Effective Contraception Research Articles

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN RENDAHNYA PEMAKAIAN KONTRASEPSI MKJP PADA AKSEPTOR KB WILAYAH KERJA PUSKESMAS PUJOKERTO KABUPATEN LAMPUNG TENGAH TAHUN 2022

One of the targets of the National Family Planning Movement is to invite as many new family planning participants as possible to use effective and long-term contraceptive methods so that couples of childbearing age have a long survival rate in contraceptive use and this will have a positive impact on preventing pregnancy. In Pujokerto District, there were 913 active family planning participants who visited the puskesmas to get contraceptive services. Consisting of 801 non MKJP active acceptors or 87.7%, while 112 MKJP active acceptors or 12.3%. The decrease in the percentage of participants using MKJP also means an increase in the percentage of family planning using non MKJP. This research uses simple random sampling technique. Data collection is done by interview technique. The study was conducted from April to July 2022 with Univariate and Bivariate analysis with chi square test. The results showed that the variables studied were proven to have a relationship with the use of long-term contraceptive methods (MKJP) in the Pujokerto District Health Center, namely: Knowledge (P value = 0.034), Number of Living Children (P value = 0.018) and husband's support (P value = 0.015)

How to complete a safe and effective contraceptive consultation

The contraceptive consultation should focus on the provision of safe, effective contraception that suits the individual’s requirements. It is important to take a comprehensive medical and drug history to ensure that the chosen method is safe for the individual at both initiation and review consultations. A review consultation is a good opportunity to discuss other – often more effective – methods of contraception. Remote contraceptive consultations are suitable for many patients, as long as the same high standards of care are provided as they would be in a face-to-face consultation. Nurses offering contraceptive services should ensure they keep up to date with the latest clinical guidance. Contraceptive consultations are a key part of providing safe and effective contraceptive care. Claire Nicol explains how to conduct these in an efficient way

How to complete a safe and effective contraceptive consultation

The contraceptive consultation should focus on the provision of safe, effective contraception that suits the individual's requirements. It is important to take a comprehensive medical and drug history to ensure that the chosen method is safe for the individual at both initiation and review consultations. A review consultation is a good opportunity to discuss other – often more effective – methods of contraception. Remote contraceptive consultations are suitable for many patients, as long as the same high standards of care are provided as they would be in a face-to-face consultation. Nurses offering contraceptive services should ensure they keep up to date with the latest clinical guidance.

‘Here, the girl has to obey the family's decision’: A qualitative exploration of the tactics, perceived perpetrator motivations, and coping strategies for reproductive coercion in Bangladesh

Reproductive coercion (RC) undermines women's decision-making in reproductive health and negatively impacts women's health and well-being. This qualitative study explored RC in Bangladesh using in-depth interviews (IDIs) and focus group discussions (FGDs) with violence support centre clients, menstrual regulation (MR) and postabortion care (PAC) clients, and MR/PAC providers and pre- and post-procedure counsellors. All IDIs and FGDs were audio recorded, transcribed verbatim, and translated from Bangla to English for thematic analysis. RC was perpetrated primarily by male partners and in-laws and included both pregnancy-promoting tactics (such as contraceptive sabotage and forced continuation of an unwanted pregnancy) and pregnancy-preventing tactics (such as forced contraceptive use and forced MR). Threats and violence were tactics used for pregnancy-promoting and pregnancy-preventing RC. Perceived motivations for RC perpetration included family formation or dissolution, son preference, and a desire to maintain power or control over a woman. The primary motivator for contraceptive sabotage was concern about the safety and side effects of contraception, rather than pregnancy promotion. We classify this as contraceptive-related coercive control rather than RC due to the lack of pregnancy promoting intent. Women's responses to RC and contraceptive-related coercive control ranged from capitulation to active coping strategies such as covert use of contraception and MR, and enlisting providers' help to avoid forced MR. Differences in motivation for perpetration of RC and contraceptive-related coercive control call for distinct intervention strategies to support women's reproductive autonomy.

