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1.
Title: [Contraception: modern trends and controversies]
Source: Srpski Arhiv Za Celokupno Lekarstvo. 2009 May-Jun;137(5-6):310-9.
Abstract: Ever since ancient civilizations, the possibility of preventing unwanted pregnancies has always been the subject of interest. All available contraception methods have both advantages and disadvantages, and it is up to the doctor and the patient to make a rational choice in each individual case. Many methods for temporary prevention of unwanted pregnancy are used for the purpose of contraception, as well as sterilization, as a permanent method. A large variety of contraceptives offers opting for the most suitable method for each patient, with the highest level of efficiency and safety. With their adequate administration, the rate of unwanted pregnancies should be significantly minimized. Methods used for contraception are constantly improving and simultaneously, new and more efficient ones are being developed. The research in the field of contraceptives is not completed yet and hopefully, in the future, we shall be closer to finding available, efficient, user-friendly medicaments in the prevention of pregnancy and sexually transmitted diseases, with minimum side effects, which is on the verge of perfection. Novelties in the field of contraception must be the theme of continuous medical education of gynaecologists, so that they could provide the right information and give advice to their patients in choosing the most adequate contraceptive.
Language: Serbian
Keywords:
GLOBAL | SUMMARY REPORT | CONTRACEPTION | DECISION MAKING | PREGNANCY, UNWANTED | STERILIZATION, SEXUAL | CONTRACEPTIVE METHODS | CONTRACEPTIVE AGENTS, SIDE EFFECTS | CONTRACEPTIVE SAFETY | CONTRACEPTIVE METHOD ACCEPTABILITY | Family Planning | Behavior | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Contraceptive Agents | Safety | Public Health | Health | Contraceptive Usage
Document Number: 342047

Title: Expanding access to injectable contraception.
Author: Family Health International [FHI]
Source: [Unpublished] [2009]. 12 p.
Abstract: A number of technological developments can make injections safer for administration, whether by health personnel, trained community workers or the women themselves: sub-cutaneous injections, which have less complications than intra-muscular injections; non-reusable disposable syringes Distribution by community health workers needs special attention to: the possibility that a woman is already pregnant (or seeking an abortion by using an injectable); the screening of women with pre-existing conditions or on medications; the need for counselling for side-effects (in particular: vaginal bleeding irregularities, amenorrhea, weight gain, delay in return to fertility); the safety of injections to the woman and to the health worker; the possible confusion between different injectables --provided by public and private sectors. To complement pre-service and in-service training, a number of job aids are available to support community workers providing injectables: medical eligibility criteria wheel to screen for eligibility; pregnancy checklist; simplified material for the management of side-effects (bleeding, amenorrhea, weight changes, etc). (Excerpt)
Language: English
Keywords:
GLOBAL | TABLES AND CHARTS | INJECTABLES | DEPO-PROVERA | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE AVAILABILITY | PROGRAM ACCESSIBILITY | COMMUNITY-BASED DISTRIBUTION | CONTRACEPTIVE SAFETY | MATERNAL MORTALITY | CAUSES OF DEATH | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Usage | Program Evaluation | Programs | Organization and Administration | Nonclinical Distribution | Distributional Activities | Program Activities | Safety | Public Health | Health | Mortality | Population Dynamics | Demographic Factors | Population
Document Number: 331838

Title: Expanding access to injectable contraceptives.
Author: United States. Agency for International Development [USAID]
Source: [Washington, D.C.], USAID, [2009]. [2] p.
Abstract: A technical consultation, co-sponsored by the World Health Organization (WHO), USAID, and Family Health International (FHI), was held June 15-17, 2009, at the WHO in Geneva to review the evidence and programmatic experience for community-based provision of injectable contraceptives. Thirty technical and program experts from countries and organizations reviewed the scientific evidence and experiences from programs that provided injectable contraceptives through community-based health workers (CHWs). This evidence and programmatic experience came from Africa, Asia, and Latin America and focused on depotmedroxyprogesterone acetate (DMPA). The evidence consistently showed that given appropriate training, CHWs can screen clients effectively, provide DMPA injections safely, and counsel on side effects appropriately, demonstrating competence equivalent to higher level facility-based providers of DMPA. Continuation of use of DMPA by clients of CHWs was as long as those of clients receiving injections at clinics. In addition, the vast majority of clients expressed satisfaction with CHW provision of DMPA. The Consultation concluded that sufficient evidence existed for national policies to support the introduction, continuation, and scale-up of community-based provision of progestin-only injectable contraceptives, especially DMPA. Provision of DMPA by CHWs will expand choice for underserved populations and contribute to reducing the unmet need for family planning. Operational guidelines for family planning should therefore reflect that appropriately trained CHWs can safely initiate use of DMPA and provide reinjection. (Excerpt)
Language: English
Keywords:
GLOBAL | SUMMARY REPORT | CONFERENCES AND CONGRESSES | COMMUNITY WORKERS | WHO | INJECTABLES | DEPO-PROVERA | SAFETY | CONTRACEPTION CONTINUATION | TRAINING ACTIVITIES | COUNSELING | FAMILY PLANNING POLICY | Health Personnel | Delivery of Health Care | Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Public Health | Contraceptive Usage | Training Programs | Education | Clinic Activities | Program Activities | Programs | Organization and Administration | Population Policy | Social Policy | Policy
Document Number: 331839

Title: Community-based health workers can safely and effectively administer injectable contraceptives: Conclusions from a technical consultation.
Author: World Health Organization [WHO]; United States. Agency for International Development [USAID]; Family Health International [FHI]
Source: Research Triangle Park, North Carolina, FHI, 2009. 4 p.
Abstract: In June 2009, a technical consultation held at the World Health Organization (WHO) in Geneva concluded that evidence supports the introduction, continuation, and scale-up of community-based provision of progestin-only injectable contraceptives. The group of 30 technical and programme experts reviewed scientific and programmatic experience, which largely focused on the progestin-only injectable, depot-medroxyprogesterone acetate (DMPA). The experts found that community-based provision of progestin-only injectable contraceptives by appropriately trained community health workers (CHWs) is safe, effective, and acceptable. Such services should be part of a family planning programme offering a range of contraceptive methods. (Excerpt)
Language: English
Keywords:
GLOBAL | CONFERENCES AND CONGRESSES | COMMUNITY WORKERS | WHO | INJECTABLES | DEPO-PROVERA | NEEDS | SAFETY | CONTRACEPTION CONTINUATION | TRAINING ACTIVITIES | MONITORING | FAMILY PLANNING POLICY | Health Personnel | Delivery of Health Care | Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Economic Factors | Public Health | Contraceptive Usage | Training Programs | Education | Evaluation | Population Policy | Social Policy | Policy
Document Number: 331834

