Showing papers in "The European Journal of Contraception & Reproductive Health Care in 2007"
TL;DR: New findings on genetics, immune modulation, and secreted products ofendometriotic lesions of affected women have given insight into the pathogenesis of this disorder and may serve as the background for new treatments of endometriosis-associated pain and infertility.
Abstract: Objective To analyse the aetiopathogenesis and the role of defective ‘immunosurveillance’ in endometriosis.Method Review of studies on the pathogenesis of endometriosis, focusing particularly on novel molecules which express adhesive or proteolytic properties. Hypotheses addressing the role of oxidative stress in endometriosis were also reviewed.Results Endometriosis is a multifactorial disease associated with a general inflammatory response aiming to clear the peritoneal cavity from the ectopic endometriotic cells and tissue. Modern theories suggest that this inflammatory response creates an environment that may promote implantation and proliferation due to defective ‘immunosurveillance’.Conclusion The modern interpretation of the theory of reflux menstruation holds that women destined to develop endometriosis have a deficient immune system, which cannot defend against regurgitated endometrial cells. New findings on genetics, immune modulation, and secreted products of endometriotic lesions of affected w...
112 citations
TL;DR: Gender of adolescents, quality of communication with mothers on general topics, and adolescent's perception of mother being the main source of sex knowledge were predictive of the level of sex communication between mother and her adolescent children.
Abstract: Background Communication concerning sexual matters between parents and their adolescent children serve as a protective factor and exerts a favourable influence on adolescents' sexual behaviours. As limited data regarding parent–adolescent sex communication are available in China, this study was undertaken with the aim of exploring the patterns and related factors of such communication and its relationship with adolescent sexual behaviour.Study design Community-based data were collected in 2001 in Changchun, China. Unmarried adolescents 15–19 years of age (322 young men and 360 young women) were included in a survey using self-administered questionnaires.Results Overall, sex communication with parents was relatively infrequent. There was a significant gender difference in the pattern of sex communication, with male adolescents being more likely to talk with fathers and female adolescents with mothers. Logistic regression analysis revealed that gender of adolescents, quality of communication with mothers on...
109 citations
TL;DR: Equal responsibility among boys and girls regarding reproductive issues is still a challenge, but nevertheless an important key to the prevention of unwanted pregnancies.
Abstract: Objective To gain deeper understanding of how teenage males view abortion, adolescent fatherhood, sexual behavior, and use of contraception. Method We conducted six focus-group interviews with 1 ...
65 citations
TL;DR: The greatest risk of COC-associated VTE occurs during the first year of use, thus suggesting the existence of a predisposing condition, such as being a carrier of a thrombogenic mutation with which the COCs would exert a synergistic effect.
Abstract: This review provides an update of knowledge regarding venous thromboembolism (VTE) and combined hormonal contraceptives (CHCs) in the light of new progestins and new administration routes for CHCs. Practical recommendations are also offered. The association between the use of combined oral contraceptives (COCs) and an increased risk of VTE has been known about for many years, it being related mainly to the dose of oestrogen; however, recent research has also shown the influence of the type of progestin. When compared to COCs containing levonorgestrel or norethisterone, those containing desogestrel or gestodene present a two-fold greater risk of VTE; for COCs containing cyproterone acetate, the risk is four-fold greater, while there are no or insufficient data for those containing norgestimate, chlormadinone acetate or drospirenone. With regard to the contraceptive patch, the available data suggest that the risk of VTE is similar to that observed with COCs. There are no data concerning vaginal rings. The greatest risk of COC-associated VTE occurs during the first year of use, thus suggesting the existence of a predisposing condition, such as being a carrier of a thrombogenic mutation with which the COCs would exert a synergistic effect. Routine screening for such conditions is not justified. Changes in haemostatic variables produced by COCs, for example, acquired resistance to protein C, could be linked to VTE, although it has yet to be demonstrated that such alterations are related to a clinical risk of VTE among COC users. At present there are no laboratory tests able to detect an increased risk of VTE in asymptomatic women. The key procedures in terms of ensuring the safe use of this contraceptive method are a full clinical, personal and family history, in order to evaluate risk factors for VTE and cardiovascular disease, along with the recording of blood pressure and body mass index prior to the prescription of COCs.
52 citations
TL;DR: The combined oral contraceptive containing 30 µg ethinyloestradiol and 3 mg drospirenone is an effective drug in the treatment of hyperandrogenism in women with PCOS; it elicits few side effects and does not significantly influence insulin resistance.
