Contraceptive Selection Research Articles

Faktor yang Memengaruhi Pemilihan Metode Kontrasepsi

Contraception was the most effective way to control the population growth. The most widely favored in Indonesia was a short-term contraceptive methods. High attainment acceptor on short-term contraceptive methods because short-term contraceptive methods was a methods contraception affordable, while the fees for the long-term contraceptive methods was more expensive. The incidence of injectable contraceptives and pills drop-out was higher than the long-term contraceptive methods that contributed to the failure of population growth control program. This study to analyze the factors that affect the selection contraceptive methods. This study was an observational study with cross sectional design. Sampling with systematic random and obtained were 79 acceptors. The independent variables were the cost of contraceptive use, non-material costs (experience side effects), cultural obstacle, social adjustments obstacle, physic and mental health obstacle, and accessibility obstacle. Data collected using the questionnaire and analyse by multiple logistic regression. The results showed that the significant factor were the cost of contraceptive usage (pvalue = 0.002), the cost of non-material (experience side eff ects) (pvalue = 0.007), and factors that didn’t have signifi cant influence were cultural obstacle (pvalue = 0.105), social adjustments obstacle (pvalue = 0.999), physic and mental health obstacle (pvalue = 0.920), and accessibility obstacle (pvalue = 0.438). The conclusion were the cost of contraceptive use and non-material costs (experience side eff ects) aff ected the selection of contraception. It was need the cooperation between religious leaders, community leaders, and health care workers in a common understanding on the cost of contraceptive usage.

Optimization of family planning service in Ukraine in the realization of modern strategy of woman health maintenance

The primary objective of the reproductive health services system and its individual institutions are, namely: to implement the strategy of women management starting from their fetal life to the old age and ensure quality of life in adolescence, reproductive and postmenopausal periods. Maternal and child death rates are above respectives rates in European countries, and utilization rate of modern contraceptive methods in Ukraine remains low. This can be explained by both, poor awareness of women and insufficient training of medical personnel. In this context, the top priority still is awareness-raising and further implementation of the strategy on reliable contraception means and methods along with effective preconception care as a potent component of family planning.Taking into account modern global trends, the principal goal of Family Planning Service in Ukraine is to improve women’s quality of life and time of active ageing, which achievement can be facilitated by the implementation of 3 priority tasks:• continued realization of the strategy on reliable contraception use and implementation of effective preconception care to abortions prevention and maternal and newborns mortality rates reduction;• reduction cardiovascular and oncological diseases incidence rate in women through development and implementation of respective screening programs, informational and preventive measures;• implementation of best international practices with respect to Family Planning Service efficacy, review and update of family planning clinical protocol with further implementation of such practices at the national and regional levels.Considering this, the Resolution of Advisory Board outlines the main tasks for the implementation of modern international experience and its further implementation at the national level, and amendments to clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care (approved by the order of MOH of Ukraine No. 59 dated January 21, 2014) “Family Planning”. The main additions and comments touched upon the issues of micronutrient status and reproductive health of women, contraceptive methods for women in perimenopause, counseling and selection of contraceptive methods for HIV-positive women. Particular attention was paid to counseling and selection of contraceptive methods for women military personnel.

P044 Contraception continuation rates in the under 18s

IntroductionEngland has one of the highest teenage pregnancy rates in Europe. Although there is a wide selection of available contraceptives, they must be used consistently and correctly to prevent pregnancy.There is limited data on contraception continuation rates in teenagers in the UK.This audit aims to establish baseline continuation rates of the contraceptive pill/injection in <18’s within a sexual health service.MethodsA retrospective audit on all 305 <18’s started on the contraceptive pill/injection between Jan-March 2014. Continuation rates at 6 and 12 months were compared with the 2002 National Survey of Family Growth in the United States, standards cited by FSRH guidance.ResultsThe continuation rates of the combined oral contraceptive pill (COC) at 6 and 12 months were 59% and 44.9% respectively, the progesterone only pill (POP) were 37.3% and 23.6% respectively and the injection were 60% and 22.9% respectively.DiscussionThe continuation rates were lower than the standard when compared with women of all ages. However, using age-adjusted rates, the COC continuation rate exceeded the standard by 3%, and the POP and injection rates were closer to the standard.The COC had the highest continuation rate, suggesting the COC should be the method of choice in <18’s.Continuation rates dropped off more sharply in the first 6 months, suggesting this is the crucial time to remind, educate and engage with teenagers.Continuation rates were higher in the section of the service with a dedicated vulnerable young persons’ worker.

