Contraceptive Risk Research Articles

Male contraceptive acceptability versus male acceptance of contraceptive responsibility.

Despite the projected impact of new male contraceptives, resources and investments directed at their development remain limited in part due to concerns that men would not actually use them. Now, more than 30 studies have been conducted over the last 30 years-regionally and internationally, within clinical trials, and across populations-examining men and women's attitudes towards new male contraceptive methods, all consistently demonstrating interest in and willingness to use new methods. Yet even these studies, inclusive of competitive contraceptive market projections, seem not to be convincing enough. Rather than study whether men would be willing to use male contraceptives, more resources should be devoted to developing the infrastructure and supporting the cultural changes needed to ensure that when new male contraceptives inevitably emerge, that they will be disseminated quickly and made readily accessible. Men's views on what their roles are in society, families, relationships, and pregnancy prevention are changing in ways that may impact what they consider to be acceptable contraceptive risks. As society moves toward more gender equitable beliefs, men's positive involvement in contraception might organically develop into an expected behavior. Interventions aimed at sensitizing men toward gender equitable beliefs may pay dividends in improving male contraceptive acceptability. The current lack of a reversible male contraceptive method prevents us from collecting data that might disprove presumptions that men would be unwilling to take on responsibility for pregnancy prevention. However, studies of men's involvement in (1) over-the-counter emergency contraception, (2) vasectomy, and (3) abortion offer case studies for men's increasing consciousness of opportunities for shared contraceptive responsibility, the structural and sociopolitical barriers that men face when trying to participate in family planning, and how these might translate into new male contraceptive interest and development.

Contraceptive risk events among family planning specialists: a cross sectional study

BackgroundProponents of abortion restriction cite advancements in contraceptive technology as a reason against the need for abortion care today, most recently through oral arguments in the Supreme Court of the United States case, Dobbs v. Jackson Women’s Health. However, consistent and correct use of contraception requires reproductive health literacy. Our objectives were to quantify contraceptive risk events and assess contraceptive history and preferences among a population well-equipped to evade contraceptive risks, family planning specialists following initiation of their medical training. “Risk events” are defined as reported episodes of contraceptive failure, emergency contraception use and/or unprotected or underprotected intercourse.MethodsThis was a cross-sectional study among current members of a professional organization of family planning specialists. Inclusion criteria included: status as a current or retired clinician, consensual penile-vaginal intercourse and personal or partner capacity to become pregnant since the start of medical training. Descriptive statistics were performed. This study was IRB exempt.ResultsAmong 229 respondents, 157 (69%) reported experiencing a contraceptive risk event since training. Twenty-nine (13%) respondents reported an occurrence within the last year. By category, 47% (108/229; 3 reported unknown) reported under- or unprotected intercourse, 35% (81/229) reported emergency contraception use, and 52% of participants (117/227; 2 unknown) reported known or suspected contraceptive failure. The mean number of contraceptive methods used was 3.7 (SD 1.7) out of the 13 methods listed. Almost all (97%) participants reported at least one method was not an acceptable option, with a mean of 5.6 (SD 2.7) of the 13 listed methods.ConclusionsThe majority of family planning specialists have experienced contraceptive risk events during times of active pregnancy prevention since their medical training. Contraceptive method change is common and most respondents were limited in the number of methods that were personally acceptable to them. Dialogue idealizing the role of contraception in minimizing or eliminating abortion need is simplistic and inaccurately represents the lived realities of pregnancy-capable individuals and their partners, including among those with exceptional contraceptive literacy and access.

