Birth Control Research Articles

Meeting people’s pregnancy prevention needs: Let’s not force people to state an “Intention”

Pregnancy intention screening does not identify need for pregnancy prevention and ignores the nuances of lived experiences while reinforcing white middle-class normative expectations. Asking about desire for contraception is a patient-centered approach to meeting people’s needs.

Qualitative research to advance social norms initiatives of the RHRA: Mombasa County, HAKI Jamii, and the RHRA Study

Background: In Kenya, there is a general lack of knowledge on the prevention of unintended pregnancies, especially among the rural poor and women living in urban and peri-urban informal settlements. Unsafe abortion is common, and stigma directed at the woman, provider, woman’s family, and facility is common. Objective: To explore public perceptions of abortion, gather awareness of the legal provisions for abortion, and determine access to information and services. Methods: Qualitative in-depth research used four focus groups of women and men aged 18-54 years. The interactions were face-to-face and verbatim transcripts. The messages were organized, coded, and categorized into three categories using the delve software. Coding followed a mix of deductive and inductive processes. Results: There were highly resistant views on abortion across all four groups, focusing mainly on potential complications and death. Emerging voices support termination for rape, defilement, and incest. Abortion occurs more often among married women than among girls. Regarding the legal provisions, safe abortion respondents said it was illegal yet legal. It can be kept secret and influenced by one’s religion. Barriers to safe abortion access included high cost and lack of knowledge of where services are available. However, unintended pregnancies were common in informal settlements, resulting from transactional sex, sex, and gender-based violence, and lack of knowledge of and access to contraception. Conclusion: There is a need to unpack the collective social silence and the association of abortion with unpleasant social issues and to understand and target the drivers of abortion stigma, including premature death, future fertility concerns, guilt, and the murder label.

Factors Associated with the Uptake of Long-acting Reversible Contraception and Contraceptive Use in Postpartum People with HIV at a Single Tertiary Care Center.

This study aimed to elucidate factors contributing to uptake of highly effective contraception, including permanent contraception, and no contraceptive plan among postpartum people with HIV (PWHIV). A retrospective cohort analysis was conducted to correlate postpartum birth control (PPBC) with sociodemographic and biomedical variables among postpartum PWHIV who received care at The Ruth M. Rothstein CORE Center and delivered at John H. Stroger, Jr. Hospital of Cook County in Chicago, from 2012 to 2020. Earlier gestational age (GA) at initiation of prenatal care, having insurance, and increased parity are associated with uptake of highly effective contraception. Meanwhile, later GA at presentation increased odds of having no PPBC plan. Early prenatal care, adequate insurance coverage, and thorough PPBC counseling are important for pregnant PWHIV. · Contraceptive use among PWHIV is poorly understood.. · Having insurance and increased parity are associated with long-acting reversible contraception use.. · Earlier GA at first prenatal care visit is associated with increased PPBC uptake..

Phytochemical study of ‘taiji’ (Handroanthus impetiginosus (Mart.) Mattos) and ‘ka’a ovetĩ’(Luehea divaricata Mart.) extracts

This study explores the phytochemical composition of leaf extracts from Handroanthus impetiginosus (Mart.) Mattos and Luehea divaricata Mart., used in a contraceptive decoction by Mbya-Guarani women. The phytocompounds were identified by gas chro­matography-mass spectrometry, while Fourier-transform infrared spectroscopy, multi-elemental, and thermal analyses were used to characterise plant biomass. Notably, no phytoconstituent supporting the efficacy of these extracts as female contraceptives was found, except for a small amount (0.3%) of sitosterol. Conversely, L. divaricata leaves contained compounds like 1,3-dihydroxyacetone dimer, N-methyl-N-nitroso-2-propanamine, 2-methoxy-N-(2-methoxyethyl)-N-methyl-ethanamine, and 1,3,5-triazine-2,4,6-triamine, potentially exerting cytotoxic, genotoxic, and toxicogenomic effects. Due to the absence of scientific support for the claimed contraceptive efficacy and the presence of safety concerns, we propose an alternative valorisation pathway centred on the presence of phytochemicals exhibiting antimicrobial activity. This proposition is substantiated by their considerable in vitro efficacy against Botrytis cinerea.