Prescription contraception use and adherence by women with substance use disorders.

Unintended pregnancy rates are high among women with substance use disorders (SUDs), which could be explained partly by lower use of and adherence to contraception. We aimed to test: (1) the association of SUD with prescription contraceptive use, contraceptive method selection and adherence; (2) whether practices participating in the Patient-Centered Medical Home Initiative (PCMHI) had better contraceptive use and adherence for patients with SUD; and (3) for differences in the association of SUD with adherence by type of contraceptive used. Retrospective cohort analysis of claims and encounter data. Massachusetts, USA. A total of 47 902 women aged 16-45years enrolled in Medicaid or Commonwealth Care in Massachusetts between 2010 and 2014. We examined three dependent variables: (1) use of a reversible prescription contraceptive during 2012; (2) the contraceptive methods used; and (3) the proportion of days covered by a prescription contraceptive in the year following the first prescription contraceptive claim. The primary predictor was diagnosed SUD, defined as at least one claim for an alcohol or drug use disorder. SUD was associated with lower rates of prescription contraceptive use during 2012 [19.2 versus 23.9%; adjusted odds ratio (aOR)=0.79, P<0.001]. SUD was associated with decreased selection of long-acting reversible contraception (LARC) compared with short-acting contraception (SARC) (42.8 versus 44.5%; aOR=0.83, P=0.011). There was no significant association between SUD and adherence (aOR=0.84, P=0.068). PCMHI enrollment did not alter the relationship between SUD and contraceptive use or adherence. Contraceptive method did not impact the relationship between SUD and adherence. Women with substance use disorders are less likely to use prescription contraceptives, especially long-acting methods, but are not significantly less likely to adhere to them once prescribed than women without substance use disorders.

Postpartum Contraception Education: Contraceptive Choice and Use of Long-Acting Reversible Contraception (LARC) [6F

INTRODUCTION: Comprehensive contraception counseling provided in the postpartum period has the potential to increase LARC use. METHODS: A prospective observational study evaluating the impact of the Bedsider.org website contraception selection among consenting patients during the immediate postpartum period was conducted. After a baseline survey assessing their intended postpartum contraception method, participants were invited to use Bedsider to explore contraception methods. A follow-up survey was administered to determine participants’ contraception choice after having an opportunity to use Bedsider. The final contraception choice at the six-week postpartum visit was captured by chart review. RESULTS: Of the 103 participants enrolled, 65 participants completed both surveys (63.1%). The most common contraception method selected at baseline was oral contraceptives and Depo Provera (43.1%), with 16.9% indicating planned LARC use. A total of 8 participants changed their baseline method after visiting Bedsider; 5 reported intended LARC use. Among women attending a post-partum follow up visit (41/65), 24% received a LARC method at their visit. When compared to the intended method documented in the follow-up survey, one third of participants selected a different final contraception method at their postpartum follow-up visit (31.7%). CONCLUSION: Most patients were not influenced by the Bedsider tool. LARC education may be more effective if delivered in the prenatal period or at the postpartum visit.

