Background: In Burkina Faso, efforts have been made between 2010 and 2015 to address the low levels of contraceptive utilization. However, the socio-cultural context in the country still reinforces traditional gender ...Background: In Burkina Faso, efforts have been made between 2010 and 2015 to address the low levels of contraceptive utilization. However, the socio-cultural context in the country still reinforces traditional gender roles, low status for women, and a strong desire for larger families. The objectives of this study are twofold: 1) to analyze the trends in reversible modern contraceptive prevalence, and 2) to identify the factors influencing the use of reversible modern contraceptives, comparing the urban and rural areas. Data and Methods: We conducted an analysis using data from Burkina Faso sourced from the 2010 Demographic and Health Survey (DHS) and the 2015 Demographic and Health Module (DHM). The 2010 DHS received responses from 17,087 women aged 15 - 49 years, achieving a response rate of 98.4%. Similarly, the 2015 DHM garnered responses from 11,504 women aged 15 - 49 years, with a response rate of 96.6%. Results: Our findings revealed that while advancements were observed in urban areas, the majority of underprivileged women still faced limited access to modern contraception. Moreover, we did not observe any significant interaction effects between age and parity with the year of the survey. However, there was a slight decrease in the impact of marital status, although the difference between married and non-married women remained significant in 2015. It is noteworthy that family planning discussions and approval continued to play crucial roles. Conclusion: The initiatives to subsidize contraceptive costs and establish mobile clinics have proven inadequate in facilitating rural, impoverished, and young women’s access to modern contraception. Additional endeavors are required to enhance geographical accessibility to modern contraceptives by expanding the availability of supply sources, particularly in rural areas. Furthermore, providing psychosocial support has the potential to empower women in making informed contraceptive decisions and exercising greater control over their reproductive choices.展开更多
Objective: To provide an evidence-based, consistent assessment of the burden of breast cancer attributable to reproductive factors (RFs, including nulliparity, mean number of children, age at first birth and breastf...Objective: To provide an evidence-based, consistent assessment of the burden of breast cancer attributable to reproductive factors (RFs, including nulliparity, mean number of children, age at first birth and breastfeeding), use of oral contraceptives (OCs, restricted to the age group of 15-49 years), and hormone replacement therapy (HRT), as well as of the burden of ovarian cancer attributable to the mean number of children in China in 2005. Methods: We derived the prevalence of these risk factors and the relative risk of breast and ovarian cancer from national surveys or large-scale studies conducted in China. In the case of RFs, we compared the exposure distributions in 2001 and counterfactual exposure. Results: Exposure of RFs in 2002 was found to account for 6.74% of breast cancer, corresponding to 9,617 cases and 2,769 deaths, and for 2.78% of ovarian cancer (712 cases, 294 deaths). The decrease in mean number of children alone was responsible for 1.47% of breast cancer and 2.78% of ovarian cancer. The prevalence of OC use was 1.74% and the population attributable fraction (PAF) of breast cancer was 0.71%, corresponding to 310 cases and 90 deaths. The PAF of breast cancer due to HRT was 0.31%, resulting in 297 cases and 85 deaths. Conclusion: RFs changes in China contributed to a sizable fraction of breast and ovarian cancer incidence and mortality, whereas HRT and OCs accounted for relatively low incidence of breast cancer in China.展开更多
The aim of this manuscript is to review the action and adverse effects of combined oral contraceptives(COCs)on ocular tissues.The percentage of unwanted pregnancies and the subsequent abortions make contraception cr...The aim of this manuscript is to review the action and adverse effects of combined oral contraceptives(COCs)on ocular tissues.The percentage of unwanted pregnancies and the subsequent abortions make contraception crucial worldwide.Over 100 million women around the world use common contraceptive methods,including intrauterine devices,combined estrogen and progestin oral contraceptives,as well as progestin only preparations(oral contraceptives,implants or injections).COCs are widely used for contraception,but they are also indicated in menorrhagia,endometriosis,acne and hirsutism,fibroid uterus and premenstrual syndrome.However,they have been associated with high rates of cardiovascular events,venous thromboembolic disease,ischemic strokes and breast cancer.The incidence of COCs-related ocular complications is estimated to be 1 in 230 000,including dry eye symptoms,corneal edema,lens opacities and retinal neuro-ophthalmologic or vascular complications.We may infer that the serious ocular complications of COCs can be prevented by eliminating the estrogen dosage and choosing third-generation progestins.In any case,doctors should take into consideration the systemic and ocular history of the patients before selecting any method of contraception.展开更多
Polycystic ovary syndrome is characterized by ovulatory dysfunction, androgen excess and polycystic ovaries and is associated with hypertension, diabetes, metabolic syndrome and cardiovascular events. Oral contracepti...Polycystic ovary syndrome is characterized by ovulatory dysfunction, androgen excess and polycystic ovaries and is associated with hypertension, diabetes, metabolic syndrome and cardiovascular events. Oral contraceptives constitute first-line treatment, particularly when symptomatic hyperandrogenism is present. However, these drugs are associated with cardiovascular events and hypersensitivity reactions that pose problem in differential diagnosis and therapy. We present a 14 year-old female with polycystic ovary syndrome taking oral contraceptive and suffering from recurrent coronary ischemic attacks with increased eosinophils, and troponin levels suggesting Kounis syndrome.展开更多
In a recent systematic review and meta-analysis of observational studies,the author found potential errors in the selection and extraction processes.The recalculated summary relative risks and the results of a dose-re...In a recent systematic review and meta-analysis of observational studies,the author found potential errors in the selection and extraction processes.The recalculated summary relative risks and the results of a dose-response metaanalysis showed that oral contraceptive use may not be associated with the risk of pancreatic cancer in women.展开更多
The aim is to evaluate the influence of oral contraceptive intake and menstrual cycle on the electrical activity and pressure pain threshold from anterior temporal and masseter muscles. Twenty-eight women on reproduct...The aim is to evaluate the influence of oral contraceptive intake and menstrual cycle on the electrical activity and pressure pain threshold from anterior temporal and masseter muscles. Twenty-eight women on reproductive age were selected, 13 OC users and 15 nonusers. They were weekly submitted to electromyography and algometry of the anterior temporal and masseter muscles during three consecutive menstrual cycles. Electrical activities at rest position and PPTs of temporal and masseter muscles were not affected by menstrual cycle or by OCs uses. Comparison between groups demonstrated that working side electrical activity was increased in OC users in both muscles, except during lutheal phase for the anterior temporal. However, comparison within weeks did not demonstrate statistical difference. It was suggested that, in healthy women, oral contraceptive use may influence electrical activity, but different phases of the cycle may not.展开更多
