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At least 19 recordsLinked to original sources
PubMed1989

Contraceptive method change among rural Sri Lankan women.

Patterns of contraceptive method change and their association with reproductive motivation and contraceptive failure are examined using data from a 1986 survey of family planning behaviour of rural Sinhalese married women aged 15-44 in seventeen districts of Sri Lanka. A notable degree of rationality in contraceptive method changes occurs with family formation. The attempt to control unwanted fertility leads to more efficacious use of contraception, including traditional methods. Some methodological improvements to the analysis of contraceptive switching are indicated. Implications of the findings for programmatic emphasis on permanent versus non-permanent modern methods are discussed.

Adolescent↗
PubMedDate not supplied

Changing men's attitudes and behavior: the Zimbabwe Male Motivation Project.

A multimedia communication campaign was conducted between 1988 and 1989 to promote family planning among men in Zimbabwe. The campaign consisted of a 52-episode semiweekly radio soap opera, about 60 motivational talks, and two pamphlets about contraceptive methods. Changes over time were measured by comparing a subset of a follow-up survey conducted from October to December 1989 to a baseline survey conducted from April to June 1988. Men exposed to the campaign were also compared to men who were not exposed. The follow-up survey revealed that the campaign reached 52 percent of men aged 18 to 55. Among married Shona-speaking men, use of modern contraceptive methods increased from about 56 percent to 59 percent during the campaign. Condom use increased from about 5 percent to 10 percent. Awareness and current use of modern contraceptives was also higher among men exposed to the campaign, primarily because of their greater awareness of condoms. Men exposed to the campaign were significantly more likely than other men to make the decision to use family planning and to say that both spouses should decide how many children to have.

Adolescent↗
PubMed1982

Intrauterine contraceptive devices in diabetic women.

11 of 30 (36.6%) insulin-dependent diabetic women fitted with intrauterine contraceptive devices (IUCDs) became pregnant within 1 year, whereas the pregnancy rate for non-diabetic women fitted with the same types of IUCD by the same consultant gynaecologists over a similar time period was 4 per 100 women years (4%). As soon as the high risk was recognised, devices were removed (2 from diabetic women who were pregnant and 19 from non-pregnant diabetic women), and patients were advised about other methods of contraception. The IUCDs were examined in a scanning electron microscope with X-ray microprobe analysis to measure the amount of copper eroded from the wire, the extent of the encrustation (if any) deposited on the wire, and the composition of the deposit, and the data were compared with those for 111 devices removed from non-diabetic women, 40% of the IUCDs from diabetic women had sulphur and chloride in the deposit, compared with 15.3% of IUCDs from normal women, and fewer IUCDs from diabetic women had calcareous deposits. In devices from normal women, erosion and deposition seemed to occur independently, but in IUCDs from diabetic women, there was high erosion, there were also large deposits, and where there was little deposit, the erosion was slight. 7 of 14 IUCDs taken from normal women who had become pregnant with an IUCD in situ had a high sulphur plus chloride deposit; none of these IUCDs had a predominantly calcareous deposit compared with 19.8% of the IUCDs from non-pregnant normal women. The evidence militates against the insertion of IUCDs in diabetic patients and indicated that, even in non-diabetic women, there may be small groups for whom the risk of becoming pregnant is very high.

Adult↗
PubMed2001

Return of fertility in nulliparous women after discontinuation of the intrauterine device: comparison with women discontinuing other methods of contraception.