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Title: Implanon: a review of the literature with recommendations for clinical management.
Author: Adams K; Beal MW
Source: Journal of Midwifery and Women's Health. 2009 Mar-Apr;54(2):142-9.
Abstract: Implanon is a new implantable, progestin-only contraceptive which was approved in the United States in July 2006. Implanon is comprised of a single ethylene vinylacetate copolymer rod that is 4 cm long and 2 mm in diameter. It is inserted subdermally in the groove between the biceps and triceps of the nondominant arm. A literature review was conducted and side effects are discussed. Implanon offers promise as a high-efficacy, long-term contraceptive and can enhance the contraceptive options offered by the women's health care providers. Clinical trial data indicate that the device is both safe and effective.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | LITERATURE REVIEW | CONTRACEPTIVE AGENTS, PROGESTIN | CONTRACEPTION | CONTRACEPTIVE EFFECTIVENESS | MANAGEMENT | Developed Countries | North America | Americas | Contraceptive Agents, Female | Contraceptive Agents | Family Planning | Organization and Administration
Document Number: 341634

Peer Reviewed

Title: Bleeding pattern and cycle control with an estradiol-based oral contraceptive: a seven-cycle, randomized comparative trial of estradiol valerate/dienogest and ethinyl estradiol/levonorgestrel.
Author: Ahrendt HJ; Makalova D; Parke S; Mellinger U; Mansour D
Source: Contraception. 2009 Nov;80(5):436-44.
Abstract: BACKGROUND: This study compared the bleeding pattern, cycle control and safety of an oral contraceptive (OC) comprising estradiol valerate/dienogest (E2V/DNG; administered using a dynamic dosing regimen) with a monophasic OC containing ethinyl estradiol 20 mcg/levonorgestrel 100 mcg (EE/LNG). E2V releases estradiol (E2), which is identical to endogenously produced 17beta-estradiol. STUDY DESIGN: This was a randomized, multicenter, double-blind, double-dummy trial lasting seven cycles in healthy women aged 18-50 years. RESULTS: Overall, 798 women were randomized and received allocated treatment (399 per group). There were significantly fewer bleeding/spotting days reported by women who received E2V/DNG than those who received EE/LNG [17.3+/-10.4 vs. 21.5+/-8.6, respectively, p<.0001, Reference Period 1 (Days 1-90); and 13.4+/-9.vs. 15.9+/-7.1, respectively, p<.0001, Reference Period 2 (Days 91-180)]. Through Cycles 1-7, the occurrence of scheduled withdrawal bleeding per cycle was 77.7-83.2% with E2V/DNG and 89.5-93.8% with EE/LNG (p<.0001 per cycle). The duration and intensity of scheduled withdrawal bleeding were reduced with E2V/DNG vs. EE/LNG. The incidence of intracyclic bleeding was similar with E2V/DNG (10.5%-18.6%) and EE/LNG (9.9%-17.1%) (p>.05 per cycle). No unintended pregnancies occurred with E2V/DNG, but there was one unintended pregnancy with EE/LNG. Adverse drug reactions occurred in 10.0% and 8.5% of women taking E2V/DNG and EE/LNG, respectively. Overall, 79.4% of women were satisfied with E2V/DNG and 79.9% with EE/LNG. CONCLUSIONS: A novel OC composed of E2V/DNG is associated with an acceptable bleeding profile that is comparable to that of an EE-containing OC.
Language: English
Keywords:
GERMANY | CZECHOSLOVAKIA | FRANCE | RESEARCH REPORT | COMPARATIVE STUDIES | WOMEN | ORAL CONTRACEPTIVES, COMBINED | ADMINISTRATION AND DOSAGE | ESTROGENS | LOW-DOSE PROGESTINS | MENSTRUAL CYCLE | BLEEDING | CONTRACEPTIVE SAFETY | Europe, Central | Europe | Developed Countries | Developing Countries | Europe, Western | Studies | Research Methodology | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Menstruation | Reproduction | Signs and Symptoms | Diseases | Safety | Public Health
Document Number: 343082

10.

11.

Peer Reviewed

Title: Menstrual blood loss in women using the frameless FibroPlant LNG-IUS.
Author: Andrade A; Wildemeersch D
Source: Contraception. 2009 Feb;79(2):134-8.
Abstract: BACKGROUND: This study was conducted to report on a menstrual blood loss (MBL) study and iron stores in women with and without heavy menstrual bleeding using the frameless FibroPlant levonorgestrel-releasing intrauterine system (LNG-IUS) for contraception. STUDY DESIGN: An open, prospective, noncomparative MBL study, using FibroPlant releasing 14 mcg of LNG/day for contraception. MBL was assessed by the quantitative alkaline hematin (QAH) technique. RESULTS: The MBL study was conducted in 40 heavy and normally menstruating Brazilian women seeking contraception. MBL was reduced from a mean baseline menstrual volume of 29.7 mL to a mean volume of 1.5 mL after 24 months, while ferritin values increased from a mean value of 31.1 ng/mL (at baseline) to a mean level of 72.5 ng/mL (after 24 months of use). Differences were highly significant (p<.0005). There were no significant differences between those who had normal menstrual bleeding and the heavy bleeders. The heavy bleeders had comparable MBL to thenormal bleeders 3 months after insertion, and by 24 months post-insertion, their ferritin levels were comparable to those of the normal bleeders. Amenorrhea occurred in 80% of women out of 40 after 24 months of use. No pregnancies were recorded. CONCLUSION: The LNG-IUS is effective in reducing MBL in normally menstruating women as well as in women with heavy menstrual bleeding. The authors agree with the recommendations by the UK National Institute for Clinical Effectiveness and the new Finnish guidelines for heavy menstrual bleeding that the LNG-IUS should be positioned as first-line treatment prior to endometrial ablation or hysterectomy.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | MENSTRUATION | SERUM IRON LEVEL | IUD, HORMONE RELEASING | LEVONORGESTREL | MENORRHAGIA | TIME FACTORS | AMENORRHEA | PREVALENCE | CONTRACEPTIVE EFFECTIVENESS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Studies | Economic Development | Economic Factors | Reproduction | Hemic System | Physiology | Biology | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Menstruation Disorders | Diseases | Population Dynamics | Demographic Factors | Population | Measurement
Document Number: 331016

12.