Background: Efforts have been made in Burkina Faso, a French-speaking country, since 2010 to improve healthcare access and provide affordable contraceptive methods to women. With the increasing prevalence of modern co...Background: Efforts have been made in Burkina Faso, a French-speaking country, since 2010 to improve healthcare access and provide affordable contraceptive methods to women. With the increasing prevalence of modern contraceptives in Burkina Faso, it is important to examine the socio-demographic factors that contribute to this new pattern of contraceptive use. This study aims to analyze the changes in socio-demographic factors associated with long-term contraceptive use and provide scientific evidence to guide policy development and action planning in family planning. Data and Methods: We utilized data from the 2010 Demographic and Health Survey, which included 17,087 women aged 15 - 49 years, and the 2015 Demographic and Health Module, which included 11,504 women in the same age group. For the analysis of contraceptive use, we focused on women who were in need of contraception (either met or unmet), of reproductive age, non-pregnant, and either married or sexually active but not married. We included users of modern reversible methods and excluded non-users, as well as users of traditional or permanent methods. Results: Our findings revealed a high prevalence of long-term contraceptive use across all categories;however, certain challenges were identified, such as lower levels of information about contraceptive methods among users and the persistence of inequalities. Family planning discussions and partner approval did not influence long-term contraceptive choice. Additionally, some providers selectively offered specific methods based on women’s life course characteristics, such as parity and marital status, despite evidence suggesting that young and nulliparous women can effectively use long-term methods. Conclusion: Given the high effectiveness of long-term contraceptive methods, it is crucial to address barriers that hinder their utilization among young and nulliparous women, as well as those who desire to delay pregnancy. Efforts should focus on improving knowledge and dispelling misconceptions surrounding long-term methods. Providers play a pivotal role in this process by adopting counseling strategies that enhance users’ understanding and facilitate informed decision-making regarding contraceptive options.展开更多
Objective To explore whether the changes on lipids profile induced by oral contraceptives could be reduced through alternatively administering two oral contraceptives of different formulations (either predominant in p...Objective To explore whether the changes on lipids profile induced by oral contraceptives could be reduced through alternatively administering two oral contraceptives of different formulations (either predominant in progestogen or estrogen) Materials &. Methods A total of 59 women aged 25- 45 were divided into two treatment groups.The subjects in Group A received oral contraceptive A (Oc A: NET 0. 600 mg + EE 0. 035 mg) and B (OcB: LNG 0. 15mg + EEO. 03 mg) alternatively during 12 treatment cycles. Each contraceptive was administrated for three cycles consecutively with starting from OcA. The subjects in the B group received OcB only during 12 treatment cycles. Fasting blood were drawn before treatment, at the end of each trimester treatment and at the end of one cycle after stopping treatment respectively. The concentrations of lipids and apolipoproteins were measured.Results OcA increased the levels of triglyceride(TG) , total cholesterol (TC), high density lipoprotein-cholesterol(HDL-c) , and apolipoprotein AI (apo AI) with statistical significance, whereas OcB significantly decreased all parameters above. As compared with the control group, the overall mean of variation in the study group was much less than that of the control group.Conclusion It indicates that the impacts of oral contraceptives on lipids profile could be moderated by means of alternatively administering Ocs of two different formulations , with estrogen-dominant or progestogen-dominant.展开更多
Aim We herein provide an umbrella review of systematic reviews(SR)and meta-analyses(MAs)of studies of the association of oral contraceptives(OCs)with the risks of multiple health outcomes in women and their descendant...Aim We herein provide an umbrella review of systematic reviews(SR)and meta-analyses(MAs)of studies of the association of oral contraceptives(OCs)with the risks of multiple health outcomes in women and their descendants.Methods Two investigators retrieved publications from four electronic databases,including PubMed,Embase,Web of Science,and the Cochrane Database of Systematic Reviews up to March 15,2021.For each association,random/fixed-effects summary effect size and 95%CIs were estimated.Heterogeneity and publication bias were also assessed.The method quality and evidence level for each publication were respectively assessed utilizing the AMSTAR and GRADE checklists.Results A total of 68 articles with 82 unique outcomes were included based on the eligibility criteria.Numerous lines of evidence indicated that OCs had effects on nearly all cardiovascular disease-related outcomes,especially for cerebral venous sinus thrombosis(OR=7.59,95%CI:3.82-15.09).Harmful associations were also found for vulvar vestibulitis(OR=2.31,95%CI:1.03-5.16),preterm birth(OR=1.17,95%CI:1.07-1.27),miscarriage(OR=1.13,95%CI:1.02-1.72),ulcerative colitis(OR=1.22,95%CI:1.06-1.41),Crohn's disease(OR=1.24,95%CI:1.09-1.40),alveolar osteitis(RR=1.86,95%CI:1.66-2.08),dry socket(RR=1.8,95%CI:1.33-2.43),and interstitial cystitis(OR=2.1,95%CI:1.26-3.49).However,oral contraceptives did not increase the risk of cancer except breast and cervical cancer.Maternal exposure to OCs was linked to an increased risk for the development of respiratory atopic disorders such as asthma(OR=1.1,95%CI:1.02-1.19)and rhinitis(OR=1.34,95%CI:1.07-1.68).Conclusion In summary,although their use obviously reduces the risk of pregnancy-and parturition-related morbidity and mortality for women,OCs were frequently related to more harm than benefit in terms of other health outcomes.This was true for both women and their descendants in this umbrella review.More large-scale prospective studies analysing different doses,structures,and durations of treatment with estrogen and progestin are needed to confirm these effects.展开更多
Considerable efforts have been made to develop a male contraceptive and the studies have provided very useful infor-mation in this field. At least five different strategies to develop a male contraceptive have been pu...Considerable efforts have been made to develop a male contraceptive and the studies have provided very useful infor-mation in this field. At least five different strategies to develop a male contraceptive have been pursued, namely: inhi-bition of sperm production, interference with sperm function, interruption of sperm transport, prevention of sperm de-position, and prevention of sperm-egg interaction. Of all these approaches, inhibition of sperm production by using an-drogens either alone or in combination with progestins have given the most encouraging results. A nmnber of clinicaltrials substantiate that it is indeed possible to have a reversible, effective and safe hormonal method of contraception. Apostmeiotic and epididymal approach to interfere with sperm function or the secretory and metabolic processes of theepididymis is another attractive option of male contraceptive development. A number of chemical compounds have beenidentified which interfere with sperm function in the epididymis without affecting sperm production, however, the com-pounds evaluated so far were found to be toxic. Interruption of sperm transport through the vas either by vasectomy orpercutaneous intmvasal injection of liquids which form cure-in-place plugs is also an attractive option. However, re-versibility of the methods is of concern in their wide scale use. The major constraint in developing a long-acting male contraceptive seems to be the need for greater investment forproduct development. The clinical trials for evaluating the efficacy and safety of the new products and formulationsstretch over several years and require enormous financial commitment. Nevertheless, the long-term gain of having along-acting reversible contraceptive for men is far greater than the financial commitments over few years. Male attitudetowards using methods of family planning is much more favourable than originally believed. The pharmaceutical indus-try as well as the health care providers therefore have a greater responsibility. For early development of a contraceptivefor men, it is essential to increase investment and simplify the drug regulatory procedures. The advent of newer tech-nologies coupled with the convergent efforts of scientists will certainly make it possible to have an effective, safe andreversible male contraceptive in the near future.展开更多