Determinants of Contraceptive Choice in Nepal

This study investigated how improvement in women's status affects the choice of contraceptive methods in Nepal. We regressed the choice of contraceptive methods on the variables of women's status and household characteristics by employing large-scale microdata representing over 12,000 married women aged 15-49 in Nepal. Years of schooling and literacy were defined as women's status variables. We estimated how educational attainment affects the choice of contraceptive methods. We also analyzed how fear of their partners affected women's choice. Female sterilization is the most common choice of contraceptive methods (25.5% of the methods users) in Nepal, followed by injections (19.9%). However, our estimation results showed that these results changed according to improvement in women's status. An additional year of education increased the probability that women would choose condoms by 1.2 percentage points (95% confidence interval [CI]: 0.7, 1.6) and decreased the probability of choosing female sterilization by 1.4 percentage points (95% CI: -1.9, -0.8). For the well-educated women, condoms became the second choice (21.5%), while female sterilization was the third option (17.8%) for contraceptive methods. Women's fear of their partners also affected the choice of contraceptive methods. The women who feared their partners were 7 percentage points more likely to choose female sterilization than condoms. The selection of contraceptive methods is associated with women's status. Women with higher status are more likely to avoid choosing female sterilization in Nepal.

Pregnancy Ambivalence and Long-Acting Reversible Contraceptive (LARC) Use Among Young Adult Women: A Qualitative Study.

Many young adults are unclear about how much they want to have, or prevent having, a baby. However, pregnancy ambivalence is an underexamined factor in the uptake of long-acting reversible contraceptive (LARC) methods-IUDs and implants-the most effective methods available. In 2014, investigators conducted six focus groups and 12 interviews with 50 women aged 18-29 in Dane County, Wisconsin; participants were either university students or community residents receiving public assistance. A modified grounded theory approach was used to analyze the data. Four themes emerged. First, participants described a pregnancy desire spectrum: Those strongly motivated to avoid pregnancy were most receptive to LARC methods, while those with less clear or mixed desires worried that these methods would prevent "accidental" pregnancies that might not be unwelcome. Second, women within a few years of wanting children perceived LARC methods as too "permanent," despite awareness of their reversibility. Third, age and life stage were important factors: Younger women and those attending school or beginning careers were more likely than others to consider these methods because they had clearer motivations to avoid pregnancy. Finally, relationship stage influenced receptiveness to LARC methods: Women in newer relationships were more receptive than were those in longer term relationships who imagined having a baby with their partner someday. Effectiveness is not the only factor in women's selection and use of contraceptive methods. Individual preferences will lead some women to choose non-LARC methods even when fully informed of their options.

Education, Knowledge, Socioeconomic Status, and Selection of Contraceptives Among Fertile Couples in Working Area of Basuki Rahmat Public Health Center Bengkulu

Fertile couples ranged between the ages of 20-45 years where couples are mature enough in everything, especially the reproductive organs are functioning properly. This study aimed to find out the correlation of educational factors, knowledge and socioeconomic status with the selection of contraceptives on fertile couples (PUS) in working area of Basuki Rahmat Public Health Center Bengkulu. Type of research used descriptive correlational with Cross Sectional design using primary data spreading questionnaire with population of 200 PUS with number of sample 134 PUS. Sampling was done by Accidental Sampling. Analysis techniqueswere univariate and bivariate analysis using statistical test that was by

PENYUSUNAN MODEL PERANGKAT LUNAK SEHATI ( SEHAT SUAMI DAN ISTRI ) UNTUK MEMBANTU PEMILIHAN ALAT KONTRASEPSI YANG COCOK BAGI PASUTRI BERBASIS EXPERT SYSTEM