Contraceptive Attitudes and Beliefs of Women With Sickle Cell Disease: A Qualitative Study

ObjectivesWe aimed to qualitatively explore factors influencing contraceptive use in women living with sickle cell disease (SCD). Study DesignWe conducted a semi-structured qualitative study using data from interviews with reproductive-aged women with SCD. The Theory of Planned Behavior, which describes an individual's attitudes, subjective norms, and perceived behavioral control as drivers of a health behavior, served as a framework for data collection and thematic analysis. ResultsWe analyzed interviews from 20 participants. Attitudes toward contraception showed skepticism regarding hormonal contraception and concern about adverse effects of contraception related to SCD. The role of subjective norms in contraceptive choice depended on whether participants possessed trusted sources of information, such as health care providers, family, and friends, or whether they relied on themselves alone in their contraceptive decision-making. The influence of health care providers was complicated by inconsistent and sometimes conflicting counseling. Finally, with regard to participants’ perceived control in their contraceptive choices, some were motivated to alleviate menstrual pain or prevent SCD-related pregnancy risks, but many reported feeling disempowered in contraceptive decision-making settings because of ways that healthcare providers exerted pressure or responded to participants’ demographic characteristics. ConclusionsWomen living with SCD are influenced by many factors similar to those documented for other populations when making decisions about contraception. However, SCD amplifies both the importance and risks of contraception and may also complicate individuals' autonomy and contraceptive access. Hematology and reproductive health providers should recognize the risk of coercion, maximize patients’ reproductive agency, and coordinate reproductive health counseling for patients with SCD.

О влиянии гормональной контрацепции на здоровье девушек-подростков.

The article presents an analysis of modern foreign scientific literature on the effect of hormonal contraception on the health of teenage girls; states the need to support expanded clinical research before implementing recommendations for the use of hormonal contraceptives among adolescents and to allocate funding for programs to promote, encourage, and distribute hormonal contraception among adolescents as the main means of preventing abortion. Given that WHO recognizes the lack of strong evidence of funding for programs promoting hormonal contraception promoted by international organizations, aimed primarily at the poor and marginalized sections of the population, in our country these programs should be considered unacceptable, and especially in general educational organizations. Today, more than ever, joint efforts are needed on the part of health authorities, education, family and society to promote preventive educational and health activities in order to inform adolescents about the risks of hormonal contraception on health, as well as to develop in young people a responsible attitude towards their health, starting a family and future motherhood.

Gap in knowledge of health benefits and risks of combined oral contraceptives among Lebanese women

BackgroundOral Contraceptive Pills (OCPs) are among the most commonly used forms of contraception, but they are associated with several health benefits and risks. This study aims to determine the gap in knowledge of the underlying health benefits and risks of OCPs among Lebanese women and to identify the factors that might influence their beliefs.MethodsA questionnaire was completed by 817 Lebanese women aged 18–64 years old and assessed sociodemographic details, medical information, contraceptive practices, knowledge of underlying health benefits and risks, and information needs related to OCPs.ResultsAmong the total participants, 41.5% of women reported using OCPs at some point in their lives yet 46.6% denied receiving information about their benefits and 48% denied receiving information about their risks. The mean total OCP knowledge score was 5.70 out of 25, the mean OCP risk knowledge score was 4.09 out of 15, and the mean OCP benefit knowledge score was 0.77 out of 6. Sociodemographic factors associated with greater total knowledge, risk knowledge and benefit knowledge included OCP usage, being a student, confidence in one’s knowledge and satisfaction with one’s information. Both the total and risk knowledge scores were found to be higher in women who found that receiving information related to OCPs was important. Finally, participants who lived in central governates had greater total knowledge scores, whereas those with higher levels of education and a family history of endometrial cancer demonstrated better benefit knowledge.ConclusionsThis study highlighted the poor knowledge of health benefits and risks associated with OCP use among Lebanese women and the associated sociodemographic factors that might influence their beliefs.

Promotion of an Algorithm-Based Tool for Pregnancy Prevention by Instagram Influencers.

