| 1. Title: Intrauterine devices: an effective alternative to oral hormonal contraception. Source: Prescrire International. 2009 Jun;18(101):125-30. Abstract: (1) Intrauterine devices (IUDs) are placed in the uterine cavity with the objective of providing long-term contraception, mainly by preventing fertilisation. The best-known IUDs contain copper, but there is also an IUD delivering levonorgestrel, a progestin; (2) How effective are these devices, and what are their adverse effects? To answer these questions, we analysed the literature using the standard Prescrire methodology; (3) T-shaped copper IUDs, with a copper surface area of 380 mm2 on 3 arms, and the levonorgestrel-releasing device, have similar contraceptive efficacy as combined oral contraceptives that are used correctly. In contrast, IUDs are more effective than oral contraception used incorrectly; (4) Among IUD users, there are on average about 6 pregnancies per 1000 woman-years. There is less experience with the levonorgestrel IUD which seems to be at least as effective as copper IUDs; (5) The rare intrauterine pregnancies that occur in women using an IUD generally end in miscarriage. About 25% of these pregnancies end in a live birth if the device is left in place, compared to about 90% if the device is removed; (6) Ectopic pregnancies are rarer in IUD users than in women who do not use contraception. However, about one in 20 pregnancies that occur in women using an IUD is ectopic; (7) The IUD is expelled in about 5% to 10% of cases within 5 years, and expulsion recurs in about 30% of these women; (8) Problems such as difficult insertion, pain, bleeding and syncope are reported in less than 1.5% of cases overall; (9) Uterine perforation during insertion is rare, occurring in 0.6 to 16 cases per 1000 insertions, regardless of the type of IUD. The risk of perforation is higher when the IUD is inserted less than 4 to 6 weeks after delivery or elective abortion; (10) During the first 3 months after insertion, the risk of pelvic infection is slightly higher than in the general population, especially in women with pre-existing asymptomatic Chlamydia trachomatis infection. There are about 6 pelvic infections per 1000 woman-years of IUD use. Routine antibiotic prophylaxis is unnecessary. The interview and physical examination may lead to diagnosis of C. trachomatis infection or other sexually transmitted infections. In these cases, treatment may be needed before IUD insertion. Women must be warned that IUDs do not protect them from sexually transmitted diseases; (11) Menstrual bleeding is often heavier in women with cooper IUDs than in women who do not use IUDs, and may be associated with menstrual pain; (12) The levonorgestrel IUD is associated with a marked reduction in menstrual blood loss and irregular bleeding; amenorrhoea occurs in 35% of women after 2 years of use. The levonorgestrel IUD also has hormonal adverse effects such as headache, acne, breast tension and functional ovarian cysts; (13) IUDs can safely be used in breastfeeding women, immediately after a pregnancy, in cases of diabetes or HIV infection, during nonsteroidal antiinflammatory drug therapy, and after an ectopic pregnancy. The only problems occurring in women who have never had children are pain during insertion and more frequent expulsions; (14) A copper IUD is a first-line contraceptive method for women with a history of deep venous thrombosis, pulmonary embolism, or coronary events; (15) It is better to postpone IUD insertion when the woman has a genital tract infection or unexplained vaginal bleeding; (16) IUD insertion is an effective alternative to "morning-after" hormonal contraception. Language: English Keywords: GLOBAL | LITERATURE REVIEW | IUD | CONTRACEPTIVE MODE OF ACTION | IUD COMPLICATIONS | IUD EXPULSION | INSERTION | IUD SIDE EFFECTS | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE SAFETY | PREGNANCY, ECTOPIC | UTERINE PERFORATION | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Safety | Public Health | Pregnancy Complications | Diseases | Perforations Document Number: 342301 |
2.  Peer Reviewed Title: Oral contraceptives for functional ovarian cysts. Source: Obstetrics and Gynecology. 2009 Sep;114(3):679-80. Abstract: BACKGROUND:: Functional ovarian cysts are a common gynecological problem among women of reproductive age worldwide. When large, persistent, or painful, these cysts may require operations, sometimes resulting in removal of the ovary. Since early oral contraceptives were associated with a reduced incidence of functional ovarian cysts, many clinicians inferred that birth control pills could be used to treat cysts as well. This became a common clinical practice in the early 1970s. OBJECTIVES:: This review examined all randomized controlled trials that studied oral contraceptives as therapy for functional ovarian cysts. SEARCH STRATEGY:: We searched the databases of CENTRAL, MEDLINE, POPLINE, and EMBASE, as well as clinical trials databases (ClinicalTrials.gov and ICTRP). We also examined the reference lists of articles and wrote to authors of identified trials to seek articles we had missed. SELECTION CRITERIA:: We included randomized controlled trials in any language that included oral contraceptives used for treatment and not prevention of functional ovarian cysts. Criteria for