Abstract: Objective To investigate the efficacy of a combined oral contraceptive containing 30 µg ethinyloestradiol and 3 mg drospirenone in the treatment of hyperandrogenism affecting women with the polycystic ovary syndrome (PCOS).Methods Prospective open study of 20 women for six cycles. At the beginning and at the end of the study the following values were determined: the Ferriman–Gallwey (F–G) score, body mass index, waist/hip ratio, serum levels of testosterone, SHBG, immune reactive insulin (IRI), glucose, the free androgenic index, and insulin resistance (HOMA-IR).Results All 20 women completed six cycles of therapy. The medication was well tolerated. At the end of the study there was a significant improvement of hirsutism, expressed in the decrease of the F–G score, accompanied by a decrease of testosterone and an increase of SHBG values. The carbohydrate metabolism was not affected significantly.Conclusion The combined oral contraceptive containing 30 µg ethinyloestradiol and 3 mg drospirenone is an effec...
45 citations
TL;DR: The results showed a high level of awareness of family planning among both study groups and most men in both groups believe that a decision about family planning should be made jointly by the spouses instead of being the prerogative of either.
Abstract: Objectives To determine the role of men in family planning decision-making in both rural and urban areas of Nigeria.Methods A total number of 370 married men (244 rural and 126 urban) were interviewed using a pre-tested, semi-structured interviewer based questionnaire. The study was conducted in the Iwaro community in Atakumosa West Local Government area (rural men) and the Oranfe Community in Ife East Local government area (urban men), both in Osun State, South West Nigeria.Results The results showed a high level of awareness of family planning among both study groups (98.3% rural and 98.4% urban). Most men in both groups believe that a decision about family planning should be made jointly by the spouses instead of being the prerogative of either. This contrasts with the generally held belief that men are opposed to family planning and a take predominant role in contraceptive decision-making. The condom was the most commonly known and used method with a preponderance among urban (81.1%) over rural men (6...
45 citations
TL;DR: Contraception is a powerful tool to promote equity between sexes; it improves women's status in the family and in the community, and is a very useful tool for educating youngsters to adopt more responsible sexual behaviors.
Abstract: Modern contraceptive technology is more than a technical advance: it has brought about a true social revolution, the 'first reproductive revolution' in the history of mankind. This latter was followed in rapid succession by other major changes in human reproductive strategies. In the human species, sexual activity began to lose its exclusive reproductive meaning at an early stage of its evolution. Human beings must have practiced non-conceptive sex from the outset and therefore must have had a need to avoid, rather than to seek conception during intercourse from time immemorial. The search for methods to control fertility went on for millennia, but a valid solution was only found during the twentieth century, when the population explosion had forever changed the shape of humanity: in only one century the total population of the planet had grown from some 1.6 billion to more than 6 billion. That increase will remain unique in the history of Homo sapiens. At the global level, contraception provided a tool to deal with overpopulation and, in only 50 years, went a long way towards its resolution. However, to solve the problem, national and international family planning initiatives were required. For individuals, contraception also meant a revolution. It allowed sexual intercourse without reproduction. Only 25 years later, in vitro fertilisation permitted childbearing without sexual intercourse. Other advances followed and now cloning, that is, reproduction without the two gametes, looms on the horizon. Such a series of rapid, major changes in human reproductive strategies has confused many. For this reason, a constructive dialogue between sociology and biology is mandatory. Contraception is a powerful tool to promote equity between sexes; it improves women's status in the family and in the community. Avoiding pregnancy during the teens increases opportunities for a young woman's education, training and employment. By controlling their fertility, women get a chance to contribute economically to their household, which in turn may give them a greater share in decision-making. There are other specific areas in which contraception has produced beneficial social effects, first and foremost in reducing the need for induced abortion. It has also helped avoiding sexually-transmitted infections and is a very useful tool for educating youngsters to adopt more responsible sexual behaviors. Interventions in the field of family planning are among the most cost-effective health interventions.
45 citations
TL;DR: In daily practice, NuvaRing® improved cycle control and was highly acceptable to women, including young women, who found ring insertion and removal to be straightforward and satisfied with its use, primarily for its once-a-month application.