According to Muhammad Arhami (2005), Expert systems are computer programs that are designated as providers of advice and aids in problem solving in various areas of particular specialization. The main purpose of the expert system is not to replace the position of an expert or experts, but only to popularize the knowledge and experience of experts are very rare. With the help of an expert system even laymen can eventually use this expert system to solve problems and take decisions usually by an expert While the definition of contraception by Prof.Dr. Sarwono Prawiroharjo are attempts to prevent pregnancy. Efforts could be temporary, can also be permanent. Permanent sterilization or contraception can be called stable.The purpose of this research is to develop a software model SEHATI to assist with selection of suitable contraceptives for married couples-based expert system. With this program are expected to society could be helped choose a contraceptive that is safe and appropriate without having met with the officer kesehatab. For health workers themselves increasingly assisted in this socialization of the use of contraceptives. The stages are done in this study systematically is starting with the stage of literature to find references supporters then gather data, identify and konseptualisiasi to determine the limits of the problem and experts involved, then formalize include manufacturing knowledge base that relate to the topic, determining inference method, followed by making the database design, new hereinafter do modeling software SEHATI to assist with selection of appropriate contraception for married couples-based expert system.In addition to producing the software modeling SEHATI to assist with selection of suitable contraceptives for married couples-based expert system that enriches the scientific work, outcomes obtained from this study is the enrichment materials teaching materials on expert systems and local scientific journals.Keywords: expert system, contraception, sterilization.

Contraception for Women with Diabetes Mellitus

use in women with diabetes mellitus.&#x0D; Method: Literature review.&#x0D; Result: Women in the reproductive age who are affected by a wide&#x0D; range of chronic medical conditions, one of which is diabetes mellitus&#x0D; (DM), may experience adverse health effects pre-conception and&#x0D; in pregnancy. This condition will influence outcome of pregnancy&#x0D; and contraceptive choice after delivery. Planning the use of contraception for women with DM who would experience high-risk pregnancy is a necessity, and counseling must consider the safety of different types of contraception that in comparison to the risk of pregnancy.&#x0D; WHO has provided a guideline on choosing contraception, which is available from the UK Medical Eligibility Criteria for Contraceptive&#x0D; Use (UKMEC), as the basis for contraception selection for women with DM. For DM patients without complication any type of contraception can be used in consideration for the advantages and disadvantages of each type of contraception. For diabetics with complications&#x0D; or multiple risk factors, in the selection of contraceptive,&#x0D; hormonal contraception (especially for combined hormonal contraception (CHC) pill and injection method) requires proper consideration and consultation with health care providers.&#x0D; [Indones J Obstet Gynecol 2014; 4: 226-231]&#x0D; Keywords: complications, contraception, diabetes mellitus, hormonal,&#x0D; pregnancy

Contraception in obese women

At present, the prevalence of overweight people in the world is more than 1.7 billion; 312 million people are obese. The 25% of them consist of reproductive age women. In the modern world contraception is not only the way to prevent unscheduled pregnancy but also the opportunity to treat endocrine and gynecological diseases. While choosing the method of contraception, it is important to realize it’s pharmacological effect on carbohydrate and lipid metabolism, hemocoagulation/fibrinolysis system, cardiovascular and other systems of body that are involved in cascade of pathological processes. Selection of contraception for overweight/obese patients needs an individualized approaches with evaluation of efficiency/risk for every specific method of fertility correction.