QRAL contraceptives are widely used to prevent pregnancy. A number of studies have dem- onstrated the increased risk of venous throm- boembolism in women taking oral contracep-tives.1, 2 Pulmonary embolism (PE) and ...QRAL contraceptives are widely used to prevent pregnancy. A number of studies have dem- onstrated the increased risk of venous throm- boembolism in women taking oral contracep-tives.1, 2 Pulmonary embolism (PE) and deep vein throm- bosis (DVT) are two clinical presentations of venous thromboembolism which share the same predisposing factors.3 This article described a female patient who taked oral contraceptives and had an unhealthy life habit de- veloped PE and DVT. CASE DESCRIPTION展开更多
Based on the data from the survey of 7826 young couples in two districts of shanghai, we analyzed the acceptability of oral pill, IUD, condom and injection in women. The results showed that 63.4% of subjects were unwi...Based on the data from the survey of 7826 young couples in two districts of shanghai, we analyzed the acceptability of oral pill, IUD, condom and injection in women. The results showed that 63.4% of subjects were unwilling to use pill and 5.7% were unwilling to use injection, mainly for the reasons that the pill was 'harmful to health' and the 'cause of obesity', 8.7% of subjects were unwilling to use IUD, mainly for the reasons of the 'cause of menorrhagia or spotting' and 'being easy to fail', 6.2% of subjects were unwilling to use condom, mainly for the reasons of 'interference with intercourse' and 'inconvenience in use'. The most important source of getting the information was 'heard from person's talking'.Simple variate and Logistic analysis showed that women's age at marriage, education, occupation, contraceptive knowledge score, history of using the contraceptives,some women's traits etc. affected the acceptability of the contraceptives. The study implies that it is necessary to strengthen provision of contraceptive knowledge for young couples and to make them have correct understanding of the side effects of contraceptives for improving family planning program.展开更多
<b>Introduction:</b> Pregnancies that occur during the first year postpartum are more likely to be unplanned. This leads to an increased risk of adverse maternal and perinatal outcomes. However, modern con...<b>Introduction:</b> Pregnancies that occur during the first year postpartum are more likely to be unplanned. This leads to an increased risk of adverse maternal and perinatal outcomes. However, modern contraceptive use during this period helps to reduce unplanned pregnancies and its associated adverse outcomes. There is scant data on postpartum contraceptives in pastoral communities in Tanzania. This study aimed to assess awareness and factors associated with postpartum modern contraceptives use among women of reproductive age in Bukombe District, Geita Region. <b>Method: </b>A community based cross-sectional study was conducted in a predominant pastoral community of Bukombe district in Geita region in north-western Tanzania from May-June 2018. A total of 511 postpartum women who were in their first year after child birth were studied. A multistage sampling technique was used to select study participants. Data analysis was performed using SPSS version 21. Multivariable logistic regression analysis was used to determine independent predictors of postpartum modern contraceptive use. <b>Results: </b>Most (97.3%) of the participants were aware about modern contraceptives. The prevalence of postpartum modern contraceptive use was 11.9%. The most frequent used contraceptive method was Implant 6.5%. Majority (75%) of women started to use the contraceptive at the first three months after delivery. Living in urban (AOR = 1.84, 95% CI: 1.20 - 3.79), business women’s (AOR = 2.34, 95% CI: 1.31 - 2.28), having last born aged 3 - 4 months (AOR = 3.30, 95% CI: 1.11 - 9.85) and menses resumption (AOR = 9.23, 95% CI: 3.60 - 23.72) were associated with postpartum modern contraceptive use. Fear of side effects, poor knowledge about contraceptives, husband restrictions, distance to health facility and availability of contraceptive were the barriers for use of contraceptive use. <b>Conclusion:</b> We found low uptake of postpartum modern contraceptive use in this population. Numerous factors were associated with modern contraceptive use. Therefore, health communication targeting this group is warranted to improve modern contraceptive uptake.展开更多
Hormonal contraceptives (HC) are thought to play a role in the pathogenesis of cardiovascular diseases. The study evaluated the use of HC as a primary </span><span style="font-family:Verdana;">ca...Hormonal contraceptives (HC) are thought to play a role in the pathogenesis of cardiovascular diseases. The study evaluated the use of HC as a primary </span><span style="font-family:Verdana;">cause of preeclampsia (PE) among Ghanaians. This study comprised 30</span><span style="font-family:Verdana;"> preec</span><span style="font-family:Verdana;">lamptic women and 30 healthy normotensive pregnant women with over 20</span><span style="font-family:Verdana;"> weeks of gestation at the Comboni Hospital, Ghana using a randomized </span><span style="font-family:Verdana;">case-control </span><span style="font-family:Verdana;">study. Blood pressure, weight, height, socio-demographics, medical and previous obstetric history were taken and recorded. Blood samples were collected for the estimation of homocysteine and fasting lipids. Estimated foetal weight (EFW) and infant birthweight (BWT) were obtained from maternal records. This study was carried out in 2019.</span><b> </b><span style="font-family:Verdana;">80.0% of women with PE used the hormonal contraceptive “depot medroxyprogesterone acetate” (DMPA) prior to pregnancy. The use of DMPA was associated with about thirty-fold increase in the odds of developing PE (OR = 29.71, p</span></span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001). Systolic blood pressure (P</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001), diastolic blood pressure (P</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001), triglycerides (P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.024), LDL-C (P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.026), and homocysteine levels (P</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001) were significantly elevated in the PE cases than the normal pregnant (NP) women, whilst EFW (P</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001), BWT (P</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001) and HDL-C levels (P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001) were significantly reduced in the PE cases when compared to NP women. 50% and 47% of PE cases had intrauterine growth restriction and low birthweight infants, respectively. In conclusion, DMPA use predisposes women to a high risk of developing PE. DMPA could partly contribute to endothelial dysfunction, hyperhomocysteinaemia, dyslipidaemia and excessive weight gain, all of which characterize PE.展开更多