Abstract: Objectives To assess clinical experience with NuvaRing® in daily practice in Switzerland, including a large subgroup of young women (aged ≤22 years).Methods Open, prospective, multicentre, observational clinical experience study to investigate cycle control, acceptability and usage of NuvaRing®.Results Altogether, 2642 women participated in the programme and were included in the analysis, of which 658 were aged ≤22 years (25% of the total group). A total of 744 women (28% of the total group) discontinued NuvaRing® use; the main reason was adverse events (11% of all users). In younger women, there was a shift from moderate (−18%) and heavy (−45%) bleeding to mild bleeding (+71%) and dysmenorrhoea decreased by 60%, despite previous hormonal contraception use by 83% of women. Most women found ring insertion and removal to be straightforward (>95%), and were satisfied with its use (85%), primarily for the ring's once-a-month application (81%). Data were very similar for the total group. Cycle control and sati...
39 citations
TL;DR: Age at sexual debut and the proportion of sexually active youth in these Balkan states do not differ from those in other parts of Europe, however, declining condom use after sexual initiation is not compensated by having recourse to other contraceptive methods, as seen in some West-European countries.
Abstract: Objectives To assess sexual and health seeking behaviour related to contraception among high school students in Bosnia (Sarajevo), the FYR of Macedonia (Skopje), and Serbia and Montenegro (Belgrade and Podgorica).Methods A standardized questionnaire was self-administered by 2150 urban high school students. Multiple logistic regression analyses accounting for within-class correlation were applied to identify determinants of sexual behaviour, and the use of contraception and sexual and reproductive health (SRH) care.Results In this group of youth with a mean age of 16.7 years, 41.3% of the boys and 20.8% of the girls had already experienced sexual intercourse. Mean age at sexual debut differed between sexually active boys (15.5) and girls (16.3). A condom was used at first sex by 73.7% of the boys and by 69.0% of the girls. Condoms were consistently used during sexual intercourse with the current or last partner by 64.3% of the boys and 48.5% of the girls. Oral contraception was resorted to by 0.0% (Macedon...
37 citations
TL;DR: College students exhibited an ‘optimism bias’ associating high rates of HIV risk indicators with low levels of perceived personal risk of infection, which has implications for HIV/AIDS control in Nigeria.
Abstract: Objectives To assess the perceptions of personal risk of acquiring HIV/AIDS infection among students of selected tertiary institutions in Osun State, Nigeria and to determine the correlates of perceptions of personal risk of infection.Methods The study employed a cross-sectional descriptive design. An interviewer-administered questionnaire was applied to the 405 study participants and correlates of perceptions of personal risk of HIV infection were evaluated using multiple logistic regression analysis, confidence intervals and odd ratios.Results Only 15% of the students perceived themselves to be at moderate-to-high risk of acquiring HIV infection compared with 85% who perceived themselves to be at little or no risk. Investigators' assessment of risk status of the participants revealed that 77% of the participants were actually at high risk of infection and only 23% at low risk. The sensitivity, specificity and negative predictive value of the students' self-perception of personal risk compared with their...
36 citations
TL;DR: Alcohol use appeared the most important contributing risk factor for non-use of contraception in relation to both first and latest intercourse, and the young men reported more unprotected latest intercourse than the young women did.
Abstract: Objectives To investigate self-reported sexual experiences, abortions, sexually transmitted infections (STIs), use of contraception and possible influencing factors on contraceptive use among Swedish high school students. Methods An anonymous classroom survey was distributed to a random sample (n = 924) of 18-year-old high school students in a medium-sized Swedish city. The response rate was 78% (n = 718). Results Three out of four students had experienced intercourse and the majority of them stated that they were satisfied with their sexual life. Few students reported having had an abortion (5%) or a STI (4%). Alcohol use appeared the most important contributing risk factor for non-use of contraception in relation to both first and latest intercourse, and the young men reported more unprotected latest intercourse than the young women did. Conclusion The fact that young men appear less inclined to use contraception is disturbing, and must be addressed in sexual education and individual counseling to promote a better sexual health for adolescents.
TL;DR: Patients considering use of Implanon® must be carefully selected and informed about its expected side effects before placement and no problem was encountered during its placement or removal.
Abstract: Objective To determine the efficacy and side effects of Implanon® used for long-term contraception.Material and method Prospective study of 80 patients who used Implanon® for long-term contraception between January 2004 and January 2006. Side effects, efficacy and removals were recorded.Results Amenorrhoea, infrequent bleeding and frequent bleeding were reported by 33 (41.25%), 19 (23.75%) and 14 patients (17.5%), respectively. Non-menstrual side effects comprised breast tenderness in 15 patients (18.75%), acne in eight (10%), headache and dizziness in three (3.75%); depressive mood disorders, pelvic pain and loss of libido were mentioned each by two of the women (2.5%). During the study period, Implanon® was removed from 20 participants. No problem was encountered during its placement or removal.Conclusion Patients considering use of Implanon® must be carefully selected and informed about its expected side effects before placement.