Peer Reviewed

Title: Bleeding pattern with drospirenone 3 mg+ethinyl estradiol 20 mcg 24/4 combined oral contraceptive compared with desogestrel 150 mcg+ethinyl estradiol 20 mcg 21/7 combined oral contraceptive.
Author: Anttila L; Kunz M; Marr J
Source: Contraception. 2009 Nov;80(5):445-51.
Abstract: BACKGROUND: The study was conducted to compare cycle control, bleeding pattern and efficacy of two low-dose combined oral contraceptives. STUDY DESIGN: Four hundred fifty-three women were randomized to receive a 24/4 regimen of drospirenone 3 mg/ethinyl estradiol 20 mcg (drsp 3 mg/EE 20 mcg; n=230) or a 21/7 regimen of desogestrel 150 mcg/EE 20 mcg (DSG 150 mcg/EE 20 mcg; n=223), and recorded bleeding daily over 7 treatment cycles. RESULTS: The duration [mean 4.7 (SD 1.5)-5.2 (SD 2.2) days in the drsp 3 mg/EE 20 mcg 24/4 group and 5.1 (SD 1.5)-5.4 (SD 2.1) days in the DSG 150 mcg/ EE 20 mcg group] and maximum intensity ("normal bleeding" for >50% of all subjects) of scheduled bleeding in Cycles 1-6 was comparable between treatment groups. The incidence of unscheduled bleeding during Cycles 2-6 was also similar between the two groups (drsp 3 mg/EE 20 mcg, 8.8-17.3%; DSG 150 mcg/ EE 20 mcg, 9.4-16.3%). CONCLUSION: Drsp 3 mg/EE 20 mcg 24/4 achieved an acceptable bleeding profile with reliable cycle control, comparable with an established formulation.
Language: English
Keywords:
EUROPE | RESEARCH REPORT | COMPARATIVE STUDIES | WOMEN | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, LOW-DOSE | LOW-DOSE PROGESTINS | DESOGESTREL | ETHINYL ESTRADIOL | ADMINISTRATION AND DOSAGE | ORAL CONTRACEPTIVES, SIDE EFFECTS | MENSTRUAL CYCLE | BLEEDING | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Estrogen | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Safety | Safety | Public Health | Menstruation | Reproduction | Signs and Symptoms | Diseases
Document Number: 343081

13.

Title: Oral Contraceptives: A Risk Factor for Squamous Cell Carcinoma?
Author: Applebaum KM; Nelson HH; Zens MS; Stukel TA; Spencer SK; Karagas MR
Source: Journal of Investigative Dermatology. 2009 Jun 25;129(12)
Abstract: Oral contraceptives (OCs) affect the risk of several cancers in women, but have been virtually unstudied for squamous cell carcinoma (SCC). We examined the hypothesis that OCs influence SCC risk in a case-control study among women and also examined whether polymorphisms in the DNA repair gene, Xeroderma pigmentosum group D (XPD), modified the risk. Incident cases of SCC were identified by a network of dermatologists and pathology laboratories. Population-based controls were frequency matched to cases by age and gender (n=261 SCC cases, 298 controls). Overall, OC use was associated with a 60% higher risk of SCC (odds ratio (OR), 1.6; 95% confidence interval (95% CI): 1.0-2.5). ORs for SCC were higher among those who last used OCs >/=25 years before diagnosis (OR: 2.1; 95% CI: 1.2-3.7), and among these women, SCC risk increased with duration of use (OR for /=7 years, 2.7; 95% CI: 0.9-8.5, P(trend)=0.01). Furthermore, the XPD Lys751Gln polymorphism was a significant modifier of the OC-SCC association (P(interaction)=0.03). These findings lead us to hypothesize a potential relationship between OCs and SCC risk, and that this could involve DNA repair pathways.Journal of Investigative Dermatology advance online publication, 25 June 2009; doi:10.1038/jid.2009.168.
Language: English
Keywords:
UNITED STATES OF AMERICA | NEW HAMPSHIRE | RESEARCH REPORT | CONTROL GROUPS | WOMEN | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, SIDE EFFECTS | RISK FACTORS | CANCER | DERMATOLOGICAL EFFECTS | ESTROGENS | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents | Health | Neoplasms | Diseases | Physiology | Biology | Hormones | Endocrine System
Document Number: 341751

14.

Peer Reviewed

Title: Ovarian activity and safety of a novel levonorgestrel/ethinyl estradiol continuous oral contraceptive regimen.
Author: Archer DF; Kovalevsky G; Ballagh SA; Grubb GS
Source: Contraception. 2009 Sep;80(3):245-53.
Abstract: BACKGROUND: A continuous regimen of oral levonorgestrel (LNG) 90 mcg/ethinyl estradiol (EE) 20 mcg was evaluated for inhibition of ovulation, time to return to ovulation after stopping treatment and safety. STUDY DESIGN: This open-label study was conducted in healthy women aged 18-35 years. Ovulation was documented before treatment, and then participants received oral tablets containing LNG 90 mcg/EE 20 mcg to be taken continuously for three 28-day intervals. Ovarian activity was assessed three times per week during the treatment period with transvaginal ultrasound scans and measurements of serum 17beta-estradiol, progesterone, follicle-stimulating hormone and luteinizing hormone concentrations. Safety assessments included physical examinations, laboratory evaluations and adverse event records. RESULTS: Thirty-seven of the 58 subjects who received treatment met predefined criteria for efficacy analysis. No on-treatment ovulations occurred in the efficacy or intent-to-treat population. There was evidence of ovulation within 37 days of stopping treatment for 46 (98%) of 47 subjects evaluated posttreatment. The final subject with a history of polycystic ovarian syndrome ovulated by Day 66. The safety profile observed during this 84-day continuous regimen was similar to that seen with other low-dose oral contraceptives administered in a cyclic regimen. CONCLUSIONS: The continuous LNG/EE regimen completely inhibited ovulation, with little evidence of follicular development and with rapid return of ovulatory capacity after stopping treatment.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | WOMEN | ORAL CONTRACEPTIVES | LEVONORGESTREL | ETHINYL ESTRADIOL | SAFETY | ULTRASONICS | OVARIAN EFFECTS | TREATMENT | Developed Countries | North America | Americas | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Estrogen | Public Health | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology
Document Number: 342575

15.

