Thai Women Research Articles

National Cervical Cancer Screening in Thailand.

Background:Cervical cancer is an important public health problem in Thailand. It was the most common cancer in Thai women with the incidence rate of 23.4 per 100,000 women in 1990. Objective:The aim of this study was to share the experiences and summary the outcome of cervical cancer screening program in Thailand. Methods: The Ministry of Public Health in cooperation with the National Health Security Office, launched the National Cervical Cancer Screening Program, covering 76 provinces nationwide under Universal Coverage Scheme in 2005. The screening method are Pap smear and Visual Inspection with Acetic acid (VIA) for women aged 30-60 and 35-45 respectively with a 5-year screening interval. Detecting cervical pre-cancerous lesions will follow by day care treatment such as cryotherapy, Loop Electrosurgical Excision Procedure, etc. Results:The first phase (2005-2009), was carried out on 3,124,855 women, the coverage reached 77.5%. For the second phase (2010-2014), 7,637,226 women were screened, reaching 53.9% coverage of target women. However, we have few data of follow up examination after abnormal screening. Therefore, we conducted new system to get more follow up data in 2019. Under the coordination of many related partners, 10,762,081 women have been screened during 2005-2014. The incidence rate declined to 11.7 per 100,000 women which is ranked as the third most common in women in 2014. Conclusion:This article briefly reviews the challenge of implementing an efficient cervical cancer screening in Thailand. In 2020, HPV testing has been introduced as a primary screening test for all Thai women attending public health sector instead of conventional Pap test.

Understanding the needs and use of sexual and reproductive health services among Thai women: a descriptive cross-sectional study in Sweden.

A cross-sectional study using postal questionnaire to all Thai-born women (age 23-60) in Stockholm, residing in Sweden since 2014. The response rate was 52.3% (n= 266). Bivariate and multivariate logistic regression analyses were used. The majority reported a significant need for information related to SRH services. Most of the women using contraception (70%) bought their contraceptives in Thailand. In total, 60% of the women had been HIV-tested at some point in their lives; the majority were tested in Thailand. Women who had been HIV-tested in Thailand were more likely to also have been tested in Sweden. Significant differences in contraception use, participation in contraceptive counselling and having had an HIV test were found between groups of younger and older women. Our findings imply that age is an important factor to understand women's need and use of SRH services in Sweden versus Thailand. Furthermore, women's lack of knowledge and reported need for SRH information needs to be considered when making policies and strategies to increase access to SRH services.

Influences on Brand Loyalty Among Thai Female Cosmetic Consumers

This study aims to examine and identify variables and factors which influence Thai women’s purchasing decision of Korean cosmetics. The data were compiled from questionnaires given to 400 female respondents living in Bangkok, who were between the ages of 14-30 and who had purchased Korean cosmetics in the past. The methodology used in this study is the correlation coefficient relationship and ANOVA to test the hypotheses. The results illustrated that the country of origin (COO) has a relationship with the perceived quality of the cosmetics and consequently, to brand equity. There are differences between packaging, price, and perceived quality for customers, in which packaging has more influence on satisfaction. In addition, customer loyalty was affected indifferently by brand equity and customer satisfaction.

‘Unintended transnationalism’: The challenging lives of Thai women who partner Western men

AbstractThis article studies a specific form of transnational living that results from Thai–Western cross‐border marriage migration: Thai women's experiences of intercultural partnerships with a Western man. The study is explicitly from a Thai female partner's perspective. It unpacks women's experiences and perceptions of living this life from their own accounts. We refer to their experiences and perceptions of living this form of transnational life as unintended transnationalism, that is, that living a life defined by dependent gendered intercultural exchanges with a foreign man was a by‐product, not an aspiration of her strategy for a better life. Living ‘unintended transnationalism’ refers to how women negotiate the specific high challenges and sociocultural pressures arising from dependency on a foreign man, who largely decides where, when and how you live. Women face strong acculturation pressures to adapt to their husbands' Western cultural needs, on his terms, even when they share a home in Thailand—a process we define as imported assimilationism. The study shows how her experiences of transnational living are importantly shaped by her: access to rights, cultural differences with her partner, and positioning in social space and place in Thailand, over this life journey. It draws from 20 biographical interviews with women in partnerships (between 7 and 30 years) with Westerners, currently resident in Thailand. Overall, we find that living ‘unintended transnationalism’ is a challenging life, even for women who make significant material gains. It can lead to isolation, dissociation from family, and dissimilation from belonging in Thailand.