TL;DR: Cerazette® in this study set-up improved oestrogen-related symptoms and dysmenorrhoea in women affected and treatment was well accepted.
Abstract: Objectives To evaluate the effects of an oestrogen-free oral contraceptive (Cerazette®; 75 mcg/day desogestrel) in women with oestrogen-related symptoms during previous combined oral contraceptive (COC) use (ERS study) and in women with dysmenorrhoea (DYS study).Methods Two similarly designed prospective, non-comparative multicentre observational studies were carried out in Germany. Altogether, 403 women with oestrogen-related symptoms during previous COC use and 406 women with dysmenorrhoea took Cerazette® continuously. Symptom-related assessments were made at baseline and after 3–4 months, along with bleeding pattern and treatment satisfaction.Results In the ERS study, the four oestrogen-related symptoms studied resolved or improved in over 70% of women. Nausea improved/resolved most (92% of women), followed by breast tenderness (90%), oestrogen-related headache (84%) and oedema (74%). In the DYS study, dysmenorrhoea resolved or considerably improved in 93% of the study population. Correspondingly, use ...
TL;DR: If proven acceptable, safe and effective, the diaphragm could be used as a female-controlled method of preventing both sexually-transmitted infections (STIs) and pregnancy in Mombasa, Kenya.
Abstract: Objectives If proven acceptable, safe and effective, the diaphragm could be used as a female-controlled method of preventing both sexually-transmitted infections (STIs) and pregnancy. This study's aim was to assess the acceptability and safety of the diaphragm among sexually-active women in Mombasa, Kenya.Methods We conducted a 6-month prospective study among female sex workers (FSWs), and women attending sexual and reproductive health services. Diaphragm acceptability was assessed using continuation rates and factors associated with acceptability. Safety evaluations included colposcopy findings and incidence of urinary tract infections (UTIs) and STIs.Results Half the 185 participants were FSWs who had less schooling and were less likely to be married than other women. After 6 months, 55% (56/102) of sexually-active women reported having used the diaphragm each sex act during the preceding month. Women liked using the diaphragm (95%, 104/109), and 96% (125/130) reported willingness to continue using it. ...
TL;DR: The prevalence rate of primary infertility in the provincial centre of Kayseri, the state–trait anxiety levels of childless women and the impact of some factors on the anxiety levels were determined and the trait anxiety scores increased with the duration of their marriage.
Abstract: Objectives To determine the prevalence rate of primary infertility in the provincial centre of Kayseri, the state–trait anxiety levels of childless women and the impact of some factors on the anxiety levels.Materials and methods The investigation was carried out in the Kayseri province of Turkey. A sample group of 2400 married women aged 15–49 was visited at home and couples with primary infertility were identified. The female partners of these couples were included in the study group and were called ‘childless women’. A control group was made up of women, with at least one child, who were of similar ages and resided in similar conditions as the study group. The State–Trait Anxiety Inventory was applied to the study group of 150 childless women, and the age and residence matched control group.Results The prevalence of primary infertility in the area was found to be 6.3%. Of the childless women, 89.3% had consulted a physician for diagnosis or treatment of infertility and 66.6% had applied traditional reme...
TL;DR: Spanish youngsters have enough knowledge regarding contraception, however, the frequency of sexually-risky behaviour is still high due to the limited use of condoms in successive sexual relations with the same partner, and to alcohol consumption on weekends.
Abstract: Objective To describe and to analyse the relationship between patterns of sexually-risky behaviour and emergency contraception among young females attending a Family Planning Centre (FPC).Methods Data was obtained from a systematic analysis of 384 health records.Results Mean age of the sample subjects was 18.24 years (SD 1.47, range 13–20). Of these, 92% were single, 60% students and 83% were with the same partner. Age at first intercourse was 16.5 years (SD 1.52, range 11–20). Those who used condoms systematically totalled 72%. Mean number of sexual partners was 1.85 (SD 2.91, range 1–50). A total of 9% had become pregnant and 2% had had an abortion. Emergency contraception was resorted to by 26% of the young women on at least one occasion. Emergency contraception was related to younger age at first sexual intercourse (p < 0.001) and to a great number of partners (p = 0.011). Of the total number of subjects, 48.4% demonstrated sexually-risky behaviour. This behaviour was related to alcohol consumption (p...