Trends in Postpartum Contraceptive Use in 20 U.S. States and Jurisdictions: The Pregnancy Risk Assessment Monitoring System, 2015-2018.

In the last decade, state and national programs and policies aimed to increase access to postpartum contraception; however, recent data on population-based estimates of postpartum contraception is limited. Using Pregnancy Risk Assessment Monitoring System data from 20 sites, we conducted multivariable-adjusted weighted multinomial regression to assess variation in method use by insurance status and geographic setting (urban/rural) among people with a recent live birth in 2018. We analyzed trends in contraceptive method use from 2015 to 2018 overall and within subgroups using weighted multinomial logistic regression. In 2018, those without insurance had lower odds of using permanent methods (adjusted odds ratio [AOR], 0.72; 95% confidence interval [CI], 0.53-0.98), long-acting reversible contraception (LARC) (AOR, 0.67; 95% CI, 0.51-0.89), and short-acting reversible contraception (SARC) (AOR, 0.61; 95% CI, 0.47-0.81) than those with private insurance. There were no significant differences in these method categories between public and private insurance. Rural respondents had greater odds than urban respondents of using all method categories: permanent (AOR, 2.15; 95% CI, 1.67-2.77), LARC (AOR, 1.31; 95% CI, 1.04-1.65), SARC (AOR, 1.42; 95% CI, 1.15-1.76), and less effective methods (AOR, 1.38; 95% CI, 1.11-1.72). From 2015 to 2018, there was an increase in LARC use (odds ratio [OR], 1.03; 95% CI, 1.01-1.05) and use of no method (OR, 1.05; 95% CI, 1.02-1.07) and a decrease in SARC use (OR, 0.97; 95% CI, 0.95-0.99). LARC use increased among those with private insurance (OR, 1.05; 95% CI, 1.02-1.08) and in urban settings (OR, 1.04; 95% CI, 1.02-1.07), but not in other subgroups. We found that those without insurance had lower odds of using effective contraception and that LARC use increased among those who had private insurance and lived in urban areas. Strategies to increase access to contraception, including increasing insurance coverage and investigating whether effectiveness of existing initiatives varies by geographic setting, may increase postpartum contraceptive use and address these differences.

Effectiveness of long-acting reversible contraception in women <25 years old

Tacoma Family Medicine, Tacoma, WA The corresponding author is Kerry Watrin; [email protected] The authors declare no conflicts of interest.

Abstract P3-03-27: Assessment of the proliferative activity of breast tissue after the administration of combined oral hormonal contraceptive, associated or not with estriol

