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Title: Prolonged use of intrauterine contraceptive device as a risk factor for tubo-ovarian abscess.
Author: Charonis G; Larsson PG
Source: Acta Obstetricia Et Gynecologica Scandinavica. 2009;88(6):680-684.
Abstract: Objective. The intrauterine contraceptive device (IUCD) is the most preferred method of reversible contraception in the world today. The Swedish Medical Products Agency currently recommends that women who had a copper IUCD inserted around age 40 do not need to have it extracted until one year after the menopause. Design. Retrospective study. Setting. Skovde Central Hospital, Sweden. Population. All 114 women receiving in-patient treatment for pelvic inflammatory disease (PID) over five years between January 2001 and December 2005. Methods. Comparison between cases of tubo-ovarian abscesses and salpingitis with focus on the effects of IUCDs used continually for >5 years after insertion. Main outcome measures. Age-adjusted risk of PID within or after five years of use, microbiological findings in blood, intraabdominal pus, cervical secretions or on extracted IUCDs. Results. There were 31 cases of tubo-ovarian abscesses, 63 of salpingitis, four of endometritis, and 16 of mild genital infection. When comparing women with the same IUCD>5 years to women having the same IUCDLanguage: English
Keywords:
SWEDEN | RESEARCH REPORT | WOMEN | PELVIC INFLAMMATORY DISEASE | IUD | GENITAL EFFECTS, FEMALE | RISK FACTORS | Developed Countries | Europe, Northern | Europe | Demographic Factors | Population | Reproductive Tract Infections | Infections | Diseases | Contraceptive Methods | Contraception | Family Planning | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Health
Document Number: 341046

Title: Infection risk and intrauterine devices.
Author: Martinez F; Lopez-Arregui E
Source: Acta Obstetricia et Gynecologica Scandinavica. 2009;88(3):246-50.
Abstract: For most women, intrauterine contraceptive devices (IUCD) are a safe option. Upper genital tract infections (pelvic inflammatory disease, PID) occur when pathogenic microorganisms ascend from the cervix and invade the endometrium and the fallopian tubes, causing an inflammatory reaction. Evidence-based recommendations regarding intrauterine contraception and risk of infection were presented at the Congress of the European Society of Contraception, in Prague, 2008: A clinical history (including sexual history) should be taken as part of the routine assessment for intrauterine contraception to identify women at high risk of sexually transmitted infections (STI); if appropriate a test should be offered; if symptoms or signs are present, appropriate diagnostic tests should be done, results awaited, necessary treatment completed, and IUCD insertion postponed until resolution. Prophylactic antibiotics are not recommended (evidence level II-3). STI screening is not routinely recommended. PID among IUCD users is most strongly related to the insertion process and to the background risk of STI (evidence level II-2). Conditions which represent an unacceptable health risk if an IUCD is inserted (WHO Medical Eligibility Criteria, MEC, Categories 3-4) are current PID, current purulent cervicitis, chlamydial or gonorrheal infection. For continuation as well as initiation, WHO MEC categories 3-4 are allotted to women with known pelvic tuberculosis, puerperal sepsis and septic abortion.
Language: English
Keywords:
SPAIN | RESEARCH REPORT | WOMEN | IUD | PELVIC INFLAMMATORY DISEASE | SEXUALLY TRANSMITTED DISEASES | RISK FACTORS | TUBERCULOSIS | GENITAL EFFECTS, FEMALE | Developed Countries | Europe, Southwestern | Europe | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Reproductive Tract Infections | Infections | Diseases | Health | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology
Document Number: 330543

3.
Title: [Pharmacotherapy for pelvic endometriosis in women] Farmakoterapia endometriozy narzaadow miednicy u kobiet.
Author: Starczewski A; Brodowska A; Brodowski J
Source: Polski Merkuriusz Lekarski. 2009 Mar;26(153):231-3.
Abstract: Pelvic endometriosis in women is a very common disease. The incidence of this condition in Poland in reproductive age women is about 7-15%, and as much as 50% of cases is diagnosed in patients with co-existing infertility and/or pain and adhesion of a true pelvis. The choice of a therapeutic method depends on the patient's age, stage of the disease, desire for pregnancy, the presence of adhesion, focus localization and a reaction to previous treatment. Currently, the most popular is surgical treatment sometimes followed by pharmacotherapy. Pharmacological treatment includes hormone therapy and symptomatic treatment, also the use of painkillers. Hormonal agents are administered to suppress ovarian activity and cause atrophy of ectopic foci of endometrium. At present, post-surgical pharmacotherapy for endometriosis uses mainly such hormones as: the Combined Oral Contraceptive Pill (COCP), progestagens, danazol, GnRh (gonadotropin-releasing hormone) analogues, aromatase inhibitors and other less common drugs. Also other therapeutic procedures are recommended in endometriosis treatment, procedures which support and in certain clinical situations even replace classical pharmacological methods. Some of them are immunotherapy and a diet rich in isoflavones, organic compounds which modulate estrogen receptor activity. Numerous clinical trials proved that preoperative pharmacotherapy does not improve treatment results and is not applicable to endometriomas in women. On the other hand, postoperative pharmacotherapy still ignites controversy. As maintained by the most recent literature, in the case of mild endometriosis (clinical Stage I and II according to the American Society for Reproductive Medicine) endometrial ablation has better effects than observation only, however postoperative pharmacotherapy does not improve the results of treatment. In more severe cases (clinical Stage III and IV), the best results are achieved by the combined treatment. Nevertheless, no randomized research has been carried out on awide scale in this group of patients.
Language: Polish
Keywords:
POLAND | RESEARCH REPORT | INCIDENCE | WOMEN | PELVIC INFLAMMATORY DISEASE | ENDOMETRIOSIS | GYNECOLOGIC SURGERY | PAIN | TREATMENT | EVALUATION | Developing Countries | Europe, Central | Europe | Measurement | Research Methodology | Demographic Factors | Population | Reproductive Tract Infections | Infections | Diseases | Urogenital Surgery | Surgery | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms
Document Number: 341113