A Perforated Intrauterine Device and Laparoscopic Removal from the Omentum: Case Report

The intrauterine device (IUD) was a very common form of birth control in Tunisia and the world wide. The most serious potential complication of IUD use is uterine perforation. Clinical trials of Multiload Cu375 have reported an incidence of less than one uterine perforation per 1,000 insertions [1-3]. The recommended treatment is removal of the perforating IUD. This can usually be managed laparoscopically unless bowel perforation or other severe sepsis is present. We report a case of 45 years old woman carrying an IUD for 6 years which was referred from the family planning for IUD "lost". Upon vaginal examination, no IUD string was detected. An abdominal X-ray localised the IUD in a right iliac fossa. The device was identified and removed with a portion of the omentum. There is not an intestinal damage fortunately. The laparoscopic approach for intrauterine device removal has multiple purposes like identifing IUD, removing it and looking for eventuelly intestinal damages. It may be a simple and safe approach, thus minimizing possible postoperative complications.

Physical activity and cognitive function in adults born very preterm or with very low birth weight-an individual participant data meta-analysis.

Individuals born very preterm (<32 weeks of gestation) or with very low birthweight (<1500g) have lower cognitive function compared with term-born peers. Furthermore, some studies suggest that they are less physically active as young adults than controls, but the relationship between physical activity and cognitive function remains unclear. We performed an individual participant data meta-analysis to examine whether being born preterm/with very low birth weight is associated with physical activity in adulthood and examined if cognitive function mediates this association. Cohorts with data on physical activity and cognitive function in adults born very preterm/very low birth weight and term-born controls were recruited from the Research on European Children and Adults Born Preterm, and the Adults Born Preterm International Collaboration Consortia. A systematic literature search was performed in PubMed and Embase. Five cohorts with 1644 participants aged 22-28 years (595 very preterm/very low birth weight and 1049 controls) were included. Adults born very preterm/very low birth weight reported 1.11 (95% CI: 0.68 to 1.54) hours less moderate to vigorous physical activity per week than controls, adjusted for cohort, age and sex. The difference between individuals born very preterm/very low birth weight and controls was larger among women than among men. Neither intelligence quotient nor self-reported executive function mediated the association between very preterm/very low birth weight and moderate to vigorous physical activity. Results were essentially the same when we excluded individuals with neurosensory impairments. Adults born very preterm/very low birth weight, especially women, reported less moderate to vigorous physical activity than their term-born peers. Cognitive function did not mediate this association. Considering the risk of adverse health outcomes among individuals born preterm, physical activity could be a target for intervention.

The effect of estrogen-containing birth control pills on the constituents of bradykinin expression in plasma

Hereditary angioedema with C1-inhibitor deficiency (HAE-C1INH) is a rare autosomal disorder presenting with recurrent angioedema. Estrogen-containing medications trigger angioedema in some patients, and conversely, progesterone may decrease attack frequency. The mechanism by which estrogen may exacerbate angioedema in HAE-C1INH is not well characterized. Our aim was to investigate the link between estrogen and bradykinin constituents to better understand the specific underlying triggers that may exacerbate angioedema in patients with HAE-C1INH. As estrogen is contraindicated for patients with HAE-C1INH, females without a history of angioedema were recruited to evaluate whether estrogen-containing oral contraceptive pills (OCPs) alter plasma protein levels of bradykinin, cleaved high-molecular-weight kininogen (cHK), and activated factor XII (FXIIa). Blood (plasma) was collected before initiation of OCP administration and 3 months thereafter. High-molecular-weight kininogen (HK) was measured by ELISA and FXIIa and cHK were analyzed by Western blot analysis. A total of 12 adult females without HAE-CINH (aged <40 years) had a median baseline plasma HK level of 33,976 ng/mL. After 3 months of OCP therapy, their median HK levelincreased to 38,202 ng/mL. With OCPs, there was also a significant increase in level of FXIIa protein (P <.01), as well asan increase in cHK protein level. This preliminary study, performed in females without HAE-C1INH, suggests that estrogen may exacerbateangioedema by increasing the production of cHK and FXIIa.

Young Women's Needs Regarding Sexual Preventive Behaviours and Unwanted Pregnancies.