Experiences in the prevention and screening of cervical cancer within Thailand.

Cervical cancer is the third most common cancer among Thai women, after breast and colon cancer, with an age-standardized incidence rate (ASR) of 11.7/100000 women each year, as of 2015. Over decades, comprehensive national cervical cancer screening programs, research, and the HPV vaccination policy have gradually helped decrease the incidence of cervical cancer in Thailand. In 2017, the Thai Ministry of Public Health signed a memorandum of understanding with the Royal Thai College of Obstetricians and Gynecologists to eliminate invasive cervical cancer from Thailand. This is a tremendous challenge for Thailand as a whole. The present paper reviews and discusses the experiences in the prevention and screening of cervical cancer in Thailand.

Intimate partner violence and factors associated with sexually transmitted infections among Thai women attending gynecology clinics.

Intimate partner violence (IPV) and sexually transmitted infections (STIs) are significant public health problems worldwide. However, most research on this association and risk of STIs has been conducted in Western countries and may not be generalizable to women living in different contexts, such as Thailand. We aimed to examine prevalence of IPV and identify factors associated with STIs among Thai women. Participants were patients aged 15-49 years attending two gynecology clinics at a university hospital in Bangkok, Thailand. Data were collected through an anonymous structured questionnaire, including sociodemographic characteristics, IPV, childhood abuse (CA), sexual risk behaviors, alcohol use, depressive symptoms, and self-reported STI diagnosis. Multivariate logistic regression analyses were used to examine factors associated with STI diagnosis. Among 400 participants, 84 (21%) had ever experienced at least one type of IPV in the past year. IPV, CA, age at first sex, multiple sexual partners, and alcohol use were significantly associated with STI-positive. Women who reported IPV (OR = 2.65, 95% CI = 1.11-6.28), experienced CA (OR = 5.59, 95% CI = 1.08-28.99), and had multiple sexual partners (OR = 1.39, 95% CI = 1.08-1.79) were significantly more likely to have an STI. Incorporation of IPV screening into general STIs screening is needed for this population to prevent and decrease IPV and STI consequences. Further research is also needed to understand the pathways linking IPV and STI risk to optimize the design of effective prevention interventions.

Polycystic ovarian morphology in Thai women of reproductive age with polycystic ovary syndrome.

Advancements in ultrasound technology have facilitated identifying polycystic ovarian morphology (PCOM) in women with and without polycystic ovary syndrome (PCOS), but it still has limitations due to follicle counting methods and variation of phenotypes according to ethnicity. Ethnicity-specific ovarian morphology may help to establish ethnicity-specific follicle count cut points for defining PCOM in women with PCOS. To investigate the prevalence and factors associated with PCOM in Thai women of a reproductive age with PCOS. This prospective cross-sectional study was conducted in our gynecology department at a tertiary teaching hospital from February 2016 to May 2017. We included women with PCOS, who were measured for weight, height, waist circumference, and blood pressure. Blood samples were taken to measure fasting blood glucose, lipid profile, testosterone level, and 2 h post-load 75 g oral glucose tolerance test (OGTT). Transvaginal or transrectal sonography was performed to evaluate their ovaries. All 143 patient participants we included had oligomenorrhea, 77.6% of them had acne, and 64.3% hirsutism. Their average total testosterone level was 0.47 ± 0.10 ng/mL. The prevalence of PCOM was 55.2%. The proportions of PCOM diagnosed by ovarian follicle and ovarian volume criteria were 36.4% and 42.0%, respectively. There were 20.0 ± 9.5 follicles per ovary, 8.3 ± 3.1 follicles per cross section, and the mean ovarian volume was 7.9 ± 3.0 mL. The overall prevalence of PCOM in Thai women of reproductive age with PCOS was 55.2%. Our univariate analysis found no factors significantly associated with PCOM.