Abstract The molecular mechanisms related to the breast cancer development are poorly understood, particularly those associated with estrogen. Evidence is mounting that developmental differences may influence the risk of cancer. However, understanding breast development, morphology and the biochemical factors that influence them is pertinent to study pre-malignant and malignant conditions that affect the breasts. Objective: To evaluate the proliferative activity of normal breast epithelium, through the c-myc expression, after the administration of combined oral hormonal contraceptive, associated or not with estriol. Retrospective double-blind study, in which the effect of combined oral contraceptives on the normal breast epithelium in women with fibroadenoma was evaluated. We analyzed 33 women In a cohort of 70 selected (37 excluded). The control group (1) received a compound containing levonorgestrel 0.15mg (LNG) and ethinylestradiol 0.03mg (EE), associated with 2mg of placebo (PLC) manufactured in the same capsule ingested daily for 21 days with an interval of 7 days, during four cycles. The study group (2) received a compound containing levonorgestrel 0.15 mg (LNG) and ethinylestradiol 0.03 mg (EE), associated with estriol 2 mg (E3) manufactured in the same capsule ingested daily for 21 days with an interval of 7 days, up to four cycles, when was proceeded the lumpectomy plus normal breast tissue sample. The UNIFESP-EPM Department of Pathology received the samples collected and fixed in 10% buffered formalin. We used an automation device to perform the Immunohistochemistry reactions, using c-myc antibodies, added DAB developer (diaminobenzidine) that provides a bright brown color that provides good contrast. We used conventional optical microscopy to read TMA slides. We considered positive the nuclei stained with dark brown in contrast to the blue negative to the c-myc reactions. We evaluated the epithelial areas at least five acinar units were present in the sample at 40X magnification. In the statistical analysis, the initial stages of consolidation as well as the analysis were performed in Software R (2020) and Rstudio (version 4.1), using the packages Tidyverse (2016), Psyco, SummaryTools, Janitor and DataExplorer. After verifying the assumptions of normality, independence and linearity, Student’s T test was performed for independent samples. An alpha of 0.05 was chosen for rejection of the null hypothesis, that is, a confidence interval of the test results of 95%. An effect size measure of the difference between the groups was also performed, called Cohen’s D; it ranges from -1 to 1, and the closer to 0, the smaller the effect size of the difference between the groups. Regarding the control group (30.30%) and the case group (69.70%). The table 2 presents the results for group 1 (COC + Placebo), while table 3 presents the results for group 2 (COC + Estriol). The T test was performed to verify a possible significant difference in the levels of cell proliferation in patients with or without Estriol. The normality was verified by the Shapiro-Wilk test, with data following a normal distribution (W = 0.901 and 0.96, p value > 0.3). The equitable variance was verified by the Levine test, which verified the equitable variance in both groups (F (1) = 0.24, p value = 0.62). A mean positive nucleus of 14 (SD = 10.65) was observed in the group of patients with contraceptive plus placebo and a mean of positive nuclei of 20.81 (SD = 9.88) in the group of patients with contraceptive plus Estriol. The ratio of positive nuclei to total was higher in the estriol group than in the control group. However, it was not possible to verify a significant difference in the two groups (T (14.57) = 1.3, p value = 0.215, d Cohen = 0.53). Cohen’s d pointed to a moderate difference effect (table 4). Table 2. Number of positive, negative and total normal epithelial cell nuclei in immunohistochemical investigation of c-myc antigens in Group 1 (COC + Placebo) (N = 10) Table 3. Number of positive, negative and total normal epithelial cell nuclei in immunohistochemical investigation of c-myc antigens in Group 2 (COC + Estriol) (N = 23) Table 4. Inferential results of the ratio of positive normal epithelial cell nuclei as a function of the control and case groups Citation Format: Osmar Pellegrini, Jr., Afonso Nazário, Angela Flavia L. Waitzberg. Assessment of the proliferative activity of breast tissue after the administration of combined oral hormonal contraceptive, associated or not with estriol [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-03-27.

Proximate determinants and decomposition of changes in fertility levels across Nigeria regions: Evidence from Nigeria Demographic Health Survey, 2003-2018.

There is disparity in fertility level across the six geopolitical zones in Nigeria. Deeper uunderstanding about the drivers of fertility trends are necessary to prioritize zonal specific strategies for fertility reduction in Nigeria. Thus, this study examined the proximate determinants (PDs) of fertility and decomposed the change in its level across the six geo-political zones in Nigeria. Data from Nigeria Demographic and Health Surveys of 2003 and 2018 were analyzed. Fertility data were based on the report of full birth history from women of reproductive age. The Revised Bongaarts framework was used to estimate PDs and fertility levels. The contribution of each PDs to the observed changes in fertility levels was quantified using Das Gupta's five- factor decomposition method. The Total fertility rate (TFR) in 2003 and 2008 across the zones are South-South (5.04 vs 4.36), South-West (4.88 vs 4.26), North West (7.25 vs 6.85), North East (6.87 vs 6.54), North Central (5.72 vs 5.48), South East (5.06 vs 4.86), Nigeria (6.00 vs 5.59). Across the zones, there was a change in the fertility inhibiting effect of Contraception (Cc) between 2003 and 2018. The fertility inhibiting effect of Postpartum Infecundability (Ci) and Abortion was the highest and smallest respectively across the zones. Delayed sexual exposure (Cm) and contraceptive use (Cc) contributed the most to the change across the regions. The percentage contribution of Cm in South-South, South West, and South East was 87.04%, 52.89%, and 172.85% respectively. Furthermore, most of the fertility change observed in North Central was attributable to Cc. Abortion index was not an important inhibiting factor of fertility in Nigeria. Delayed sexual exposure and contraceptive use accounted for the largest change observed in fertility levels across the six geo-political zones in Nigeria between 2003 and 2018. Strategies that promote delayed sexual exposure, contraceptive use and breast feeding practices will enhance fertility transition in Nigeria.