TL;DR: Mainly because of irregular bleeding, the discontinuation rate of Implanon® at 6 months among the women in this region is high (19.5%) and the circulating levels of protein C, total cholesterol and oestradiol dropped significantly.
Abstract: Objective To assess side effects during the first 6 months of use of Implanon®.Design and methods The study was conducted in eastern Turkey between June 2004 and May 2005. Forty-one healthy women, aged 18–40 years who chose to use Implanon® participated in the study. The implant was inserted between days 1 and 5 of the menstrual cycle. Findings were recorded before and during 6 months following insertion. Statistical analyses were performed using SPSS package programme including paired samples t-test.Results No pregnancy occurred during the study. Ninety days after initiation of therapy, three of the 41 patients (7.3%) had regular periods, 14 (34.1%) were amenorrhoeic and the remaining 24 (58.5%) had some type of abnormal bleeding. Dysmenorrhoea affected significantly less women (1/41, i.e. 2.4%) than before treatment (17/41, i.e. 41.5%), but mastalgia increased significantly as it was reported by five previously unaffected participants (12.2%). Mood changes appeared in seven patients (17.1%) and acne in ...
TL;DR: The median age at which adolescents in Europe start having sexual intercourse is presently 15–16 years, but notable differences exist between countries, and the following factors have been found to increase the risk for early sexual activity.
Abstract: Adolescents tend to behave impulsively and may show a low capacity for abstraction and planning ahead of time. This also applies to their sexual behaviour. Worrying parents, and all others providin...
TL;DR: It was found that the woman's age, her own or her husband's level of education, previous awareness about contraceptive methods, number of abortions, and number of sons and daughters were factors that were significantly associated with contraceptive use.
Abstract: Objectives In spite of the government's efforts, the prevalence of contraceptive use in Iran is only 55.4%. Health concerns, side effects, failure of the methods and some demographic issues, among which education, age, and number of daughters, have a great influence on the enforcement of contraceptive measures. The aim of the present study was to identify factors affecting contraceptive use in Iran.Methods Data from the project ‘The study of contraceptive practice in Tehran, 1999–2000’ were analyzed with regard to the factors associated with contraceptive use by Iranian couples. A total of 4042 women at reproductive ages who had delivered in one of the 12 teaching hospitals of Tehran and had at least one child that lived for at least 24 hours after birth, were interviewed using a questionnaire that gathered information about their socio-demographic status, fertility history, and other characteristics.Results Using a multinomial logistic regression, it was found that the woman's age, her own or her husband...
TL;DR: A methodology to systematically evaluate menstrual bleeding patterns that distinguishes between cyclical and continuous hormonal regimens is developed that allows regulatory agencies and prescribing physicians to make meaningful comparisons of different products.
Abstract: Objective To develop a universal guideline allowing the comparison of interventions like oral contraceptives and hormone replacement therapy with an impact on menstrual bleeding pattern.Methods Literature analysis and cluster analysis of 4612 bleeding diaries.Results We summarized key definitions needed for the evaluation of menstrual bleeding patterns from the literature. We developed a methodology to systematically evaluate menstrual bleeding patterns that distinguishes between cyclical and continuous hormonal regimens.Conclusion This universal guideline can be applied to all prospective clinical studies that affect menstrual bleeding patterns. It allows regulatory agencies and prescribing physicians to make meaningful comparisons of different products.
TL;DR: This study confirms that s-hCG levels drop sharply after medical abortion, and recommends that clinical examination to be combined with determination of s- hCG to assess the completeness of medical abortion.
Abstract: Objective The combination of mifepristone and misoprostol is an established method for induction of early first trimester abortion, but there is no consensus about the best evaluation of treatment outcome. We assessed endometrial thickness, determined by ultrasound and serum-human chorionic gonadotropin (s-hCG) as markers of successful management.Methods Prospective trial involving 255 women, with a gestation of 62 days or less, who were to undergo medical abortion. In addition to our established routines of performing clinical and ultrasound examinations, we also determined the s-hCG level prior to treatment and at follow-up.Results Of the 255 subjects treated during the study, 20 (7.8%) were lost to follow-up. The overall complete abortion rate was 94.0%. Fourteen subjects required vacuum aspiration, nine of them prior to the scheduled follow-up and five thereafter. None of the pregnancies were ongoing. A decrease of 99% in s-hCG levels was noted in 99% of the women, when levels determined prior to mife...
