Role Of Contraceptives Research Articles

Insights on estetrol, the native estrogen: from contraception to hormone replacement therapy.

Estetrol (E4) is a natural estrogen that has recently emerged as new option for contraception and hormone replacement therapy (HRT). Unlike other estrogens, E4 primarily stimulates nuclear estrogen receptor alpha (ERα) and does not activate membrane ERα. For this reason, this novel estrogen has tissue-specific effects across various organs such as liver, vascular endothelium, mammary glands, brain, vagina, and uterus. The selective activation of the nuclear ERα results in distinct pharmacological properties that contribute to its unique therapeutic profile. Moreover, E4 shows minimal interaction with the hepatic cytochrome P450 enzyme system, leading to a favorable pharmacokinetic profile and a reduced potential for drug-drug interactions. Currently, E4 is commercially available in combination with drospirenone as a combined oral contraceptive and its application in HRT is undergoing late-stage clinical development. Many studies have demonstrated that E4 has a lower impact on hemostatic and metabolic parameters compared to other estrogens, potentially reducing the risk of adverse effects commonly associated with hormonal therapies such as thromboembolic events or dyslipidemia. Beyond its role in contraception and HRT, E4 shows promising therapeutic potential in other medical fields, including neuroprotection in neonatal hypoxic-ischemic encephalopathy, enhancement of hematopoietic stem cell transplantation outcomes and prostate cancer management. This review synthesizes the latest evidence on E4 primarily focusing on its pharmacological characteristics and clinical applications. The findings suggest that E4 versatility and peculiar mechanism of action may represent an important therapeutic option for a broad spectrum of medical conditions.

How do South African policies address provision of contraception among adolescents?

The South African government has pioneered several policy documents that emphasise the importance of sexual and reproductive health (SRH). We examined how national policies address access and provision of contraception to adolescents in South Africa. South African national policies. We systematically searched various academic databases such as EbscoHost, Science Direct, Google Scholar, PubMed and Scopus, and other relevant sources to obtain 854 policy documents. Using a set of explicit inclusion criteria, we screened and selected 11 South African policies for analysis. Next, we analysed three international policies and frameworks to extract the key elements from them. Thereafter, we used these key elements to develop an analytical framework for conducting the analysis of the South African national policies. We found that South Africa's SRH policies largely address the provision of contraception by following international guidelines. These policies recognise the value of providing contraception to adolescent girls. However, we also found gaps in some policies, which could impede how they are translated into practice. These include recognising that adolescent boys can play a role in contraception; adolescents have varying SRH needs and are a key stakeholder not only for policy development but also for monitoring and accountability. With a specific focus on South Africa's contraception services in the public sector, these findings are relevant to policymakers, providers and users of contraceptives.Contribution:This review proposes recommendations that will assist with strengthening health policy development and thus improve primary health care services related to contraception for adolescents.

Male characteristics and contraception in four districts of the central region, Ghana

BackgroundA lack of male involvement in contraception can negatively affect its practice. To promote male participation in family planning, there is a dire need to understand male attributes that play a role in contraception. This study focuses on the male characteristics that influence the practice of traditional and modern methods of contraception.MethodsThis study is a secondary analysis of quantitative data obtained from the baseline assessment of the Ghana Community-Based Action Teams Study that aimed to prevent violence against women in the Central Region of Ghana in 2016. The analysis included 1742 partnered males aged 18–60 years. Chi-square test, t-test and logistic regression analyses were used to assess the association between male characteristics and the practice of contraception (significance level = 0.05).ResultsThe prevalence of contraception was 24.4% (95% CI = 20.8–28.5). Significant male characteristics that were positively associated with the practice of contraception in adjusted models were: post-primary education (AOR = 1.96, 95% CI = 1.27–3.04), perpetration of Intimate Partner Violence (AOR = 1.83, 95% CI = 1.49–2.26), and the number of main sexual partners (AOR = 1.78, 95% CI = 1.15–2.75). However, wanting the first child (AOR = 0.71, 95% CI = 0.54–0.94) and male controlling behaviour (AOR = 0.7, 95% CI = 0.49–0.99) statistically significantly associated with reduced odds of practicing contraception.ConclusionMale partner characteristics influence the practice of contraception. Family planning sensitization and education programs should target males who are less likely to practice contraception.