The association between serum 25-hydroxyvitamin D concentrations and serum lipids in the Southern Thai population.

IntroductionDyslipidaemia is a major risk factor for cardiovascular diseases (CVD). Vitamin D deficiency has been found to be associated with CVD. However, the relationships between vitamin D and lipids are inconsistent. The aim of this study was to investigate the relationship between vitamin D status and serum lipids in Southern Thai subjects.Material and methodsA total of 726 healthy subjects in Southern Thailand were enrolled in the study. Serum 25-hydroxyvitamin D (25(OH)D), lipid profiles, fasting plasma glucose, anthropometric data, blood pressure, and body composition were measured. The relationship between serum 25(OH)D levels and biochemical data was evaluated by partial correlation and multiple linear regression analyses. The association of serum 25(OH)D levels with dyslipidaemia was analysed using multivariate regression analysis.ResultsSerum 25(OH)D levels were negatively correlated with body mass index (BMI), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and body composition parameters after adjusting for age in women. Multiple linear regression analysis showed that TC and BMI were independent predictors for 25(OH)D concentrations in women. Multivariate logistic regression analysis showed that the odds ratio of hypertriglyceridaemia (OR = 0.51; 95% CI: 0.32–0.80, p = 0.004) and reduced high-density lipoprotein cholesterol (HDL-C) (OR = 0.43; 95% CI: 0.26–0.71, p = 0.001) were significantly lower in vitamin D sufficiency when compared with hypovitaminosis D in women.ConclusionsVitamin D sufficiency could reduce risk of hypertriglyceridaemia and reduced HDL-C, particularly in women, suggesting that vitamin D sufficiency may have beneficial effects on lipids and a decreased risk for CVD in Thai women.

Variability of urinary creatinine, specific gravity, and osmolality over the course of pregnancy: Implications in exposure assessment among pregnant women

Due to dilution status of the urine, chemical concentrations measured in spot urine are frequently adjusted using correction factors, such as creatinine, specific gravity (SG), or osmolarity of the urine. Urinary correction factors, however, can be influenced dramatically by physiological changes such as pregnancy. Details about the variation of urine dilution over the course of pregnancy are not well characterized. In the present study, we investigated the variation of urine correction factors over time among the pregnant women of Korea (n = 69) and Thailand (n = 102). Creatinine, SG, and osmolality were determined in the urine samples obtained in each trimester of the participating women, and were compared by sampling time and by nationality. Implication of the variation in these correction factors was studied using phthalate metabolites measured in the urine samples as model chemicals. Urinary correction factors significantly varied across the trimesters especially in Korean pregnant women: urinary creatinine and osmolality were significantly lower in the third trimester (T3) urine than the first trimester (T1) urine. Urinary creatinine and SG of the T3 urine of Korean pregnant women were also significantly lower than those reported from the non-pregnant women who participated in Korean National Environmental Health Survey (KoNEHS) 2015–2017. Among Thai women, however, these correction factors were rather stable across the pregnancy. Differences in ethnicity, or in behavior such as water consumption amount may partly explain the differences. Temporal changes in these urine correction factors influenced the urinary phthalate metabolite concentrations adjusted for dilution, in both Korean and Thai pregnant women. The present observations show that the variations of urinary correction factors should be considered in exposure assessment of urinary chemicals for pregnant women, in order to circumvent potential bias due to physiological changes occurring during pregnancy, and to reduce errors in exposure classification and association.

Mediating Roles of Intimate Partner Violence, Stress, and Social Support on Depressive Symptoms Among Thai Women.