Title: Is there a role for use of levonorgestrel intrauterine system in women with chronic pelvic pain?
Author: Anpalagan A; Condous G
Source: Journal of Minimally Invasive Gynecology. 2008 Nov-Dec;15(6):663-6.
Abstract: This review focuses on the available evidence for the use of levonorgestrel (LNG) intrauterine system (IUS) in women with chronic pelvic pain (CPP). We have searched MEDLINE, Pubmed, Embase, and the Cochrane electronic library with the keywords "chronic pelvic pain," "endometriosis," "Mirena IUS," and "levonorgestrel IUS" from 1956 through April 2008. Review articles, randomized trials, prospective cohort studies, and retrospective studies were analyzed and the available evidence included in this review. Case reports were not included in the analysis. Laparoscopic surgery was shown to be useful in clarifying the underlying cause in women with CPP, with 70% having abnormal findings at laparoscopy. Endometriosis, particularly deep infiltrating endometriosis, is found in 40% to 60% of women with dysmenorrhea. Laparoscopic excision of endometriosis was shown to be associated with improvement of symptoms in 70% to 80% of women. Up to 36% need repeated surgery during a 5-year period after the primary procedure. The absolute reduction in recurrence of dysmenorrhea in women who also had the LNG IUS inserted at the time of surgery was 35% (95% CI 9%-61%). The LNG IUS was shown also to reduce the blood flow in the uterine artery and the subendometrial spiral arteries. This may explain the reduction in primary dysmenorrhea in women who have the LNG IUS inserted. Insertion of the LNG IUS at the time of primary laparoscopic surgery in women with CPP caused by endometriosis has the potential to reduce postoperative pain scores. This medical approach is also a promising alternative to repeated laparoscopic surgery especially in those women who have continuing symptoms after laparoscopic excision of endometriosis. This nonsurgical option could potentially reduce the rate of repeated laparoscopies in women with CPP and, in turn, reduce overall intervention rates. Although growing evidence exists that the LNG IUS can be useful in this group of women, large randomized controlled studies are needed to validate its benefits in day-to-day practice.
Language: English
Keywords:
AUSTRALIA | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | PELVIC INFLAMMATORY DISEASE | ENDOMETRIOSIS | IUD | LAPAROSCOPY | LEVONORGESTREL | Oceania | Developed Countries | Demographic Factors | Population | Reproductive Tract Infections | Infections | Diseases | Contraceptive Methods | Contraception | Family Planning | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents
Document Number: 330290

Title: Induced abortion and the risk of tubal infertility.
Author: Chen XQ; Tang YJ; Liu L; Ren J; Lei ZW
Source: Journal of Reproduction and Contraception. 2008 Dec;19(4):219-225.
Abstract: Objective: To explore the association between induced abortion and tubal infertility in Chengdu, China. Method: A 1:2 case-control study was designed. Infertile women with bilateral tubal occlusion in the case group compared with two control groups: infertile control group with bilateral tubal patency and pregnant control group with currently pregnancy. Data were collected using questionnaires through face-to-face interviews, covering the subjects' demographic details and histories of gynecology and obstetrics. Adjusted odds ratio was calculated as a measure of the association using stepwise multiple logistic regression analysis. Results: Induced abortion was not found to be associated with tubal infertility in the analysis including either the infertile controls or the pregnant controls, but other risk factors were found, such as history of acute pelvic inflammatory disease (PID), lower abdominal surgeries, dysmenorrhea and pregnancy. Conclusion: It is contended that facing an increasing trend of infertile cases with tubal occlusion in China, it is emphasized that special attention should paid to the long term impact of reproductive tract infection, especially, asymptomatic ones, rather than induced abortion.
Language: English
Keywords:
CHINA | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | MULTIVARIATE ANALYSIS | WOMEN IN DEVELOPMENT | ABORTION | INFERTILITY | TUBAL OCCLUSION | PELVIC INFLAMMATORY DISEASE | SURGERY | DYSMENORRHEA | PREGNANCY, UNPLANNED | RISK FACTORS | Asia, Eastern | Asia | Developing Countries | Research Methodology | Studies | Data Analysis | Economic Development | Economic Factors | Fertility Control, Postconception | Family Planning | Reproduction | Female Sterilization | Sterilization, Sexual | Reproductive Tract Infections | Infections | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Menstruation Disorders | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Biology
Document Number: 328030 Notification

9.
Title: [Dysmenorrhea in pediatric and adolescent gynaecology] Bolesne miesiaczkowanie w ginekologii dzieciecej i dziewczecej.
Author: Drosdzol A; Skrzypulec V
Source: Ginekologia Polska. 2008 Jul;79(7):499-503.
Abstract: Dysmenorrhea is the most common problem in pediatric and adolescent gynaecology and it reaches approximately 20-90% of adolescents and young adult females. Dysmenorrhea in adolescent girls is usually primary and is associated with normal ovulatory cycles and with no pelvic pathology. Secondary dysmenorrhea, associated with some pelvic pathology, constitutes approximately 10% of the cases and its most frequent reasons are: endometriosis, pelvic inflammatory disease, congenital mullerian anomalies and ovarian cysts. Prostaglandins and leukotriens play a significant role in etiopathogenesis of the primary dysmenorrhea. The therapy of the primary dysmenorrheal in adolescent girls involves: nonsteroidal anti-inflammatory drugs for at least 3 months, combined with oral contraceptives for at least 3-6 menstrual cycles, as well as dietary supplementation, other alternative therapies (vitamins, herbal remedies, acupuncture, TENS) and surgical treatment Secondary causes of dysmenorrhea should be considered in adolescents with dysmenorrhea who do not respond to the treatment. The role of the pediatric and adolescent gynaecologist is to diagnose the reason of symptoms, educate the patient, review effective treatment options as well as to restore normal daily functioning.
Language: Polish
Keywords:
RESEARCH REPORT | ADOLESCENTS, FEMALE | DYSMENORRHEA | ENDOMETRIOSIS | PELVIC INFLAMMATORY DISEASE | OVARIAN CYSTS | CONGENITAL ABNORMALITIES | ORAL CONTRACEPTIVES | SIGNS AND SYMPTOMS | DIET | TREATMENT | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Menstruation Disorders | Diseases | Reproductive Tract Infections | Infections | Neonatal Diseases and Abnormalities | Contraceptive Methods | Contraception | Family Planning | Nutrition | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 329467

10.

