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Women's satisfaction with birth control: a population survey of physical and psychological effects of oral contraceptives, intrauterine devices, condoms, natural family planning, and sterilization among 1466 women.
User satisfaction and the physical and psychological effects of five commonly used contraceptive methods were investigated in a population survey among 1466 West German women. The focus was on effects attributed by current and past users to these methods, rather than objectively assessed effects, to shed further light on personal experiences that are highly relevant to the user but often remain unknown to prescribers and unreported in the medical literature. Within the overall sample, 1303 women were surveyed concerning their current or past use of oral contraceptives (OC), 996 regarding condoms, 342 with respect to intrauterine devices (IUD), 428 in regard to natural family planning (NFP), and 139 in relation to sterilization (respondents completed questions about each method used). It emerged that satisfaction was greatest with sterilization (92% of users), followed by OC (68% of ever users), IUD (59%), NFP (43%), and condoms (30%). Almost one in three NFP users had experienced an unwanted pregnancy during use of this method, as compared with one in 20 OC and condom users. The majority of users reported no mood changes during use of the methods studied. The percentages reporting negative mood changes (various items were scored) were up to 16% among OC users, 23% among condom users, and 30% among NFP users. The latter observations suggested that subjective side effects of a contraceptive agent on mood generally reflected, at least in part, the user's sense of confidence in the method concerned (notably, with regard to efficacy and safety). Oral contraceptives, IUD, and sterilization had a broadly positive impact on sex life, whereas that of condoms was often negative. Whereas OC users often reported less heavy and painful menstruation (in up to 56% of cases), IUD were associated with heavier, prolonged, and more painful menstruation (in up to 65% of cases), as also was sterilization, although to a lesser extent (in up to 32% of cases). Overall, the study findings indicated that OC and sterilization had less negative impact on physical and psychological functioning than the other methods studied, in contrast to what the general public often believes.
The family planning users' perspective.
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NFP update: researcher cites need to improve instruction.
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A review of cervical mucus and sperm interactions in humans.
Cervical mucus is an aqueous or gel mixture of fluids, ions and compounds, and cells, primarily produced by the endocervical epithelium. The amount secreted varies with menstrual phase and compositions changes under hormonal influence. Sodium shows the greatest concentration change at ovulation but does not change early enough to be of value in natural family planning practice. Dried mucus has a fern appearance due to NaCl crystals at ovulation. Other substances, less clearly related, are too difficult to analyze or in too low concentration. Soluble proteins, amino acids, and simple sugars show wide fluctuation and probably influence sperm penetration and nutrition. One function of mucus is antimicrobial activity of leukocytes, which decreases at midcycle. Another, sperm transport, is a function of estrogen's effect on mucus rather than ovulation. Sperm concentration in the mucus column is maximal from 15 minutes to 2 hours after vaginal deposition. Rapid penetration into cervical mucus favors sperm survival because of its optimal pH. Infertility may be caused by immunoglobulins or spermagglutinins in cervical mucus. To date, no constituent of cervical mucus has been identified which undergoes an easily detectable change 4 days before ovulation. Several potential methods for use in natural family planning are suggested.
Combination of the ovulation method with diaphragm.
A marked increase in acceptance of the ovulation method of contraception, together with promising method and user failure rates, were revealed in this study of women to whom a system of combining the ovulation method with the optional use of a diaphragm, advisedly as a menstrual seal, was offered.
[On the reliability of temperature method for contraception].
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Attitudes of some couples using natural family planning.
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[Varying opinions of the temperature method of birth control].
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Ideally suited. Looking at the prospects of natural family planning in the Philippines today.
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Self-observation of the cervix to distinguish days of possible fertility.
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[Re-establishment of fertility in post-partum. Connections between the basal body temperature and the cervical mucus].
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Cervical mucus: the biological marker of fertility and infertility.
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Natural family planning after pregnancy. A problem for women with previously irregular menstrual cycles.
A prospective six-year study (1975-1980) of 273 patients, monitored in the use of natural family planning (NFP), has shown that those with previously irregular menstrual cycles are disadvantaged in the subsequent use of the ovulation method after pregnancy in that they have fewer recognizable safe days and/or are more likely to have unplanned pregnancies than women who had regular cycles prior to pregnancy. Eight patients, seven nursing and one non-nursing mother, conceived during postpartum amenorrhoea. The reliability of memory in the recall of previous menstrual histories is discussed in relation to the results of an international study of menstrual cycles by the World Health Organization (WHO 1983). The relevance of prediction of menstrual events in natural family planning is also considered.