The use of hormonal contraceptives has been implicated in the depletion of serum antioxidants and resultant promotion of oxidative stress which is associated with various disorders including cardiovascular disease and...The use of hormonal contraceptives has been implicated in the depletion of serum antioxidants and resultant promotion of oxidative stress which is associated with various disorders including cardiovascular disease and cancer. This study investigated serum total antioxidant status (TAS) in women taking hormonal contraceptives and compared their results with non-contraceptive users (age- and sex-matched). Sixty women aged 30 - 45 years, were enrolled for the study which included forty-five users of hormonal contraceptives from the Planned Parenthood Federation of Nigeria, Isolo, Lagos state and fifteen age-matched, apparently healthy, non-contraceptive users from the same geographical location were selected as controls. The in vitro determination of the serum total antioxidant status (TAS) was performed using Biorex enzymatic kit. Data obtained were statistically analyzed using student’s t-test and P < 0.05 was considered significant. The serum levels of TAS in the users of hormonal contraceptives were significantly lower than non-users (P < 0.05). The study concluded that women on hormonal contraceptives especially those taking either combined oral or combined injectable contraceptives were at risk of developing disorders associated with reduced levels of serum antioxidants.展开更多
Modern women have increased options for birth control with the development of Long Acting Reversible Contraceptives (LARCs). These methods are reliable, easy to use, and require less daily maintenance while providing ...Modern women have increased options for birth control with the development of Long Acting Reversible Contraceptives (LARCs). These methods are reliable, easy to use, and require less daily maintenance while providing contraception for an extended period of time. However, despite the surge of LARCs as contraceptive options, the prevalence of unintended pregnancies is still alarmingly high in the United States. As LARCs are the most effective reversible method of birth control at preventing pregnancy, and therefore the potential social, financial, and medical complications associated, we examined whether social determinants of health play a role in LARC usage. While parity and marriage do not seem to affect LARC utilization, increased research is needed to determine the effects of race. Age can affect the type of LARC implemented, as younger women prefer implants to intrauterine devices (IUDs). Insurance coverage was an apparent influencer of LARC usage, as low out-of-pocket costs translate to increased utilization. This is linked to socioeconomic status (SES), as lower SES is associated with decreased access to healthcare in general. Increased research is needed in order to draw conclusions about the effects of education, intimate partner violence, geographic location, and other SDH on LARC usage.展开更多
Progestogen-only injectable contraceptive is a highly effective, long lasting and reversible agent of fertility control. The objective is to determine the profile of the acceptors, side effects and indication for disc...Progestogen-only injectable contraceptive is a highly effective, long lasting and reversible agent of fertility control. The objective is to determine the profile of the acceptors, side effects and indication for discontinuation of progestogen-only injectable contraceptives at UCTH, Calabar. This was a retrospective study of the clients who used progestogen-only injectable contraceptives at the family planning unit between 1<sup>st</sup> January 2008 and 31<sup>st</sup> December 2014. A total of 1392 clients used the injectable progestogen-only contraceptive out of 5986 total contraceptive users giving the prevalence rate of 23.3% over the period. Of these, 60.4% of the clients accepted the depot medroxyprogesterone acetate, while 39.6% accepted the norethisterone enanthate. It was mostly utilized by multiparous women, clients with tertiary education and those in their third decade of life. Secondary amenorrhea was the commonest side effect in 47.7% of the clients. Over the study period, 243 (19.8%) discontinued the method and 48.1% discontinued due to secondary amenorrhea while 31.4% was due to desire to get pregnant. Progestogen-only injectable contraceptive was associated with multiple side-effects, with secondary amenorrhea being the most common, and menstrual irregularity was the main reason for discontinuation. Providing adequate information to clients about this method of contraception and its probable side effects, supportive counseling during initiation of contraception and re-enforcement during follow-up visit can go a long way in enhancing patient satisfaction and hence continuation of progestogen-only injectable contraceptive despite minor side effects.展开更多
Objective: Contraception has gained gradual popularity in many parts of the developing world including Pakistan. Despite this increase in acceptance, the birth rate remains high. Failure of contraception has been repo...Objective: Contraception has gained gradual popularity in many parts of the developing world including Pakistan. Despite this increase in acceptance, the birth rate remains high. Failure of contraception has been reported in the literature, which made us aim to conduct this study. The efficiency of hormonal contraceptives in the study area was assessed and this is the first report from Pakistan. Methods: A total of 200 women (aged 20-30 and 31-40 years;n = 100 each) with minimum consistent use of hormonal contraceptives in the form of pills (Combined oral contraceptives) for 12 months were enrolled in this study. Blood samples were collected from women of each age group and corresponding control groups (n = 100) from local hospitals and reproductive health service center. Serum levels of the fertility hormones viz leutinizing and follicle stimulating hormones were measured through ELISA technique. Results: Our data revealed that over all in the both age groups, 72% women had normal, 16% increased and 12% showed decreased levels of leutinizing hormone (p > 0.05) and 67% women showed normal, 33% showed decreased and no increased levels were found for follicle stimulating hormone (p > 0.05). No age-wise significant difference in response was observed among both the age groups tested. Conclusion: Statistically insignificant difference in serum leutinizing hormone and follicle stimulating hormone seen among both the age groups of hormonal contraceptive users and control group indicates less effective hormonal contraception response in the study area.展开更多
Objective To evaluate the prevalence of functional ovarian cysts in users of two different types of contraceptive implants. Methods A total of 239 women were enrolled at 3 months of use of the etonogestrelreleasing ...Objective To evaluate the prevalence of functional ovarian cysts in users of two different types of contraceptive implants. Methods A total of 239 women were enrolled at 3 months of use of the etonogestrelreleasing implant (Implanon) and the levonorgestrel-releasing implant (Jadelle). Bimanual pelvic examination and vaginal ultrasound were performed during routine 3, 6 and 12-month visits of asymptomatic women(control group). Women with ovarian cysts (or enlarged ovarian follicles 〉25 mm) (cysts group) were assessed weekly until disappearence or reduction of the image (including estradiol (E2) and progesterone measurement and women with no ovarian enlargement underwent same evaluation for the same period of time. Results Ovarian cysts were detected in 5.1% and 13.0% of users of Implanon and Jadelle, respectively, at 3rd month. At the 6th month of use, prevalences were 7.1% and 7.8%, and at 12th month rates were 25.7% and 14.7% in the two groups, respectively. E2 levels were significantly higher in cysts group than in control group. The time until disappearance of the ovarian cyst was similar in Implanon and Jadelle group. There were more cases of menorrhagia in patients rveth ovarian cysts than in patients with no ovarian enlargement. Conclusions The finding of ovarian cysts or enlarged ovarian follicles during the first year of use of Implanon and Jadelle implants is common and transient and should not be interpreted as a pathologic ovarian cyst. No further medical interventions are necessary.展开更多