Title: Update on infectious diseases in adolescent gynecology.
Author: Erb T; Beigi RH
Source: Journal of Pediatric and Adolescent Gynecology. 2008 Jun;21(3):135-143.
Abstract: Adolescents represent a unique population in terms of infectious disease susceptibility and associated morbidity. Numerous developments have recently occurred with respect to sexually transmitted infection guidelines, human papillomavirus immunization, and other vaccine-preventable diseases. These topics will be highlighted in this review. For the interested reader, further in-depth discussions of each of these topics related to infectious diseases control is accessible from the list of references provided. (excerpt)
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | ADOLESCENTS | SEXUALLY TRANSMITTED DISEASES | EXAMINATIONS AND DIAGNOSES | TREATMENT | PELVIC INFLAMMATORY DISEASE | TRICHOMONIASIS | HPV | TESTING | VACCINES | ADOLESCENT HEALTH | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Measurement | Research Methodology
Document Number: 327037

11.
Peer Reviewed

Title: Pelvic pain in women: common and challenging [editorial]
Author: Farquhar CM
Source: Medical Journal of Australia. 2008 Aug 4;189(3):131-2.
Abstract: Pelvic pain in women is as common as the common cold, it seems. Certainly that is the impression one is left with after reading the article by Pitts et al (page 138) on the prevalence and correlates of pelvic pain in Australian women. Pitts and colleagues found that 72% of women experienced dysmenorrhoea and only one in four women did not report any kind of pelvic pain. A systematic review of international studies reported a similar prevalence of dysmenorrhoea and pelvic pain. (excerpt)
Language: English
Keywords:
AUSTRALIA | CRITIQUE | WOMEN | PELVIC INFLAMMATORY DISEASE | PAIN | EXAMINATIONS AND DIAGNOSES | TREATMENT | LAPAROSCOPY | MANAGEMENT | Developed Countries | Oceania | Demographic Factors | Population | Reproductive Tract Infections | Infections | Diseases | Signs and Symptoms | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Endoscopy | Physical Examinations and Diagnoses | Organization and Administration
Document Number: 328541

12.

Title: Intrauterine devices and adolescents.
Author: Gold M; Johnson L
Source: Current Opinion in Obstetrics and Gynecology. 2008 Oct;20(5):464-469.
Abstract: This article reviews adolescents' knowledge of and attitudes toward IUDs; the mechanism of action of copper-releasing and levonorgestrel-releasing IUDs; the benefits of using IUDs with adolescents; and the IUD's safety, side effects, and noncontraceptive benefits such as management of menstrual disorders and endometriosis. The authors conclude that IUDs are a safe and effective long-term contraceptive method with no increase in risk of pelvic inflammatory disease, tubal infertility, or ectopic pregnancies. Because adolescents contribute disproportionately to the epidemic of unintended pregnancy, IUDs should be considered as a first-line contraceptive choice regardless of parity. The levonorgestrel-releasing intrauterine system is a particularly good choice for adolescents because of associated noncontraceptive benefits such as decreased menstrual bleeding, dysmenorrhea, and decreased pain associated with endometriosis. There is a clear need for more studies in the use of the IUD among adolescents.
Language: English
Keywords:
UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | KAP SURVEYS | ADOLESCENTS | IUD | IUD EXPULSION | INFERTILITY | IUD COMPLICATIONS | TUBAL EFFECTS | PELVIC INFLAMMATORY DISEASE | CONTRACEPTIVE SAFETY | CONTRACEPTIVE EFFECTIVENESS | IUD SIDE EFFECTS | ATTITUDES | Developed Countries | North America | Americas | Research Methodology | Surveys | Sampling Studies | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Reproduction | Fallopian Tubes | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Reproductive Tract Infections | Infections | Diseases | Safety | Public Health | Health | Psychological Factors | Behavior
Document Number: 322768

13.
Peer Reviewed

Title: [Chronic pelvic pain and combined oral hormonal contraception]
Author: Lukanova M; Popov I
Source: Akusherstvo I Ginekologiia. 2008;47(3):20-9.
Abstract: PURPOSE OF THE STUDY: To determine the frequency of usage of combined oral hormonal contraception/COHC/ and its efficiency in women with chronic pelvic pain/CPP/. MATERIALS AND METHODS: Three-hundred and seventy, consecutively admitted in the Clinic women with CPP, were included in the study. They were divided into 2 groups--group A/n = 80/--women that had used COHC, and group B/n = 290/--women that had not used COHC in order to cope with pain symptomatic. The patients from the both groups were compared according to their socio-demographic, menstrual and reproductive characteristics, type of disease, duration of CPP assessment of pain intensity and McGill pain indices, subjective rating of efficiency of the used COHC by the means of 5-rate scale in diseases, manifested with chronic pain symptomatic/leiomyoma /L/ endometriosis/E, pelvic congestion syndrome/PCS/, adhaesion syndrome/AS, Allen-Masters syndrome and other gynaecologic pathology/OGP/--chronic pelvic inflammatory disease/ CPID/, ovarian cysts /OC/, etc./. RESULTS AND DISCUSSION: Duration of CPP /in months/ was comparatively longer in group A /50,74 +/- 10,33/in comparison wit group B/41,38 +/- 5,97/. No significant difference was found in quantitative pain assessment, but in group A higher values of all pain indices/sensory, affective, total pain rating index/and of evaluative overall pain intensity of total pain experience were set, compared with those of group B. It was ascertained a bigger number of types of used medicines in group A/analgesics, spasmolytics, gestagenes and GnRH-agonists/. Efficiency of COHC was assessed by the patients in the range "good-/basically/very good-excellent", and that was well demonstrated by women with L, E, AS and OGP/CPID, etc./. CONCLUSION: COHC was administered to patients with more heavily demonstrated chronic pelvic pain symptomatic, that required combination of more than two medicines in order to obtain a better therapeutic effect. Diseases, manifesting with CPP like E, L and OGP/CPID, OC, AS, etc/are of great priority in treatment with COHC.
Language: Bulgarian
Keywords:
RESEARCH REPORT | CLINICAL TRIALS | WOMEN | PAIN | ORAL CONTRACEPTIVES | PELVIC INFECTIONS | ENDOMETRIOSIS | PELVIC INFLAMMATORY DISEASE | TREATMENT | DRUGS | Clinical Research | Research Methodology | Demographic Factors | Population | Signs and Symptoms | Diseases | Contraceptive Methods | Contraception | Family Planning | Infections | Reproductive Tract Infections | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 329055

14.