OBJECTIVE: To clarify the effect of the using the intrauterine device on fertility in nulliparous women. DESIGN: Prospective cohort study of two groups of nulliparous women, one recruited while using an intrauterine device and the other while using an oral contraceptive. SETTING: Seventeen family planning clinics in England and Scotland. SAMPLE: 1,071 nulliparous, married women, aged 18-40 years, 558 of whom contributed information to the main objective of the study. METHODS: The women were recruited between 1982 and 1985 and followed up annually to 1994. Dates and reasons for any contraceptive method changes (which were most frequently to barrier methods) were recorded, together with the outcome of any pregnancies, at each follow up. MAIN OUTCOME MEASURES: The number of nulliparous women giving birth at term after stopping contraception (oral contraceptive, intrauterine device or barrier method) in order to conceive. RESULTS: Women who stopped using a barrier method to achieve a planned pregnancy conceived most quickly: 54% were delivered after one year vs 39% of intrauterine device and 32% of oral contraceptive users (log rank P = 0.002). There was no association between fertility and duration of oral contraceptive use: However, short term intrauterine device users (< 42 months) showed a fertility pattern more favourable than seen in those discontinuing oral contraceptives, with increasing duration of intrauterine device use being associated with decreasing fertility (linear trend P = 0.005); the fertility of women who had used the intrauterine device for 78 + months was the most impaired (28% were delivered by 12 months vs 46% of short term users; at 36 months the corresponding figures were 79% vs 91%). This association remained after adjusting for potential confounding factors, including maternal age, husband's social class, and history of gynaecological illnesses, factors which themselves had independent associations with fertility. CONCLUSIONS: Long term intrauterine device use in nulliparous women appears to be associated with an increased risk of fertility impairment.

Adolescent↗
PubMed1991

Trends in the contraceptive practices of women seeking abortions in the 1980s.

The demographic features and contraceptive practices of 1000 women attending Parkview clinic of Wellington Hospital for termination of pregnancy were studied over an eight month period in 1988-9. Comparisons were made with a previous study at the same clinic in 1980-1. The overall abortion rate has increased from 6.8/1000 women in the Wellington statistical area in 1981 to 9.8 in 1989. The proportion of Pacific Island and Asian women presenting for abortions is high and has increased disproportionately between 1981 and 1989. The abortion rate has also increased in lower socioeconomic groups in 1989. The proportion of women using contraception at the time of conception increased from 50% in 1981 to 68.5% in 1989. The methods used by women presenting for abortion have changed significantly. There has been an increase in the proportion of women using condoms (from 13.3% to 36.2%) and the oral contraceptive pill from (14% to 21.4%).

Abortion Applicants↗
PubMed1990

Modern trends in contraception.

Substantial improvements have been made in oral contraceptives, a new injectable contraceptive (Norplant), and the intrauterine device (IUD). Major risks with oral contraceptives have declined substantially, and a number of noncontraceptive health benefits have been discovered. Norplant is probably the first new contraceptive in recent years, and offers long-term contraception with high efficacy and modest risks. The IUD, by carefully selecting users, is a safe and efficacious contraceptive method. The major risk, pelvic inflammatory disease (PID), is far less common if one avoids use in the presence of risk factors for PID.

Contraceptive Agents, Female↗
PubMed1988

Haemostasis and oral contraceptives.

Selected hemostasis parameters were assayed in 131 women ingesting different kinds of oral contraceptives and 36 control women. No differences were noted in the plasma levels of fibrinogen, antithrombin III, prekallikrein, alpha 2 antiplasmin, fibrinopeptide A, platelet factor 4 and beta-thromboglobulin. Protein C and plasminogen levels were significantly higher in pill users (p less than 0.001, p less than 0.01) and fibronectin levels were lower (p less than 0.05). Canonical correlation, performed between clinical parameters and hemostasis data, revealed a negative correlation between antithrombin III levels and family history for thromboembolic diseases. A positive correlation was noted between fibrinogen and fibronectin levels in obese OC users. The data suggest that women taking OCs are not in a state of "hypercoagulability."

Adult↗
PubMed1987

Intrauterine contraceptive devices: MR imaging.