Objectives: To determine the percentage of women who accepted a LARC after abortion, specify the interval time for the insertion of the LARC and compare such interval time with that of injectable and oral contraceptiv...Objectives: To determine the percentage of women who accepted a LARC after abortion, specify the interval time for the insertion of the LARC and compare such interval time with that of injectable and oral contraceptives. Patients and Methods: This is a prospective, descriptive and comparative study conducted in Libreville (Gabon), from February 1, 2013 to August 31, 2013. After receiving post-abortion care (PAC), all patients with stable general states were counseled about three types of contraceptive methods: combined oral contraceptive pills, LARCs (Jadelle? implants, Copper IUDs) and injectable Medroxyprogesterone Acetate (DMPA). Results: 231 women received PAC and among them 215 (93%) wanted to use one of the three proposed contraceptive methods. At the end of the study, only 193 women (89.7%) used contraception and 22 others (10.3%) abandoned their intentions. LARCs were used by 31 (16.0%) women. The average period for the insertion of LARCs was 15.4 ± 15.5 days with extremes of 1 to 53 days. This period for the insertion of LARCS was significantly longer than that of other methods (p < 0.001). LARCs were inserted more often after the 2nd day than immediately (same day) with a highly significant difference (p < 0.0001). Conclusion: LARCs could constitute an appropriate approach to reducing unintended pregnancies in Gabon. However, in order to increase their rates of use, it is necessary to improve women awareness.展开更多
文摘Background: In Burkina Faso, efforts have been made between 2010 and 2015 to address the low levels of contraceptive utilization. However, the socio-cultural context in the country still reinforces traditional gender roles, low status for women, and a strong desire for larger families. The objectives of this study are twofold: 1) to analyze the trends in reversible modern contraceptive prevalence, and 2) to identify the factors influencing the use of reversible modern contraceptives, comparing the urban and rural areas. Data and Methods: We conducted an analysis using data from Burkina Faso sourced from the 2010 Demographic and Health Survey (DHS) and the 2015 Demographic and Health Module (DHM). The 2010 DHS received responses from 17,087 women aged 15 - 49 years, achieving a response rate of 98.4%. Similarly, the 2015 DHM garnered responses from 11,504 women aged 15 - 49 years, with a response rate of 96.6%. Results: Our findings revealed that while advancements were observed in urban areas, the majority of underprivileged women still faced limited access to modern contraception. Moreover, we did not observe any significant interaction effects between age and parity with the year of the survey. However, there was a slight decrease in the impact of marital status, although the difference between married and non-married women remained significant in 2015. It is noteworthy that family planning discussions and approval continued to play crucial roles. Conclusion: The initiatives to subsidize contraceptive costs and establish mobile clinics have proven inadequate in facilitating rural, impoverished, and young women’s access to modern contraception. Additional endeavors are required to enhance geographical accessibility to modern contraceptives by expanding the availability of supply sources, particularly in rural areas. Furthermore, providing psychosocial support has the potential to empower women in making informed contraceptive decisions and exercising greater control over their reproductive choices.
基金supported by International Agency for Research on Cancer (Lyon, France) (No. CRA No GEE/08/19)supported in part by the Fogarty International Clinical Research Scholars and Fellows Program at Vanderbilt University (R24 TW007988)
文摘Objective: To provide an evidence-based, consistent assessment of the burden of breast cancer attributable to reproductive factors (RFs, including nulliparity, mean number of children, age at first birth and breastfeeding), use of oral contraceptives (OCs, restricted to the age group of 15-49 years), and hormone replacement therapy (HRT), as well as of the burden of ovarian cancer attributable to the mean number of children in China in 2005. Methods: We derived the prevalence of these risk factors and the relative risk of breast and ovarian cancer from national surveys or large-scale studies conducted in China. In the case of RFs, we compared the exposure distributions in 2001 and counterfactual exposure. Results: Exposure of RFs in 2002 was found to account for 6.74% of breast cancer, corresponding to 9,617 cases and 2,769 deaths, and for 2.78% of ovarian cancer (712 cases, 294 deaths). The decrease in mean number of children alone was responsible for 1.47% of breast cancer and 2.78% of ovarian cancer. The prevalence of OC use was 1.74% and the population attributable fraction (PAF) of breast cancer was 0.71%, corresponding to 310 cases and 90 deaths. The PAF of breast cancer due to HRT was 0.31%, resulting in 297 cases and 85 deaths. Conclusion: RFs changes in China contributed to a sizable fraction of breast and ovarian cancer incidence and mortality, whereas HRT and OCs accounted for relatively low incidence of breast cancer in China.
文摘The aim of this manuscript is to review the action and adverse effects of combined oral contraceptives(COCs)on ocular tissues.The percentage of unwanted pregnancies and the subsequent abortions make contraception crucial worldwide.Over 100 million women around the world use common contraceptive methods,including intrauterine devices,combined estrogen and progestin oral contraceptives,as well as progestin only preparations(oral contraceptives,implants or injections).COCs are widely used for contraception,but they are also indicated in menorrhagia,endometriosis,acne and hirsutism,fibroid uterus and premenstrual syndrome.However,they have been associated with high rates of cardiovascular events,venous thromboembolic disease,ischemic strokes and breast cancer.The incidence of COCs-related ocular complications is estimated to be 1 in 230 000,including dry eye symptoms,corneal edema,lens opacities and retinal neuro-ophthalmologic or vascular complications.We may infer that the serious ocular complications of COCs can be prevented by eliminating the estrogen dosage and choosing third-generation progestins.In any case,doctors should take into consideration the systemic and ocular history of the patients before selecting any method of contraception.
文摘Polycystic ovary syndrome is characterized by ovulatory dysfunction, androgen excess and polycystic ovaries and is associated with hypertension, diabetes, metabolic syndrome and cardiovascular events. Oral contraceptives constitute first-line treatment, particularly when symptomatic hyperandrogenism is present. However, these drugs are associated with cardiovascular events and hypersensitivity reactions that pose problem in differential diagnosis and therapy. We present a 14 year-old female with polycystic ovary syndrome taking oral contraceptive and suffering from recurrent coronary ischemic attacks with increased eosinophils, and troponin levels suggesting Kounis syndrome.
文摘In a recent systematic review and meta-analysis of observational studies,the author found potential errors in the selection and extraction processes.The recalculated summary relative risks and the results of a dose-response metaanalysis showed that oral contraceptive use may not be associated with the risk of pancreatic cancer in women.