Peer Reviewed

Title: Increased expression of uteroglobin associated with tubal inflammation and ectopic pregnancy.
Author: Quintar AA; Mukdsi JH; Bonaterra M; Aoki A; Maldonado CA
Source: Fertility and Sterility. 2008 Jun;89(6):1613-1617.
Abstract: The objective was the evaluation of uteroglobin (UG) expression in the fallopian tube in different tubal diseases. The UG was screened and quantified in samples of fallopian tubes from patients with salpingitis, hydrosalpinx, and ectopic pregnancy by exposing the UG with immunohistochemical techniques. The setting was the University hospital and electron microscopy center. The patient(s) were women with pelvic inflammatory disease (PID) and complicated tubal ectopic pregnancy consulting for medical care. The intervention was Salpingectomy. Tubal tissues were collected and examined using regular pathologic techniques. The UG immunoreactivity in the tubal epithelium was also assessed. Fallopian tube epithelium displayed an increased UG expression in patients with PID and complicated tubal pregnancy compared with control patients. Uteroglobin is present in the human fallopian tube as a secretory protein and appears to be involved in immunosuppressive responses in the fallopian tube. (author's)
Language: English
Keywords:
ARGENTINA | RESEARCH REPORT | SCREENING | PREGNANT WOMEN | PREGNANCY, ECTOPIC | PREGNANCY, TUBAL | FALLOPIAN TUBES | TUBAL EFFECTS | PELVIC INFLAMMATORY DISEASE | PREGNANCY COMPLICATIONS | South America, Southern | South America | Latin America | Americas | Developing Countries | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Characteristics | Demographic Factors | Population | Diseases | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Reproductive Tract Infections | Infections
Document Number: 327232

15.
Title: Caesarean section and tubal infertility: is there an association?
Author: Saraswat L; Porter M; Bhattacharya S; Bhattacharya S
Source: Reproductive Biomedicine Online. 2008 Aug;17(2):259-64.
Abstract: Rising Caesarean section (CS) rates have fuelled concerns about the effect of abdominal delivery on female fertility due to post-surgical complications affecting the Fallopian tubes. The association between exposure to CS and subsequent tubal infertility was explored by means of a case-control study. This study compared 220 women with secondary infertility due to tubal factor with 1244 women with secondary infertility due to non-tubal causes and 18,376 fertile women (women with a previous live birth followed by another live birth during the time period when the infertile cases were trying to conceive) in terms of exposure to CS. Exposure to CS in women with secondary tubal infertility was similar to other infertile women (21.4% versus 21.6%) but lower in fertile controls (14.5%). After adjusting for confounding factors, CS does not appear to be significantly associated with tubal infertility [adjusted odds ratio (95% confidence interval) for previous CS for infertile and fertile controls were 1.06 (0.73-1.52) and 1.2 (0.9-1.7), respectively]. However, other factors that were found to be predictive of secondary tubal infertility include history of intrauterine device use, pelvic inflammatory disease, ectopic pregnancy, endometriosis and previous pelvic surgery.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CASE CONTROL STUDIES | WOMEN | PREVALENCE | CESAREAN SECTION | FALLOPIAN TUBES | TUBAL EFFECTS | INFERTILITY | COMPLICATIONS | IUD | PELVIC INFLAMMATORY DISEASE | PREGNANCY, ECTOPIC | Developed Countries | Europe, Western | Europe | Research Methodology | Studies | Demographic Factors | Population | Measurement | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Reproduction | Diseases | Contraceptive Methods | Contraception | Family Planning | Reproductive Tract Infections | Infections | Pregnancy Complications
Document Number: 328958

16.

Peer Reviewed

Title: Pelvic inflammatory disease attributable to the IUD: Modeling risk in West Africa.
Author: Stanback J; Shelton JD
Source: Contraception. 2008 Apr;77(4):227-229.
Abstract: In Africa, use of the intrauterine device (IUD) is avoided because of perceived risk of pelvic inflammatory disease (PID) associated with sexually transmitted infections (STI). However, one recent model suggests that the risk of PID attributable to the IUD is very low, only 0.15% or less than 1 in 600. The study design used rates from a 2004 study of cervical STI prevalence in Benin, Burkina Faso, Ghana, Guinea, and Mali; we calculate PID risk attributable to the IUD in West Africa. Based on 4.4% combined prevalence of chlamydial and gonococcal infections, we estimate the risk is 0.075%, or less than 1 in 1,300. In West Africa, PID risk from IUDs is extremely low. This should be better communicated to family planning providers in the region who may under-provide the IUD based on erroneous perceptions of PID risk. (author's)
Language: English
Keywords:
BENIN | BURKINA FASO | GHANA | GUINEA | MALI | RESEARCH REPORT | IUD | IUD SIDE EFFECTS | PELVIC INFLAMMATORY DISEASE | SEXUALLY TRANSMITTED DISEASES | PREVALENCE | RISK FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Contraceptive Methods | Contraception | Family Planning | Reproductive Tract Infections | Infections | Diseases | Measurement | Research Methodology | Biology
Document Number: 325383

17.

Title: Prevalence of infertility in women in a Southwestern Nigerian community.
Author: Sule JO; Erigbali P; Eruom L
Source: African Journal of Biomedical Research. 2008 May;11(2):225-227.
Abstract: The prevalence and common causes of infertility in women aged between 15 and 55 years was assessed in four hospital centers in Osun State, located in the SouthWestern part of Nigeria. A survey of a consecutive sample of 200 cases of infertility were carried out in four hospital centers with a total of 50 cases of infertility evaluated in each of the centers between 2001 - 2003. The incidence of high infertility in women was established in all the centers; (Obafemi Awolowo University Teaching Hospital, Ile-Ife), 59.4%, (Obafemi Awolowo University Teaching Hospital, Ilesa), 47.7%, (Ladoke Akintola University Teaching Hospital, Oshogbo), 54.8% and (General Hospital, Ikire), 44.2%. 77.5% was recorded for a high rate of secondary Infertility, while Primary Infertility was 22.5%. The commonest causes of infertility in this environment were, the tubal factor, uterine factor, and ovarian factor representing 39.5%, 30% and 13% respectively. The least common cause were cervical factor, Pelvic Infection Disease (PID), and endometriosis which was seen in 3%, 5.5% and 2.5% of the subjects respectively. There was also prevalence of infertility between the ages: 15 - 25 years at the rate of 17%, while 26 - 35 years at the rate of 31.5%. The majority of the cases occurred between the ages of 36 - 45 at the rate of 50.5% and between 46 - 55 years at the rate 1%.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | WOMEN | INFERTILITY | ENDOMETRIOSIS | PELVIC INFECTIONS | PELVIC INFLAMMATORY DISEASE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Demographic Factors | Population | Reproduction | Diseases | Infections | Reproductive Tract Infections
Document Number: 340136

18.