A Survey of Medical Professionals on the Level of Sexual Competence and Reproductive Health in Teenagers

The article analyzes data from a survey conducted with 34 medical professionals in the field of sexual and reproductive health regarding their opinion and observation of the level of competence in this area in adolescent patients who sought medical care. The results are summarized in seven tables and three diagrams. The analysis of the results indicates that the most significant, from a medical point of view, are the personal deficits related to the lack of adequate information among patients regarding: the role of contraception and protective means for preventing unwanted pregnancy and avoiding sexually transmitted diseases; the provoking of risky behavior by the use of psychoactive substances; underestimating the role of prevention for the individual's general and sexual health, etc. The low level of knowledge, skills and competencies of adolescent patients in this aspect necessitates the search for more effective approaches, methods and means to involve adolescents in understanding and evaluating the importance of this issue for their health and for ensuring a satisfying sexual and reproductive future.

The role of contraception in preventing HIV-positive births: global estimates and projections

BackgroundMeeting the contraceptive needs of women living with HIV (WLHIV) has primary health benefits for women, in addition to being a key element to prevent mother-to-child HIV transmission. This analysis will estimate the current number of infant HIV infections prevented by contraception in the era of increased HIV treatment coverage and; 2) model the additional HIV benefits of preventing unintended births to WLHIV.MethodsSecondary data analysis was conducted using publicly available data from the United Nations Programme on HIV/AIDS (UNAIDS) and Population Division, Demographic Health Surveys, and peer-review literature. National data from 70 countries, that had a UNAIDS estimate for the number of WLHIV nationally, were combined into country-level models. Models estimated the current number of infant HIV infections averted by contraception annually and potentially averted if unintended births to WLHIV were prevented. Estimates take into account pregnancy and live birth rates, contraceptive coverage, contraceptive method mix and failure rates, and HIV treatment coverage during pregnancy to prevent mother to child transmission.ResultsContraception use among WLHIV prevents an estimated 43,559 new infant HIV infections annually across 70 countries. Countries with the largest number of infant infections averted by contraception included South Africa (9441), Nigeria (4195), Kenya (3508), Zimbabwe (2586), and India (2145). Preventing unintended births to WLHIV could avert an additional 43,768 new infant infections per year, with the greatest potential gains to be made in South Africa (12,036), Nigeria (2770), Uganda (2552), and the Democratic Republic of the Congo (2324).ConclusionsContraception continues to play an integral role in global HIV prevention efforts in the era of increasing HIV treatment coverage, especially in sub-Saharan Africa. Broad contraceptive availability, increased contraceptive voluntarism and method mix are key components to preventing unintended births and ending new infant HIV infections worldwide.

How do male students perceive their role in contraception and the protection against STDs?

Abstract Background A lot of research has been done on women and contraception. How men perceive their role regarding contraception is largely unknown. Previous research shows that factors like intentions, communication and knowledge are of importance. The aim of this study is to get more insight that could provide us with more starting points for preventing unwanted pregnancies and STDs. Methods Eight semi-structured interviews with male students from Amsterdam, The Netherlands (aged 18-25, different study programs) were conducted based on a, previously developed, topic list. Convenience sampling was used to select respondents. The interviews were processed with thematic content analysis. Open, axial, and selective coding was used to analyze the interviews. Results Four themes emerged from the data: openness of parents, making an informed decision, prevention of pregnancy and STDs and durance of relationship. Men do not have a clear view on their role in contraception regarding responsibility and are still struggling with the autonomy of their partner, also in relation to the length of the relationship. When in a relationship they feel their role should be to support and communicate with their partner, but not to make the final contraceptive choice. When not in a committed relationship, men feel their role is solely to protect themselves against fatherhood and, to a much lesser extent, STDs. Conclusions Communication is key in preventing unwanted pregnancies and STDs, and working towards a shared responsibility. Following up on the role of parents in communicating well about these subjects, both men and women should take their responsibility in communicating. Furthermore, fear of unwanted pregnancy seems much larger than fear for STDs for male students. These subjects can be addressed in a university institutional context in a variety of ways (f.i. via flyers, projects, student counselors, student health services). Key messages More attention for the role of both men and women in communicating about contraception and STDs is necessary in a student population within the university institutional context. More attention for the dangers of STDs and the importance of protection against STDs is necessary in a student population within the university institutional context.