Peer Reviewed

Title: Bleeding patterns associated with non-oral hormonal contraceptives: a review of the literature.
Author: Bachmann G; Korner P
Source: Contraception. 2009 Apr;79(4):247-58.
Abstract: It is generally accepted that poor tolerance to changes in vaginal bleeding associated with hormonal contraceptive use may influence compliance and continuation with the chosen method. However, disparities in the collation and reporting of bleeding data hamper comparison among studies and products. In this review, we systematically assessed MEDLINE and EMBASE for articles assessing parenteral hormonal contraceptives that reported bleeding data based on reference periods as recommended by the World Health Organization (WHO). Overall, 31 studies published between 1986 and October 2007 were included in this review. The use of parenteral hormonal contraception was in general associated with a decrease in bleeding with continued use from Reference Period 1 to 4. However, this decrease was less marked with the combined hormonal depots and both progestin-only and combined hormonal vaginal rings than with progestin-only implants, depots and the levonorgestrel intrauterine system. Overall, reporting vaginal bleeding by 90-day reference periods as recommended by the WHO allows straightforward comparison of bleeding patterns between studies.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | BLEEDING | CONTRACEPTIVE IMPLANTS | VAGINAL RING | CONTRACEPTIVE AGENTS, PROGESTIN | Developed Countries | North America | Americas | Demographic Factors | Population | Signs and Symptoms | Diseases | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents
Document Number: 330560

16.
Title: Drospirenone/ethinyl estradiol 3 mg/20 mug (24/4 day regimen): hormonal contraceptive choices - use of a fourth-generation progestin.
Author: Bachmann G; Kopacz S
Source: Patient Preference and Adherence. 2009;3:259-64.
Abstract: The combined oral contraceptive pill (COC) consisting of drospirenone 3 mg/ethinyl estradiol 20 mug (3 mg DRSP/20 mug EE-24/4) supplies 24 days of pills with hormones followed by 4 days of hormone-free pills. This regimen is called the 24/4 regimen. The progesterone component of this oral contraceptive pill (OCP), drospirenone (DRSP), is a fourth-generation progestin that has potent progestogenic, antimineralocorticoid, and antiandrogenic activity, which are unique characteristics compared with the other progestogens contained in most of the other OCPs currently marketed. This formulation, in addition to being an effective long-term OCP, has the additional medical benefit of providing a good parallel treatment for premenstrual dysphoric disorder and moderate acne. The effectiveness of 3 mg DRSP/20 mug EE-24/4, its tolerability and safety, and its additional non-contraceptive benefits are discussed.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | ORAL CONTRACEPTIVES, COMBINED | PROGESTERONE | ETHINYL ESTRADIOL | ADMINISTRATION AND DOSAGE | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE SAFETY | ACNE | PREMENSTRUAL TENSION | TREATMENT | METABOLIC EFFECTS | DRUG INTERACTIONS | Developed Countries | North America | Americas | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Drugs | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Safety | Public Health | Dermatitis | Diseases | Menstruation Disorders
Document Number: 343375

17.
Title: Emergency contraception: how does it work?
Author: Baird DT
Source: Reproductive Biomedicine Online. 2009;18 Suppl 1:32-6.
Abstract: Emergency (or post-coital) contraception is any substance or device that is used to prevent pregnancy after unprotected intercourse. Currently used hormonal methods of emergency contraception (high-dose combined oral contraceptive pill or levonorgestrel) prevent about 50-80% of pregnancies. Research has demonstrated that these methods inhibit the midcycle surge of LH from the pituitary and, if given at least 2 days before ovulation, ovulation is delayed or prevented. Ovulation still occurs if administration is delayed until ovulation is imminent. Biological data that suggest that the most likely mode of action is by preventing fertilization are supported by the clinical observation that the greater the interval between coitus and administration the greater the chance of pregnancy. There are no data supporting the view that levonorgestrel can impair the development of the embryo or prevent implantation. In contrast, other very effective methods of emergency contraception, such as mifepristone and intrauterine devices, can also inhibit implantation.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | EMERGENCY CONTRACEPTION | IUD | RU-486 | LEVONORGESTREL | CONTRACEPTIVE EFFECTIVENESS | Developed Countries | Europe, Western | Europe | Contraception | Family Planning | Contraceptive Methods | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents
Document Number: 330739

18.

Peer Reviewed

Title: Contraception availability in China.
Author: Baltsezak S
Source: Journal of Family Planning and Reproductive Health Care. 2009 Jul;35(3):206.
Abstract: This letter to the editor focuses on the availability of contraception in China and the importance because of the one-child policy in the country. It talks about condoms, IUDs, and natural methods as being the most accepted and known forms of contraception in the country and provides reasons behind the lower usage of oral contraceptive pills (OCPs).
Language: English
Keywords:
CHINA | CRITIQUE | CONTRACEPTIVE AVAILABILITY | CONTRACEPTIVE METHODS | KNOWLEDGE | FAMILY PLANNING PROGRAMS | INFORMATION DISTRIBUTION | CONTRACEPTIVE AGENTS, SIDE EFFECTS | BELIEFS | CONTRACEPTIVE METHOD ACCEPTABILITY | SOCIOCULTURAL FACTORS | Asia, Eastern | Asia | Developing Countries | Contraception | Family Planning | Communication | Contraceptive Agents | Culture | Contraceptive Usage
Document Number: 342133

19.