Prior research has shown that intimate partner violence (IPV), stress, and social support are associated with depressive symptoms. However, a possible mediating role of these variables linking depressive symptoms has not been fully investigated in Thailand. This study was conducted to assess the mediating roles of IPV, stress, and social support in the relationships between childhood abuse (CA), number of sexual partners (NSP), and depressive symptoms among 400 Thai women attending gynecology clinics. Results indicated that IPV was significantly positively correlated with stress and depressive symptoms but negatively correlated with social support. CA and NSP were significantly positively correlated with IPV, stress, and depressive symptoms, but negatively correlated with social support. Structural equation models (SEMs) showed that not only did IPV severity exhibit significantly indirect effect on depressive symptoms (β = .178; p < .05), but it also had a significant, positive total effect on depressive symptoms (β = .252; p < .05). In particular, IPV severity had the fully mediating effect on depressive symptoms through social support (β = -.204; p < .05) and stress (β = .158; p < .05). CA severity and NSP exhibited the significant indirect effect on depressive symptoms through IPV severity, stress, and social support. All the models analyzed showed that stress had an important mediator role (β = .583; p < .05) on depressive symptoms. The model fitted very well to the empirical data and explained 53% of variance. Findings affirmed the important role of these mediators as well as the need to design interventions for reducing stress or increasing support for women experiencing IPV. Utilizing an empowerment approach among female outpatients to decrease stress and depressive symptoms is recommended.

Gender, class, and paradoxical mobilities of Thai marriage migrants in Austria

In this paper, we investigate whether marriage‐related migration promotes socioeconomic mobility and how class belonging and educational background affects Thai women's migration experience and socioeconomic mobility. Drawing on qualitative interviews, supported by a questionnaire survey with Thai women living in Austria and who are in a relationship with a Western male citizen, we seek to dismantle simplistic notions about hypergamy and question common assumption about marrying up or down in migration contexts. We compare socioeconomic indicators such as formal education, occupation, and income before and after the migration and analyse migrants’ experiences in Austria. The results show a complex picture of upward and downward socioeconomic mobilities. Two distinct scenarios of paradoxical mobilities have been identified. On the one hand, some migrants feel empowered (when experiencing economic downward mobility) as they enjoy the freedom of living in Austria, while on the other hand, those migrants experiencing upward mobility feel a loss of their personal autonomy.

Knowledge and Attitude Toward Human Papillomavirus Infection and Vaccination among Thai Women: A Nationwide Social Media Survey.

Objectives:This study was performed first to assess Thai women’s knowledge and attitude toward Human papillomavirus (HPV) infection and vaccination and second to find out factors associated with knowledge in this regard. Methods:The survey announcement was advertised via Facebook from 17 May 2019 to 14 June 2019 to recruit women aged 18-26 years living in Thailand. A score below 5 out of total score of 10 on the survey was considered as a poor level of knowledge. Multivariate analysis was applied to identify factors associated with HPV infection and vaccination knowledge. Results:A total of 1,175 participants were recruited. The participants’ median age was 22 years. Approximately, 46% of the participants had poor level of knowledge regarding HPV infection and vaccination. Factors associated with poor knowledge included low educational level (adjusted OR, 1.35; 95% CI 1.04-1.77), low family income (adjusted OR, 2.14; 95% CI 1.65-2.78), being Christian (adjusted OR, 4.04; 95% CI 1.22-13.40), being engaged in sexual intercourse (adjusted OR, 0.75; 95%CI 0.58-0.97), and being unvaccinated against HPV infection (adjusted OR, 5.74; 95% CI 3.07-10.74). Conclusion:Nearly half of the Thai women who participated in the survey had poor level of knowledge regarding HPV infection and vaccination, indicating a need for more effective health education intervention. Factors associated with knowledge included socioeconomic status and sexual behavior.

Vaginal tablets of dequalinium chloride 10 mg versus clotrimazole 100 mg for vaginal candidiasis: a double-blind, randomized study