Objective: Despite growing concerns that some digital algorithm-reliant fertility awareness-based methods of pregnancy prevention are marketed in an inaccurate, opaque, and potentially harmful manner online, there has been limited systematic examination of such marketing practices. This article therefore provides an empirical examination of how social media influencers have promoted the fertility tracking tool Daysy on Instagram. We investigate: (1) how the tool is framed in relation to pregnancy prevention using Health Belief Model (HBM) constructs, and (2) the promotional and disclosure practices adopted by influencers. Materials and Methods: We collected Instagram posts mentioning Daysy made between June 2018 and May 2022 using the tool CrowdTangle. Using a qualitative content analysis approach, we coded a random sample of 400 Daysy posts. This yielded 122 Instagram influencer posts promoting Daysy for pregnancy prevention that we coded for promotional content and HBM constructs. Results: Posts originated primarily from Europe (n = 62, 50.82%) and the United States (n = 37, 30.33%). Findings indicate that barriers to use (n = 18, 15.57%) and the severity of risks from unplanned pregnancy (n = 8, 6.56%) were rarely conveyed, whereas benefits of use (n = 122, 100%) and the severity of risks of hormonal contraception (n = 31, 25.41%) were covered more extensively. Only about one third of posts disclosed any formal relationship to the brand Daysy. Conclusions: With many posts emphasizing benefits and obscuring potential limitations, we argue that accurate and transparent information about the effectiveness and limitations of fertility tracking technologies is critical for supporting informed decision-making and, as such, should remain a public health priority.

"I was just concerned about getting pregnant”: Attitudes toward pregnancy and contraceptive use among adolescent girls and young women in Thika, Kenya

BackgroundAdolescent girls and young women (AGYW) have a high incidence of unplanned pregnancies, especially in low-resource settings. AGYW assess the overlapping risks of pregnancy, contraception, and STIs as they navigate relationships. Few studies have examined how AGYW consider the comparative risks of their decisions around sexual and reproductive health in this context or how risk perception influences contraceptive use.MethodsTwenty in-depth interviews (IDIs) and 5 focus group discussions (FGDs) were conducted with a subset of sexually active AGYW enrolled in the Girls Health Study (GHS), a longitudinal cohort study in Thika, Kenya, assessing HSV-2 incidence in a cohort of AGYW aged 16–20. Interview questions were focused on perspectives and decision-making around sexual and reproductive health. Interviews were conducted in both English and Kiswahili, transcribed, and coded using inductive and deductive approaches to identify emerging themes.ResultsMisconceptions about long-acting reversible contraceptives (LARCs), injectables, and daily oral contraceptive pills strongly disincentivized their use among AGYW. Participants described pregnancy as undesirable, and AGYW reported prioritizing contraceptive methods that were effective and reliable in pregnancy prevention, even if not effective in preventing STI/HIV infection. Participants reported that AGYW relied heavily on emergency contraceptive (EC) pills for pregnancy prevention.ConclusionsThough the goal of avoiding unintended pregnancy was common, this did not suffice to motivate the uptake of long-term contraceptives among AGYWs. Given the convenience, cost-effectiveness, and lower perceived risk of side effects, EC pills were more likely to be accepted as a form of contraception. Understanding the reasons for AGYW’s acceptance of certain contraceptive methods over others can help future interventions better target communication and counseling about contraception and influence key drivers of AGYW behavior and decision-making around sexual and reproductive health.

(522) Possible Role of the Sex Script in the Orgasm Gap Between Genders: How Sodomy is an Egalitarian Practice