diagnosis of cysts were those used by authors of trials. DATA COLLECTION AND ANALYSIS:: Two authors independently abstracted data from the articles. One entered the data into RevMan and a second verified accuracy of data entry. For dichotomous outcomes, we used Peto odds ratios with 95% confidence intervals (CIs). For continuous outcomes, we calculated mean differences with 95% CI. MAIN RESULTS:: We identified seven randomized controlled trials from four countries; the studies included a total of 500 women. Treatment with combined oral contraceptives did not hasten resolution of functional ovarian cysts in any trial. This held true for cysts that occurred spontaneously as well as those that developed after ovulation induction. Most cysts resolved without treatment within a few cycles; persistent cysts tended to be pathological (e.g., endometrioma or para-ovarian cyst) and not physiological. AUTHORS' CONCLUSION:: Although widely used for treating functional ovarian cysts, combined oral contraceptives appear to be of no benefit. Watchful waiting for two or three cycles is appropriate. Should cysts persist, surgical management is often indicated.Grimes DA, Jones LB, Lopez LM, Schulz KF. Oral contraceptives for functional ovarian cysts. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD006134. DOI: 10.1002/14651858.CD006134.pub2. Copyright the Cochrane Collaboration, reproduced with permission. Language: English Keywords: GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | INCIDENCE | OVARIAN CYSTS | ORAL CONTRACEPTIVES | TREATMENT | EXAMINATIONS AND DIAGNOSES | Measurement | Research Methodology | Diseases | Contraceptive Methods | Contraception | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342569 |
3.  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 |
| 4. Title: Scientists recommend new design for female condom research. Author: Family Health International [FHI] Source: [Research Triangle Park, North Carolina], FHI, [2009]. [2] p. (Research Briefs on the Female Condom) Abstract: As the result of a USAID-supported workshop organized by the nonprofit organization CONRAD, scientists have proposed a new design for studies testing the effectiveness of innovations in the female condom. For a female condom to gain regulatory approval in the United States, the U.S. Food and Drug Administration (FDA) currently requires that the product be tested in a large -- and often expensive -- phase III contraceptive-effectiveness trial. CONRAD held the workshop specifically so that experts on female condoms and semen biomarkers could explore acceptable alternatives to this type of trial. The experts identified the well-studied biomarker prostate-specific antigen (PSA) as the most promising marker to pursue for this application. The new study design uses PSA to show the presence of semen in the vagina, which should be a more reliable indicator of clinical condom failure than is the incidence of pregnancy or a sexually transmitted infection. A report of the workshop and the details of the study design are published in the journal Contraception. (Excerpt) Language: English Keywords: UNITED STATES OF AMERICA | SUMMARY REPORT | STUDY DESIGN | WORKSHOPS | FEMALE CONDOMS | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTION RESEARCH | CONDOM FAILURE | SEMEN | ANTIGENS | VAGINA | Developed Countries | North America | Americas | Research Methodology | Education | Vaginal Barrier Methods | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Condoms | Seminal Vesicles | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Immunologic Factors | Immunity | Immune System | Genitalia, Female Document Number: 331704 |
| 5. Title: Use of and unmet need for injectable contraception. Author: Family Health International [FHI] Source: [Unpublished] 2009 Jun 8. 12 p. Abstract: Understanding trends in contraceptive use and unmet need for family planning is critical to creating policies which respond to current gaps in service delivery and address future needs for services to meet existing and unmet demand. Creating non clinic-based mechanisms to deliver services has the potential to expand access to underserved populations and reduce pressure on weak health systems. This document examines patterns of the current use of and unmet demand for injectable services. Trends in use of clinic and non clinic-based services for injectables, differentials in injectable use by place of residence, and potential negative consequences of increased use of injectables are explored. Information described in this paper is intended to inform the Technical Consultation on Expanding Access to Injectable Contraception. (Excerpt) Language: English Keywords: DEVELOPING COUNTRIES | TECHNICAL REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | INJECTABLES | CONTRACEPTIVE USAGE | NEEDS | COMMUNITY-BASED DISTRIBUTION | CLINICAL DISTRIBUTION | PHARMACIES | CONTRACEPTIVE DISTRIBUTION | GEOGRAPHIC FACTORS | CONTRACEPTION CONTINUATION | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Economic Factors | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Health Facilities | Delivery of Health Care | Health Document Number: 331836 |