To compare the clinical response, microscopic examination and fungal culture between dequalinium chloride (DQC) and clotrimazole (CT) for treating vaginal candidiasis (VC). The double-blind, randomized study was conducted from September 2014 to September 2016 at Siriraj Hospital, Thailand. Eligible participants were Thai women diagnosed with VC by microscopic examination. The exclusion criteria included immunocompromised conditions, consumption of antifungal drugs, and having recurrent VC. Each participant was randomized with a 1:1 allocation to receive six vaginal tablets of 100mg CT or 10mg DQC. Two visits included 10 ± 2days (C1) and 38 ± 4days (C2). Outcome measures were improvement of VC symptoms, microscopic examination, culture, satisfaction and tolerability. Of 155 eligible participants, 150 were randomized and allocated into CT (N = 76) and DQC (N = 74). The average age was 31.1 ± 7.2years. Comparable improvement of clinical response was demonstrated (OR at C1 0.79, 95% CI 0.56-1.10, p = 0.197; and OR at C2 0.99, 95% CI 0.69-1.43, p = 0.985). Of CT and DQC groups, the microscopic examination was positive at 11/75 (14.9%) vs 18/72 (25.3%) at C1 and 18/74 (24.3%) vs 28/66 (42.4%) at C2. And the culture was positive at 25/75 (33.8%) vs 46/72 (65.7%) at C1 and at 26/74 (36.6%) vs 46/66 (69.7%) at C2. Most participants had high satisfaction and tolerability and none reported any side effects. DQC and CT show comparable clinical response but CT results in greater improvement of microscopic examination and fungal culture. The Clinical Trial Registry number was NCT02242695. (September 17, 2014).

Perceptions of transnational family responsibilities’ effects on subjective health and wellness – voices of Thai immigrant women

PurposeGlobalisation provides new opportunities for immigrant women to supply financial benefits transnationally to uphold their families in their home countries. The purpose of this study is to explore the experiences of Thai immigrant women regarding transnational family responsibilities effects on their health and wellness.Design/methodology/approachQualitative data were collected using semi-structured interviews with 40 Thai immigrant women, of which 34 described having transnational family responsibilities. The transcribed data were analysed using a phenomenographic approach.FindingsThe findings revealed five structural aspects of transnational family responsibilities of Thai immigrant women: being a dutiful daughter, being a caring mother, being a kind relative, being a “giving” person and striving for a wealthy life. The interviewees seldom encountered enough support from the spouse in handling their transnational family responsibilities. In general, a transnational marriage includes family responsibilities that are continuous and that often is the cause of migration.Practical implicationsThis paper illuminates the transnational responsibilities of marriage migration and argues for women’s rights of culturally congruent health care.Originality/valueTraditionally Thai women’s values are based on how they handle family responsibilities and acknowledging own health needs are not. These interviewees perceived doubled burden in terms of family responsibilities and workload in employed work, which contributed to poor health and wellness.

Differences in body composition and grip between Japanese and Thai older people living in Thailand

Abstract Background Age-related muscle mass loss is one of the main risk factors for osteoporosis and fractures among older people. Thus, prevention of muscle mass loss in older people is an important issue. We examined ethnic group-related differences in body composition and grip strength among older people living in the same area. Methods We measured body composition and grip strength among local Thai older people living in Chiang Mai Province, as well as in Japanese older people who emigrated to Chiang Mai Province in their retirement. A self-reported questionnaire regarding socio-demographic status was also administered. Measurement items were averaged and compared by sex and ethnic group. Questionnaire items were also categorized by sex and ethnic group. Results A total of 119 older people participated, including 47 Japanese participants (26 men, 21 women) and 72 Thai participants (16 men, 56 women). The average age of Japanese participants was 71.1 years (standard deviation: 4.89), and the average age of Thai participants was 68.8 years (standard deviation: 5.61). Significant differences between ethnic groups were found in percentage of body fat in women (Japanese average: 32.9% vs. Thai average: 37.6%, p &amp;lt; 0.05), skeletal muscle mass index (SMI) in men (Japanese average: 7.85 kg/m2 vs. Thai average: 7.31 kg/m2, p &amp;lt; 0.05) and average grip strength in men (Japanese: 35.1 kg vs. Thai: 30.7 kg, p &amp;lt; 0.05). Conclusions Our preliminary results suggest that Thai older people, particularly men, are weaker than Japanese older people. Decreased muscle mass is directly responsible for functional impairment, involving loss of strength, increased likelihood of falls, and loss of autonomy. Preventing muscle weakness among older people is important. In future studies, we plan to analyze and clarify the differences between Thai and Japanese older people to identify effective methods to prevent muscle mass decreases. Key messages There were significant differences in average % body fat between older Japanese and Thai women. There were significant differences in average SMI and grip strength between older Japanese and Thai men.