Abstract Introduction The orgasm gap between genders is found in scientific and generalist literature: men, of all sexual orientations, report reaching orgasm during nearly 90% of sexual intercourses, while heterosexual women only achieve orgasm during 65% of intercourse. Objective We want to demonstrate that the sexual script of penis/vagina penetration is anatomically less satisfactory than anal penetration, and carries risks for women: unwanted pregnancy, iatrogenic risks of contraception We want to highlight, that in terms of gender, this script is unequal, while during sodomy, role can be exchanged, with the help of a dildo, the man can discover his passivity, and no longuer submit to the erection's performance. Methods Literature review: -we introduced the words “orgasm gap” on PubMed for the last five years -press articles Results We have found only four survey about the orgasm gender gap on PubMed When the women can't achieve orgasm, they are generally advised clitoral stimulation During the consultation we hear the women say: I do not feel anything during vaginal penetration, indeed the vaginal mucosa is weakly innervated, and vagina does not have sphincters, which decreases the sensation after childbirth. Conversely the anal region and the rectal mucosa are strongly innervated. Conclusions Sodomy requires learning as sport or music. This learning can cause unpleasant sensations, but when the technique is acquired, as for sport or music, the pleasure is deep intense and continuous. We do not stop sport or music because of aches and pains of the beginner. Sodomy is egalitarian, that can be practiced by all genders, bringing intense pleasure, too often reserved for initiates, and therefore we can say that sodomy is sacred, leaving to the laymen the few orgasmic tremors obtained painfully by external stimulation of the penis or the clitoris. Disclosure No

Attention-Deficit Hyperactivity Disorder and Contraceptive Risks

Attention-Deficit Hyperactivity Disorder and Contraceptive Risks

Why we need more methods for male contraception.

The US Supreme Court decision against abortion has once again triggered the call for male contraception. However, in addition to existing methods, there are further reasons why pharmacological reversible easy-to-use male contraception should be available. Green activists and environmentalists have to recognize that overpopulation consume resources. Medical progress results in increasing life expectancy and must be combined with contraception. Sharing the risks of contraception among partners and "Reproductive Autonomy for All" are ethical issues. The resistance of the pharmacological industry to becoming partners in male contraception must be overcome by public financial subsidies and popular demand.

Evaluation of Risk Factors of Venous Thromboembolism in Imam Sadiq Teaching Hospital at Babylon City

Venous thromboembolism (VTE), a term referring to blood clots in the veins, is an underdiagnosed and dangerous, yet avoidable, medical illness that can result in disability and mortality. When a blood clot develops in a deep vein, commonly in the lower leg, thigh, or pelvis, it is referred to as a deep vein thrombosis (DVT). To evaluate the risk factors of VTE between cases and controls in the hospital Imam Sadiq Teaching in Babylon City and to predict variables that contribute to the risk factors of VTE among the studied samples. The study was conducted in a hospital, Imam Sadiq Teaching in Babylon, Iraq, and was designed as a case control. There were 165 participants (55 cases and 110 controls). Data was collected during a four-month period. The findings show that there are no significant sociodemographic risk factors for VTE, with the most significant being obstructive sleep apnea syndrome (p. value < 0.05) among patients. The frequency of exercise in patients with VTE and the control group was 20.0%, 36.4% respectively, at a significant level (P. value < 0.05). There was no significant association between risk factors for females and VTE (P. value > 0.05) except for used contraceptive pills and a history of a cesarean operation. There was no significant link between medical history and the outcome of this investigation (hypertension, diabetes, heart disease, and lung diseases) ... except kidney disease was likely at a higher risk of VTE than participants who had no kidney disease. Although there is no significant relationship between sociodemographic and VTE, the study found that there was a very high correlation between the risk of obstructive sleep apnea syndrome, caesarean sections, oral contraceptives, and renal disease with VTE.

Analysis of Contraceptive Risk Factors in Clinical Application of Intrauterine Device in Women of Different Ages

Analysis of Contraceptive Risk Factors in Clinical Application of Intrauterine Device in Women of Different Ages

Combined Oral Contraceptives and Vascular Thrombosis: A Single-Center Experience.