| 6. Title: Community-based distribution of injectable contraceptives. Approaches that work. Author: Futures Group International. Health Policy Initiative Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2009 Apr. [1] p. Abstract: Contraceptive prevalence rates in many sub-Saharan African countries surged in the mid-1990s. Much of this increase can be attributed to additional resources devoted to family planning (FP) programs and the uptake of specific methods, including injectable contraceptives. For example, use of injectables in Malawi grew from 2 percent in 1992 to 18 percent in 2004. Surveys in many African countries have found that women prefer injectable contraceptives; in some cases, preference for injectables is 2-1 over oral contraceptives and other methods. In recent years, however, these same countries have experienced a stagnation or decline in overall contraceptive prevalence. Particularly in rural areas, modern contraceptives are often scarce, and few trained professionals are available to provide FP services. One way to increase access to and use of family planning is to promote community-based distribution (CBD) of injectables. Countries struggling with stagnating contraceptive prevalence can begin to alterthis trend by training and empowering community-based workers to provide injectable contraceptives. Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | CONTRACEPTIVE PREVALENCE | INJECTABLES | ORAL CONTRACEPTIVES | COMMUNITY-BASED DISTRIBUTION | PRIVATE SECTOR | HEALTH SERVICES | Contraceptive Usage | Contraception | Family Planning | Contraceptive Methods | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Macroeconomic Factors | Economic Factors | Delivery of Health Care | Health Document Number: 331532 |
| 7. Title: Success story: Bangladesh averts a stock crisis with help from the USAID | DELIVER PROJECT. Author: John Snow [JSI]. DELIVER Source: Arlington, Virginia, JSI, DELIVER, 2009 Apr. [2] p. (USAID Deliver Project, Task Order 1) Abstract: In the fall of 2007, the Ministry of Health in Bangladesh faced a severe shortage of condoms in the public sector; countrywide stockouts were very likely. A shipment was underway, but despite negotiated contracts, the supplier made some last minute changes that were unacceptable to the Government of Bangladesh (GoB). While the GoB and the supplier continued to negotiate, the condom supply dwindled. December 2007 approached, and the condom stocks continued to go down. It soon became clear that negotiations with the supplier were not going to be resolved in time to head off a countrywide stockout of public sector condoms. As always, the Directorate General of Family Planning (DGFP) and the USAID | DELIVER PROJECT jointly monitored the consumption and pipeline for public sector products; the project kept the U.S. Agency for International Development (USAID) and other partners informed of the potential stock issues. The USAID | DELIVER PROJECT, in discussions with DGFP and local stakeholders, pursued various options for alleviating this short-term problem, including moving up other procurement ship dates and borrowing supplies. These solutions, however, would not be enough to fill the gap in time. At this point, after the project alerted USAID to the potential stockout, they agreed to airlift 6 million condoms to Bangladesh-in time to prevent a stockout. The project worked closely with the DGFP, with USAID in Washington and in Dhaka, as well as with the Bangladesh Social Marketing Company (SMC) to get the condoms into the country and through the various tiers of the supply chain. SMC, a recipient of USAID-donated condoms, agreed to receive and clear the emergency condom donation-the shipment came into the country quickly, without any disruption. In just one month, Bangladesh had received the USAID-donated condoms in-country, and the condoms were on their way through the supply chain to the end user. This action successfully averted a full blown stockout and gave the government time to sort out issues with the supplier. The contract negotiation was eventually completed and the first shipment arrived in-country in March 2008. At the time of delivery, condoms were still available because fewer condoms than usual were distributed during the shortages. Language: English Keywords: BANGLADESH | SUMMARY REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | CONDOMS | CONTRACEPTIVE SECURITY | CONTRACEPTIVE IMPORTATION | Developing Countries | Asia, Southern | Asia | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Contraceptive Availability | Family Planning Program Administration | Family Planning Programs Document Number: 339992 |
| 8. Title: USAID | DELIVER Project. No product? No program. Logistics for health. Author: John Snow [JSI]. DELIVER Source: Arlington, Virginia, JSI, DELIVER, 2009 Aug. [2] p. Abstract: The USAID | DELIVER PROJECT, a U.S. Agency for International Development (USAID)-funded project, works with national and international partners to increase the availability of essential health commodities for customers around the world. The project strengthens in-country supply chains and the host country's ability to manage them; works with partners to create a supportive policy environment for health commodities; and, upon request, procures and delivers health commodities. We work with a wide range of health products -- contraceptives and condoms; essential drugs; and select commodities for HIV and AIDS, laboratories, malaria, maternal and child health, infectious diseases, and avian influenza (AI). (Excerpt) Language: English Keywords: GLOBAL | SUMMARY REPORT | USAID | DELIVERY OF HEALTH CARE | LOGISTICS | TRANSPORTATION | CONDOMS | DRUGS | INFLUENZA | MALARIA PREVENTION | BED NETS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Health | Management | Organization and Administration | Economic Factors | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Viral Diseases | Diseases | Malaria | Parasitic Diseases | Parasite Control | Public Health Document Number: 331661 |