Title: RISUG: a potential candidate for the entry inhibitor group of antiretroviral drugs.
Author: Banerjee S; Guha SK
Source: Medical Hypotheses. 2009 Aug;73(2):150-2.
Abstract: Entry inhibitors are a group of antiretroviral drug which prevents HIV from entering human immune cells. They include both fusion and attachment inhibitors. A hypothesis is put forward in which a new male contraceptive drug with proven antimicrobial property is proposed as a possible candidate for the entry inhibitor group of antiretroviral drugs. The proposed mechanism of action involves (i) interaction with gp120 and thereby preventing binding to CD4 and (ii) competitive binding with the viral glycoprotein and inhibit the glycoprotein - cell surface glyocosaminoglycan Heparan Sulfate (HS) interaction. A new drug RISUG (Reversible Inhibition of Sperm Under Guidance) presently undergoing Phase III clinical trials throughout India for its contraceptive effect in male has also antimicrobial actions. RISUG is a chemical complex of styrene maleic anhydride (SMA(AN)) and dimethyl sulfoxide. On injection into the vas deferens, it reacts with the components of intravas fluid, the spermatic fluid and gets converted to styrene maleic acid (SMA(AC)) and breakdown products like mandelic acid. An anti HIV activity of RISUG is likely due to its electrical charge and mandelic acid generation. For experimental validation HIV in vitro assays can be performed which will involve infectivity assays, luciferase assay and soluble gp120 assays. A positive result from the studies will validate the hypothesis.
Language: English
Keywords:
INDIA | RESEARCH PROPOSAL | DRUGS | CONTRACEPTIVE AGENTS, MALE | MICROBICIDES | ANTIRETROVIRAL DRUGS | HIV INFECTIONS | IMMUNE SYSTEM | ANTIGEN-ANTIBODY REACTIONS | Asia, Southern | Asia | Developing Countries | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents | Contraception | Family Planning | Viral Diseases | Diseases | Physiology | Biology | Antibodies | Immunologic Factors | Immunity
Document Number: 342410

20.

Peer Reviewed

Title: Polycystic ovary syndrome and cardiovascular risk in young patients treated with drospirenone-ethinylestradiol or contraceptive vaginal ring. A prospective, randomized, pilot study.
Author: Battaglia C; Mancini F; Fabbri R; Persico N; Busacchi P; Facchinetti F; Venturoli S
Source: Fertility and Sterility. 2009 Jul 8;
Abstract: OBJECTIVE: To compare the effects of a pill containing drospirenone with those of a combined contraceptive vaginal ring on the lipid and carbohydrate metabolism and on the surrogate markers of arterial function. SETTING: Bologna University School of Medicine. PATIENT(S): Thirty-seven women with polycystic ovary syndrome (PCOS) were randomly submitted to drospirenone + ethinylestradiol (group I; n = 19) or combined contraceptive vaginal ring (group II; n = 18) therapy. The duration of the study was 6 months. INTERVENTION(S): The effect of treatments was assessed after 6 months of therapy. MAIN OUTCOME MEASURE(S): Utero-ovarian ultrasound analysis and color Doppler evaluation of uterine and stromal ovarian arteries. In addition, analysis of brachial artery flow-mediated vasodilatation and 24-hour ambulatory blood pressure monitoring were performed. Fasting blood samples were drawn for testing biochemical and hormonal parameters and nitrites/nitrates. RESULT(S): Both treatments improved hirsutism, hyperandrogenemia, and ultrasound and color Doppler ovarian parameters. Both drospirenone + ethinylestradiol or contraceptive vaginal ring induced a slight but significant increase of diurnal and 24-hour blood pressure. Although both therapies worsened the lipid profile, the oral pill administration was associated with a more evident increase of circulating triglycerides. The 6-month treatment with the vaginal ring significantly improved the area under the curve for glucose, insulin, and C-peptide, whereas the drospirenone + ethinylestradiol pill induced an increase in the insulinogenic index and homeostatic model assessment estimate for insulin resistance values. CONCLUSION(S): Vaginal hormonal contraception appears to be preferable to oral ethinylestradiol + drospirenone administration in hyperinsulinemic patients with PCOS.
Language: English
Keywords:
ITALY | RESEARCH REPORT | PROSPECTIVE STUDIES | COMPARATIVE STUDIES | CLIENTS | OVARIAN CYSTS | ORAL CONTRACEPTIVES, COMBINED | ETHINYL ESTRADIOL | LOW-DOSE PROGESTINS | VAGINAL RING | CARDIOVASCULAR EFFECTS | CARBOHYDRATE METABOLIC EFFECTS | LIPID METABOLIC EFFECTS | BLOOD PRESSURE | ULTRASONICS | Developed Countries | Europe, Southern | Europe | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Diseases | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Progestin | Physiology | Biology | Metabolic Effects | Lipids | Hemic System | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342128

21.

Peer Reviewed

Title: Bone mineral density in a cohort of adolescents during use of norethisterone enanthate, depot-medroxyprogesterone acetate or combined oral contraceptives and after discontinuation of norethisterone enanthate.
Author: Beksinska ME; Kleinschmidt I; Smit JA; Farley TM
Source: Contraception. 2009 May;79(5):345-9.
Abstract: BACKGROUND: Depot medroxyprogesterone acetate (DMPA), norethisterone enanthate (NET-EN) and combined oral contraceptives (COCs) have been shown to have a negative effect on bone mineral density (BMD) in adolescents. The aim of this study was to investigate BMD in 15- to 19-year-old new users of DMPA, NET-EN and COCs. STUDY DESIGN: This 5-year longitudinal study followed up new users of DMPA (n=115), NET-EN (n=115) and COCs (n=116) and 144 nonuser controls. BMD was measured at the distal radius using dual-energy X-ray absorptiometry. RESULTS: BMD increased in all groups (annual percent increase: nonusers, 1.49%; DMPA, 1.39%; NET-EN, 1.03%; COCs, 0.84%) during follow-up (p<.001). There was evidence for lower BMD increases per annum in NET-EN (p=.050) and COC (p=.010) users compared to nonusers but no difference between DMPA and nonusers (p=.76). In 14 NET-EN discontinuers, an overall reduction of 0.61% per year BMD was followed upon cessation by an increase of 0.69% per year (p=.066). CONCLUSION: This study suggests that BMD increases in adolescents may be less in NET-EN and COC users; however, recovery of BMD in NET-EN users was found in the small sample of adolescents followed post-discontinuation.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | CLINICAL RESEARCH | COHORT ANALYSIS | COMPARATIVE STUDIES | ADOLESCENTS, FEMALE | WOMEN IN DEVELOPMENT | SKELETAL EFFECTS | CONTRACEPTION TERMINATION | NORETHINDRONE ENANTHATE | DEPO-PROVERA | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE SAFETY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Studies | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Physiology | Biology | Contraception | Family Planning | Norethindrone | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Medroxyprogesterone Acetate | Oral Contraceptives | Contraceptive Methods | Safety | Public Health | Health
Document Number: 330938