TL;DR: It is suggested that institutions where men and women are heard can help both partners to outlive this experience as a constructive step in their personal psychosocial evolution and in their relationship.
Abstract: Objectives To investigate the way men experience abortion from a psychodynamic perspective in order to understand better the impact of this experience on their own image as men and on the couple's ...
TL;DR: The findings illustrate the complexities inherent in contraceptive health care in relation to hormonal methods and highlight not only potential targets for enhancing effective use, but the importance of the way such information is disseminated.
Abstract: Objectives Britain has high rates of unintended adolescent pregnancy compared to other European countries. Relatively little is known about the beliefs, attitudes and experiences of using hormonal contraceptive methods amongst middle-class adolescents, and mention of their views in the literature will add to the knowledge in this area. The current qualitative study addresses these issues to some extent.Methods Middle-class 16–18-year-old men and women were interviewed about their understanding and use of hormonal contraceptives. The interviews were transcribed verbatim and transcripts subjected to an adaptation of interpretative phenomenological analysis (IPA).Results Six emergent themes represent important aspects of these adolescents' experiences: negative experiences, experiences unrelated to pregnancy prevention, mistrust of the pill, risk reduction, issues of communication and trust, and perceptions of pill promotion by adults.Conclusions The findings illustrate the complexities inherent in contracep...
TL;DR: Consumers need to have at least a high school reading level in order to comprehend current OTC contraceptive product instructions, despite calls to simplify written instructions.
Abstract: Objective To assess readability of over-the-counter (OTC) contraceptive product instructions currently available, compare the results with previous studies from a decade ago, and review the implications for health care providers, in particular pharmacists counseling on OTC contraceptives.Methods A sample of contraceptive instructions was submitted to a readability analysis using four standard readability formulas. Products included condoms, spermicides, and emergency contraception instruction pamphlets.Results Reading grade levels for condoms ranged from 6th to 12th grade. The average reading levels for the spermicides were 9th–10th grade and for the emergency contraceptives 10th–12th grade. These results were consistent with those of similar studies performed a decade ago.Conclusions Consumers need to have at least a high school reading level in order to comprehend current product instructions. Very little has changed in the past decade regarding readability of OTC contraceptive patient instructions, des...
TL;DR: There are inequalities in the achievement of fertility preferences and in accessibility to family planning services between urban and suburban parts of the city.
Abstract: Objectives To explore the differences in unwanted fertility in different parts of a city.Methods Data were obtained from the 1999 Manisa Demographic and Health Survey (MDHS) in Turkey. We collected information from a representative sample of 1728 ever-married women aged 15–49 years on fertility, fertility preferences, unmet need for family planning, contraceptive discontinuation, and abortion. Data were analyzed using SPSS 10.0 for Windows®.Results Of the persons studied, 1238 (71.6%) were living in urban settlements and 490 (28.4%) in suburban (gecekondu) settlements. The total fertility rate is higher among gecekondu women (2.42) than among urban women (2.14) although gecekondu women have a lower wanted fertility rate (1.54) than urban women (1.77). Married women in the urban area were currently using a contraceptive method more frequently (75.6%) than those living in the gecekondu area (61.7%) (OR 2.5; 95% CI 1.9–3.2; p < 0.001). The unmet need percentage in gecekondu women (17.7%) is higher than in ur...
TL;DR: The nursing and midwifery students of a university in the Eastern-Mediterranean region of Turkey assessed have a very insufficient knowledge of EC and probably are prejudiced against it.
Abstract: Objectives To assess the knowledge and attitudes of emergency contraception (EC) among nursing and midwifery students of a university in the Eastern-Mediterranean region of Turkey.Methods The survey was conducted among 210 nursing and midwifery students.Results One hundred and twenty-five participants (59.5%) knew at least one method of EC. One hundred and fourteen participants (54.3%) had heard about emergency contraceptive pills (ECPs), but only 17 (8.1%) knew what they contained. Rates of hearing about ECPs were statistically higher in third and fourth classes than first and second classes, and in midwifery students than in nursing students (P < 0.001). In spite of their very unsatisfactory level of knowledge, 166 students (79.0%) thought that ECPs should be sold in pharmacies.Conclusion The nursing and midwifery students we assessed have a very insufficient knowledge of EC. Probably therefore, many are prejudiced against it. They should be much better acquainted with this modality of contraception sin...