Efficacy and tolerability of low-dose spironolactone and topical benzoyl peroxide in adult female acne: A randomized, double-blind, placebo-controlled trial.

Effective therapies for adult female acne (AFA) are limited. Oral spironolactone (SPL), 100-200mg/day, is currently used off-label to treat AFA. However, high-dose SPL results in clinically significant side-effects which prevent widespread use in clinical practice. The efficacy of low-dose spironolactone in AFA is unknown. We examined the efficacy and tolerability of low-dose (25-50mg/day) oral SPL in Thai women with moderate AFA. A randomized, double-blind, placebo-controlled trial was conducted for 12weeks. Moderate AFA patients aged between 25 and 45years received a combination of daily topical benzoyl peroxide (BP) 2.5% plus either SPL 25mg (SPL25 group), SPL 50mg (SPL50 group) or placebo. We performed total acne counts and Adult Female Acne Scoring Tool (AFAST) grading at 4-week intervals. The success rate, defined as the proportion of participants achieving a "clear/almost clear" AFAST grade by the end of week 12, was considered as the main outcome. Treatment-related adverse events (TRAE) were recorded. We enrolled 63 participants in the study. The total acne counts decreased significantly in all three groups (P<0.05) as compared with baseline. Participants in the SPL50 group had a significantly higher success rate than those in the placebo group (P<0.05). Serum potassium and creatinine levels showed no significant changes with treatment or between groups. A small number of participants in SPL25 and SPL50 reported mild and temporary TRAE, such as menstrual irregularities, breast tenderness and dizziness. The combination of SPL 50mg/day and topical BP proved effective in improving moderate AFA in Thai women, with an acceptable side-effect profile. We propose this regimen as an option for treating moderate AFA.

ASCCP Risk-Based Colposcopy Recommendations Applied in Thai Women With Atypical Squamous Cells of Undetermined Significance or Low-Grade Squamous Intraepithelial Lesion Cytology.

To compare the proportion of cervical intraepithelial neoplasia (CIN) 2 or worse pathology among different risk strata according to the ASCCP when applied in women who had atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesion (LSIL) cervical cytology; to assess performance of colposcopy; and to assess the independent predictors for detected CIN 2 or worse pathology. This is a secondary analysis of a previous prospective study, which included Thai women with ASC-US or LSIL cytology who underwent high-risk human papillomavirus (HPV) testing and subsequent colposcopy with directed biopsy. Patients were classified as lowest-risk, intermediate-risk, or highest-risk based on cervical cytology, high-risk HPV testing, and colposcopic impression. The proportion of CIN 2 or worse pathology and associated prognostic factors were analyzed. Of 697 women, 103 (14.8%), 573 (82.2%) and 21 (3%) were classified into lowest-risk, intermediate-risk, and highest-risk groups, respectively. The proportion of CIN 2 or worse pathology was 1%, 11.2%, and 61.9% in those same groups, respectively (P<.001). Colposcopy to detect CIN 2 or worse pathology had a sensitivity, specificity, positive predictive value, and negative predictive value of 98.7%, 18%, 13.2%, and 99.1%, respectively. Independent predictors for detecting CIN 2 or worse pathology were positive high-risk HPV, HPV 16/18 positivity, and high-grade colposcopic impression. This study supports a no biopsy with follow-up strategy in the lowest-risk group, inconsistent with ASCCP recommendations, but is in alignment with a strategy of multiple targeted biopsies in the intermediate-risk and highest-risk groups.