| 9. 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 |
| 10. Title: Public health procurement guide 2010. Author: United States. Agency for International Development [USAID]; John Snow [JSI]. DELIVER Source: Arlington, Virginia, JSI, DELIVER, 2009. [45] p. (USAID Contract No. GPO-I-01-06-00007-00) Abstract: USAID's Public Health Procurement Guide 2010 is an annual publication of current contraceptive and condom ordering procedures for missions. It includes USAID contraceptive ordering procedures and guidance on how to use logistics data and forecasts to calculate contraceptive requirements. Language: English Keywords: DEVELOPING COUNTRIES | MANUAL | STANDARDS | LOGISTICS | CONTRACEPTION | CONDOMS | COLD CHAIN | CONTRACEPTIVE DISTRIBUTION | DISTRIBUTIONAL ACTIVITIES | CONTRACEPTIVE SECURITY | Research Methodology | Management | Organization and Administration | Family Planning | Barrier Methods | Contraceptive Methods | Program Activities | Programs | Contraceptive Availability Document Number: 331472 |
| 12. 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 |
| 13. Title: WHO / USAID / FHI Technical Consultation: Expanding Access to Injectable Contraception, 15-17 June 2009, Room M405, WHO, Geneva. Author: World Health Organization [WHO]; United States. Agency for International Development [USAID]; Family Health International [FHI] Source: [Unpublished] 2009. 5 p. Abstract: The agenda for the consultation is presented. The objectives of the consultation were: To review systematically the evidence and programmatic experience on interventions designed to expand access to / provision of contraceptive injectables, focusing on non clinic-based services and programs; To reach conclusions on issues: (a) for which evidence is consistent and strong; (b) for which evidence is mixed; and (c) for which evidence is marginal or entirely lacking and, thus requires additional research; To document discussions and conclusions of the Consultation, including policy and program implications, and to disseminate these widely. Language: English Keywords: GLOBAL | TABLES AND CHARTS | CONFERENCES AND CONGRESSES | WHO | USAID | INJECTABLES | CONTRACEPTIVE AVAILABILITY | INTERVENTIONS | NEEDS | COMMUNITY-BASED DISTRIBUTION | CONTRACEPTION CONTINUATION | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Government Agencies | Contraceptive Methods | Contraception | Family Planning | Programs | Organization and Administration | Economic Factors | Nonclinical Distribution | Distributional Activities | Program Activities | Contraceptive Usage Document Number: 331853 |
| 14. Title: Knowledge, practices, and attitudes regarding emergency contraception among students at a university in Ghana. Author: Addo VN; Tagoe-Darko ED Source: International Journal of Gynaecology and Obstetrics. 2009 Jun;105(3):206-209. Abstract: An anonymous, self-administered, 39-item questionnaire was sent to 3,200 students. The sample size was stratified, and 2,292 students were randomly selected. Of the 71.6% of students who responded, 51.4% had heard of emergency contraception (EC). Among those, 19.4% thought EC consisted of contraceptive pills, 19.1% of "morning-after pills," and 12.8% of an intrauterine device. Only 4.2% had ever used EC, but 73.9% wished it were provided on campus. Of all the respondents, 90.9% called for the establishment of a reproductive health counseling center on campus. Language: English Keywords: GHANA | RESEARCH REPORT | KAP SURVEYS | CONTRACEPTIVE PREVALENCE SURVEYS | STUDENTS | UNIVERSITIES | EMERGENCY CONTRACEPTION | KNOWLEDGE | CONTRACEPTIVE USAGE | ATTITUDES | IUD | CONTRACEPTIVE PREVALENCE | COUNSELING | FAMILY PLANNING EDUCATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Family Planning Surveys | Family Planning | Education | Schools | Contraception | Sociocultural Factors | Psychological Factors | Behavior | Contraceptive Methods | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 330422 |
| 15. Peer Reviewed Title: Evaluation of mifepristone as a once a month contraceptive pill. Author: Agarwal M; Das V; Agarwal A; Pandey A; Srivastava D Source: American Journal of Obstetrics and Gynecology. 2009 May;200(5):e27-9. Abstract: OBJECTIVE: The purpose of this study was to assess the efficacy and safety of mifepristone as a contraceptive pill. STUDY DESIGN: A prospective case-control study was conducted in a tertiary care center of North India. The study group (n = 86) was given 200-mg mifepristone tablets on the 16th day of the menstrual cycle. The control group (n = 92) received combined oral contraceptive (COC) as per protocol. Subjects were followed for drug compliance, satisfaction, side effects, and failure. RESULTS: Acceptability of mifepristone was significantly higher in educated population (P < .001), with fewer side effects (P = .001), good satisfaction (P < .001), and higher compliance rate (P = .05). The oral contraceptive pill group had higher adverse biochemical parameters. CONCLUSION: Mifepristone can be used as a monthly contraceptive pill effectively. Language: English Keywords: INDIA | RESEARCH REPORT | ORAL CONTRACEPTIVES | RU-486 | TIME FACTORS | ADMINISTRATION AND DOSAGE | Asia, Southern | Asia | Developing Countries | Contraceptive Methods | Contraception | Family Planning | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Population Dynamics | Demographic Factors | Population | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341243 |