Male partner influence on Women's choices and utilisation of family planning services in Mufulira district, Zambia

BackgroundFamily planning services are essential in reducing maternal deaths as well as improving the reproductive and sexual health of women. Although family planning services are frequently focused on women, men are often the primary decision-makers. We conducted a study to explore male partner influence on women's choices and utilisation of family planning services in Mufulira district, Zambia. MethodsA qualitative explorative study design that utilised two focus group discussions (n = 20) and in-depth interviews (n = 30) involving women of reproductive age was conducted. Convenient sampling was employed to select participants. In-depth interviews and focus group discussions were recorded, translated, and transcribed verbatim. Content analysis was utilised through code classification and theme identification. Data were imported into NVivo.×64 for coding and node generation. FindingsThe study revealed key themes on male partner influence on contraception use such as fear of infidelity, fear of physical abuse, preference for a large family size , disruption of sexual pleasure, and perceived side effects of contraceptives. These themes highlight the influence of culturally driven gender and power dynamics on male partner attitudes towards contraception. Participants described how their male partners exhibited prenatal attitudes and control over them thereby limiting their decision-making power on contraception use. Undesirable contraception side effects such as reduced vaginal lubrication contributed to sexual pleasure disruption among men. Concerns that women's use of contraception can lead to infidelity also contributed to male partner disapproval of contraception use. ConclusionsUnderstanding barriers to contraception utilisation presented by male partners is essential in preventing contraception discontinuation and can increase contraception uptake among women. Our findings highlight the influence of culturally driven gender and power dynamics on male partner attitudes towards contraception. Therefore, male partner education on family planning services is key. Also, men need to be incorporated as key stakeholders when planning and implementing family planning programmes.

Is self-administered DMPA an answer to contraception access in the post-Roe era?

Compared with provider-administered depot medroxyprogesterone acetate, a prefilled formulation may offer patients improved access to effective contraception.

Abstract P390: Trends in Contraceptive Prescribing in Women With Hypertension From 2017-2022

Introduction: Estrogen based contraception is not recommended by the U.S. Medical Eligibility Criteria (MEC) in women with hypertension (HTN), regardless of control. While the CDC reports 65.3% of women of child-bearing age use contraception, little is known about rates of contraceptive prescriptions in women with HTN. Purpose: To examine contraceptive prescription patterns among women with and without HTN. Methods: Retrospective review of electronic health record (EHR) data through EPIC from a large health system was performed using a data extraction tool called EPIC SlicerDicer. All women aged 18-55 with HTN who presented to the health system from 2017-2022 were included. HTN, defined by ICD codes, included essential HTN, benign HTN, HTN in CKD due to T2DM, HTN in CKD III due to T2DM, HTN concurrent and due to end stage renal disease, HTN secondary to endocrine disorder, renovascular HTN, HTN with albuminuria, and secondary HTN. Contraceptive prescriptions were abstracted from the EHR including estrogen based contraception (combination oral contraceptive pills, patch, and ring), long acting reversible contraception (intrauterine device or implant), progestin only pills, and depo-provera. Results: Over 5 years, 33.5% (613 of 1,831) of women with HTN were prescribed contraceptives vs. 12.2% of women without HTN (77,742 of 637,820, p < 0.001, Table ). Women with HTN prescribed contraceptives were mean age 43 (SD 9) years, 76.2% White, 9.3% Black, and 16.2% Hispanic/Latina. Women with HTN not prescribed a contraceptive were mean age 48 (7) years (p < 0.001) with similar racial/ethnic background (p = 0.47). Among prescriptions for women with HTN, 37.7% were estrogen based. Conclusions: Women with HTN are prescribed effective contraception at a higher rate compared to the general population. Despite US MEC recommendations, over 1/3 of women with HTN are prescribed estrogen based contraception. Further efforts are warranted to encourage effective contraception counseling and prescription in this high-risk population.