The Role of Contraception in the Past, Present and Future

Contraceptives play an undeniable important role in woman’s lives. It is widely accepted that the availability of both hormonal and non-hormonal modern contraceptives have improved 0 women’s lives worldwide by allowing women to control their own fertility. Indirectly, contraceptives have been shown to reduce maternal mortality, unwanted pregnancy, and overpopulation. However, the contraceptives available today may not be suitable for all users. Furthermore, there is still need to expand available current contraceptives choices especially long-term contraceptives in order to improve acceptability. As a result, several novel products such as implants, contraceptive vaginal rings, and transdermal patches have recently been introduced in family planning programs. Additional issue of contraceptive needed to be addressed is the adverse effects of hormonal contraceptives. Therefore, new combinations with an improved metabolic profile is currently being researched. Generally, the introduction of new methods with additional health benefits and less side effects would help women with their unmet needs to obtain access to a wider range of contraceptives.

Rehabilitation of reproductive-age patients with recurrent vaginosis, vulvovaginitis and cystitis: the role of contraceptives with bioidentical estrogen

Rehabilitation of reproductive-age patients with recurrent vaginosis, vulvovaginitis and cystitis: the role of contraceptives with bioidentical estrogen

Sexual Health Behaviours: HIV/STI Risk Perception among Namibian University Students

Background: The attitude of young people towards the use of contraceptives differs and it is linked with their sexuality. One of the most frequent assertions for the lack of use of the condoms as contraceptive is that boys did not like using them because it reduces the feeling and pleasure during intercourse and some of the young mothers’ belief that putting on condom just prior to intercourse did interrupt the spontaneous feelings during sexual intimacy. Methods: Data was collected using self completed questionnaires for quantitative cross-sectional survey among students in classes selected through simple random sampling in each stratum (University Campus). Relationship between independent variables (method of contraception, misconceptions about the role of contraceptives in preventing STIs/HIV, transactional sex, HIV/STIs Risk perception of young people) and dependents variable (multiple sexual partners) was measured using multivariate model of logistic regression analysis. Results: Among sexually active students, condom use was 88.7%, abstinences 10.1% and did not use anything 1.3%. In thirty days under study about 20.0% have had sex at least twice, 8.2% more than four times and 37.4% did not have vaginal sex. Other forms of intercourse observed among the respondents are oral and anal sex which recorded 11.5% and 2.0% respectively. Only 13.9% have had transactional sex within the last 12 months. Conclusion: Some risky sexual practices such as multiple sexual partners, anal and oral sex and having unprotected vaginal intercourse were noted among the students, despite regular campaigns in media. However, it is a general belief that, the use of contraceptive like condom may interrupt spontaneous arousal feeling and pleasure during intercourse against the backdrop of likelihood of HIV/STDs infection and unwanted pregnancy. Therefore, more rigorous campaign from government at all levels is recommended.

Menstrual cycle, sex hormones in female inflammatory bowel disease patients with and without surgery.