22.

Peer Reviewed

Title: Bone mineral density in young women aged 19-24 after 4-5 years of exclusive and mixed use of hormonal contraception.
Author: Beksinska ME; Kleinschmidt I; Smit JA; Farley TM; Rees HV
Source: Contraception. 2009 Aug;80(2):128-32.
Abstract: BACKGROUND: Use of depot-medroxyprogesterone acetate (DMPA), norethisterone enanthate (NET-EN) and low-dose combined oral contraceptives (COCs) has been associated with loss of bone mineral density (BMD) in adolescents. However, the effect of using a combination of these methods over time in this age group is limited. The aim of this cross-sectional study was to investigate BMD in young women (aged 19-24 years) with a history of mixed hormonal contraceptive use. STUDY DESIGN: BMD was measured at the spine, hip and femoral neck using dual X-ray absorptiometry. Women were classified into three groups: (1) injectable users (DMPA, NET-EN or both) (n=40), (2) mixed COC and injectable users (n=13) and (3) non-user control (n=41). RESULTS: Women in the injectables-only user group were found to have lower BMDs compared to the non-user group at all three sites, and there was evidence of a difference in BMD between these two groups at the spine after adjusting for body mass index (p=.042), hip (p=.025) and femoral neck (p=.023). The mixed COC/injectable user group BMD values were lower than those for controls; however, there was no evidence of a significant difference between this group and the non-user group at any of the three sites. CONCLUSION: This study suggests that BMD is lower in long-term injectable users but not when women have mixed injectable and COC use.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | CONTROL GROUPS | WOMEN | YOUTH | INJECTABLES | DEPO-PROVERA | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTIVE AGENTS, SIDE EFFECTS | SKELETAL EFFECTS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Demographic Factors | Population | Age Factors | Population Characteristics | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Oral Contraceptives | Physiology | Biology
Document Number: 342307

23.

Title: Genetic counseling for teratogenic risk due to exposure to medications: 89 pregnancies conceived during oral contraceptive use.
Author: Belli S; Mazzola S; Luongo R; Barcella L; Alushi B
Source: American Journal of Medical Genetics. Part A. 2009 Jun 5;149A(7)
Abstract: Congenital malformations are relatively frequent (2% of the general population) but only a small proportion of them can be ascribed to medication exposure during pregnancy. Nevertheless, for the purposes of accurate prenatal diagnosis, monitoring and research, is it important to offer teratology counseling to patients exposed to drugs. There are approximately 20 medications currently on the market that have been universally acknowledged as teratogenic. At the current state of the art, exposure of early embryos to oral contraceptives is not considered teratogenic. Oral contraceptive use may be continuous (estrogen and progesterone or progesterone alone) or emergency (levonorgestrel is the only drug authorized in Italy). Like all drugs, oral contraceptives have a therapeutic failure rate, which means that a number of women on oral contraceptives conceive each year and request genetic counseling about teratogenic effects. During the period 1998-2006 at our genetics clinic we received 89 requests for counseling regarding teratogenic risk due to oral contraceptives. Our study of these patients confirms an absence of teratogenic risk for pregnancies occurring during oral contraceptive use. Teratology counseling was useful to reassure the mothers about the low risk (in the case of oral contraceptive use alone), since only 12 women chose to terminate pregnancy.
Language: English
Keywords:
ITALY | RESEARCH REPORT | GENETICS | COUNSELING | EXPOSURE | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, ESTROGEN | PROGESTERONE | LEVONORGESTREL | CONGENITAL ABNORMALITIES | RISK FACTORS | PREGNANCY | Developed Countries | Europe, Southern | Europe | Biology | Clinic Activities | Program Activities | Programs | Organization and Administration | Health | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Progestational Hormones | Hormones | Endocrine System | Physiology | Contraceptive Agents, Progestin | Neonatal Diseases and Abnormalities | Diseases | Reproduction
Document Number: 341602

24.

Title: Perception and practice of emergency contraception among female undergraduates of the University of Ibadan, Nigeria.
Author: Bello FA; Olayemi O; Fawole AO; Ogunbode OO; Sobukunola T
Source: Journal of Reproduction and Contraception. 2009 Jun;20(2):113-121.
Abstract: The authors performed a cross-sectional questionnaire study with 383 female undergraduates in Nigeria in June 2006 to assess their perceptions about and proper use of emergency contraception (EC). One hundred and five (48.2%) of the students had been sexually exposed. Only 32 (30.5%) used regular contraception. Seventy-three (24.3%) female undergraduates were aware of EC. Only 29 (7.6%) had used EC before. Most would not use EC drugs in the future due to lack of awareness (64.8%), fear for future fertility, and fear that EC was injurious to health. Use of EC was associated with awareness of correct interval for use. The authors concluded that there was poor knowledge about EC and poor use. Most knowledge was acquired from peers and was inaccurate.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | DATA ANALYSIS | YOUTH | STUDENTS | ADOLESCENTS, FEMALE | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AGENTS, POSTCOITAL | KNOWLEDGE | PEER EDUCATORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Adolescents | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Sociocultural Factors
Document Number: 339903