Histological Evaluation of Uterus and Bone response to Hormonal Contraceptive in Rats

Background: Sex hormones play an important role in uterus and bone tissue integration. Oral hormonal contraceptive pills (OCPs) were developed over 50 years ago. Aims of the study: to clarify the histological evaluation of different types of hormonal contraceptive effects on uterus, cervix, ovary, endometrium, and bone in the female albino rat. Materials and methods: The study was conducted on thirty albino rats. three groups each group 10 rats one of them considered as a control group and the other two groups considered as a treated group which taking oral hormonal contraceptive once daily for about 8 weeks and another group takes injectable hormonal contraceptive once weekly for about 8 weeks then euthanized for histological examination. Result: After 8 weeks of drug administration histological findings show significant differences in the thickness of articular cartilage, the thickness of metaphyseal plate, the thickness of trabecular bone, and thickness of endometrium between the control group and experimental group. Conclusion: The current study showed that hormonal contraceptives exhibited histological changes on the uterus and bone which can be correlated to different clinical findings.

Progestin intrauterine devices versus copper intrauterine devices for emergency contraception.

The copper intrauterine device (Cu-IUD) is a highly effective method of contraception that can also be used for emergency contraception (EC). It is the most effective form of EC, and is more effective than other existing oral regimens also used for EC. The Cu-IUD provides the unique benefit of providing ongoing contraception after it is inserted for EC; however, uptake of this intervention has been limited. Progestin IUDs are a popular method of long-acting, reversible contraception. If these devices were also found to be effective for EC, they would provide a critical additional option for women. These IUDs could not only provide EC and ongoing contraception, but additional non-contraceptive benefits, including a reduction in menstrual bleeding, cancer prevention, and pain management. To examine the safety and effectiveness of progestin-containing IUDs for emergency contraception, compared with copper-containing IUDs, or compared with dedicated oral hormonal methods. We considered all randomized controlled trials and non-randomized studies of interventions that compared outcomes for individuals seeking a levonorgestrel IUD (LNG-IUD) for EC to a Cu-IUD or dedicated oral EC method. We considered full-text studies, conference abstracts, and unpublished data. We considered studies irrespective of their publication status and language of publication. We included studies comparing progestin IUDs with copper-containing IUDs, or oral EC methods for emergency contraception. We systematically searched nine medical databases, two trials registries, and one gray literature site. We downloaded all titles and abstracts retrieved by electronic searching to a reference management database, and removed duplicates. Three review authors independently screened titles, abstracts, and full-text reports to determine studies eligible for inclusion. We followed standard Cochrane methodology to assess risk of bias, and analyze and interpret the data. We used GRADE methodology to assess the certainty of the evidence. We included only one relevant study (711 women); a randomized, controlled, non-inferiority trial comparing LNG-IUDs to Cu-IUDs for EC, with a one-month follow-up. With one study, the evidence was very uncertain for the difference in pregnancy rates, failed insertion rates, expulsion rates, removal rates and the difference in the acceptability of the IUDs. There was also uncertain evidence suggesting the Cu-IUD may slightly increase rates of cramping and the LNG-IUD may slightly increase bleeding and spotting days. AUTHORS' CONCLUSIONS: This review is limited in its ability to provide definitive evidence regarding the LNG-IUD's equivalence, superiority, or inferiority to the Cu-IUD for EC. Only one study was identified in the review, which had possible risks of bias related to randomization and rare outcomes. Additional studies are needed to provide definitive evidence related to the effectiveness of the LNG-IUD for EC.