Peer Reviewed

Title: Safety of intrauterine contraceptive device (copper T 200 B) in women with cardiac disease.
Author: Suri V; Aggarwal N; Kaur R; Chaudhary N; Ray P
Source: Contraception. 2008 Oct;78(4):315-318.
Abstract: Women with cardiac disease have need for effective long-lasting reversible contraception. Women with cardiac disease are at increased risk for bacterial endocarditis. There is limited research regarding the use of intrauterine contraceptive devices (IUD) in women with cardiac disease. In a prospective study, the IUD copper (Cu T200B) was inserted in 40 women with cardiac disease. Infective endocarditis prophylaxis was given 1 h before IUD insertion. The IUD was inserted under aseptic conditions. Ten milliliters of venous blood was obtained for culture of aerobic and anerobic bacteria within 1 h of insertion of the copper T IUD. Women were contacted for follow-up at frequent intervals. There was no incidence of uterine perforation, hemorrhage or spontaneous expulsion of the IUD. All blood cultures were sterile. There were no cases of infective endocarditis. Four women (10%) had menorrhagia at the 6-month follow-up which responded to medical management. One woman had PID for which antibiotics were given. Five women had mild cramps and five had spotting after insertion of the IUD. Patient adherence was excellent as none returned for removal for reasons other than desire for another pregnancy. The Cu T200B IUD is a reasonably safe and effective method of temporary contraception in women with cardiac disease who are not receiving anticoagulant therapy. (author's)
Language: English
Keywords:
INDIA | RESEARCH REPORT | PROSPECTIVE STUDIES | IUD, COPPER RELEASING | IUD | CARDIOVASCULAR EFFECTS | RHEUMATIC HEART DISEASE | CONTRACEPTIVE SAFETY | UTERINE PERFORATION | IUD EXPULSION | BLEEDING | MENORRHAGIA | PELVIC INFLAMMATORY DISEASE | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Contraceptive Methods | Contraception | Family Planning | Physiology | Biology | Bacterial and Fungal Diseases | Infections | Diseases | Safety | Public Health | Health | Perforations | Signs and Symptoms | Menstruation Disorders | Reproductive Tract Infections
Document Number: 328082

19.

Peer Reviewed

Title: Infectious correlates of HIV-1 shedding in the female upper and lower genital tracts.
Author: Coleman JS; Hitti J; Bukusi EA; Mwachari C; Muliro A
Source: AIDS. 2007 Mar 30;21(6):755-759.
Abstract: The objectives were to determine the effects of vaginal, cervical, and endometrial infections on shedding of HIV-1 RNA in the female genital tract. Design: Cross-sectional. Antiretroviral-naive women from Nairobi, Kenya with CD4 cell counts >/= 350 cells/microliter had plasma and endocervical wick samples collected for HIV quantification by real-time RNA reverse transcriptase-polymerase chain reaction. Vaginal and cervical Gram stains and endometrial biopsies were obtained. Vaginal Gram stain was used to diagnose bacterial vaginosis and to quantify Lactobacillus levels. Twenty-six of 50 (52%) women had detectable endocervical HIV-1 RNA with a median endocervical viral load of 1760 copies/ml (range: undetectable to 1 030 000 copies/ml). Women with decreased Lactobacillus had 15.8-fold [95% confidenceinterval (CI), 2.0-123] greater endocervical HIV-1 RNA than women with normal Lactobacillus levels. Women with plasma cell (PC) endometritis [>/= 1 PC/ high-power field (hpf)] had a 15.8-fold (95% CI, 2.0-120) higher endocervical HIV RNA level than women without PC endometritis. Both these associations remained after controlling for plasma viral load. Cervicitis (>/= 30 polymorphonuclear leukocytes/hpf), however, was not associated with endocervical HIV-1 RNA shedding (P=0.81). In HIV-1-infected, antiretroviral-naive women without symptoms of pelvic inflammatory disease infection, abnormal vaginal flora and inflammatory cells in the endometrium affected HIV-1 shedding from the lower genital tract. These data suggest that both the upper and lower genital tracts contribute to female HIV-1 genital shedding. (author's)
Language: English
Keywords:
KENYA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | WOMEN | PERSONS LIVING WITH HIV/AIDS | IMMUNITY, CELLULAR | LABORATORY PROCEDURES | GENITAL EFFECTS, FEMALE | ENDOMETRITIS | VAGINOSIS | PELVIC INFLAMMATORY DISEASE | SEXUALLY TRANSMITTED DISEASES | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Demographic Factors | Population | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Immunity | Immune System | Physiology | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Genitalia, Female | Genitalia | Urogenital System | Reproductive Tract Infections | Infections | Vaginal Abnormalities
Document Number: 315497

20.

Peer Reviewed

Title: To bleed or not to bleed, that is the question.
Author: Coutinho EM
Source: Contraception. 2007 Oct;76(4):263-266.
Abstract: Menstruation may be considered the endocrine equivalent of miscarriage. In both menstruation and miscarriage, endometrial shedding is provoked by the sudden decline in estrogen and progesterone that occurs when fertilization or implantation fails to take place or is defective. The monthly bleeding is, therefore, the result of repeated reproductive failure since, in a free, natural setting, women would be either pregnant or lactating ad libitum, hence amenorrheic. Menstruation has become an obligatory feature of life for civilized women, who are educated to accept the monthly bleeding as a price to pay for avoiding pregnancy. This "avoidance of conception" does not occur naturally since sexual activity in nature is predominantly associated with ovulation, a condition that renders females both attractive and receptive. In order to avoid conception, civilized women had to learn how to minimize their sexual attractiveness while retaining their enhanced social magnetism during ovulation by bathing, using deodorants and perfume and covering their bodies as completely as possible. Whenever they succeeded in avoiding sex during ovulation, they then had to deal with the inevitable bleeding that would ensue. In the beginning, they had to hide during menstruation, secluding themselves in a separate room or location, as women of many indigenous tribes still do today. The development of fabrics such as cotton, silk and linen led to the creation of sanitary protection, which could be replaced at regular intervals. (excerpt)
Language: English
Keywords:
BRAZIL | LITERATURE REVIEW | CRITIQUE | WOMEN | MENSTRUATION | ABORTION, SPONTANEOUS | CONTRACEPTION | INJECTABLES | CONTRACEPTION RESEARCH | LOW-DOSE PROGESTINS | ENDOMETRIOSIS | BLEEDING | PELVIC INFLAMMATORY DISEASE | PREVENTION AND CONTROL | South America, Eastern | South America | Latin America | Americas | Developing Countries | Demographic Factors | Population | Reproduction | Pregnancy Complications | Diseases | Family Planning | Contraceptive Methods | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Signs and Symptoms | Reproductive Tract Infections | Infections
Document Number: 320543