Factors Affecting Selection of Contraceptive Methods and Its Length of Use

Objective: To evaluate the factors related to the selection of contraceptive&#x0D; methods and length of use on acceptors in Raden Saleh Clinic&#x0D; and Fatmawati General Hospital.&#x0D; &#x0D; Method: The study was a prospective observational study designs.&#x0D; The factors that we observed include the family planning factor (wife&#x0D; age, number of desired children and infertility), subjective factors&#x0D; (side effect experience of contraception, support from the husband/&#x0D; family, and religion), objective factors (medical disorders, person&#x0D; helping to select contraception, family planning service centre&#x0D; and availability of contraceptives) and the level of motivation (level&#x0D; of education). All the clients who will receive contraception and meet&#x0D; the criteria for the research were interviewed and given questionnaires&#x0D; until the desired sample size is achieved. The study was conducted&#x0D; at the Raden Saleh Clinic and Fatmawati General Hospital. We&#x0D; then conducted follow-up at 3 and 6 months after the use of the contraceptive&#x0D; methods to assess the length of use.&#x0D; &#x0D; Result: The total number of subjects was 151 people. The average&#x0D; age of respondents was 31 years old, with the contraception options&#x0D; being IUD (67.1%), implants (17.8%), sterilization (7.2%), injectable&#x0D; contraception (3.9%), and oral contraception (3.9%). From all&#x0D; the factors studied, only the number of desired children were found&#x0D; to affect the selection of contraceptive methods significantly&#x0D; (p=0.008) in Fatmawati General Hospital, while in Raden Saleh Clinic&#x0D; all of the factors did not affect the selection of contraceptive method&#x0D; (p&gt;0.05). We also found that all of these factors do not have a significant&#x0D; relationship to the length of contraceptive use (p&gt;0.05). There&#x0D; were 6.6% of subjects (n=10) who switched the type of contraception.&#x0D; From all of them, there was a trend of switching from oral contraceptive&#x0D; to injectable method (33.3%) and from IUD to injectable&#x0D; method (66.7%).&#x0D; &#x0D; Conclusion: Only the number of desired children has an effect on the&#x0D; selection of contraceptive methods in Fatmawati General Hospital,&#x0D; while in Raden Saleh Clinic all of the factors studied do not affect in&#x0D; selection of contraceptive methods. Family planning factors, subjective&#x0D; factors, objective factors and motivation levels have no effect on&#x0D; the length of contraceptive use by clients at Raden Saleh Clinic and&#x0D; Fatmawati General Hospital.&#x0D; &#x0D; Keywords: contraception methods, factors, length of use, selection

Provider Bias in Long-Acting Reversible Contraception (LARC) Promotion and Removal: Perceptions of Young Adult Women.

Long-acting reversible contraception (LARC) is effective and acceptable. However, concern exists about potential provider bias in LARC promotion. No study has documented contraceptive users' attitudes toward or experiences with provider influence and bias regarding LARC. We collected qualitative data in 2014 to address this gap. Participants were 50 young adult women with any history of contraceptive use (including LARC) in Dane County, Wisconsin. Women often described providers as a trusted source of contraceptive information. However, several women reported that their preferences regarding contraceptive selection or removal were not honored. Furthermore, many participants believed that providers recommend LARC disproportionately to socially marginalized women. We encourage contraceptive counseling and removal protocols that directly address historical reproductive injustices and that honor patients' wishes.

Analisis Faktor-faktor yang Mempengaruhi Pemilihan Metode Kontrasepsi Jangka Panjang (MKIP) pada Wanita Pasangan Usia Subur (PUS) di Kabupaten Kendal Tahun 2013

ABSTRACTAnalysis Factors Affecting Selection Of Long-Term Contraception Method (Ltcm) Non Hormonal On Woman Of Fertile Couple (Pus) In Kendal By 2013; Women of fertile couple more than 30 years old have a higher risk factor for their health, including reproduction, which is expected they will use LTCM non-Hormonal. The purpose of this study is to analyze factors that related to the selection of LTCM Non-Hormonal in women of fertile couple in Kendal 2013. The type of this research is descriptive analytics and cross-sectional design with quantitative and qualitative approaches and the sample is 400 respondents from 20 districts in Kendal Regency. The qualitative sample is 6 respondents. The results showed a relationship between knowledge with selection of contraception method (p value = 0.034), there is a relationship between attitudes to the selection of contraception method (p value = 0.027), there is a relationship between support of birth control officer with selection contraception method (p value = 0.049), and there is a correlation between the availability of service of birth control with the selection of contraception method (p value = 0.011), there is no relationship between husband support to selection of contraception method (p value = 0835, and there is no relationship between religious leaders or community leaders on selection contraception method (p value = 0384). The most influential factor in the selection of LTCM non-hormonal is the attitude with OR 2,041.Keywords : selection of long term contraception, factor, affect