To assess the safety of magnetic resonance (MR) imaging in women who have an intrauterine contraceptive device (IUD) in place, in vitro and in vivo studies were performed at both 0.35 and 1.5 T. Two commonly used IUDs were tested, one all of plastic, the other with a coil of copper wire on it. Specifically, the study assessed possible motion of the IUD in the magnetic field, potential of the IUD to heat up during two spin-echo imaging sequences commonly used in MR imaging of the pelvis (2,000/30 and 60 [repetition time, msec/echo time, msec], and 500/30), and the appearance on MR images of the IUD devices. A retrospective review of MR images of the pelvis in six women who had an IUD in place was also performed. Results show that an IUD does not move under the influence of the magnetic field, does not heat during spin-echo sequences commonly used for pelvic imaging, and does not produce artifacts in vitro or in vivo. Patients with either type of IUD can be safely imaged with MR, and MR images of the pelvis are not degraded by the presence of an IUD.

Female↗
PubMed1987

The in vivo biodegradation of nylon 6 utilized in a particular IUD.

The particular IUD of this study was composed of a plastic shield and a nylon 6 coated filament tail string. This IUD was unique, in the fact that its tail string was the only one (and has been to date) that consisted of a coated multifilament arrangement. Studies on the tail string have revealed bacteria and debris existing between the outer filaments that are underneath the coating. Other studies have reported that removed devices were found to exhibit an unusually high incidence of breaks in the tail string coating. Studies at the University of Lowell also found that upon examination of devices that had been in vivo for periods of two years or longer, 67% of these devices examined had breaks in the coating of the tail string. Investigations have determined that the design of the tail string was serving as an avenue of transport for the bacteria to bypass the protective cervical mucus barrier and enter the sterile uterine cavity through the breaks in the tail string coating. This mechanism has been suggested to account for the higher frequency of uterine infections associated with this device. Research at the University of Lowell was undertaken to study the degradation of the nylon 6 coating and to determine the in vivo degradation mechanism. The biochemistry of the fluids present in the reproductive tract were carefully documented and the more aggressive ones selected for in vitro trials. The results of the study revealed that the in vivo physical breakdown of the coating may depend upon a series of mechanisms and variables.

Biodegradation, Environmental↗
PubMed1991

Risk reduction among injecting drug users: changes in the sharing of injecting equipment and in condom use.

In an investigation of risk behaviour among injecting drug users in the North-West of England, information was obtained concerning the sharing of injecting equipment, respondent's sexual partners and the use of condoms. Between six and nine months after the initial contact, 169 respondents (56%) were contacted again. The emphasis in the second phase of the project was on changes, if any, in risk behaviour that had occurred in the intervening period. Significant reductions were found in sharing, mostly in the more indiscriminate use of others' injecting equipment. No reduction was observed in sharing between injecting partners and little in sharing between close friends. The number of sexual partners had decreased and the use of condoms, although it increased among those involved in temporary relationships, remained low. Impediments to further progress in risk reduction are discussed.

Adolescent↗
PubMed1977

Contraceptive method continuation according to type of provider.

A study was undertaken at the main PROFAMILIA clinic in Bogota, Colombia to compare the effectiveness of nurses and physicians in the delivery of family planning services. Contraceptive method continuation was the major outcome variable in this analysis. Clients were randomly assigned to physicians or nurses on their first visit and for the duration of care. On all revisits, data were collected pertaining to method prescribed, side effects, pregnancy, and method changes. There was a field survey at eight months to locate clinic drop-outs and determine their contraceptive use status. There were no significant differences in method continuation between clients who received services from physicians and those who received services from nurses. At nine months, the overall continuation of the first method prescribed was 79.1 per cent in the physicians' group and 75.8 per cent in the nurses' group (t = 1.057, p greater than .20). When controlling for first method used, the IUD users in the physicians' group had a continuation rate of 86.1 per cent and in the nurses' group 84.0 per cent (t = 0.556, p greater than .50). Of the pill users who received services from physicians, 78.1 per cent were continuing at nine months and 74.3 per cent of the pill clients in the nurses' group were continuing at nine months (t = 0.573, p greater than .50). There were no differences in pregnancy rates, side effects rates, and method change rates between the two groups. It may be concluded that these nurses were as effective as physicians in the delivery of family planning services.