21.
Title: Gynaecological care of the HIV patient.
Author: Guidozzi F
Source: SA Pharmaceutical Journal. 2007 Jan-Feb;74(1):1012, 14-16.
Abstract: It is estimated that every day in sub-Saharan Africa approximately 5 500 women are newly infected with HIV and more than 3 000 die from AIDS-related illnesses. In this region, where women comprise 58% of the existing HIV-positive patients, infection is increasing faster among women than among men. Among young people aged 15 - 24 years, women are 2.5 times more likely than men to be infected by HIV. In southern Africa, HIV infection is transmitted overwhelmingly through heterosexual contact and is more likely to occur from seropositive male to seronegative female than from seropositive female to seronegative male. Risk factors for the transmission of HIV are shown in Table I. Gynaecological diseases are commonly encountered in HIV-infected women, with the likelihood of the condition being more common and more severe the greater the immunosuppression. Conditions that may arise include vaginal and cervical infections, lower genital tract neoplasia, pelvic inflammatory disease, menstrual irregularities, aspects pertaining to contraception and reproductive options. (excerpt)
Language: English
Keywords:
SOUTH AFRICA | LITERATURE REVIEW | WOMEN | PERSONS LIVING WITH HIV/AIDS | GYNECOLOGY | VAGINOSIS | GENITAL EFFECTS, FEMALE | PELVIC INFLAMMATORY DISEASE | CERVICAL CANCER | MENSTRUATION DISORDERS | CONTRACEPTIVE METHODS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Medicine | Health Services | Delivery of Health Care | Health | Vaginal Abnormalities | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Reproductive Tract Infections | Infections | Cancer | Neoplasms | Contraception | Family Planning
Document Number: 318224

22.

Peer Reviewed

Title: A randomized trial on the clinical performance of Nova T 380 and Gyne T 380 Slimline copper IUDs.
Author: Haugan T; Skjeldestad FE; Halvorsen LE; Kahn H
Source: Contraception. 2007 Mar;75(3):171-176.
Abstract: The objective of this open randomized study was to compare the clinical performance of Nova T380 and Gyne T380 Slimline copper intrauterine devices (IUDs). Eligible for analyses were 957 Norwegian parous women aged 18-45 years. Clinical performance was measured upon the removal of IUD due to contraceptive failure, expulsion, bleeding, pain, pelvic inflammatory disease and other medical reasons during a 5-year study period. The discontinuation rate due to contraceptive failure was significantly higher in the first year for Nova T380 users than for Gyne T380 Slimline users, whereas no differences were observed thereafter (the 5-year cumulative failure rates were 4.4% and 2.2%, respectively, per 100 women). However, the partial expulsion rate was significantly higher in the first year for Gyne T380 Slimline users than for Nova T380 users (the 5-year cumulative rates were 3.4% and 1.1% respectively, per 100 women). No other major differences in reasons for discontinuation were found between the study groups. There was a slight nonsignificant increase in hemoglobin levels for both study groups over the course of the study. Clinical performance was considered satisfactorily high for both devices. (author's)
Language: English
Keywords:
NORWAY | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | IUD, COPPER RELEASING | CONTRACEPTION FAILURE | CONTRACEPTIVE REMOVAL | IUD EXPULSION | BLEEDING | PAIN | PELVIC INFLAMMATORY DISEASE | PREGNANCY | Developed Countries | Europe, Northern | Europe | Clinical Research | Research Methodology | Demographic Factors | Population | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Usage | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Reproductive Tract Infections | Infections | Reproduction
Document Number: 313007

23.

Peer Reviewed

Title: Intrauterine devices -- upper and lower genital tract infections.
Author: Meirik O
Source: Contraception. 2007 Jun;75(6 Suppl 1):S41-S47.
Abstract: The clinical diagnosis of a pelvic inflammatory disease (PID) is notoriously difficult. The incidence rate of PIDs among intrauterine device (IUD) users as reported from different studies depends heavily on the definition used and the means available for diagnosing PIDs. It varies by almost 10-fold from 1 per 100 to 1 per 1000 woman-years in different publications. PID risk has been found to be 6-fold higher in the first month after IUD insertion than it is thereafter. It is not known if the overall PID risk in IUD users beyond the first month of IUD insertion is higher than that in nonusers; however, if it is higher, the additional risk is small. The PID risk in IUD users is modified by the number of sexual partners of the IUD user and that of her partner(s), community prevalence of STDs and age of the IUD user. Bacterial vaginosis appears not to be associated with IUD use. Overall, bacterial vaginosis is not associated with PIDs, but specific subgroups of patients with BV that may be difficult to identify clinically are at an increased risk for PIDs. Because of the long duration of use of current copper IUDs, replacement of the IUD is infrequent and insertion-associated PIDs should consequently also be less frequent. IUD use has become safer with respect to PIDs through more effective screening and counseling procedures described in current guidelines for the initiation of IUD use. Current guidance must be followed to preserve the IUD as a safe contraceptive method. (author's)
Language: English
Keywords:
CHILE | LITERATURE REVIEW | WOMEN | IUD | IUD, COPPER RELEASING | REPRODUCTIVE TRACT INFECTIONS | RISK FACTORS | PELVIC INFLAMMATORY DISEASE | VAGINOSIS | BACTERIAL AND FUNGAL DISEASES | SAFETY | Developing Countries | South America, Southern | South America | Latin America | Americas | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Infections | Diseases | Biology | Vaginal Abnormalities | Public Health | Health
Document Number: 316860

24.

Title: Intrauterine contraception: An under-utilized method of family planning [editorial]
Author: Mishell Dr Jr
Source: European Journal of Contraception and Reproductive Health Care. 2007 Mar;12(1):1-2.
Abstract: Women wish their method of contraception to have the following characteristics: a high efficacy; an absence of health risks (especially neoplasia), adverse symptoms, and metabolic effects; a long duration of action; rapid reversibility; cost effectiveness; easily accessibility. Copper bearing intrauterine contraceptives (IUCs) have each of these attributes except that they may cause uterine cramping pain, whereas the progestin releasing system has all except that it may infrequently cause androgenic symptoms. Nevertheless, despite the many benefits of IUCs, this contraceptive method is under-utilized in most countries in the world, with the notable exception of China. In the United States, less than 1% of women of reproductive age use an IUC for family planning. (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | SUMMARY REPORT | IUD, COPPER RELEASING | IUD SIDE EFFECTS | PELVIC INFECTIONS | PELVIC INFLAMMATORY DISEASE | CONTRACEPTIVE METHODS CHOSEN | CONTRACEPTIVE USE-EFFECTIVENESS | FAMILY PLANNING | North America | Americas | Developed Countries | IUD | Contraceptive Methods | Contraception | Infections | Diseases | Reproductive Tract Infections | Contraceptive Usage | Contraceptive Effectiveness
Document Number: 314547

25.