Unwanted pregnancies are considered a public health problem that affects women's mental health and quality of life. The aim of this paper was to access university students' understanding and behaviours regarding unwanted pregnancies and identify their needs to prevent them. Qualitative descriptive design was used, and 13 semi-structured interviews were carried out. Women between 18 and 20 years old participated. They discussed a lack of training for themselves, their partners, and their families, their desire to have access to non-in-person health care resources, and their belief that contraception was expensive. Emotional aspects were relevant, affecting the way communication is established with those close to them and with health professionals. Despite the existence of access to sexual health resources, the findings show the existence of needs related to the prevention of unwanted pregnancies. The findings are presented grouping the main identified needs as "related to capability", "related to opportunity", and "related to motivation". Among the aspects to consider when designing interventions to prevent unwanted pregnancies are the feelings shown by these women, the inclusion of couples and family members in educational programs, and access to non-face-to-face health resources and less expensive contraceptive methods. Interventions for social support and understanding of women are necessary both to prevent unwanted pregnancies and to support adolescents with unwanted pregnancies by avoiding criminalization or blame.

Increasing Adolescent Sexual Activity Screening Through a Provider-Based Intervention.

Screening for adolescent sexual activity is a vital aspect of comprehensive pediatric care. Adolescents engage in risky sexual behaviors. Thus, a complete and accurate sexual health history can assist in the prevention and treatment of disease, prevention of unwanted pregnancy, treatment of existing diseases, and optimal planning of future healthcare for adolescents. Current evidence shows that provider-focused strategies improve the delivery of preventive services, including sexual health screenings. In this initiative, we assessed and examined pre- and post-screening rates for sexual activity among adolescents by advanced practice providers. This multi-site initiative was implemented in four school-based health centers and a school-linked center that included 2,102 unique patients ages 9 to 24 years. Our biphasic intervention included education for advanced practice providers and electronic health record modifications. Pre- and post-data collection was conducted to determine changes in the rate of screening for sexual activity during a primary care adolescent health visit over a 3-year period. Data were collected via retrospective medical chart review and analyzed in three time periods for comparison from 2018 to 2021. Screening rates for sexual activity increased significantly after the intervention (all p < .001) with the likelihood more than double that of the year before it was implemented. The intervention was deemed to be a feasible and cost-effective strategy to improve the provider's willingness and ability to provide more adolescent sexual health screenings.

PERANCANGAN SISTEM INFORMASI PELAYANAN PASIEN BERBASIS WEB PADA PRAKTIK MANDIRI BIDAN LIA YULIANINGSIH

Midwife Lia Yulianingsih Independent Practice is a place to provide services in the health sector such as serving examinations for pregnant women, examination of children and toddlers, providing child immunizations, injecting birth control, and assisting the delivery process. The patient service process is still relatively conventional and less effective and efficient in the process of patient registration, reporting, and data collection. Management of patient examination history data is also still carried out manually. Based on this, solutions are needed in overcoming existing problems, it is necessary to have a computerized system so that information runs quickly and accurately. The method is the waterfall with Unified Modelling Language (UML). The programming language used is PHP with a Mysql database. The purpose is to determine the proposed system, design and implement a web-based patient service information system at the Independent Practice of Midwife Lia Yulianingsih. The results obtained are midwives and assistant midwives will be more effective and efficient in registering patients and recording patient examination data, providing ease of searching patient data and previous patient history examination data, thus helping all related processes become faster, facilitating the work of officers in making patient visit reports and income reports more quickly and accurately

Barriers and facilitators to access sexual and reproductive health services among young migrants in Tarapacá, Chile: a qualitative study.

Chile has become a destination country for immigrants from Latin America, including youth. Guaranteeing access and use of sexual and reproductive health services for young migrants is crucial because of their overlapping experiences of transitioning to a new country and to adulthood. However, the existing evidence shows barriers to accessing sexual and reproductive healthcare among young migrant populations. In this context, the main objective of this article is to identify the barriers and facilitators that young migrants experience to access sexual and reproductive healthcare in the Tarapacá region of Chile. A qualitative study was conducted in the Tarapacá region of Chile. Semi-structured interviews with 25 young migrants from Venezuela, Colombia, and Ecuador, as well as 10 health workers, were carried out. The interviews were transcribed and thematically analysed. The study was approved by the Ethics Committee of the Universidad del Desarrollo (#2019-22). Young migrants face barriers linked to structural shortcomings within the healthcare system, which may be similar to those faced by the local population. Barriers are also derived from reductionist sexual and reproductive health approaches, which prioritise the prevention of pregnancy, sexually transmitted infections, and HIV, with a predominantly heteronormative focus. The prevailing narratives from the health system are those of risk and lack of control and self-care among young people, and they are exacerbated in the case of migrants. Young migrants, especially from the Caribbean, are stereotyped as over-sexualised and liberal in comparison to the local population and believed to be engaging in riskier sexual behaviours that should be kept under check. This may translate into experiences of discrimination and mistreatment when receiving care. Facilitators include good-quality information and community-level interventions. This study shows a limited approach to the sexual and reproductive health of young migrants in Chile, severely hampering their reproductive and sexual rights. Policies and initiatives must work towards removing structural barriers, changing narratives, and empowering young migrants regarding their sexual and reproductive health.