Adult↗
PubMed2001

Oligo-amenorrheic long-distance runners may lose more bone in spine than in femur.

PURPOSE: Strenuous training can be associated with amenorrhea leading to amenorrhea-related accelerated bone loss. Insufficient calorie energy, calcium, and/or protein intakes can also be frequently encountered in women with intense training, possibly contributing to bone loss. Long-distance runners with or without regular menses (age range 19-37 yr) were prospectively studied. METHODS: Changes in areal bone mineral density (BMD) were measured at 1-yr interval. RESULTS: Among 10 eumenorrheic, 11 oligo-amenorrheic, and 9 oral contraceptive users, there was no difference in energy, calcium, or protein intakes. Baseline BMD values were significantly lower in the oligo-amenorrheic group than in the two others at the level of lumbar spine (anteroposterior view: 0.941+/-0.039 in oligo-amenorrheic vs 1.077+/-0.029 or 1.051 +/-0.017 g x cm(-2), P < 0.005, in the eumenorrheic and contraceptive user groups, respectively) but not in weight-bearing bone such as proximal and midshaft femur. Over a 1-yr interval, during which the three groups did not differ in terms of running distances and dietary intakes, oligo-amenorrheic women displayed a significant decrease in lumbar spine BMD in lateral view (-0.049+/-0.012 in oligo-amenorrheic vs -0.001+/-0.013 and 0.014+/-0.012 g x cm(-2), p < 0.005, in the eumenorrheic and contraceptive user groups, respectively). We did not detect any significant change in femoral neck, trochanter, or midshaft BMD. CONCLUSIONS: Oligo-amenorrhea in long-distance runners, with adequate dietary intakes, was associated with a decrease in BMD affecting more the lumbar spine than the proximal and midshaft femur during a 1-yr follow-up.

Adult↗
PubMed2002

Nonmenstrual adverse events during use of implantable contraceptives for women: data from clinical trials.

Contraceptive methods, including implants, do not prevent common symptoms and adverse health events that most people experience. It is difficult, therefore, to decide whether or not the occurrence of symptoms or adverse events that are common can be attributed to use of a contraceptive method or to determine if a given method changes the likelihood of their occurrence. Based on the review of the literature, no apparent differences in the frequency of adverse events are evident between the six-implant or two-rod levonorgestrel systems and the single implant etonogestrel and nomegestrol acetate systems. The most frequent adverse events reported in clinical trials that are probably related to implant use are headaches and acne. Weight gain, dizziness, and mood changes are also frequently mentioned adverse events and are possibly steroid-related. Other possibly related adverse events, although much less frequently reported, are loss of libido, fatigue, hair loss, and other skin conditions. Persistent ovarian follicles that spontaneously disappear are a common event during use of progestin-only contraceptives, and providers should be aware of this condition to avoid unnecessary interventions. Overall, the vast experience reported in the clinical studies reviewed here show that all existing implantable contraceptives are equally safe. This can probably be attributed to the low-hormonal dose delivered by progestin-implant systems.

Abdominal Pain↗
PubMed1992

Changing patterns in reported sexual practices in the population: multiple partners and condom use.

OBJECTIVE: To determine whether the pattern of change with regard to condom use and multiple sexual partners is influenced by gender or educational level. DESIGN: Findings from data collected from 1987 to 1990 about changes in condom use and multiple-partner activities are presented, based on telephone interviews with 9416 participants aged 18 to 44 years resident in central Scotland, UK. METHODS: Change in patterns over time were modelled in a multivariate logistic regression using a linear interactive modelling program. RESULTS: Several models showing changes in the proportion of multiple-partner respondents and condom users yielded a complicated pattern of behavioural change in educational status and gender. CONCLUSIONS: There is a large difference in reported condom use and multiple sexual partners by gender, but the difference is decreasing over time. Better educated respondents increased their use of condoms while less educated respondents showed a decrease in the proportion of multiple partners.

Adolescent↗