25.
Title: Safety, efficacy and patient satisfaction with continuous daily administration of levonorgestrel/ethinylestradiol oral contraceptives.
Author: Benagiano G; Carrara S; Filippi V
Source: Patient Preference and Adherence. 2009;3:131-43.
Abstract: The progestational steroid norgestrel was synthesized and tested between 1960 and 1965 through an international cooperation between Wyeth, USA and Schering, Berlin. It is a mixture of two "enantiomers," with only one form (designated as levonorgestrel) biologically active. When taken orally, it is rapidly absorbed, not subjected to a "first-pass" effect and is approximately 90% bioavailable, with a circulating half-life around 15 hours. Its contraceptive action is exerted at the central (hypothalamic) and peripheral (cervical mucus and endometrium) levels. Levonorgestrel (LNG), alone or in combination with ethinyl estradiol (EE), is the most widely employed contraceptive progestin: it is used in combined oral contraceptives, progestogen-only pills, long-acting contraceptive implants, intrauterine contraceptive systems and in emergency contraception. It is also the steroid of choice for new oral contraceptive regimens aimed at reducing the frequency of bleeding episodes. This novel approach, already tried more than 30 years ago, gained interest around the year 2000 when surveys of women's attitudes toward monthly menstrual bleeding started to show a major change: more and more women declared that they would welcome a hormonal contraceptive method that reduced bleeding episodes to 4, 2 or even 1 per year. At this point, while the debate on the significance and "usefulness" of menstruation went on, attention focused on new regimens. The first new modality consisted of changing the 7-day medication-free interval, either shortening it to fewer than 7 days, or by the administration of low-dose estrogens during the interval between packages. Then, continuous administration regimens started to be investigated. This, however, did not happen suddenly, since, in specific situations, doctors had for years empirically utilized various continuous administration regimens. The first extended-cycle oral contraceptive regimen introduced in clinical practice is an 84-day regimen that results in bleeding only 4 times a year. A commercial product specifically packed for continuous use is now available in Europe and contains 30 mug EE and 150 mug LNG. In a variation of this regimen, after administration of the same combination for 84 days, women are given 7 pills containing 10 mug EE. A 6-monthly regimen has also been tested in a small study using EE 20 mug plus LNG 100 mug taken with and without a hormone-free interval. Women in the continuous group reported significantly fewer bleeding days requiring protection and were more likely to have amenorrhea; in addition they also reported significantly fewer days of bloating and menstrual pain. A yearly regimen is now being developed. Each pill of this novel formulation contains EE 20 mug and LNG 90 mug to be taken continuously for 364 days (13 cycles) per year. A phase III trial has now evaluated safety, efficacy and menses inhibition. At the end of the 1-year trial amenorrhea was present in 58.7% of the women and a complete absence of bleeding in 79.0%. Overall, the number of bleeding and spotting days per pill pack declined with time and adverse events and discontinuations were comparable to those reported for cyclic oral contraceptive regimens.
Language: English
Keywords:
ITALY | HISTORICAL REVIEW | LITERATURE REVIEW | ORAL CONTRACEPTIVES, COMBINED | LEVONORGESTREL | ETHINYL ESTRADIOL | ADMINISTRATION AND DOSAGE | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE SAFETY | MENSTRUATION | AMENORRHEA | ATTITUDES | CONTRACEPTIVE MODE OF ACTION | Developed Countries | Europe, Southern | Europe | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Estrogen | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Safety | Public Health | Reproduction | Menstruation Disorders | Diseases | Psychological Factors | Behavior
Document Number: 343377

26.

Peer Reviewed

Title: Changes in weight, total fat, percent body fat, and central-to-peripheral fat ratio associated with injectable and oral contraceptive use.
Author: Berenson AB; Rahman M
Source: American Journal of Obstetrics and Gynecology. 2009 Mar;200(3):329.e1-8.
Abstract: OBJECTIVE: The purpose of this study was to determine changes in bodyweight and composition that result from hormonal contraception. STUDY DESIGN: Dual-energy x-ray absorptiometry was performed at baseline and every 6 months for 3 years for 703 women (African American, 200; white, 247; Hispanic, 256) who were beginning the use of oral contraception (OC; n = 245), depot medroxyprogesterone acetate (DMPA; n = 240), or nonhormonal contraception (NH; n = 218). DMPA discontinuers were observed for up to 2 years to examine the reversibility of the observed changes. RESULTS: Over 36 months, DMPA users increased their weight (+5.1 kg), body fat (+4.1 kg), percent body fat (+3.4%), and central-to-peripheral fat ratio (+0.1) more than OC and NH users (P < .01). OC use did not cause weight gain. After DMPA discontinuation, NH users lost 0.42 kg in 6 months; OC users gained 0.43 kg in 6 months. CONCLUSION: Bodyweight and fat significantly increase with the use of DMPA. After discontinuation of DMPA, some decrease in bodyweight and fat occurs when NH is used.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | RETROSPECTIVE STUDIES | WOMEN | ORAL CONTRACEPTIVES | BODY WEIGHT | MEDROXYPROGESTERONE ACETATE | CONTRACEPTIVE USAGE | LIPIDS | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents
Document Number: 330467

27.