Integrating Pregnancy Ambivalence and Effectiveness in Contraceptive Choice

ABSTRACTApproximately 70% of pregnancies among young unmarried women living in the United States are unintended. Unintended pregnancy results in negative health and economic outcomes for infants, children, women, and families. Further research into the decision-making process of contraceptive selection is needed to meet young women’s contraceptive needs in the United States. Overall, 53 women ages 18–24 years completed in-depth qualitative interviews. Researchers used analytical techniques from grounded theory and HyperRESEARCH 3.5.2 qualitative data analysis software to identify emergent themes. Problematic integration theory provided a theoretical lens to identify young women’s probabilistic and evaluative orientations toward contraception. Researchers identified two profound values at stake to participants regarding their contraceptive decisions: avoiding pregnancy in the present, and protecting future fertility. Participants resisted long-acting reversible contraception (LARC) methods (e.g., the intrauterine device and the implant) due to concerns about safety and fears about infertility. Participants experienced ambivalence toward the idea of pregnancy, which complicated contraceptive decisions, especially regarding long-term methods. Uncertainty led participants to rationalize their use of less effective methods and reduced information seeking. Findings from this study offer practical suggestions for practitioners and health communication campaign planners. Contraceptive access campaigns should focus on the effectiveness, safety, and convenience of LARC methods. Messages should help young women make contraceptive choices that better fit their needs in order to reduce unintended pregnancy.

Tingkat Pendidikan PUS Berhubungan dengan Pemilihan Jenis Alat Kontrasepsi tetapi Tidak Berhubungan dengan Keikutsertaan KB di Desa Argomulyo, Sedayu, Bantul, Yogyakarta

&lt;p&gt;Data of community practices in 2013 at the Argomulyo village known that total of reproductive age couples were 900 couples and 533 couples (59,22%) following family planning (FP). The purpose of this study was to know the relationship between the education level of reproductive age couples with FP participation and selection of contraceptives on reproductive age couples in the Argomulyo village, Sedayu, Bantul Yogyakarta. The study design was observational analytic with the cross sectional. The total population of reproductive age couples in hamlet of Kemusuk Kidul, Karang lo, Pedes, Surobayan, Kali Berot in the Argomulyo village, Sedayu Bantul were 916 couples. Samples were selected by total sampling technique which consisted of 907 couples and 9 couples included in the exclusion criteria. Data analysis was done by chi-square test. The results showed that 610 couples (67,3%) was following FP and 297 couples (32,7%) not following FP programs. The results of chi-square x2 of wife participation was 3,658 and selection of contraceptives was 50,194, x2 of husband participation was 0,926 and selection of contraceptives was 53,862. In conclusion, there was no relationship between the education level of reproductive age couples with FP participation and there was a relationship between the education level of reproductive age couples with selection of contraceptives in Argomulyo village, Sedayu, Bantul, Yogyakarta.&lt;/p&gt;

HUBUNGAN PENGETAHUAN IBU DAN PEKERJAAN IBU DENGAN PEMILIHAN KONTRASEPSI SUNTIK

Abstract Indonesian is one of the developing countries with various kinds of issues which is population growth was too high and the problem of maternal mortality. One of ways government to keep pressing the rate of increase parity through family planning programs. Family planning programs in Indonesia be stagnant has marked with the increase family planning service where the number of family planning participants had just reach 57,9%. Family planning program in South Kalimantan on 2014 was not yet reached a target where the participants of family planning programs recorded 52,82% of the mother. This study is to analyze if there are relationship between the mother’s knowledge about contraceptive method and mother’s occupation with injection contraception selection in Paringin City, South Kalimantan. The study used analytic observasional method with cross sectional approach. The samples were taken as many as 50 people were considered representative of study sites. The instrument used was a questionnaire. Samples were taken by using purposive sampling technique. The primary data analysis research using by chi-square test. Based on the results, relationship between mother’s knowledge with injection contraception selection was not significant (p- value=0,180). However, there is a significant relationship between mother’s occupation with injection contraception selection (p=0,031, OR=4,455). If mother’s knowledge about methods of contraception getting better, the user of injection contraception will be increase. Occupation status will affect the economic status of the family. A family with high economic status is encouraged the formation of a large family. Therefore, it is necessary to further dissemination of the benefits and impacts of using the injection contraception selection that have an impact on increasing public knowledge. Keywords : knowledge, occupation, family planning program, injection contraception