The Perfect Storm: Perceptions of Influencing Adults Regarding Latino Teen Pregnancy in Rural Communities.

Recognition of the importance of adolescents' environments in influencing their sexual and reproductive health (SRH) decision-making necessitates a deeper understanding of the role that community stakeholders play in shaping Adolescent and Young Adults (AYA) access to SRH education and care. We describe community stakeholders' knowledge, beliefs, and attitudes about AYA's SRH needs in three rural Latino communities in Kansas. Key stakeholders completed a written survey incorporating the theory of Planned Behavior to assess attitudes, norms, and intentions to support AYA's SRH education and access to care. Across three rural immigrant community settings, respondents (N = 55) included 8 community health workers, 9 health care providers, 7 public health officials, 19 school health officials, and 12 community members. More than half self-identified as Latino (55%). Six (11%) participants, half of whom were in the health sector, thought SRH education would increase the likelihood that teens would engage in sexual activities. In contrast, other stakeholders thought that providing condoms (17, 30.9%), contraception other than condoms (14, 25.5%), and providing HPV immunization (5, 9.6%) would increase the likelihood of engaging in sexual activity. Ambivalence regarding support for SRH education and service provision prevailed across sectors, reflected even in the endorsement of the distribution of less effective contraceptive methods. Obstacles to care include immigration status, discrimination, lack of confidential services, and transportation. Key stakeholders living in rural communities revealed misconceptions, negative attitudes, and ambivalent beliefs related to the delivery of SRH education and services, potentially creating barriers to AYA's successful access to care.

Menstrual cycle and hormonal contraceptive phases' effect on elite rowers' training, performance and wellness.

Objectives: To investigate the effect of menstrual cycle (MC) and hormonal contraception (HC) phases in elite rowers training, performance and wellness monitoring. Methods: Twelve French elite rowers were follow-up for 4,2 cycles on average in their final preparation for the Olympics and Paralympics Games in Tokyo 2021 through an on-site longitudinal study based on repeated measures. Daily self-reported evaluation using Likert rating scales of wellness (sleep quality, fitness, mood, injuries' pain), menstrual symptoms and training parameters (perceived exertion and self-assessment of performance) were collected (n = 1,281) in parallel to a coach evaluation of rowers' performance (n = 136), blinded to theirs MC and HC phases. Salivary samples of estradiol and progesterone were collected in each cycle to help to classify the MC into 6 phases and HC into 2-3 phases depending on the pills' hormone concentration. A chi-square test normalized by each rower was used to compare the upper quintile scores of each studied variable across phases. A Bayesian ordinal logistic regression was applied to model the rowers' self-reported performance. Results: Rowers with a natural cycle, n = 6 ( + 1 amenorrhea) evaluate their performance and wellness with significant higher score indices at the middle of their cycle. Top assessments are rarer at the premenstrual and menses phases, when they more frequently experience menstrual symptoms which are negatively correlated with their performance. The HC rowers, n = 5, also better evaluate their performance when taking the pills and more frequently experience menstrual symptoms during the pill withdrawal. The athletes self-reported performance is correlated with their coach's evaluation. Conclusion: It seems important to integrate MC and HC data in the wellness and training monitoring of female athletes since these parameters vary across hormonal phases affecting training perception of both athlete and coach.