Peer Reviewed

Title: Effect of injectable and oral contraceptives on serum lipids.
Author: Berenson AB; Rahman M; Wilkinson G
Source: Obstetrics and Gynecology. 2009 Oct;114(4):786-94.
Abstract: OBJECTIVE:: To estimate the effects of using depot medroxyprogesterone acetate (DMPA) or oral contraceptives (OCs) containing 20 micrograms ethinyl estradiol and 0.15 mg desogestrel on serum lipid levels. METHODS:: Serum lipids were measured at baseline and every 6 months thereafter for 3 years in 703 white, African-American, and Hispanic women using DMPA, OC, or nonhormonal birth control. Those who discontinued DMPA were followed for up to 2 additional years. Participants completed questionnaires containing demographic and behavioral measures every 6 months and underwent 24-hour dietary recalls annually. Mixed-model regression analyses and general-estimating-equations procedures were used to estimate changes over time in lipids by method along with their predictors. RESULTS:: Users of OCs experienced significantly greater increases in levels of triglycerides, total cholesterol, very-low-density lipoprotein (VLDL) cholesterol, and high-density lipoprotein (HDL) cholesterol than did nonhormonal-contraceptive users (P<.001). However, no difference was noted in the low-density lipoprotein (LDL) cholesterol:HDL ratio between OC users and nonhormonal-contraceptive users. Among DMPA users, HDL levels initially decreased for 6 months but then returned to baseline. The LDL:HDL ratio rose in the first 6 months of DMPA use but then dropped back to baseline over the next 24 months. After DMPA was discontinued, triglyceride, VLDL, and HDL levels were significantly higher in women who used OCs than in those who chose nonhormonal (P<.05) methods. CONCLUSION:: Use of very-low-dose OCs containing desogestrel can elevate lipid levels. Users of DMPA were at increased risk of developing an abnormally low HDL level as well as an abnormally high LDL level and an increase in the LDL:HDL cholesterol ratio, although these effects appeared to be temporary. LEVEL OF EVIDENCE:: II.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CONTROL GROUPS | ETHNIC GROUPS | DEPO-PROVERA | ORAL CONTRACEPTIVES, COMBINED | DESOGESTREL | LIPID METABOLIC EFFECTS | CHOLESTEROL | LIPIDS | TIME FACTORS | Developed Countries | North America | Americas | Research Methodology | Cultural Background | Population Characteristics | Demographic Factors | Population | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods | Physiology | Biology | Population Dynamics
Document Number: 343161

28.

Title: Limited knowledge on progestogen-only contraception and risk of venous thromboembolism.
Author: Bergendal A; Odlind V; Persson I; Kieler H
Source: Acta Obstetricia et Gynecologica Scandinavica. 2009;88(3):261-266.
Abstract: Objective. To assess the current knowledge concerning progestogen-only contraception (POC) and risks of venous thromboembolism (VTE). Design and setting. Systematic review of the literature on observational and analytical studies reporting risk estimates for VTE in women exposed to POCs. Methods and main outcome measures. We performed a computerized literature search in the Pub Med, Embase, and the Cochrane Library for studies published between 1966 and February 13, 2008. Based on the evaluated studies we calculated an overall risk estimate for VTE in association with POC. Results. Four case-control studies and one cohort study were included. Of the case-control studies, three reported an increased risk and one a decreased risk of VTE. The cohort study found divergent results depending on the type of statistical analysis used. None of the results was statistically significant. The overall odds ratio for POC-associated VTE in the four case-control studies was 1.45 (95% CI=0.92-2.26). Conclusions. The risk of VTE associated with use of POCs is poorly investigated. The slightly elevated overall risk estimate might suggest an association between POC and an increased risk for VTE. The results must, however, be interpreted with caution due to the possibility of residual confounding. Well-designed studies with sufficient statistical power to evaluate risks of VTE with POC are warranted.
Language: English
Keywords:
SWEDEN | RESEARCH REPORT | EPIDEMIOLOGY | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | THROMBOEMBOLISM | RISK FACTORS | KNOWLEDGE | Europe, Northern | Europe | Developed Countries | Public Health | Health | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Embolism | Vascular Diseases | Diseases | Sociocultural Factors
Document Number: 329655

29.

Peer Reviewed

Title: Contraceptive failure with Depo-Provera� [letter]
Author: Bhathena R
Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):130.
Abstract: I have a concern regarding the recent case report where a 28-year-old woman was given a subsequent (second) injection of Depo-Provera� by a practice nurse when she attended after 13 weeks, and when no precautions were advised, nor documentation done. The patient subsequently again reported with a positive pregnancy test and opted for a termination of pregnancy. My personal feeling is that although by and large consultation times are often too short for practising doctors to cover all aspects of counselling at all times, when a patient is using a contraceptive method outside the terms of the product licence, to ensure that optimal service is offered and also in view of the remote possibility of litigation following failure of the method, it should be mandatory for the practising doctor to also get involved and appropriately counsel, and to adequately document such an episode. (full-text)
Language: English
Keywords:
INDIA | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | WOMEN IN DEVELOPMENT | PHYSICIANS | NURSES AND NURSING | DEPO-PROVERA | CONTRACEPTION FAILURE | ABORTION | REFERRAL AND CONSULTATION | COUNSELING | TIME FACTORS | FAMILY PLANNING EDUCATION | Asia, Southern | Asia | Developing Countries | Research Methodology | Studies | Economic Development | Economic Factors | Health Personnel | Delivery of Health Care | Health | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Usage | Fertility Control, Postconception | Program Activities | Programs | Organization and Administration | Clinic Activities | Population Dynamics | Demographic Factors | Population | Education
Document Number: 330946 Notification

30.

Peer Reviewed

Title: Potential acceptability of microbicides in HIV prevention in stable marital relationships in Malawi.
Author: Bisika T
Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):115-7.
Abstract: BACKGROUND: The XVII International Conference on AIDS held in Mexico City in August 2008 emphasised the importance of dual prevention using both vaccines and microbicides in the fight against HIV and AIDS. Microbicides are important because they constitute one of the potentially important female-controlled methods of HIV and sexually transmitted infection prevention, especially in Malawi where the use of the female condom has not yet been fully embraced. METHODS: A qualitative study utilising focus group discussions was used to assess the acceptability of the microbicide nonoxynol-9 (N-9) as part of the ongoing Preparatory AIDS Vaccine Evaluation (PAVE) studies. RESULTS: The study observed that men oppose the use of N-9, and that although women consider themselves at risk for HIV they caution against the unintended consequence of altering the vaginal environment with the use of microbicides, which can interfere with the men's preference for dry sex. DISCUSSION AND CONCLUSIONS: Although N-9 did not produce the desired results, these can inform the development of other promising microbicide candidates. The study concludes that it is important to pay attention to how new microbicides are formulated rather than just concentrating solely on an individual product's effectiveness.
Language: English
Keywords:
MALAWI | RESEARCH REPORT | FOCUS GROUPS | CURRENTLY MARRIED | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | MICROBICIDES | NONOXYNOL-9 | HUSBAND-WIFE COMPARISONS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Marital Status | Nuptiality | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Spermicidal Contraceptive Agents | Contraceptive Agents | Contraception | Family Planning | Comparative Studies | Studies
Document Number: 341651


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