| 16. Title: Migration of an intrauterine contraceptive device into the sigmoid colon. Author: Al-Mukhtar RS; Al-Ali JA; Amin MM; Al-Sumait BM Source: Saudi Medical Journal. 2009 Apr;30(4):561-3. Abstract: We present a case of migrating copper-T intrauterine contraceptive device (IUCD) into the bowel wall at the recto-sigmoid junction, and the colonoscopic retrieval of the device. This case introduces the possibility of safe rectal retrieval of migrating IUCD implanted into the bowel wall. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | CASE STUDIES | INCIDENCE | WOMEN | IUD COMPLICATIONS | IUD MIGRATION | BLEEDING | PERFORATIONS | SAFETY | Studies | Research Methodology | Measurement | Demographic Factors | Population | IUD | Contraceptive Methods | Contraception | Family Planning | Signs and Symptoms | Diseases | Public Health | Health Document Number: 331021 |
| 17. Title: [Of office hysteroscopy for the removal of intrauterine device. Literature review] Histeroscopia de consultorio para la extraccion de dispositivo intrauterino. Author: Alanis Fuentes J; Amoroso Hernandez MA Source: Ginecologia Y Obstetricia De Mexico. 2009 Apr;77(4):197-201. Abstract: OBJECTIVE: To review the literature related to the hysteroscopic techniques such as outpatient diagnostic and therapeutic tools for the extraction of foreign bodies in patients with intrauterine device. METHOD: We searched the main electronic databases were searched for those words: hysteroscopy and intrauterine device in articles related to the removal of intrauterine devices by hysteroscopy. RESULTS: The loss or translocation of IUD is a common problem resulting from the large number of women who have applied. The importance of early diagnosis is to avoid, such as the inappropriate position of the device promotes an unwanted pregnancy, genital bleeding and injury to adjacent organs such as bowel and bladder. The assessment by ultrasound or X-rays, or both, allowing the device to locate and determine the desirability or otherwise of outpatient hysteroscopy (in practice) without anesthesia and with low morbidity for the patient or, well, resorting to other methods, and laparoscopy in the operating room. CONCLUSIONS: Hysteroscopy is an effective procedure for recovering intrauterine foreign bodies or hidden in properly selected patients. Language: Spanish Keywords: GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | HYSTEROSCOPY | IUD | CONTRACEPTIVE REMOVAL | CONTRACEPTIVE USE-EFFECTIVENESS | PROGRAM EFFECTIVENESS | Demographic Factors | Population | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Treatment | Contraceptive Effectiveness | Program Evaluation | Programs | Organization and Administration Document Number: 342313 |
| 18. Title: Headache induced by the use of combined oral contraceptives. Author: Allais G; Gabellari IC; Airola G; Borgogno P; Schiapparelli P; Benedetto C Source: Neurological Sciences. 2009 May;30 Suppl 1:S15-7. Abstract: Although combined oral contraceptives (COCs) are a safe and highly effective method of birth control, they may also give rise to problems of clinical tolerability in migraine patients. Indeed, headache is among the most common side effects reported with the use of COCs, frequently leading to their being discontinued. The latest International Classification of Headache Disorders identified at least two entities evidently related to the use of COCs, i.e., exogenous hormone-induced headache and estrogen-withdrawal headache. As to the former, the newest formulations of COCs are generally well tolerated by migraine without aura patients, but can worsen headache in migraine with aura patients. Headache associated with COCs, generally, tends to improve as their use continues. However, although it is not yet clear if there is an association between headache and the composition of COCs (both in the type and amount of hormones), it has been observed that the incidence of headache during COC use seems greater if migraine is associated with menstrual trigger. The estrogen-withdrawal headache is a headache that generally appears within the first 5 days after cessation of estrogen use and resolves within 3 days, even if in some cases it may appear on the sixth or seventh day after pill suspension and lasts more than 3 days. Language: English Keywords: ITALY | LITERATURE REVIEW | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, SIDE EFFECTS | HEADACHE | MIGRAINE | INCIDENCE | HORMONES | ESTROGENS | Developed Countries | Europe, Southern | Europe | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Safety | Safety | Public Health | Health | Signs and Symptoms | Diseases | Vascular Diseases | Measurement | Research Methodology | Endocrine System | Physiology | Biology Document Number: 342617 |