Agama dengan Keikutsertaan Keluarga Berencana (KB) dan Pemilihan Jenis Alat Kontrasepsi pada Pasangan Usia Subur (PUS) di Desa Argomulyo Sedayu Bantul Yogyakarta

&lt;p&gt;Family Planning (FP) in view of religion is still arise differences of opinion, where there are allow and forbid the recommended types of contraceptives in family planning programs. Based on the interviews with 30 respondents, 10 of them said that religion permits do family planning, 15 of them do not understand what religion does not permit or allow the use of contraceptives, 5 of them said that religion does not allow the use of contraceptives because of their belief in family planning was considered refusing sustenance given (children). The purpose of this study was to determine the relationship between religion in family planning participation and contraceptives selection of reproductive age couples in Argomulyo village, Sedayu, Bantul, Yogyakarta Year 2014. This study was observational with cross sectional design. The Results showed that there was 67.2% of Muslim participated FP, 80% of Christians and 55.6% of Catholics. 71.35% respondents were believing and participated FP and 66.5% respondents does not believe and participate FP. Most of respondents choose injection contraceptives, there was 28.4% in Islam, 20% of Christians, and 44.4% of Catholic. Respondents who believe in FP 31.6% choose injection contraceptive and 27.9% respondents who did not believe in FP also choose injection contraseptive. In conclusion, there was no relationship between religion and family planning participation, there was no correlation between faith and family planning participation, there was no relationship between religion and contraceptive selection, there was a relationship between faith and contraceptive selection.&lt;/p&gt;

Effective Contraception in Women over Forty: Risks and Benefits of Various Contraceptive Options

Ovarian activity decreases, menstrual cycles are disrupted and fertility declines in women over 40 years old. Although the risk of conception gradually diminishes, it does not disappear. Women in older ages have to use an effective contraceptive method in order to avoid unwanted pregnancies. The frequency of sexual intercourses, sexual problems, non-contraceptive benefits, menstrual irregularities and health status of women will have an influence on selection of contraceptives. Age alone is not a contraindication for any contraceptive methods. Before a combined hormonal contraceptive is initiated, women should be exposed to a complete examination and those with obesity, migraine or hypertension and smokers should not be offered combined methods. Combined hormonal contraception can be recommended to perimenopausal women since it treats vasomotor symptoms, protects against bone losses, reduces the risk of some cancers and treats heavy menstrual bleeding. Perimenopausal women with excessive menstrual bleeding are recommended progestin-only intrauterine devices after abnormal vaginal bleeding is excluded. Many perimenopausal women use barrier methods with confidence and good adherence. However, male condoms, a barrier method, may create problems for couples when male partners have erectile dysfunctions. In such cases, another barrier method, female condoms can be preferable. Perimenopausal women need contraception counseling so that they can select an appropriate contraceptive method. They should be informed about the time to give up contraceptive methods during contraception counseling.

The role of zonisamide in the treatment of women with epilepsy

The antiepileptic drugs can effect fertility, development of gynecological diseases and occurence of sexual problems. They can cause a number of "cosmetic" problem and also influence the selection of safe contraceptive method. Many antiepileptic drugs can cause congenital malformations or affect the new-born child's psychomotor and cognitive development, therefore during pregnancy should be treated with extreme caution in women with epilepsy. Most types of epilepsies accompany the patient through their whole life. Women spend almost the third of their lives after menopause and - due to the formation of associated diseases as well - this period is also special. According to the 2013 recommendation of International League Epilepsy (ILAE), zonisamide is one of the first-line antiepileptic drugs in focal epilepsy. In my review I discuss women's epilepsy in the viewpoint of the application of zonisamid.