TL;DR: Age at menarche in adolescents in the Eastern Mediterranean city of Kahramanmaras, Turkey is determined by estimating the age at which 10, 25, 50, 75 and 90% of the girls reached menarches by using a standard questionnaire.
Abstract: Objectives To determine the age at menarche in adolescents in the Eastern Mediterranean city of Kahramanmaras, Turkey.Methods The study was conducted in primary and high schools of Kahramanmaras, during the academic year 2003–2004. Data of 8212 female students were collected by using a standard questionnaire. Mean and median ages at menarche (with 95% confidence intervals) were calculated by Kaplan–Meier survival analysis. Also, probit analysis was performed to determine the age at menarche for all girls by estimating the age at which 10, 25, 50, 75 and 90% of the girls reached menarche.Results According to the answers obtained through the questionnaire, 5506 (67.5%) of 8161 respondents had had their menarche. Mean age at menarche was 13.04 years (95% CI: 13.01–13.06), and median age 13.00 years (95% CI: 12.97–13.03). According to probit analyses, the probability of menstruating before the age of 11.48 years was 10% and before 15.08 years 90%.Conclusion We provide data about age at menarche in Kahramanmar...
TL;DR: The desire to become pregnant was the leading reason for discontinuation of most modern methods, while method failure was an equally important reason for traditional methods.
Abstract: Objectives (1) To examine the probability of discontinuation of various methods within 1, 2, and three years of use and the reasons for discontinuation; 2) to analyse the socio-demographic correlates of discontinuation.Methods Data from a survey of Kuwaiti women in reproductive ages conducted in 1999 were used. Information on duration of use of modern and traditional methods, and reasons for discontinuation during the 72 months before the survey were analysed. Probabilities of discontinuation were estimated through multiple decrement life table analysis.Results After 1 year, 30% of modern and 40% of traditional method users had discontinued; after 3 years, discontinuation increased to 66 and 70%, respectively. After 36 months, only 40% of IUD users discontinued compared with 74% of oral contraceptive users. The desire to become pregnant was the leading reason for discontinuation of most modern methods, while method failure was an equally important reason for traditional methods. Discontinuation was signif...
TL;DR: Although the most common reason for having an abortion was unwanted pregnancy in all age groups and nearly 60.0% of the women aged less than 55 reported that they were not using any FP method at the time of the TOP, the proportion of women having undergone at least one of these procedures increased after the law was passed, indicating that abortion is used as a FP method.
Abstract: Objective To determine the effects of the 1983 law that legalized induced abortion on the number and place of abortions, and on the use of family planning (FP) methods before and after abortion, and to determine the demographic characteristics and reproductive health features according to the order of abortion.Method This study included 2455 married, widowed or divorced women presenting at Mother and Child Health-Family Planning Centres in Ankara. A questionnaire was used for data collection.Result Nearly three out of 10 (28.7%) of the women had undergone at least one induced abortion. In the age groups 45–54 and 55–64, 49 and 37.3%, respectively, had had one or more terminations of pregnancy (TOPs). The induced abortion rate increased following the enacting of the law. In the 15–24 and in the 55–64 age group, 55.6 and 89%, respectively, of the women had been aborted by a private physician. Before the index pregnancy, 63.1% were not using contraception compared with 37.3% thereafter. The rate of use of FP...
TL;DR: All elements of the FP services need improvement, and special attention should be paid to interactive communication, information given to clients, privacy and confidentiality, as well as to infection prevention procedures.
Abstract: Objective To determine the quality of family planning (FP) services at primary care facilities in Tabriz, Iran, and to identify areas for improvementMethods Structured observations of 469 client–provider interactions and some clinical procedures at 34 facilities Exit interviews with 416 of the observed clientsResults The providers treated the clients respectfully in more than 80% of the consultations and discussed a return visit in 89% Privacy was not assured in one-third of the cases Over two-thirds of the clients were not encouraged to ask questions or raise concerns, and 54% were not satisfied with the amount of information given The use of educational audio-visual and printed materials was very infrequent Reported waiting time was less than 30 minutes in 89% Most new clients received their preferred contraceptive method, but were informed about neither other available methods, nor common side effects and warning symptoms due to the chosen method Provider performance in some clinical procedure