文摘The aim is to evaluate the influence of oral contraceptive intake and menstrual cycle on the electrical activity and pressure pain threshold from anterior temporal and masseter muscles. Twenty-eight women on reproductive age were selected, 13 OC users and 15 nonusers. They were weekly submitted to electromyography and algometry of the anterior temporal and masseter muscles during three consecutive menstrual cycles. Electrical activities at rest position and PPTs of temporal and masseter muscles were not affected by menstrual cycle or by OCs uses. Comparison between groups demonstrated that working side electrical activity was increased in OC users in both muscles, except during lutheal phase for the anterior temporal. However, comparison within weeks did not demonstrate statistical difference. It was suggested that, in healthy women, oral contraceptive use may influence electrical activity, but different phases of the cycle may not.
文摘Background: Efforts have been made in Burkina Faso, a French-speaking country, since 2010 to improve healthcare access and provide affordable contraceptive methods to women. With the increasing prevalence of modern contraceptives in Burkina Faso, it is important to examine the socio-demographic factors that contribute to this new pattern of contraceptive use. This study aims to analyze the changes in socio-demographic factors associated with long-term contraceptive use and provide scientific evidence to guide policy development and action planning in family planning. Data and Methods: We utilized data from the 2010 Demographic and Health Survey, which included 17,087 women aged 15 - 49 years, and the 2015 Demographic and Health Module, which included 11,504 women in the same age group. For the analysis of contraceptive use, we focused on women who were in need of contraception (either met or unmet), of reproductive age, non-pregnant, and either married or sexually active but not married. We included users of modern reversible methods and excluded non-users, as well as users of traditional or permanent methods. Results: Our findings revealed a high prevalence of long-term contraceptive use across all categories;however, certain challenges were identified, such as lower levels of information about contraceptive methods among users and the persistence of inequalities. Family planning discussions and partner approval did not influence long-term contraceptive choice. Additionally, some providers selectively offered specific methods based on women’s life course characteristics, such as parity and marital status, despite evidence suggesting that young and nulliparous women can effectively use long-term methods. Conclusion: Given the high effectiveness of long-term contraceptive methods, it is crucial to address barriers that hinder their utilization among young and nulliparous women, as well as those who desire to delay pregnancy. Efforts should focus on improving knowledge and dispelling misconceptions surrounding long-term methods. Providers play a pivotal role in this process by adopting counseling strategies that enhance users’ understanding and facilitate informed decision-making regarding contraceptive options.
基金This study was supported by the State Family Planning Committee
文摘Objective To explore whether the changes on lipids profile induced by oral contraceptives could be reduced through alternatively administering two oral contraceptives of different formulations (either predominant in progestogen or estrogen) Materials &. Methods A total of 59 women aged 25- 45 were divided into two treatment groups.The subjects in Group A received oral contraceptive A (Oc A: NET 0. 600 mg + EE 0. 035 mg) and B (OcB: LNG 0. 15mg + EEO. 03 mg) alternatively during 12 treatment cycles. Each contraceptive was administrated for three cycles consecutively with starting from OcA. The subjects in the B group received OcB only during 12 treatment cycles. Fasting blood were drawn before treatment, at the end of each trimester treatment and at the end of one cycle after stopping treatment respectively. The concentrations of lipids and apolipoproteins were measured.Results OcA increased the levels of triglyceride(TG) , total cholesterol (TC), high density lipoprotein-cholesterol(HDL-c) , and apolipoprotein AI (apo AI) with statistical significance, whereas OcB significantly decreased all parameters above. As compared with the control group, the overall mean of variation in the study group was much less than that of the control group.Conclusion It indicates that the impacts of oral contraceptives on lipids profile could be moderated by means of alternatively administering Ocs of two different formulations , with estrogen-dominant or progestogen-dominant.
基金supported by the Henan University Science and Technology Innovation Talents Support Program[Grant 19HASTIT005]the National Key Research and Development Program[Grant 2017YFC1309200]the Medical Science and Technology Key Projects of Henan Province and Zhengzhou[Grant numbers 192102310088 and 19A32000820].
文摘Aim We herein provide an umbrella review of systematic reviews(SR)and meta-analyses(MAs)of studies of the association of oral contraceptives(OCs)with the risks of multiple health outcomes in women and their descendants.Methods Two investigators retrieved publications from four electronic databases,including PubMed,Embase,Web of Science,and the Cochrane Database of Systematic Reviews up to March 15,2021.For each association,random/fixed-effects summary effect size and 95%CIs were estimated.Heterogeneity and publication bias were also assessed.The method quality and evidence level for each publication were respectively assessed utilizing the AMSTAR and GRADE checklists.Results A total of 68 articles with 82 unique outcomes were included based on the eligibility criteria.Numerous lines of evidence indicated that OCs had effects on nearly all cardiovascular disease-related outcomes,especially for cerebral venous sinus thrombosis(OR=7.59,95%CI:3.82-15.09).Harmful associations were also found for vulvar vestibulitis(OR=2.31,95%CI:1.03-5.16),preterm birth(OR=1.17,95%CI:1.07-1.27),miscarriage(OR=1.13,95%CI:1.02-1.72),ulcerative colitis(OR=1.22,95%CI:1.06-1.41),Crohn's disease(OR=1.24,95%CI:1.09-1.40),alveolar osteitis(RR=1.86,95%CI:1.66-2.08),dry socket(RR=1.8,95%CI:1.33-2.43),and interstitial cystitis(OR=2.1,95%CI:1.26-3.49).However,oral contraceptives did not increase the risk of cancer except breast and cervical cancer.Maternal exposure to OCs was linked to an increased risk for the development of respiratory atopic disorders such as asthma(OR=1.1,95%CI:1.02-1.19)and rhinitis(OR=1.34,95%CI:1.07-1.68).Conclusion In summary,although their use obviously reduces the risk of pregnancy-and parturition-related morbidity and mortality for women,OCs were frequently related to more harm than benefit in terms of other health outcomes.This was true for both women and their descendants in this umbrella review.More large-scale prospective studies analysing different doses,structures,and durations of treatment with estrogen and progestin are needed to confirm these effects.
文摘Considerable efforts have been made to develop a male contraceptive and the studies have provided very useful infor-mation in this field. At least five different strategies to develop a male contraceptive have been pursued, namely: inhi-bition of sperm production, interference with sperm function, interruption of sperm transport, prevention of sperm de-position, and prevention of sperm-egg interaction. Of all these approaches, inhibition of sperm production by using an-drogens either alone or in combination with progestins have given the most encouraging results. A nmnber of clinicaltrials substantiate that it is indeed possible to have a reversible, effective and safe hormonal method of contraception. Apostmeiotic and epididymal approach to interfere with sperm function or the secretory and metabolic processes of theepididymis is another attractive option of male contraceptive development. A number of chemical compounds have beenidentified which interfere with sperm function in the epididymis without affecting sperm production, however, the com-pounds evaluated so far were found to be toxic. Interruption of sperm transport through the vas either by vasectomy orpercutaneous intmvasal injection of liquids which form cure-in-place plugs is also an attractive option. However, re-versibility of the methods is of concern in their wide scale use. The major constraint in developing a long-acting male contraceptive seems to be the need for greater investment forproduct development. The clinical trials for evaluating the efficacy and safety of the new products and formulationsstretch over several years and require enormous financial commitment. Nevertheless, the long-term gain of having along-acting reversible contraceptive for men is far greater than the financial commitments over few years. Male attitudetowards using methods of family planning is much more favourable than originally believed. The pharmaceutical indus-try as well as the health care providers therefore have a greater responsibility. For early development of a contraceptivefor men, it is essential to increase investment and simplify the drug regulatory procedures. The advent of newer tech-nologies coupled with the convergent efforts of scientists will certainly make it possible to have an effective, safe andreversible male contraceptive in the near future.
