprogesterone acetate and estradiol cypionate injectable suspension) and ortho-Novum 7/7/7 oral contraceptive (norethindrone/ethinyl estradiol triphasic) on lipid profiles. Investigators from the Lunelle Study Group.

As part of a 60-week, open-label, nonrandomized, parallel, controlled study comparing a monthly contraceptive injection containing medroxyprogesterone acetate (MPA) 25 mg and estradiol cypionate (E(2)C) 5 mg (Lunelle Monthly Contraceptive Injection) and a norethindrone 0.5, 0.75, 1.0 mg/0.035 mg ethinyl estradiol (NET/EE) triphasic oral contraceptive (Ortho-Novum(R) 7/7/7), a longitudinal examination of lipid profiles was conducted. Lipid parameters were assessed at screening and at weeks 20, 40, and 60 (or the final visit) in 114 women using MPA/E(2)C and 93 using NET/EE (lipid analysis population). Extra blood samples were obtained at weeks 21, 22, and 23 in 61 MPA/E(2)C users and 51 NET/EE users (index-cycle analysis population) to investigate lipid changes during one cycle of use. In the index-cycle population, median changes from screening to week 60 showed a decrease in apolipoprotein (apo) A-I and apo A-II in both groups. MPA/E(2)C users had a decrease in total cholesterol (C), total triglycerides, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), with maintenance of the total C/HDL-C ratio. NET/EE users showed an increase in total C and LDL-C, with no change in HDL-C or the total C/HDL-C ratio. Within the index cycle (weeks 20 to 23), median changes in lipid values in both MPA/E(2)C and NET/EE users were generally greatest during the first week after the injection or the start of the pill pack. The results of this first longitudinal examination of serum lipids in US women using MPA/E(2)C confirm earlier findings in women in other countries. However, a direct comparison of the effects of MPA/E(2)C and NET/EE on lipid profiles was not possible in this study because of its design and because of the baseline and pharmacokinetic/pharmacodynamic differences between the two contraceptive groups. The results of this analysis showed that, although overall lipid values decreased, including a significant decrease in HDL cholesterol, the maintenance of the total-C/HDL-C ratio suggests that the effect of MPA/E(2)C on lipid parameters may not negatively affect CVD risk over 1 year of use. However, these results warrant further investigation, given the nature of this trial.

Apolipoprotein A-I↗

PubMed1998

Contraceptive efficacy and acceptability of a monophasic oral contraceptive containing 30 microg ethinyl estradiol and 150 microg desogestrel in Latin-American women.

Contraceptive efficacy, subject acceptability (cycle control, side-effects, acne score and weight gain) and blood pressure of a monophasic oral contraceptive containing 30 microg ethinyl estradiol plus 150 microg desogestrel (Marvelon) were assessed in an open-label 6-cycle multicenter study in Argentina (7 centers) and Venezuela (5 centers). Of the 407 participating women, 389 (95.6%) completed six cycles of treatment, providing data for a total of 2383 cycles. No pregnancies occurred during the course of the study, confirming the high contraceptive reliability of Marvelon. Cycle control was excellent; the duration of withdrawal bleeding decreased during consecutive treatment cycles and the incidence of spotting and breakthrough bleeding was low. The desogestrel/ethinyl estradiol combination was well tolerated and the incidence of minor side-effects, which was already low in the first treatment cycle, in most cases decreased during the subsequent cycles. The preparation was effective in reducing pre-existing acne, whereas it did not induce clinically relevant changes in blood pressure and body weight. Marvelon was shown to provide effective oral contraception, with good tolerance and excellent cycle control in Latin-American women.

Acne Vulgaris↗

PubMed2002

Mifepristone: contraceptive and non-contraceptive uses.

Mifepristone is an orally active progesterone antagonist. It can be used for both contraceptive and non-contraceptive clinical indications. It is a very effective drug for emergency contraception with a low incidence of side effects. There is a potential for mifepristone to be used as a once-a-month pill. There is a need, however, for a simple, inexpensive and accurate method to identify the luteinizing hormone surge before this method can be used in clinical practice. The daily administration of mifepristone offers promise as an effective method of contraception but more studies need to be done. The combination of mifepristone with a prostaglandin analogue is a well-established method for termination of pregnancy of up to 9 weeks. Recent data suggest that this combination may also be used up to 9-13 weeks of pregnancy. Although mifepristone is effective in dilating the cervix before vacuum aspiration, misoprostol is probably the drug of choice in most situations. In the second trimester, mifepristone is effective in shortening the abortion process induced by prostaglandin analogues. The combination of mifepristone and prostaglandin also offers a medical method for management of miscarriages. Mifepristone has been used for a number of other indications, but further studies are needed before such treatment can be recommended.

