Showing papers by "Ronald T. Burkman published in 1999"
TL;DR: There is lack of compelling evidence that the intrauterine contraceptive device acts as an abortifacient, and the risk for pelvic inflammatory disease among users now appears to be extremely low, primarily as a result of better selection of candidates.
28 citations
Journal Article•
TL;DR: There is a paucity of information testing new approaches to improve contraceptive compliance, and systems improvements that address issues such as access and enhancement of provider-patient interaction appear to be areas of potential opportunity.
Abstract: About 5% of women in the United States (approximately three million) are not using contraception despite being at risk of unintended pregnancy. Teenagers have the highest rate of unintended pregnancy. Women 40 years and older most frequently terminate unintended pregnancy. Multiple theories and models, including the health belief model, the health decision model, the Prochaska change model, and the conviction-confidence model, have been developed to address choices and change in health behavior. Despite this information, current data on contraceptive compliance show considerable need for improvement. Side effects and patients' beliefs and preferences appear to influence strongly whether a method will be used appropriately. Systems improvements that address issues such as access and enhancement of provider-patient interaction appear to be areas of potential opportunity. Despite continued need for improvement, there is a paucity of information testing new approaches to improve contraceptive compliance.
15 citations
TL;DR: The need for a reliable method of contraception is the greatest among adolescents and women older than 35 years--the two groups in the United States with the highest abortion rates.
Abstract: Oral contraceptives are used by large numbers of reproductive-aged women across the world. Recent data examining cardiovascular risk indicates a persistent risk for venous thromboembolism among all oral contraceptive users. This risk is enhanced by the presence of hemostatic disorders such as factor V Leiden. Whether the progestins gestodene and desogestrel also affect the risk of venous thromboembolism is controversial. Ischemic stroke is rare among users unless they smoke or have hypertension. Similarly, there appears to be no increased risk of hemorrhagic stroke among oral contraceptive users who do not have these risk factors present. Myocardial infarction is rare among oral contraceptive users. However, cigarette smoking coupled with age acts synergistically to substantially increase the risk of this disorder among oral contraceptive users. There is a small increase in risk of breast cancer among oral contraceptive users, although the risk disappears about 10 years after the last use of these preparations. Successful use of oral contraceptives appears to be significantly affected by side effects, understanding of the package insert and time of pill taking. Since serious sequelae are uncommon, improved compliance may be the most important challenge towards improving the use of oral contraceptives for the future.
3 citations