Healthy women at reproductive age experience a cyclical alteration of gastrointestinal (GI) symptomatology during their menstrual cycle. Additionally, the majority of healthy women also complain of worsening of GI symptoms either during the premenstrual or menstrual phase. Despite conflicting evidence, studies suggest that sex hormones may increase GI transit time during the luteal phase. Similar phenomenon is also observed in women with underlying inflammatory bowel disease (IBD). The mechanism underlying this complex pathophysiology is still not completely understood. However, a possible influence of sex hormones on the brain-gut-microbiota axis is hypothesized. The diagnosis of IBD is associated with a delay in menarche as well as menstrual function irregularities including alterations in cycle length and the duration of flow. There is little data on the effect of menopause on IBD disease activity and conflicting data on the effect of IBD diagnosis on the onset of menopause. The role of contraceptives and hormone replacement therapies on the development or disease activity of IBD has not been yet established. Moreover, IBD patients with concomitant dysmenorrhea report heightened pain during menses. The effect of non-steroidal anti-inflammatory drugs in treating primary dysmenorrhea on the disease course of IBD is unknown. In addition, the effect of IBD medications including immunomodulators and biologics on menstrual function remains unclear. Also, the role of IBD surgery on menstrual irregularities needs to be fully elucidated. Hence, understanding the influence of menstrual function on IBD disease activity and vice versa and the maintenance of normal menstrual function in those patients is important in improving overall reproductive health and fertility and outcome of IBD.

Knowledge, Perception and Practice of Mothers/Caretakers and Family’s regarding Child Nutrition (under 5 years of age) in Nekemte Town, Ethiopia

The purpose of this study was to assess the knowledge, perception and practices of mothers/caretakers, families and community regarding child nutrition. A community based descriptive cross-sectional study was employed through quantitative techniques. A semistructured interview and questionnaires was used to collect information in the areas of socio-demographic, knowledge, attitude and practices towards child nutrition and nutritious weaning foods from mothers/caregivers. Of the total 240 mothers interviewed, about 84.2% of mothers practiced exclusive breastfeeding (EBF) for the first 4-6 months, and highest proportions (92.4%) of women have the knowledge that breastfeeding should continue up to 2 years or older. About 55.4% of mothers practiced complementary food starting from 6 months, while significant proportion (42.1%) has introduced before 6 months and 2.1% even did as early as before 4 months of infant’s life. Moreover, significant proportions of mothers have good knowledge on the benefits that breast milk could give to their babies. More than 86.3% of mothers know breast milk is nutritious, healthy, encourages infantmother relationships and 69.1% of them even knows the contraceptive role that EBF could have. Besides, about 72% of mothers have positive attitude towards colostrums, while significant proportion (21%) of mothers wrongly perceived as nutritionally useless. The study also revealed that knowledge, attitude and practice of mothers on child nutrition were found to be influenced by socio-demographic factors and information’s. It can be concluded from this study that improving maternal knowledge, attitude and practices of mothers would have direct impact in changing the nutritional situation of children that will in turn improve rate of child malnutrition.

Leukemia inhibitory factor: roles in embryo implantation and in nonhormonal contraception.

Leukaemia inhibitory factor (LIF) plays an indispensible role in embryo implantation. Aberrant LIF production is linked to implantation failure. LIF regulates multiple processes prior to and during implantation such as uterine transformation into a receptive state, decidualization, blastocyst growth and development, embryo-endometrial interaction, trophoblast invasion, and immune modulation. Due to its critical role, LIF has been a target for a nonhormonal contraception. In this review, we summarize up-to-date information on the role of LIF in implantation and its role in contraception.

Contraception as a risk factor for urinary tract infection in Port Harcourt, Nigeria: A case control study