| 19. Title: Oral contraceptives in migraine. Author: Allais G; Gabellari IC; De Lorenzo C; Mana O; Benedetto C Source: Expert Review of Neurotherapeutics. 2009 Mar;9(3):381-93. Abstract: Combined oral contraceptives are a safe and highly effective method of birth control, but they can also raise problems of clinical tolerability and/or safety in migraine patients. It is now commonly accepted that, in migraine with aura, the use of combined oral contraceptives is always contraindicated, and that their intake must also be suspended by patients suffering from migraine without aura if aura symptoms appear. The newest combined oral contraceptive formulations are generally well tolerated in migraine without aura, and the majority of migraine without aura sufferers do not show any problems with their use; nevertheless, the last International Classification of Headache Disorders identifies at least two entities evidently related to the use of combined oral contraceptives: exogenous hormone-induced headache and estrogen-withdrawal headache. As regards the safety, even if both migraine and combined oral contraceptive intake are associated with an increased risk of ischemic stroke, migraine without aura per se is not a contraindication for combined oral contraceptive use. Other risk factors (tobacco use, hypertension, hyperlipidemia, obesity and diabetes) must be carefully considered when prescribing combined oral contraceptives in migraine without aura patients, in particular in women aged over 35 years. Furthermore, the exclusion of a hereditary thrombophilia and of alterations of coagulative parameters should precede any decision of combined oral contraceptive prescription in migraine patients. Language: English Keywords: ITALY | RESEARCH REPORT | CLIENTS | WOMEN | MIGRAINE | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTIVE SAFETY | CONTRACEPTIVE USE-EFFECTIVENESS | Developed Countries | Europe, Southern | Europe | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Vascular Diseases | Diseases | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Safety | Public Health | Health | Contraceptive Effectiveness Document Number: 330561 |
| 20. Title: Catching up on contraception. Author: Allen K Source: Australian Family Physician. 2009 Jun;38(6):380-2. Abstract: BACKGROUND: Providing contraceptive advice is a core activity in general practice. There have been numerous changes to the contraceptive options available in Australia over the past 10 years. It is important that general practitioners are aware of these changes so that they can advise patients appropriately. OBJECTIVE: This article examines the changes that have occurred in contraception over the past decade and discusses the implications of these changes to clinical practice. DISCUSSION: Up-to-date knowledge about how the combined oral contraceptive pill works is reflected in changes to packaging and formulations, with varying success. Other changes include the over-the-counter availability of emergency contraceptive pills and the new combined hormonal vaginal ring. There has been a resurgence in intrauterine device use and their insertion has Level 1 (nonprocedural) indemnity status in most medical defence organisations. Bleeding with long acting progestogen only contraception remains a problem and management options include antiprostaglandins, tranexamic acid, doxycycline, the combined oral contraceptive pill and removal of the device. Sterilisation remains an option for older men and women and newer methods are available. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | KNOWLEDGE | ORAL CONTRACEPTIVES, COMBINED | EMERGENCY CONTRACEPTION | SATISFACTION | VAGINAL RING | STERILIZATION, SEXUAL | INFORMED CHOICE | Oceania | Developed Countries | Sociocultural Factors | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Psychological Factors | Behavior | Contraceptive Usage Document Number: 341574 |
| 21. Peer Reviewed Title: Expanding access to intrauterine contraception. Author: Allen RH; Goldberg AB; Grimes DA Source: American Journal of Obstetrics and Gynecology. 2009 Jun 13; Abstract: The intrauterine device is a safe, highly effective, long-lasting, yet reversible method of contraception. Expanding access to intrauterine contraception is an important measure to reduce the rate of unintended pregnancy in the United States. Clinicians should consider intrauterine contraception in appropriate candidates, including women who are nulliparous, adolescent, immediately postpartum or postabortal, and desiring emergency contraception, and as an alternative to permanent sterilization. Barriers to intrauterine contraception such as requiring cervical cancer screening before insertion, routine testing for gonorrhea and chlamydial infection in low-risk women, or scheduling insertion only during menses are unnecessary. Language: English Keywords: UNITED STATES OF AMERICA | CRITIQUE | ADOLESCENTS, FEMALE | IUD | CONTRACEPTIVE AVAILABILITY | MISINFORMATION | CONTRAINDICATIONS | INSERTION | PAIN | IUD EXPULSION | NULLIPARITY | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Communication | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Parity | Fertility Measurements | Fertility | Population Dynamics Document Number: 341709 |