Peer Reviewed

Title: Copper-T intrauterine device and levonorgestrel intrauterine system: Biological bases of their mechanism of action.
Author: Ortiz ME; Croxatto HB
Source: Contraception. 2007 Jun;75(6 Suppl 1):S16-S30.
Abstract: All intrauterine devices (IUDs) that have been tested experimentally or clinically induce a local inflammatory reaction of the endometrium whose cellular and humoral components are expressed in the tissue and the fluid filling the uterine cavity. Depending on the reproductive strategy of the species considered and the anatomical features and physiologic mechanisms that characterize their reproductive system, the secondary consequences of this foreign body reaction can be very localized within the uterus, as in the rabbit, or widespread throughout the entire genital tract as in women or even systemic as in some farm animals. Levonorgestrel released from an IUD causes some systemic effects, but local effects such as glandular atrophy and stromal decidualization, in addition to the foreign body reaction, are dominant. Copper ions released from an IUD enhance the inflammatory response and reach concentrations in the luminal fluids of the genital tract that are toxic for spermatozoa. In the human, the entire genital tract appears affected due to luminal transmission of the noxa that accumulates in the uterine lumen. This affects the function and viability of gametes, decreasing the rate of fertilization and lowering the chances of survival of any embryo that may be formed, before it reaches the uterus. The bulk of the data indicate that if any embryos are formed in the chronic presence of an IUD, it happens at a much lower rate than in non-IUD users. The common belief that the usual mechanism of action of IUDs in women is destruction of embryos in the uterus is not supported by empirical evidence. (author's)
Language: English
Keywords:
CHILE | LITERATURE REVIEW | WOMEN | IUD, COPPER RELEASING | IUD | LEVONORGESTREL | SIDE EFFECTS | REPRODUCTIVE TRACT INFECTIONS | PELVIC INFLAMMATORY DISEASE | SPERMATOZOA | TOXICITY | FERTILITY RATE | Developing Countries | South America, Southern | South America | Latin America | Americas | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infections | Diseases | Germ Cells | Genitalia | Urogenital System | Physiology | Biology | Birth Rate | Fertility Measurements | Fertility | Population Dynamics
Document Number: 316857

26.

Peer Reviewed

Title: The levonorgestrel intrauterine system in nulliparous women.
Author: Prager S; Darney PD
Source: Contraception. 2007 Jun;75(6 Suppl 1):S12-S15.
Abstract: The levonorgestrel intrauterine system (LNG-IUS) has been used internationally for over 15 years by 7 million women. Concern about providing the LNG-IUS to nulliparous women still exists, despite growing evidence of its safety and efficacy in this population. Expulsion rates do not vary by parity and, although evidence in nulliparas is scant, perforation rates are low in all women. Efficacy of the LNG-IUS is excellent regardless of parity, with less than 1 pregnancy per 100 woman-years of use. Efficacy with immediate post-abortal insertion is also excellent and unvaried by parity. The presence of an LNG-IUS does not increase the risk of PID or infertility in either parous or nulliparous women and the LNG may be protective against infection. Acceptability is high in nulliparous women when compared either to parous LNG-IUS users or to nulliparous users of combined oral contraceptive pills. In conclusion, LNG-IUS is both safe and extremely efficacious for use in nulliparous women. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | LITERATURE REVIEW | WOMEN | NULLIPARITY | IUD | LEVONORGESTREL | SAFETY | CONTRACEPTIVE USE-EFFECTIVENESS | RISK FACTORS | PELVIC INFLAMMATORY DISEASE | INFERTILITY | North America | Americas | Developed Countries | Demographic Factors | Population | Parity | Fertility Measurements | Fertility | Population Dynamics | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Public Health | Health | Contraceptive Effectiveness | Biology | Reproductive Tract Infections | Infections | Diseases | Reproduction
Document Number: 316856

27.

Peer Reviewed

Title: A randomized trial of the intrauterine contraceptive device vs hormonal contraception in women who are infected with the human immunodeficiency virus.
Author: Stringer EM; Kaseba C; Levy J; Sinkala M; Goldenberg RL
Source: American Journal of Obstetrics and Gynecology. 2007 Aug;197(2):144.e1-144.e8.
Abstract: The purpose of this study was to determine whether the intrauterine contraceptive device (IUD) is effective and safe among women who are infected with the human immunodeficiency virus (HIV). We randomly assigned 599 postpartum, HIV-infected women in Zambia to receive either a copper IUD or hormonal contraception and followed them for at least 2 years. Women who were assigned randomly to hormonal contraception were more likely to become pregnant than those who were assigned randomly to receive an IUD (rate, 4.6/100 vs 2.0/100 woman-years; hazards ratio, 2.4; 95% CI, 1.3-4.7). One woman who was assigned to the IUD experienced pelvic inflammatory disease (crude rate, 0.16/100 woman-years; 95% CI, 0.004-868); there was no pelvic inflammatory disease among those women who were assigned to hormonal contraception. Clinical disease progression (death or CD4+ lymphocyte count dropping below 200 cells/microL) was more common in women who were allocated to hormonal contraception (13.2/100 woman-years) than in women who were allocated to the IUD (8.6/100 woman-years; hazard ratio, 1.5; 95% CI, 1.04-2.1). The IUD is effective and safe in HIV-infected women. The unexpected observation that hormonal contraception was associated with more rapid HIV disease progression requires urgent further study. (author's)
Language: English
Keywords:
AFRICA, SUB SAHARAN | RESEARCH REPORT | CLINICAL TRIALS | COMPARATIVE STUDIES | POSTPARTUM WOMEN | PERSONS LIVING WITH HIV/AIDS | IUD, COPPER RELEASING | ORAL CONTRACEPTIVES | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE SAFETY | PELVIC INFLAMMATORY DISEASE | HIV | Developing Countries | Africa | Clinical Research | Research Methodology | Studies | Puerperium | Reproduction | HIV Infections | Viral Diseases | Diseases | IUD | Contraceptive Methods | Contraception | Family Planning | Safety | Public Health | Health | Reproductive Tract Infections | Infections
Document Number: 313787