BackgroundThe concerted effort of government and donor agencies to limit fertility by the use of contraceptives has been reported in some studies to predispose to urinary tract infection (UTI). Similar studies have not been conducted in the General Outpatient Department (GOPD) of the University of Port Harcourt Teaching Hospital (UPTH).ObjectivesThis study was aimed at assessing the role of contraceptives in the development of UTI amongst adult females attending the GOPD of UPTH.MethodA case control study in which contraceptive users who attended the GOPD of the UPTH in four months, and an equal number of age-matched controls, were screened for UTI. The information obtained from them was entered into a specially designed pre-tested questionnaire for analysis. The results were analysed using SPSS version 14.ResultsA total of 150 contraceptive users and controls were evaluated. Their age range was 18–50 years, with a mean of 27.8 ± 5.3 years. Most of the participants belonged to the lower socioeconomic classes. The combined prevalence of UTI amongst the contraceptive users and the controls was 23.7%, with the contraceptive users at 35.3% and the controls at 12.0%. The association of UTI with contraceptive use was statistically significant, with McNemar's χ2 = 16.28, p = 0.000, odds ratio (OR) = 2.9, 95% confidence interval (CI) = 1.7 – 5.3, attributable risk (AR) = 23.3, population attributable risk (PAR) = 11.7. The users of barrier contraceptives were more predisposed to UTI (OR = 17.30, 95% CI = 7.49 -39.96).ConclusionContraceptive use is a significant risk factor for acquiring urinary tract infection, with the barrier methods being more predisposing. Health education for the hygienic and safe use of family planning methods will prevent long-term complications.

Non-contraceptive applications of the levonorgestrel intrauterine system

Intrauterine progestins have many important current and potential gynecologic applications. This article describes the evidence for use of intrauterine progestin for common gynecologic conditions beyond its important role in contraception. The pharmacology of and selection criteria for use of the levonorgestrel intrauterine device is discussed, and the evidence for use of intrauterine progestin delivery for menorrhagia, endometriosis management, uterine fibroids, adenomyosis and endometrial hyperplasia is reviewed.

Opinions concerning male and female sterilisation in Turkey

Background Vasectomy is well accepted in some countries, but uncommonly used in others. The failure of family planning programmes may be the result of men failing to play a role in contraception. This study was carried out to determine the attitudes of women and men regarding male and female sterilisation.Study design Women of reproductive age (17–35 years old; n = 1211) and their husbands (n = 1174) were enrolled in this study. Information was collected from the participants via face-to-face interviews using a questionnaire.Results In our study, 61.4% of women would agree to their husbands' undergoing a vasectomy but only 3.7% of husbands agreed to it. Most (92.7%) men said they would agree to their wives' undergoing a sterilisation and 83.1% of women would agree to tubal occlusion. Only 2% knew anyone who had been sterilised. Nearly a fifth of women thought vasectomy could lead to impotence.Conclusion The prejudices against vasectomy are probably due to misinformation. Female sterilisation, however, is widely accepted by both participants. Family planning programmes organised equally for women and men, supported also by mass media could improve access to convenient and effective contraception.

Preparing Daughters: The Context of Rurality on Mothers' Role in Contraception

The United States continues to have the highest rate of adolescent childbearing among developed countries. Lack of access and disadvantage contribute to this problem, which disproportionately impacts rural women. Given the increased difficulty rural young women face regarding contraceptive access, parental communication and support play an even more vital role in assisting them to navigate decisions about and access to contraception. To examine rural women's perspectives on how living in a rural area impacts issues surrounding pregnancy prevention for their daughters and parent-child communication regarding pregnancy prevention. Open-ended interviews were conducted with 30 mothers of adolescent women in 3 rural counties in southern Oregon. Thematic analysis within and across interviews using constant comparative analysis was used to explore barriers, facilitators and strategies mothers identified in talking with their daughters about contraception. Specific themes found that related to the rural environment included (1) conservatism, (2) isolation, (3) lack of privacy, (4) stigma, (5) the paradox of the rural environment, and (6) the uniqueness of rural life. The context of living in a rural environment may present unique barriers to facilitate parent-child communication when discussing intimate topics. The design of interventions needs to take into consideration these issues, particularly when attempting to serve hard-to-reach populations.