文摘QRAL contraceptives are widely used to prevent pregnancy. A number of studies have dem- onstrated the increased risk of venous throm- boembolism in women taking oral contracep-tives.1, 2 Pulmonary embolism (PE) and deep vein throm- bosis (DVT) are two clinical presentations of venous thromboembolism which share the same predisposing factors.3 This article described a female patient who taked oral contraceptives and had an unhealthy life habit de- veloped PE and DVT. CASE DESCRIPTION
文摘Based on the data from the survey of 7826 young couples in two districts of shanghai, we analyzed the acceptability of oral pill, IUD, condom and injection in women. The results showed that 63.4% of subjects were unwilling to use pill and 5.7% were unwilling to use injection, mainly for the reasons that the pill was 'harmful to health' and the 'cause of obesity', 8.7% of subjects were unwilling to use IUD, mainly for the reasons of the 'cause of menorrhagia or spotting' and 'being easy to fail', 6.2% of subjects were unwilling to use condom, mainly for the reasons of 'interference with intercourse' and 'inconvenience in use'. The most important source of getting the information was 'heard from person's talking'.Simple variate and Logistic analysis showed that women's age at marriage, education, occupation, contraceptive knowledge score, history of using the contraceptives,some women's traits etc. affected the acceptability of the contraceptives. The study implies that it is necessary to strengthen provision of contraceptive knowledge for young couples and to make them have correct understanding of the side effects of contraceptives for improving family planning program.
文摘<b>Introduction:</b> Pregnancies that occur during the first year postpartum are more likely to be unplanned. This leads to an increased risk of adverse maternal and perinatal outcomes. However, modern contraceptive use during this period helps to reduce unplanned pregnancies and its associated adverse outcomes. There is scant data on postpartum contraceptives in pastoral communities in Tanzania. This study aimed to assess awareness and factors associated with postpartum modern contraceptives use among women of reproductive age in Bukombe District, Geita Region. <b>Method: </b>A community based cross-sectional study was conducted in a predominant pastoral community of Bukombe district in Geita region in north-western Tanzania from May-June 2018. A total of 511 postpartum women who were in their first year after child birth were studied. A multistage sampling technique was used to select study participants. Data analysis was performed using SPSS version 21. Multivariable logistic regression analysis was used to determine independent predictors of postpartum modern contraceptive use. <b>Results: </b>Most (97.3%) of the participants were aware about modern contraceptives. The prevalence of postpartum modern contraceptive use was 11.9%. The most frequent used contraceptive method was Implant 6.5%. Majority (75%) of women started to use the contraceptive at the first three months after delivery. Living in urban (AOR = 1.84, 95% CI: 1.20 - 3.79), business women’s (AOR = 2.34, 95% CI: 1.31 - 2.28), having last born aged 3 - 4 months (AOR = 3.30, 95% CI: 1.11 - 9.85) and menses resumption (AOR = 9.23, 95% CI: 3.60 - 23.72) were associated with postpartum modern contraceptive use. Fear of side effects, poor knowledge about contraceptives, husband restrictions, distance to health facility and availability of contraceptive were the barriers for use of contraceptive use. <b>Conclusion:</b> We found low uptake of postpartum modern contraceptive use in this population. Numerous factors were associated with modern contraceptive use. Therefore, health communication targeting this group is warranted to improve modern contraceptive uptake.
文摘Hormonal contraceptives (HC) are thought to play a role in the pathogenesis of cardiovascular diseases. The study evaluated the use of HC as a primary </span><span style="font-family:Verdana;">cause of preeclampsia (PE) among Ghanaians. This study comprised 30</span><span style="font-family:Verdana;"> preec</span><span style="font-family:Verdana;">lamptic women and 30 healthy normotensive pregnant women with over 20</span><span style="font-family:Verdana;"> weeks of gestation at the Comboni Hospital, Ghana using a randomized </span><span style="font-family:Verdana;">case-control </span><span style="font-family:Verdana;">study. Blood pressure, weight, height, socio-demographics, medical and previous obstetric history were taken and recorded. Blood samples were collected for the estimation of homocysteine and fasting lipids. Estimated foetal weight (EFW) and infant birthweight (BWT) were obtained from maternal records. This study was carried out in 2019.</span><b> </b><span style="font-family:Verdana;">80.0% of women with PE used the hormonal contraceptive “depot medroxyprogesterone acetate” (DMPA) prior to pregnancy. The use of DMPA was associated with about thirty-fold increase in the odds of developing PE (OR = 29.71, p</span></span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001). Systolic blood pressure (P</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001), diastolic blood pressure (P</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001), triglycerides (P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.024), LDL-C (P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.026), and homocysteine levels (P</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001) were significantly elevated in the PE cases than the normal pregnant (NP) women, whilst EFW (P</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001), BWT (P</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001) and HDL-C levels (P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001) were significantly reduced in the PE cases when compared to NP women. 50% and 47% of PE cases had intrauterine growth restriction and low birthweight infants, respectively. In conclusion, DMPA use predisposes women to a high risk of developing PE. DMPA could partly contribute to endothelial dysfunction, hyperhomocysteinaemia, dyslipidaemia and excessive weight gain, all of which characterize PE.
文摘The use of hormonal contraceptives has been implicated in the depletion of serum antioxidants and resultant promotion of oxidative stress which is associated with various disorders including cardiovascular disease and cancer. This study investigated serum total antioxidant status (TAS) in women taking hormonal contraceptives and compared their results with non-contraceptive users (age- and sex-matched). Sixty women aged 30 - 45 years, were enrolled for the study which included forty-five users of hormonal contraceptives from the Planned Parenthood Federation of Nigeria, Isolo, Lagos state and fifteen age-matched, apparently healthy, non-contraceptive users from the same geographical location were selected as controls. The in vitro determination of the serum total antioxidant status (TAS) was performed using Biorex enzymatic kit. Data obtained were statistically analyzed using student’s t-test and P < 0.05 was considered significant. The serum levels of TAS in the users of hormonal contraceptives were significantly lower than non-users (P < 0.05). The study concluded that women on hormonal contraceptives especially those taking either combined oral or combined injectable contraceptives were at risk of developing disorders associated with reduced levels of serum antioxidants.