A longitudinal cross-sectional study on awareness of contraception

Contraception is a method or a way to stop or prevent pregnancy. Since from ancient times birth control has its prevalence but the safest and most efficient methods of contraception was only introduced in 20th century. An ideal contraceptive is considered when it is user-friendly, effective and reversible with less or zero side effects and lesser adverse complications and more importantly one which is easily available. There are wide range of contraception or birth control methods currently available which includes traditional methods, barriers, oral contraceptives pills (OCP), implants, Intra Uterine Devices (IUDs) and Surgical methods along with injectable. The United States Center for Disease Control and Prevention jointly with World Health Organization has provided with guidelines on the safety of contraception for women with specific medical condition. According to another report documented by World Health organization, which stated that most effective and safest methods of contraception is sterilization by means of vasectomy in males and in cases of females by means of tubal linguation, intra uterine devices and implantable birth control. This data of safest birth control method also includes vaginal rings, oral pills, patches and injections. World Health Organization Department of Reproductive Health and Research has also stated that less effective methods includes physical barriers & spermicide and the least effective methods of contraception is traditional or natural method.A longitudinal cross-sectional study was conducted in the Department of Obstetrics and Gynecology at Gyan Sagar Medical College and Hospital in Punjab, India. Ethical approval was taken from the committee before commencing of this study. To determine the prevalence of awareness of Contraception and to determine the most commonly used contraceptive method among subjects. We hereby conclude our longitudinal cross-sectional study by indicating the fact that prevalence of awareness of contraception is higher in urban and educated classes of our society. We thereby wanted to spread one message through our study so that special initiative on birth control method should be mandated by Government in various medical colleges and hospitals in India to create awareness in rural sections and interior villages, social awareness of safe sexual practice could be spread each and every section of our country because contraception does not only prevent pregnancy it also protects the mankind and save one’s life from HIV and other sexually transmitted infections. As is always quoted correctly that “Prevention is better than cure”.

Progesterone and contraceptive progestin actions on the brain: A systematic review of animal studies and comparison to human neuroimaging studies

In this review we systematically summarize the effects of progesterone and synthetic progestins on neurogenesis, synaptogenesis, myelination and six neurotransmitter systems. Several parallels between progesterone and older generation progestin actions emerged, suggesting actions via progesterone receptors. However, existing results suggest a general lack of knowledge regarding the effects of currently used progestins in hormonal contraception regarding these cellular and molecular brain parameters. Human neuroimaging studies were reviewed with a focus on randomized placebo-controlled trials and cross-sectional studies controlling for progestin type. The prefrontal cortex, amygdala, salience network and hippocampus were identified as regions of interest for future preclinical studies. This review proposes a series of experiments to elucidate the cellular and molecular actions of contraceptive progestins in these areas and link these actions to behavioral markers of emotional and cognitive functioning. Emotional effects of contraceptive progestins appear to be related to 1) alterations in the serotonergic system, 2) direct/indirect modulations of inhibitory GABA-ergic signalling via effects on the allopregnanolone content of the brain, which differ between androgenic and anti-androgenic progestins. Cognitive effects of combined oral contraceptives appear to depend on the ethinylestradiol dose.

Perceived motivators, knowledge, attitude, self-reported and intentional practice of female condom use among female students in higher training institutions in Dodoma, Tanzania

BackgroundUnplanned pregnancies and sexually transmitted infections (STIs) Human Immunodeficiency Virus (HIV) inclusive, have remained to be a significant public health challenges among young people, especially across middle and low-income countries. Self-efficacy on the right ways of using condoms appears to be effective against the aforementioned health-related problems. However, most women of reproductive age tend not to use them when they are using highly effective contraceptives such as implants, and/or injectable hormones. It is unknown whether the uptake of female condoms among young girls is significantly high or not. Examining female students’ perceived motivators, knowledge, attitudes, and self-reported and intentional female condom practice in training institutions seems to be a key precursor in addressing the challenge.MethodsThe institutional-based analytical cross-sectional survey in a quantitative research approach was adopted to study 384 randomly selected female students from higher training institutions, in Tanzania. Interviewer-administered structured questionnaires from previous studies were the main data collection tools. Data analysis was done using a statistical package for social science (SPSS) with the strength of statistical limits set at a 95% confidence interval and a 5% significance level.ResultsThe response rate of the study was 100% with 24 ± 2.122 years respondents’ mean age while and 32.7% of them were in the third year of their studies. Only 6.2% of the respondents reported having used female condoms while 26.3% of them have not ever seen packages of female condoms. The minority of the respondents (21.7%, 23.3%, and 9.4%) demonstrated good knowledge, positive attitude, and intention to use female condoms respectively. Their age, accommodation, marital status, peer groups, previous training, knowledge, and attitude related significantly to their intentional practices of female condom use (p < 0.05).ConclusionGiven the existing governmental and non-governmental efforts that advocate awareness creation and the uptake of various contraceptives, this study has found that knowledge, attitude, self-reported and intentional practices of female students admitted in higher training institutions within Dodoma region, Tanzania is low. Institutionalized educational programs on sexual and reproductive health matters may need to be prioritized to increase the availability, accessibility, and uptake of female condoms among female students in higher training institutions.