Copyright and digital music platforms: harmony or dissonance?

This study addresses the complex relationship between copyright and digital music platforms in the digital era. As digital platforms become the primary means of music distribution, significant challenges arise concerning the protection and fair compensation of authors. The article explores the evolution of the music industry, from the early days of the phonograph to modern streaming platforms, highlighting the technological changes that have shaped the relationship between music and technology. The copyright system in Brazil is also discussed, influenced by the French dual protection model, encompassing both economic and moral rights. The text also analyzes the role of the Central Office for Collection of Copyright (ECAD) and its seven Associations in the collective management of copyright, as well as the issue of transparency in the distribution of economic rights. One point of debate is whether music transmission through streaming platforms should be considered public or private performance, directly impacting copyright revenue collection. Therefore, this study aims to present the relevant panorama of this new context of copyright associated with digital music platforms (streaming). Adopting a deductive methodology with exploratory research, the article concludes that the landscape of copyright in Brazil and its relationship with digital music platforms is a complex and challenging topic that requires careful consideration and appropriate regulation to ensure authors are adequately protected in a constantly evolving digital environment. It emphasizes the need for greater transparency and clarity in the collection, calculation, and distribution system of economic rights by digital music platforms.

“Even when you write with a pencil there is an eraser to clean it”: Examining men's conceptualisations of and involvement in emergency contraceptive use in Accra, Ghana

Emergency contraceptive pills are an essential and unique post-coital method to avoid a pregnancy, with evidence showing the significant role men can have in procurement and decisions to use. Global Health recommendations specify that emergency contraceptive pills be used sparingly and under specific conditions. This increasingly misaligns with the myriad conceptualisations and rationales among the public for why they choose to use emergency contraceptive pills. There has been a paucity of research aiming to understanding men's involvement and how they shape women's access, choice, and autonomy.This study interrogates how emergency contraceptive pills are conceptualised by men in James Town, Ghana, and how this intersects with their motivations to be involved in its use. Mixed method data from a survey (n = 270) and in-depth interviews (n = 37) were collected between July 2020 and January 2021. The analysis examines men's framings of emergency contraceptive pills and how these shape their involvement in its use.Men's knowledge of post-coital contraceptives was high, while knowledge of the specific term ‘emergency contraception’ was lower. While some men understood the pills in ways that aligned to Global Health framings, many more men saw emergency contraceptive pills as another means of pregnancy prevention in line with other contraceptives. This included its conceptualisation as a contraceptive that facilitates pleasurable (condomless) and spontaneous sex. Gendered perceptions of women who use emergency contraceptive pills were bound in sexual stigma, and men indicated that emergency contraceptive pills were a directly observable form of contraception that they could pressure their partner into using. Understanding plural conceptualisations away from ‘emergency’ are necessary to create policies and programmes that account for men's involvement. This includes understanding how emergency contraceptive pills are located within people's sexual and reproductive lives and gendered power dynamics, to reflect the public's own rationales for and experiences using post-coital contraceptives.