文摘Modern women have increased options for birth control with the development of Long Acting Reversible Contraceptives (LARCs). These methods are reliable, easy to use, and require less daily maintenance while providing contraception for an extended period of time. However, despite the surge of LARCs as contraceptive options, the prevalence of unintended pregnancies is still alarmingly high in the United States. As LARCs are the most effective reversible method of birth control at preventing pregnancy, and therefore the potential social, financial, and medical complications associated, we examined whether social determinants of health play a role in LARC usage. While parity and marriage do not seem to affect LARC utilization, increased research is needed to determine the effects of race. Age can affect the type of LARC implemented, as younger women prefer implants to intrauterine devices (IUDs). Insurance coverage was an apparent influencer of LARC usage, as low out-of-pocket costs translate to increased utilization. This is linked to socioeconomic status (SES), as lower SES is associated with decreased access to healthcare in general. Increased research is needed in order to draw conclusions about the effects of education, intimate partner violence, geographic location, and other SDH on LARC usage.
文摘Progestogen-only injectable contraceptive is a highly effective, long lasting and reversible agent of fertility control. The objective is to determine the profile of the acceptors, side effects and indication for discontinuation of progestogen-only injectable contraceptives at UCTH, Calabar. This was a retrospective study of the clients who used progestogen-only injectable contraceptives at the family planning unit between 1<sup>st</sup> January 2008 and 31<sup>st</sup> December 2014. A total of 1392 clients used the injectable progestogen-only contraceptive out of 5986 total contraceptive users giving the prevalence rate of 23.3% over the period. Of these, 60.4% of the clients accepted the depot medroxyprogesterone acetate, while 39.6% accepted the norethisterone enanthate. It was mostly utilized by multiparous women, clients with tertiary education and those in their third decade of life. Secondary amenorrhea was the commonest side effect in 47.7% of the clients. Over the study period, 243 (19.8%) discontinued the method and 48.1% discontinued due to secondary amenorrhea while 31.4% was due to desire to get pregnant. Progestogen-only injectable contraceptive was associated with multiple side-effects, with secondary amenorrhea being the most common, and menstrual irregularity was the main reason for discontinuation. Providing adequate information to clients about this method of contraception and its probable side effects, supportive counseling during initiation of contraception and re-enforcement during follow-up visit can go a long way in enhancing patient satisfaction and hence continuation of progestogen-only injectable contraceptive despite minor side effects.
文摘Objective: Contraception has gained gradual popularity in many parts of the developing world including Pakistan. Despite this increase in acceptance, the birth rate remains high. Failure of contraception has been reported in the literature, which made us aim to conduct this study. The efficiency of hormonal contraceptives in the study area was assessed and this is the first report from Pakistan. Methods: A total of 200 women (aged 20-30 and 31-40 years;n = 100 each) with minimum consistent use of hormonal contraceptives in the form of pills (Combined oral contraceptives) for 12 months were enrolled in this study. Blood samples were collected from women of each age group and corresponding control groups (n = 100) from local hospitals and reproductive health service center. Serum levels of the fertility hormones viz leutinizing and follicle stimulating hormones were measured through ELISA technique. Results: Our data revealed that over all in the both age groups, 72% women had normal, 16% increased and 12% showed decreased levels of leutinizing hormone (p > 0.05) and 67% women showed normal, 33% showed decreased and no increased levels were found for follicle stimulating hormone (p > 0.05). No age-wise significant difference in response was observed among both the age groups tested. Conclusion: Statistically insignificant difference in serum leutinizing hormone and follicle stimulating hormone seen among both the age groups of hormonal contraceptive users and control group indicates less effective hormonal contraception response in the study area.
基金This study received partial financial support from the Fundaǎo de Amparo a Pesquisa do Estado de So Paulo (FAPESP), Brazil under award #03/083917.
文摘Objective To evaluate the prevalence of functional ovarian cysts in users of two different types of contraceptive implants. Methods A total of 239 women were enrolled at 3 months of use of the etonogestrelreleasing implant (Implanon) and the levonorgestrel-releasing implant (Jadelle). Bimanual pelvic examination and vaginal ultrasound were performed during routine 3, 6 and 12-month visits of asymptomatic women(control group). Women with ovarian cysts (or enlarged ovarian follicles 〉25 mm) (cysts group) were assessed weekly until disappearence or reduction of the image (including estradiol (E2) and progesterone measurement and women with no ovarian enlargement underwent same evaluation for the same period of time. Results Ovarian cysts were detected in 5.1% and 13.0% of users of Implanon and Jadelle, respectively, at 3rd month. At the 6th month of use, prevalences were 7.1% and 7.8%, and at 12th month rates were 25.7% and 14.7% in the two groups, respectively. E2 levels were significantly higher in cysts group than in control group. The time until disappearance of the ovarian cyst was similar in Implanon and Jadelle group. There were more cases of menorrhagia in patients rveth ovarian cysts than in patients with no ovarian enlargement. Conclusions The finding of ovarian cysts or enlarged ovarian follicles during the first year of use of Implanon and Jadelle implants is common and transient and should not be interpreted as a pathologic ovarian cyst. No further medical interventions are necessary.
文摘Objectives: To determine the percentage of women who accepted a LARC after abortion, specify the interval time for the insertion of the LARC and compare such interval time with that of injectable and oral contraceptives. Patients and Methods: This is a prospective, descriptive and comparative study conducted in Libreville (Gabon), from February 1, 2013 to August 31, 2013. After receiving post-abortion care (PAC), all patients with stable general states were counseled about three types of contraceptive methods: combined oral contraceptive pills, LARCs (Jadelle? implants, Copper IUDs) and injectable Medroxyprogesterone Acetate (DMPA). Results: 231 women received PAC and among them 215 (93%) wanted to use one of the three proposed contraceptive methods. At the end of the study, only 193 women (89.7%) used contraception and 22 others (10.3%) abandoned their intentions. LARCs were used by 31 (16.0%) women. The average period for the insertion of LARCs was 15.4 ± 15.5 days with extremes of 1 to 53 days. This period for the insertion of LARCS was significantly longer than that of other methods (p < 0.001). LARCs were inserted more often after the 2nd day than immediately (same day) with a highly significant difference (p < 0.0001). Conclusion: LARCs could constitute an appropriate approach to reducing unintended pregnancies in Gabon. However, in order to increase their rates of use, it is necessary to improve women awareness.