| 22. Title: Interventions for pain with intrauterine device insertion. Author: Allen RH; Bartz D; Grimes DA; Hubacher D; O'Brien P Source: Cochrane Database of Systematic Reviews. 2009;(3):CD007373. Abstract: BACKGROUND: Fear of pain during intrauterine device (IUD) insertion is a barrier to use of this contraceptive method. Interventions for pain during IUD insertion include non-steroidal anti-inflammatory drugs (NSAIDs), local cervical anesthetics, and cervical ripening agents such as misoprostol. OBJECTIVES: To review all randomized controlled trials that have evaluated a treatment for IUD insertion-related pain. SEARCH STRATEGY: We searched the computerized databases MEDLINE, POPLINE, CENTRAL, and EMBASE for relevant trials. We also examined reference lists of pertinent articles and wrote to known investigators for information about other published or unpublished trials. SELECTION CRITERIA: We included all randomized controlled trials in any language that evaluated a treatment for IUD insertion-related pain. The intervention could be compared to a placebo or another active intervention. DATA COLLECTION AND ANALYSIS: Two authors independently abstracted data from relevant trials and data were entered into RevMan 5.0 for analysis. For dichotomous variables, the Peto odds ratios with 95% confidence intervals was calculated. For continuous variables, the mean differences with 95% confidence interval was computed. MAIN RESULTS: Four trials met the inclusion criteria; the total number of participants was 2204. Nonsteroidal anti-inflammatory drugs of varying types and doses were not effective for reducing pain during IUD insertion. Misoprostol for cervical ripening did not reduce pain with IUD insertion in nulliparous women. Two trials evaluated pain that occurs after IUD insertion using nonsteroidal anti-inflammatory drugs. In one trial, naproxen taken prior to IUD insertion was effective in reducing pain compared with placebo in the first two hours after IUD insertion in mostly nulliparous women. However, this trial utilized the Dalkon Shield, an IUD with a wider diameter than modern IUDs. In another trial, ibuprofen 600 mg taken before IUD insertion did not show evidence of an effect on pain four to six hours after IUD insertion. AUTHORS' CONCLUSIONS: No interventions that have been properly evaluated reduce pain during or after IUD insertion. One poorly controlled trial suggested that topical lidocaine gel may reduce insertion-related pain and warrants further investigation. Language: English Keywords: UNITED STATES OF AMERICA | CHILE | DENMARK | SWEDEN | LITERATURE REVIEW | CLINICAL TRIALS | IUD | INSERTION | PAIN | DRUGS | ADMINISTRATION AND DOSAGE | MISOPROSTOL | Developed Countries | North America | Americas | Developing Countries | South America, Southern | South America | Latin America | Europe, Northern | Europe | Clinical Research | Research Methodology | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology Document Number: 342475 |
| 23. Peer Reviewed Title: Safety analysis of the diaphragm in combination with lubricant or acidifying microbicide gels: effects on markers of inflammation and innate immunity in cervicovaginal fluid. Author: Anderson DJ; Williams DL; Ballagh SA; Barnhart K; Creinin MD; Newman DR; Bowman FP; Politch JA; Duerr AC; Jamieson DJ Source: American Journal of Reproductive Immunology. 2009 Feb;61(2):121-9. Abstract: OBJECTIVE: Diaphragms are being considered for use with vaginal microbicide gels to provide enhanced protection against sexually transmitted pathogens. The purpose of this study was to determine whether use of a diaphragm with microbicide or placebo gel causes cervicovaginal inflammation or perturbations in cervicovaginal immune defense. METHOD OF STUDY: Eighty-one non-pregnant women were randomized into three groups and instructed to use Milex (CooperSurgical, Inc., Trumbull, CT, USA)diaphragms overnight for 14 days in combination with one of the two acid-buffering microbicide gels [ACIDFORM (Instead Inc., La Jolla, CA, USA) or BufferGel(trade mark) (BG; ReProtect Inc., Baltimore, Maryland)] or placebo gel (K-Y Jelly); Personal Products Inc., Raritan, NJ, USA). Cervicovaginal lavages (CVLs) were performed prior to study entry and on days 8 and 16. Nine soluble mediators of vaginal inflammation or immune defense were measured in CVLs by Bio-Plex or ELISA. RESULTS: Use of diaphragms with placebo ormicrobicide gel was not associated with increased levels of inflammation markers. Concentrations of secretory leukocyte protease inhibitor (SLPI) were markedly reduced in the BG group. CONCLUSION: Daily use of a diaphragm with placebo or acidifying microbicide gel did not cause cervicovaginal inflammation. However, diaphragm/BG use was associated with markedly reduced levels of SLPI, an important mediator of innate immune defense. Further studies are warranted to establish the safety of diaphragm/microbicide gel combinations. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | CASE CONTROL STUDIES | MICROBICIDES | VAGINAL GEL | LUBRICANTS | IMMUNITY, NATURAL | CONTRACEPTIVE SAFETY | VAGINAL DIAPHRAGM | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Studies | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Vaginal Spermicides | Contraceptive Methods | Contraception | Family Planning | Ingredients and Chemicals | Immunity | Immune System | Physiology | Biology | Safety | Public Health | Vaginal Barrier Methods | Barrier Methods Document Number: 330234 |