BackgroundCombined oral contraceptives (COCs) are frequently prescribed for contraception, to regulate ovulation and treat endometriosis, and to control menopausal symptoms. A major risk of hormonal contraceptives is vascular thrombosis.MethodsA retrospective chart review of female patients with deep vein thrombosis (DVT), pulmonary embolism (PE), or other sites of thrombosis or emboli seen in the thrombosis clinic of the department of internal medicine at a tertiary care hospital in Saudi Arabia between March 2010 and February 2015 was performed to identify and characterize which women were taking COCs.ResultsOf 1,008 patients treated for DVT, PE, or other sites of thrombosis or emboli, 100 (9.9%) were taking COCs. Venous (98%) and arterial (2%) thromboses were seen. Overall, 62% of the patients experienced a DVT and 26% pulmonary emboli, and 20% of the patients experienced unusual sites of thrombosis. Furthermore, 53% were obese or morbidly obese. The incidence of venous thrombosis was the highest during the first year of COC use (73%). Of the patients, 8% had thrombophilia.ConclusionThis study characterizes Saudi women with thrombotic events taking COCs and identifies risk factors, including unusual sites of thrombosis. Most patients experienced the vascular event during the first year of taking COCs. Age of 40-50 years, obesity, and thrombophilia were the commonly observed risk factors.

Benefits and risks of combined hormonal contraception

Since the introduction of the Pill over 60 years ago, combined hormonal contraception (CHC) has remained one of the most popular forms of contraception. This article outlines the choice of CHC available, including different formulations of the combined oral contraceptive pill, the transdermal patch and the vaginal ring, and discusses the benefits and risks associated with their use.

Adolescent Women with Congenital Heart Disease: Self-Reported Reproductive Health Discussions with Health Care Providers

Study ObjectiveThis study evaluated self-reported discussions with health care providers (HCPs) among adolescent and young adult (AYA) women with congenital heart disease (CHD). DesignData were collected through a one-time survey of AYA women. SettingParticipants were recruited from pediatric cardiology clinics. ParticipantsAYA women with CHD, ages 14-21 (N = 107) InterventionsNone Main Outcome MeasuresQuestionnaires assessed adolescent characteristics and specific HCP discussions regarding transmissibility of a cardiac condition to the infant, risk of pregnancy, and hormonal contraception. Outcome measures were self-reported discussions with HCPs about these reproductive health topics. ResultsMean age was 16.8 years (SD = 2.1). Self-reported reproductive health discussions were infrequent, including discussions on transmissibility of a heart condition to their offspring (37%), risk of pregnancy to their offspring (34%), risks of pregnancy to their health (46%), and risks of hormonal contraception given their heart condition (21%). Reported discussions were most commonly with a cardiologist. ConclusionsAYA women with CHD reported limited discussions about reproductive health topics important to those with CHD. Lack of appropriate and timely counseling could lead to poor maternal and child health outcomes. Targeted interventions that improve reproductive health discussions between HCPs and AYA women with CHD are needed to close critical information and service gaps.

Evaluation of a Peer-Led Comprehensive Sexual Health Program for College Teens

The study evaluated safe sex attitudes and intentions from a comprehensive, peer-led sexual health program for teenage students enrolled in three rural colleges in Mississippi. The methods consisted of pretest and posttest survey items regarding attitudes and intentions toward safe sex from 149 participants and a peer educator focus group on curriculum delivery and participation. Intentions and motivations for contraception and sexual risk awareness significantly improved at posttest for all participants. The focus group suggested that peer-led approaches are critical for engaging students, fostering participation, and addressing students’ sexual health needs in culturally sensitive ways.

Abstract 878: Contraceptive use and ovarian cancer risk in BRCA1 and BRCA2 mutation carriers: A prospective cohort study