Deteksi Perubahan Berat Badan Akseptor KB Hormonal dengan Menggunakan Model Regresi Linear Berganda

Hormonal contraception, which uses estrogen and progesterone preparations, is a contemporary method of contraception that is popular among active birth control participants. Apart from stopping population growth, it also has negative effects on its users. The side effect of increasing body weight can occur due to the nature of the acceptor and the use of hormonal contraceptives for a long period of time. The aim of the study was to detect changes in body weight of hormonal birth control acceptors based on age, parity and length of use of contraception using a multiple linear regression model. Non-experimental quantitative analytical research method with a cross sectional design. The research was conducted at several PMBs in Palembang City in July-September 2023 with samples consisting of hormonal birth control acceptors taken using a purposive sampling technique. Data were collected using questionnaires and body weight measurements and analyzed by multiple linear regression. The results of the research show that the prediction model for weight change = 5.789 - 0.098 Age + 1.4 Parity - 0.008 Length of birth control. Weight gain will definitely affect the health of the recipient and can increase the risk of obesity if it continues. To maintain a stable weight, birth control acceptors must pay attention to their daily diet and exercise regularly. It is very important to obtain information about the effects caused by the use of hormonal birth control with a high number of parities and ages at risk.

FACTORS CONTRIBUTING TO WOMEN’S PSYCHOLOGICAL BIRTHING TRAUMA: VICTORIAN MIDWIVES’ PERSPECTIVES

This article reports midwives’ perspectives on factors contributing to women’s psychological birthing trauma, including recommendations for practice. Interviews with 11 participants identified three themes: ‘It’s this complete control of birth’ – how the healthcare system is patriarchal and assumes control of the woman and her process. ‘No one actually informed me’ – women are kept ignorant, unable to confidently advocate for themselves. ‘Feeling… she has… failed’ – the accumulating demands of external events overwhelming emotional needs. The findings show that further research about healthcare providers’ views on factors contributing to women’s psychological birthing trauma is needed to improve Australian maternity services.

Birth control and sleep disturbances

Birth control and sleep disturbances

Factors Affecting Contraceptives usage among Pupils in Selected Secondary Schools within Chingola District, Zambia

Background: The contraceptives usage among pupils remains a topical issue globally, regionally and locally. Zambia is underpinned by Christian principles and values and despite that, the country continues to record high levels of unplanned pregnancies among pupils and this hampers the education of a girl child. The study has established that most pupils are sexually active and this puts them at a higher risk of getting unplanned pregnancies and consequently dropping out of School. Objective: The study aimed at investigating the “Factors Affecting Contraceptive Usage Among Pupils in Selected Secondary Schools within Chingola District, Zambia”. Methods and Materials: The study used a cross- sectional study design in which 52 pupils from Chingola and Sekela Secondary Schools were included in a study. The study employed semi-questionnaires and interview guides. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 21. Chi-square test was used to determine the relationship between independent and dependent variables. Conclusion: The study has revealed that pupils are at a higher risk of unplanned pregnancies as well as sexually transmitted diseases despite them having knowledge of contraceptives usage. The study has also indicated that 63.5% of pupils were aware of the existence of contraceptives and their functions as a means of prevention of pregnancies. Therefore, there is need of deliberate move by Ministry of Health through District Health offices to promote accessibility to various methods of contraceptives by pupils especially those in Secondary Schools who are sexually active.

Menopause-Associated Changes in Mandibular Bone Microarchitecture Are Site-Specific

BackgroundThere are conflicting reports on the effects of decreased estrogen levels on mandibular bone microarchitecture, and whether these effects are consistent throughout the mandible is unclear and may have important implications for treatment planning. PurposeThe goal of this study was to evaluate trabecular and cortical bone microstructure in the mandibular condyle and the mandibular basal bone and compare these sites between premenopausal and postmenopausal women. Study Design, Setting, SampleParticipants were recruited for a cross-sectional cohort study at Columbia University Irving Medical Center. Each participant had CBCT taken of their mandibular condyles and of the basal bone. Exclusion criteria for the population included a) current chemo- or immunotherapy; b) history of bisphosphonate or other osteoporosis therapy; and c) currently pregnant, nursing, or on hormonal birth control. Independent VariableThe predictor variables are menopausal status (before or after menopause) and mandibular region of interest (condyle/basal bone). Outcome VariableParameters of interest included the following indicators of bone quality: trabecular bone volume fraction (BVF), trabecular thickness, trabecular number, trabecular separation, cortical BVF, cortical thickness, and cortical porosity. CovariatesCovariates included demographic variables such as age, estrogen levels, and ethnicity. AnalysesQuantitative microstructure analyses were conducted on CBCT images, and differences between groups for continuous measures (including age) were assessed with unpaired t-test, and demographic variables were assessed by Chi-square. Statistical significance was recorded at p<0.05. ResultsThe premenopausal and postmenopausal groups each had 31 participants, with the following average age: premenopausal= 43.9±6.9 vs. postmenopausal = 57.5±7.6 years old; p<0.001, and estrogen levels: premenopausal =91.77±80.13 pg/ml vs. postmenopausal= 41.44±61.62 pg/ml; p <0.01). Postmenopausal women had significantly greater condylar trabecular separation (0.61±0.18 vs 0.47±0.11 mm; p<0.001) and lower trabecular number (1.03±0.18 vs 1.21±0.19 1/mm; p<0.001) compared to premenopausal women. There were no significant differences in the basal bone microarchitectural parameters between the menopausal groups. Conclusion and RelevanceMenopause is associated with mandibular condylar trabecular bone loss but has minimal effects on the mandibular basal bone. This may have important ramifications for treatment planning in advanced age individuals.