Inhibitory Effect of &lt;i&gt;Perilla frutescens&lt;/i&gt; L. Leaves Extract on Melanogenesis and Skin Whitening Efficacy in the Underarm Whitening Product Application

The effect of Perilla frutescens L. leaves extract (PFLE) on melanogenesis regulation in B16F10 cells was investigated. The extract had a significant inhibitory effect on melanogenesis in a dose-dependent manner without cytotoxicity at concentrations between 2.5 and 10 μg/mL. The PFLE was formulated as an underarm serum (PL serum) and evaluated for skin irritation and its skin whitening efficacy on 30 Thai women twice daily for 4 weeks. Changes in skin melanin and erythema index, L* a* values were studied. A gradual decrease in melanin index from 37.94±0.66 to 35.90±0.64 (5.38%), and a significant decrease in erythema index from 11.32±0.79 to 10.21±0.11 (9.80%) could be observed during a 4-week period. Therefore, the efficacy of PL serum in improving skin was demonstrated by a significant decrease in melanin and erythema index compared with initial values and skin tone was improved without skin irritation. Extract from Perilla frutescens L. leaves can be used as a novel whitening cosmeceutical ingredient.

Preliminary Report on Comparative Study of Side Effects of Progestin-Only Contraceptive Methods between Thai Women Using DMPA and a Single-Rod Sub-Dermal Implant at Siriraj Hospital, Bangkok, Thailand

Objective: To compare the side effects or specific adverse events except bleeding pattern reported between women using depo-medroxy progesterone acetate (DMPA) and a single-rod sub-dermal etonogestrel implant (Implanon). Materials and Methods: This comparative study assessed women returning for follow-up visit at the Unit of Family planning, Siriraj Hospital between January and December 2019. Women aged 18 to 45 years old who used one of the progestin-only contraceptive methods, either DMPA or Implanon, as a birth control for six months were invited in the present study. Any adverse effects were recorded and analyzed. Results: Fifty-nine women were in the Implanon group and 52 women were in the DMPA group. More women in the DMPA group were older [34.5 (27.5 to 38) versus 25 (22 to 31) years] and less single (26.9% versus 61.0%), p=0.001. The reported side effects in both groups were similar in degree and extent with no statistical significant difference except the symptom of flushing where more women in the Implanon group observed this event, p=0.004. There was borderline significance that women using Implanon had higher incidence of headache, gastrointestinal symptoms, and depression. Conclusion: Both groups of women observed comparable adverse events except bleeding events. Flushing, headache, gastrointestinal symptoms, and depression were more reported by women using Implanon. Close method counseling during the course of use is essential to prolong continuing use to meet their contraceptive goal. Keywords: DMPA, Implanon, Side effects, Thai women

Cytological Follow-Up of Cervical Intraepithelial Neoplasia 1 after Initial Management During 2-Year Period: Bhumibol Adulyadej Hospital Experience

Objective: To evaluate the frequency of cervical cytological results in patients diagnosed as low-grade squamous intraepithelial lesion (LSIL) in cytology report between women younger than 30 and woman 30 or older after initial management and the completed 2-year follow-up to suggest the proper management for Thai women. Materials and Methods: The present study was retrospectively conducted at Bhumibol Adulyadej Hospital, Bangkok, Thailand between January 2011 and December 2016. The medical records of 279 patients whose cervical cytology reported LSIL were reviewed. The prevalence of silent high grade cervical intraepithelial neoplasia (CIN 2/3) in LSIL cytology result was determined. The results of the cervical cytology after the patients completed the 2-year follow-up were evaluated. Results: During the present study period, 279 cases of LSIL in cytology result were enrolled. In women with LSIL in the cytology report, two-third were in pre-menopausal status. The prevalence of CIN 2/3 in LSIL cytology in women younger than 30 and 30 or older were 11.9% and 11.2%, respectively. At 2-year follow-up, around 97% of the patients who completed the follow-up had a spontaneous regression of the disease in both aged groups. Three percent of cases (3/85) had persistent disease in women 30 or older only. There was no progressive disease in the present study. Conclusion: Silent CIN 2/3 in LSIL cytology in the present study were high. Colposcopy should be recommended for diagnosis and follow-up in this setting. Abnormal Pap at 2-year follow-up was around three percent, therefore, abnormal cytology was still a problem. Continuous close cytology follow-up is still recommended. Keywords: Low-grade squamous intraepithelial lesion, LSIL, Cervical intraepithelial neoplasia, CIN, Cytology