Abstract Background: Oral contraceptive use is associated with a significantly reduced risk of ovarian cancer among BRCA1 and BRCA2 mutation carriers. To date, there have been no prospective analyses of this relationship, and the impact of other types of contraception (e.g. intrauterine device (IUD), implant, patch, injection) on BRCA-associated ovarian cancer risk is unknown. The goal of this study is to prospectively evaluate the relationship between types of contraception and ovarian cancer incidence in women with a BRCA1 or BRCA2 mutation. Methods: The longitudinal study included 3,298 eligible BRCA1/2 mutation carriers. Self-reported information regarding contraceptive use, including medication name, start year, end year, duration of use and method of administration were collected by biennial questionnaire. Women were classified according to history of contraceptive use (ever/never), duration of use, contraceptive method, calendar year of initiation and time since last use. Time-dependent Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of ovarian cancer associated with each contraceptive method. Results: There were 84 incident ovarian cancer cases diagnosed over a mean follow-up period of 5.1 years. There was no significant association between ever use of an IUD (HR: 0.78; 95% CI: 0.28-2.14) and risk of ovarian cancer compared to IUD never users. Ongoing analyses will focus on the relationships between other contraceptive methods, formulations and duration of use on ovarian cancer risk, further stratified by histology and site of origin. Conclusions: Preliminary findings from this prospective analysis suggest that IUD use may not be protective among BRCA1/2 mutation carriers. Ongoing results will elucidate the impact of contraceptive formulation and method on ovarian cancer risk to inform clinical recommendations surrounding the use of contraceptive agents for chemoprevention in high risk women. Citation Format: Yue Yin Xia, Jan Lubinski, Barry Rosen, Pal Moller, Andrea Eisen, Peter Ainsworth, Leigha Senter, Louise Bordeleau, Susan L. Neuhausen, Christian F. Singer, Jennifer Brooks, Ping Sun, Steven A. Narod, Joanne Kotsopoulos. Contraceptive use and ovarian cancer risk in BRCA1 and BRCA2 mutation carriers: A prospective cohort study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 878.

Modern approaches to the management of menopause

Aim. To conduct an analytical review of modern publications highlighting modern approaches to improving the quality and increasing life expectancy in postmenopausal women.
 Materials and methods. The analysis of 47 foreign and domestic literature sources on this topic is carried out.
 Results. Menopause is a time of significant change for women and a good time to assess and promote health. Patient counseling should include information on lifestyle, contraception, individual and family risks of cancer and osteoporosis. Hormonal, non-hormonal and complementary methods can be used to correct the symptoms of menopause. MHT is the most effective treatment for symptom relief and can be offered to most women. Topical vaginal oestrogen treatment is effective in relieving urogenital symptoms. Women should be able to make informed choices regarding the use of MHT, based on balanced and accurate information about its benefits and risks.
 Conclusion. Menopause is a time of change for women and provides an opportunity for health assessment and promotion. The decision to treat menopausal symptoms using hormonal, non-hormonal and complementary methods should be made on an individual basis depending on the presence of risk factors and the patients preferences.

Informed Choice: A Review of the Benefits and Risks of Hormonal Contraception

Informed Choice: A Review of the Benefits and Risks of Hormonal Contraception

Contraceptive use and maternal mortality in Indonesia: a community-level ecological analysis

BackgroundPrior studies have shown that contraceptive use reduces maternal mortality independently of other maternal health services. The present study took advantage of geographically detailed Indonesian data to study the interplay between contraceptive use and other risk and protective factors for maternal mortality at the community level, a level of analysis where the protective effects of family planning can be best understood.MethodsData from the 2015 Intercensal Population Survey (SUPAS) and the 2014 Village Potential Survey (PODES) were used to construct a series of census block-level variables measuring key risk and protective factors for maternal mortality. The relationships between these factors and maternal mortality, measured via natural log-transformation of past five-year maternal mortality ratios in each of the 40,748 census blocks were assessed via log-linear regressions.ResultsHigher community maternal mortality ratios were associated with lower community contraceptive prevalence, higher percentage of parity four-plus births, higher proportion of poor households, lower population density of hospitals, higher density of traditional birth attendants (TBA), and residence outside of Java-Bali. For every percentage point increase in CPR, community maternal mortality ratios were lower by 7.0 points (95% CI = 0.9, 14.3). Community-level household wealth was the strongest predictor of maternal mortality.ConclusionsCommunity contraceptive prevalence made a significant contribution to reducing maternal mortality net of other risk and protective factors during 2010–2015. Increased health system responsiveness to the needs of pregnant women and reductions in socioeconomic and geographic disparities in maternal health services will be needed for Indonesia to reach the 2030 SDG maternal mortality goal.