| 24. 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 |
| 25. 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; 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 |
| 26. Title: Hormonal methods of contraception for youth. More effective strategies are needed to improve access and encourage consistent use. Author: Aradhya K; Lebetkin E Source: Research Triangle Park, North Carolina, Family Health International [FHI], Interagency Youth Working Group, 2009 May. [4] p. (YouthLens on Reproductive Health and HIV / AIDS No. 30) Abstract: Youth, defined here as people ages 10 to 24 years old, need better access to contraception. The decreasing age of menarche and increasing age of marriage have created an ever-widening window of time for premarital sexual intercourse and pregnancies. Hormonal methods of contraception -- including oral contraceptive pills, injectables, and implants -- are among the most effective methods of preventing unintended pregnancies. They are generally well known among youth and, as an alternative to condoms, allow a young woman to control her risk of pregnancy. (Excerpts) Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | YOUTH | ORAL CONTRACEPTIVES | INJECTABLES | CONTRACEPTIVE IMPLANTS | PREGNANCY, UNPLANNED | PREVENTION AND CONTROL | STIGMA | HEALTH FACILITIES | PROGRAM ACCESSIBILITY | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Age Factors | Population Characteristics | Contraceptive Methods | Contraception | Family Planning | Reproductive Behavior | Fertility | Diseases | Social Problems | Sociocultural Factors | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration Document Number: 331499 |
| 27. 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 |
| 28. Title: Combined oral contraceptive pills for treatment of acne. Author: Arowojolu AO; Gallo MF; Lopez LM; Grimes DA; Garner SE Source: Cochrane Database of Systematic Reviews. 2009;(3):CD004425. Abstract: BACKGROUND: Acne is a common skin disorder among women. Although no uniform approach to the management of acne exists, combination oral contraceptives (COCs), which contain an estrogen and a progestin, often are prescribed for women. OBJECTIVES: To determine the effectiveness of combined oral contraceptives (COCs) for the treatment of facial acne compared to placebo or other active therapies. SEARCH STRATEGY: We searched for randomized controlled trials of COCs and acne in the computerized databases of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, POPLINE, and LILACS. We also searched for clinical trials in ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP). We wrote to authors of identified trials to seek any unpublished or published trials that we might have missed. SELECTION CRITERIA: All randomized controlled trials reported in any language that compared the effectiveness of a COC containing an estrogen and a progestin to placeboor another active therapy for acne in women were eligible. DATA COLLECTION AND ANALYSIS: We extracted data on total and specific (i.e., open or closed comedones, papules, pustules and nodules) facial lesion counts; acne severity grades; global assessments by the clinician or the participant and discontinuation due to adverse events. Data were entered and analyzed in RevMan. MAIN RESULTS: The search yielded 25 trials: 7 placebo-controlled trials made 4 different comparisons, 17 trials made 13 comparisons between 2 different COC regimens, and 1 additional trial compared a COC to an antibiotic. COCs reduced acne lesion counts, severity grades and self-assessed acne compared to placebo. Differences in the comparative effectiveness of COCs containing varying progestin types and dosages, though, were less clear. COCs that contained chlormadinone acetate or cyproterone acetate improved acne better than levonorgestrel, although this apparent advantage was based on limited data. A COC with cyproterone acetate might result in better acne outcomes than one with desogestrel; however, the three studies comparing these COCs produced conflicting results. Likewise, levonorgestrel showed a slight improvement over desogestrel in acne outcomes in one trial, but a second trial found the COC groups were similar. AUTHORS' CONCLUSIONS: The four COCs evaluated in placebo-controlled trials are effective in reducing inflammatory and non-inflammatory facial acne lesions. Few important differences were found between COC types in their effectiveness for treating acne. How COCs compare to alternative acne treatments is unknown since limited data were available regarding this question. Language: English Keywords: GLOBAL | LITERATURE REVIEW | CLINICAL TRIALS | COMPARATIVE STUDIES | WOMEN | ACNE | TREATMENT | ORAL CONTRACEPTIVES, COMBINED | ADMINISTRATION AND DOSAGE | ANTIBIOTICS | HORMONES | Clinical Research | Research Methodology | Studies | Demographic Factors | Population | Dermatitis | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Drugs | Endocrine System | Physiology | Biology Document Number: 341912 |
| 29. 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 |
| 30. 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 |
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