What happened when Scottish women were given advance supplies of emergency contraception? A survey and qualitative study of women's views and experiences

The Lothian Emergency Contraception Project in Scotland was a radical intervention in which women aged 16–29 were given 5 packs of emergency contraception (EC) to keep at home. We use survey and qualitative interview data to describe how women used the project packs and their views of advance supplies. The women's accounts suggest that concerns that eased access to emergency contraception will lead to repeated use and risky sex appear to be largely unfounded. Women were pleased to be offered the packs, which were reported as having practical advantages and also sparing them the difficulty of negotiating a sometimes awkward consultation. Respondents explained how they used their packs of EC and in their accounts used justifications, repetition and distancing to emphasise that they would not take risks with contraception or sexually transmitted infections. We interpret the data in the light of the observation that EC has an anomalous role in contraception and the work of applied linguists Candlin and Lucas who have demonstrated the difficulties inherent in the family planning consultation.

Use of cauda epididymis extract as immunocontraceptive

The objective of this study was to evaluate use of a cauda epididymis extract (CEE) as an immunocontraceptive in rats. Twenty-two rats in puberty or 19 rats that gave birth once (primipara) were immunized with intraperitoneal (IP) injection of CEE. Rats in puberty received one or two injections of CEE containing 1.5 × 10 9 sperm/mL, while primipara rats received injections of CEE containing 3 × 10 6 sperm/mL up to three times. Animals were tested for the presence and concentration of anti-CEE antibody by enzyme-linked immunosorbent assay (ELISA) and monitored for pregnancy following natural insemination. Results revealed that 38 (92.6%) of the 41 rats were positive for anti-CEE antibodies, regardless of animal type or immunization procedure. However, there was no relation between pregnancy rates and concentration of anti-CEE antibody in rats immunized with CEE. These results indicate that immune response against CEE may not play a major role in contraception in rats.

Canadian Physicians’ Role in Contraception from the 19th Century to Now

Birth control techniques were widely available in 19th-century Canada, despite the fact that they were illegal. Most physicians remained silent about contraception, with a small minority vocally opposed to the practice of birth control. Canadian physicians were influenced by the social, economic, legal, and political values of their time, and their support of birth control initially lagged far behind public interest and need. At later points in Canadian medical history, physicians actively supported increased access to contraceptive services, and played a significant role in the legalization of contraception in this country. The Canadian birth control movement made tremendous strides in the 1930s with the dissemination of contraceptive information to the public and the opening of the first public birth control clinic. The Canadian Medical Association supported contraceptive practice as part of preventive medicine in the 1930s, and the legalization of contraception in the early and mid 1960s. Contraception was formally legalized in Canada in 1969 and has become a significant aspect of medical practice. In Canada, current medical controversies in contraception include issues of public education, advertising, contraceptive research, and the integration of contraception with other aspects of reproductive and sexual health in medical practice.

Pregnancies Averted Among U.S. Teenagers by the Use of Contraceptives

The personal and social costs associated with teenage pregnancy in the United States concern many policymakers and researchers, yet the role of contraception in preventing these pregnancies has not been adequately quantified. Published estimates of contraceptive effectiveness were applied to 1995 National Survey of Family Growth data on sexual and contraceptive practices in order to estimate the number of pregnancies averted through the use of contraceptives by U.S. teenagers. Four scenarios of contraceptives access--from current levels of access to highly restricted access--and teenagers' sexual and contraceptive practices in response to such restrictions are used to project the potential impact on pregnancies among teenagers. Current levels of contraceptive use averted an estimated 1.65 million pregnancies among 15-19-year-old women in the United States during 1995. If these young women had been denied access to both prescription and over-the-counter contraceptive methods, an estimated one million additional pregnancies (ranging from 750,000 to 1.25 million) would have occurred, assuming some decrease in sexual activity. These pregnancies would have led to 480,000 live births, 390,000 abortions, 120,000 miscarriages, 10,000 ectopic pregnancies and 37 maternal deaths. Contraceptive use by teenage women prevents pregnancies and negative pregnancy-related health consequences that can disrupt the lives of adolescent women and that have substantial societal costs. Continued and expanded access to contraceptives for adolescents is a critically important public health strategy.