Perceived knowledge of female athletes on the influence and effects of the menstrual cycle on musculoskeletal injuries

Background and Study Aim. The menstrual cycle (MC) has been theorized as a significant factor that contributes to musculoskeletal injuries amongst female athletes. However, the literature showing its effects are limited. Additionally, very little is known about the knowledge of the MC and its effects on the body and injury occurrence amongst competitive female athletes. The aim of the study was to investigate the knowledge levels on the effects of the MC and hormonal contraceptives amongst female athletes.&#x0D; Material and Methods. An online questionnaire was utilized. The questionnaire was distributed by the researchers, sports coaches and managers of the respective sports teams to university athletes older than 18 years. The data was analyzed quantitatively using the Statistical Package for the Social Sciences (SPSS, version 28).&#x0D; Results. A total of 76 participants were recruited in this study with a mean age of 21,12±2,033. Out of the 76 respondents, 50% had no knowledge and only 2,6% had very high knowledge of the MC and its effects on musculoskeletal injuries. Majority of the respondents had “low knowledge” (n=32) on the effects of hormonal contraceptives on the body and only 5 participants had “very high knowledge”.&#x0D; Conclusion. Majority of the female athletes’ knowledge ranged from no to low knowledge of the MC and its effects on the body and musculoskeletal injuries. Additionally, the knowledge levels on the effects of hormonal contraceptives on the body were predominantly low. This highlights the importance of expanding the knowledge of female athletes and stakeholders within the sports community on the effects of the MC on injury occurrence.

A 5-year comparative study of efficacy and acceptability of three different sizes of TCu380Ag and TCu380A intrauterine devices.

The intrauterine contraceptive device TCu380Ag when compared with TCu380A at 1 year of use had better acceptability and continuation rates. To study the continuation rate, efficacy, and acceptability of TCu380Ag in three sizes versus TCu380A at 5 years of use. A total of 600 women opting for intrauterine contraceptive devices were randomized equally into two groups. Group 1 received the TCu380Ag device (Normal, Maxi, and Mini for uterocervical length 7-8.5cm, 8-9cm, and 6-7.5cm, respectively) and Group 2 received the TCu380A device. Follow-up was performed at 5 years to assess efficacy, acceptability, and continuation. Frequency data comparisons was performed across categories using χ2 /Fisher exact test. At 5 years of use, Kaplan-Meier survival analysis showed that TCu380Ag compared with TCu380A had a higher continuation rate (45% vs. 35%, P= 0.010) with 100% efficacy each. TCu380Ag had fewer side effects, including heavy menstrual bleeding (16.6% vs. 34.1%, P< 0.001), abdomen pain (12.1% vs. 23.0%, P= 0.001), and expulsions (4.4% vs. 8.7%, P< 0.050), and fewer discontinuations attributable to contraceptive side effects (42.7% vs. 56.9%, P= 0.012). The mini TCu380Ag had the highest continuation rates and least menstrual irregularity (P< 0.050). The TCu380Ag device in three sizes is an alternative to TCu380A for women desiring 5 years of contraception with equal efficacy, better continuation, and acceptability. The mini size is preferred for women with a uterocervical length of 6 to 7.5cm.