28.
Title: Vaginal douching and associated factors among married women attending a family planning clinic or a gynecology clinic.
Author: Caliskan D; Subasi N; Sarisen O
Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2006 Aug;127(2):244-251.
Abstract: The aim of this study was to determine the vaginal douching habits and associated factors of women attending two different healthcare clinics. This cross-sectional study was conducted between 1 and 31 May 2004. All participants were women (n = 635) who attended either a university hospital gynecology clinic or a primary health care center family planning unit. One-way ANOVA, chi-squared test, and binary and multiple logistic regression analyses were used for the statistical evaluation of data. The mean age of the participants was 36.90 � 10.72 years (range: 18--75). Half of the participants believed vaginal douching had a positive effect on health. They believed vaginal douching demonstrates cleanliness, prevents infections and pregnancy, removes sperm following intercourse, a necessity of Islamic doctrine, and reduces symptoms like discharge, unpleasant odor, etc. Of the women, 50.2% performed vaginal douching. Vaginal douching was associated with age, education level, type of dwelling, working outside of the home, age at marriage, age at birth of first child, parity, spontaneous abortion, history of pelvic inflammatory disease, use of contraceptives, and attending a healthcare clinic. Douching is a common habit among Turkish women. Many women are not aware of the harmful effects of douching. Public health and health professionals should monitor more closely this traditional habit in Turkey. (author's)
Language: English
Keywords:
TURKEY | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | QUESTIONNAIRES | WOMEN | CURRENTLY MARRIED | CLINICS | CONTRACEPTIVE USAGE | REPRODUCTIVE HEALTH | PELVIC INFLAMMATORY DISEASE | WOMEN'S HEALTH | Developing Countries | Europe, Southeastern | Europe | Research Methodology | Demographic Factors | Population | Marital Status | Nuptiality | Health Facilities | Delivery of Health Care | Health | Contraception | Family Planning | Reproductive Tract Infections | Infections | Diseases
Document Number: 306533

29.
Title: Pelvic inflammatory disease in adolescents.
Author: Gray-Swain MR; Peipert JF
Source: Current Opinion in Obstetrics and Gynecology. 2006 Oct;18(5):503-510.
Abstract: We discuss the epidemiology, risk factors, microbiology, diagnosis, treatment and prevention of pelvic inflammatory disease in adolescents. Young age is one of the most important risk factors for sexually transmitted diseases and pelvic inflammatory disease. Sexually active adolescents have the highest incidence of Chlamydia trachomatis, Neisseria gonorrhoeae, and pelvic inflammatory disease of any sexually active age group. Long-term sequelae of pelvic inflammatory disease include ectopic pregnancy, tubal factor infertility, tubo-ovarian abscesses and chronic pelvic pain. Subclinical pelvic inflammatory disease is responsible for a significant portion of these long-term sequelae. New (2006) Centers for Disease Control and Prevention treatment guidelines for pelvic inflammatory disease are available. One of the best methods of prevention of pelvic inflammatory disease is to screen and treat sexually active adolescents for chlamydial infection. Implementation of nucleic acid amplification assays allows screening of adolescents via self-collected urine or vaginal swab samples. Pelvic inflammatory disease is a highly preventable source of reproductive morbidity for adolescents. It is prudent that clinicians provide counseling regarding healthy sexual behaviors, STD prevention, and contraception whenever an adolescent presents in need of STD screening or evaluation for pelvic inflammatory disease. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | ADOLESCENTS, FEMALE | PELVIC INFLAMMATORY DISEASE | RISK FACTORS | EPIDEMIOLOGY | TREATMENT | LABORATORY EXAMINATIONS AND DIAGNOSES | CHLAMYDIA | GONORRHEA | PREGNANCY, ECTOPIC | BEST PRACTICES | North America | Americas | Developed Countries | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Tract Infections | Infections | Diseases | Biology | Public Health | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Examinations and Diagnoses | Sexually Transmitted Diseases | Pregnancy Complications | Programs | Organization and Administration
Document Number: 304775

30.
Peer Reviewed

Title: The levonorgestrel-releasing intrauterine system (LNG-IUS) in HIV-infected women -- effects on bleeding patterns, ovarian function and genital shedding of HIV.
Author: Heikinheimo O; Lehtovirta P; Suni J; Paavonen J
Source: Human Reproduction. 2006 Nov;21(11):2857-2861.
Abstract: Safe and effective contraceptives are needed for human immunodeficiency virus (HIV)-infected women. The levonorgestrel-releasing intrauterine system (LNG-IUS) is a highly effective contraceptive with additional health benefits. The objective of this study was to evaluate the effects of the LNG-IUS among HIV-infected women. Twelve systematically managed HIV-infected women were studied prospectively. Following a 2-month run-in period, the subjects had an LNG-IUS inserted and were followed up for 1 year. Patterns of bleeding, blood haemoglobin and CD4-lymphocyte content, plasma HIV RNA, serum levels of LNG, of estradiol (E/2) and of ferritin and genital shedding of HIV RNA were monitored. Menstrual bleeding was reduced significantly during the use of the LNG-IUS; this was associated with slight increases in serum haemoglobin and ferritin levels. Serum E/2 concentrations remained in the follicular range in all subjects. Among subjects using antiretroviral medication, the proportion of cervicovaginal lavage specimens with detectable HIV RNA was 10% before and after the insertion of the LNG-IUS. The effects of the LNG-IUS on bleeding patterns, body iron stores and ovarian function were similar to those seen in healthy women. Genital shedding of HIV RNA was not affected by the LNG-IUS. These data encourage further studies on the effects of the LNG-IUS on reproductive health among HIV-infected women. (author's)
Language: English
Keywords:
FINLAND | RESEARCH REPORT | PROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | WOMEN | MENSTRUAL CYCLE | PHYSICAL EXAMINATIONS AND DIAGNOSES | HEMOGLOBIN LEVEL | REPRODUCTIVE HEALTH | PELVIC INFLAMMATORY DISEASE | LEVONORGESTREL | Europe, Northern | Europe | Developed Countries | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Demographic Factors | Population | Menstruation | Reproduction | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Hemic System | Physiology | Biology | Reproductive Tract Infections | Infections | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning
Document Number: 309295


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