Abortifacient Agents, Steroidal↗

PubMedDate not supplied

Expanding contraceptive choices: lunelle monthly contraceptive injection.

Contraceptive options for women have expanded with the FDA approval of a monthly injectable contraceptive. Containing a progestin and estrogen (25 mg medroxyprogesterone acetate and 5 mg estradiol cypionate; Lunelle/Lunella; Pharmacia and Upjohn), this novel once-a-month injection is characterized by the convenience and contraceptive efficacy of long-term reversible methods and the cycle control, return to fertility and side-effect profiles common to low-dose oral contraceptives. The association of these desirable attributes may increase the likelihood that a woman's chosen method will be used consistently and correctly to reduce the frequency of unintended pregnancy.

Adolescent↗

PubMed1986

New Zealand contraception and health study: design and preliminary report. New Zealand Contraception and Health Study Group.

The New Zealand contraception and health study is investigating the potential health risks associated with oral contraceptives, intrauterine contraceptive devices and injectable medroxy-progesterone acetate. This prospective observational study, begun as a pilot study in 1980, will record for at least six years the health of approximately 7500 women divided into three groups of equal size according to contraceptive method at entry. A major objective is to compare the incidence of dysplasia, carcinoma in situ and invasive carcinoma of the cervix in each group. This paper describes the design of the study and reports its progress.

Adult↗

PubMed1980

[Medicamentous enzyme induction and hormonal contraception. Second communication: effects of phenobarbital and phenylbutazone on hormonal contraception (author's transl)].

The effects of phenobarbital and phenylbutazone on hormonal contraception of clinically intact women were studied for the purpose of obtaining information on consequences of medicamentous enzyme induction. Disorders of bleeding were evaluated from four groups of probands who had received complementary doses of phenobarbital or phenylbutazone along with hormonal contraception, and findings were compared with data obtained from a control group. Occurrence of medicamentous enzyme induction was clinically reflected in an accumulation of functional bleeding disorders, depending on the hormonal contraceptive used as well as on the additionally administered drug. Conclusions were drawn for contraceptive practice.

Adult↗

PubMed1996

[Diabetes regulation and oral contraceptives. Lipoporotein metabolism in women with insulin dependent diabetes mellitus using oral contraceptives].

In an open prospective study we evaluated the glycaemic control and lipoprotein metabolism in 22 women with uncomplicated insulin dependent diabetes mellitus during one year of oral contraception with ethinyl oestradiol and gestodene. Twenty women of comparable diabetic status using non hormonal contraception served as controls. No changes in glycaemic control were observed in any of the groups. In the oral contraceptive group decreased serum levels of low-density lipoprotein cholesterol and increased levels of triglycerides and lipoprotein A were noted whereas total cholesterol and high-density lipoprotein cholesterol levels were unchanged. In the control group a decrease of low-density lipoprotein cholesterol was observed. No effect of tobacco smoking on glycometabolic control or lipoprotein metabolism could be demonstrated during hormonal intake. In conclusion, we found no evidence of impaired glycometabolic control or adverse changes in serum levels of lipoproteins known to be associated to atherosclerosis in diabetic women during one year of oral contraception with ethinyl oestradiol and gestodene.

Adolescent↗

PubMed1991

The WHO Collaborative Study of Neoplasia and Steroid Contraceptives: the influence of combined oral contraceptives on risk of neoplasms in developing and developed countries.

A hospital-based case-control study was conducted in eight developing and three developed countries to determine whether use of combined oral contraceptives alters risks of various cancers. An observed trend of increasing risk of invasive cervical cancer with duration of use may not represent a causal relationship and is the subject of further study. Decreased risks of ovarian and endometrial carcinomas in users likely indicate a protective effect of oral contraceptives, the degree of which was similar in developing and developed countries. A small increase in risk of breast cancer in recent and current users was found to be somewhat greater in developing than developed countries. Both causal and non-causal interpretations of this finding have been offered. No associations were found between oral contraceptives and in situ cervical, hepatocellular, cholangio, or gallbladder carcinomas, or uterine sarcomas; but the power of this study to detect alterations in risks of these neoplasms in long-term users was low.

Breast Neoplasms↗