Abstract TMP62: The Delayed Seizure CVT Score Predicts Delayed Seizure After Cerebral Venous Thrombosis - A Secondary Analysis of ACTION-CVT

Introduction: Seizures are a common initial manifestation of cerebral venous thrombosis (CVT). We sought to establish predictive factors for delayed seizures to stratify risk and guide clinical management. Methods: We analyzed data from the Direct Oral Anticoagulants Versus Warfarin in the Treatment of Cerebral Venous Thrombosis (ACTION-CVT) study of consecutive patients with CVT from 2015 - 2020. The primary outcome was delayed seizure(s), occurring after 7 days from CVT diagnosis. Patients with outcome data for late seizures and follow-up of at least 7 days from time of diagnosis were included. Univariate analysis was performed using Chi-square, rank-sum, and t-tests. Variables with P-value &lt; 0.2 were included in the backward stepwise regression model with 0.2 as cutoff, based on which we constructed the Delayed Seizure CVT (Delayed Seizures after CVT) score. Results: We identified 599 patients who met inclusion criteria: mean age 44.9(± 16.6) years, 62.9% female. Delayed seizures occurred in 37 (6.1%) patients. Risk factors included intracranial hemorrhage (OR 2.0 95% CI 0.7-5.74 p=0.196), alcohol abuse (OR 3.88 95% CI 1.45-10.38 p=0.007), focal neurologic deficit (OR 2.05 95% CI 0.95-4.44 p=0.067), seizure on presentation (OR 2.88 95% CI 1.32-6.29 p=0.008), hormonal birth control (OR 2.38 95% CI 1.06-5.37 p=0.0036), endovascular therapy (OR 2.86 95% CI 1.16-7.07 p=0.023) and decompressive hemicraniectomy (OR 3.357 95% CI 1.02-10.99 p=0.046), respectively. Based on coefficients of these variables, a 7-item score was created with acceptable performance for seizure prediction (AUC 0.796, 95% CI 0.72 - 0.86) (Table 1). Conclusions: Delayed seizure CVT score is a clinical tool to identify risk of delayed seizure in CVT. Further research is needed to validate these findings in an external cohort.

Leveraging web search data in Germany to identify unmet needs of contraceptives on a population-based level: A longitudinal retrospective study.

There are a variety of possible contraceptives available. While medical advice is an important resource for selecting the individual contraceptive, previous research has shown that the Internet has become an increasingly important source of health care information. This study aims to identify key trends in contraception-related web searches in Germany and thus allows conclusions about preferences and unmet needs with regard to pregnancy prevention. Longitudinal retrospective study. Google Ads Keyword Planner was used to identify contraception-related keywords and their search volume in Germany and all federal states between 2018 and 2021. The keywords were categorized based on gender, hormonal/non-hormonal, and different contraceptive methods. Search volume and categories were analyzed for temporal trends, regional differences, and underlying socioeconomic variables. The 1481 contraception-related keywords corresponded to 15,081,760 searches. In total, a 56% increase in searches/100,000 inhabitants was observed. Highest mean search volume was observed in categories "woman," "woman/non-hormonal" and "woman/non-hormonal/barrier," respectively, and in the federal state Hamburg, while the lowest was seen in North Rhine-Westphalia. The increase in search volume reflects a high interest in contraception, particularly in non-hormonal female methods. This stands in contrast to the limited number of effective non-hormonal contraceptives available and points to an unmet need. In addition, the low search volume for male contraceptives demonstrates gender-specific responsibilities regarding family planning in German society.