Years Of Contraceptive Use Research Articles

Applicability of a web app for breast cancer risk calculation and personalized recommendations for screening in Mexico.

1567 Background: A minority of women with breast cancer in Mexico are being diagnosed through a screening program, which translates into late diagnosis and a worse prognosis. It is imperative to develop easy access and low-cost interventions to increase the screening rate. Methods: We developed a web app tailored to guide patients to seek medical consultation if they were at high risk for breast cancer or standard screening recommendations based on the predicted risk for age (https://cuccuanl.com/calcula-tu-riesgo-de-cancer-de-mama/). The web app consisted of an 8-question survey designed using object-based programming with HTML5, the additional logic was programmed on JavaScript. The program logic automatically guided patients to medical consultation if they were at high risk for breast cancer, or standard screening recommendations based on their predicted risk for age. On each confirmation page, the contact information of the hospital appeared, also, consultation at the clinic could be scheduled within the web app. The web app was distributed via social media on International Breast Cancer Awareness Day. Results: A total of 1,012 persons answered the survey after a follow-up period of two weeks. The median age of respondents was 34 years. Among participants, 10.8% were considered at very high risk for breast cancer due to symptoms, 22% were classified as high risk based on family history or more than 5 years of contraceptive use, and 19% were considered as average-risk population for whom age-based screening tests were recommended. The remaining 48% of participants were considered at low risk for breast cancer development and were directed to educational information about breast cancer awareness. Among all persons that answered our survey, 21 requested a specialized medical appointment within the web app. Conclusions: This pilot study showed a high response of Mexican population seeking breast cancer risk evaluation, 11% of women that responded to our survey had symptoms highly suggestive of breast cancer. The use of web apps can result in mass diffusion which will help reach people with less medical access, a common scenario in many developing countries. Further analysis should be made to measure the real impact on breast cancer diagnosis and oncological outcomes. This study shows how effective social media is as a means of diffusion on health topics. [Table: see text]

Relationship Between Method and Duration of Contraception Usage to Subjective Health Complaints

Subjective health complaints is identified is symptoms and uncomfortable feeling felt by the respondents. Health Complaint is the most common cause of acceptor stops using contraception. The aim of this study was to exsamine between of subjective health complaints related by contraception method and duration of contraception usage. This study was observational analytic with cross sectional design. The sample of study were acceptor living at RW 6 Kalitengah Sidoarjo district and using simple random sampling technique to collect the data. Statistical test using chi square to determine the relationship between variables. The study showed that most of the respondents were aged > 35 years old (62,5%), educated as high as high school (59,7%), were housewife (70,8%). Statistic test using chi square showed that there was relationship between contraception method (p = 0.0098) and the duration of contraception usage (p = 0.012) with subjective health complaints. Hormonal contraceptive methods may increase the risk of 4,05 times to experience subjective health complaints compared with respondents who use non-hormonal contraception. Respondents with long ≤ 5 years of contraceptive use may increase the risk of 7,82 times to experience subjective health complaints compared with respondents who used the contraceptive for > 5 years. It is concluded that contraception method and the duration of contraception usage are related to subjective health complaints. It is recommended for the midwives to educate respondents who were using hormonal contraception to change into using non hormonal contraception when have complaint.Keywords: contraception method, usage duration, subjective health complaints

Relationship Between Method and Duration of Contraception Usage to Subjective Health Complaints

Subjective health complaints is identified is symptoms and uncomfortable feeling felt by the respondents. Health Complaint is the most common cause of acceptor stops using contraception. The aim of this study was to exsamine between of subjective health complaints related by contraception method and duration of contraception usage. This study was observational analytic with cross sectional design. The sample of study were acceptor living at RW 6 Kalitengah Sidoarjo district and using simple random sampling technique to collect the data. Statistical test using chi square to determine the relationship between variables. The study showed that most of the respondents were aged > 35 years old (62,5%), educated as high as high school (59,7%), were housewife (70,8%). Statistic test using chi square showed that there was relationship between contraception method (p = 0.0098) and the duration of contraception usage (p = 0.012) with subjective health complaints. Hormonal contraceptive methods may increase the risk of 4,05 times to experience subjective health complaints compared with respondents who use non-hormonal contraception. Respondents with long ≤ 5 years of contraceptive use may increase the risk of 7,82 times to experience subjective health complaints compared with respondents who used the contraceptive for > 5 years. It is concluded that contraception method and the duration of contraception usage are related to subjective health complaints. It is recommended for the midwives to educate respondents who were using hormonal contraception to change into using non hormonal contraception when have complaint.Keywords: contraception method, usage duration, subjective health complaints

High prevalence of insulin resistance assessed by the glucose clamp technique in hormonal and non-hormonal contraceptive users

Objective To assess the prevalence of insulin resistance (IR) and associated factors in contraceptive users. Methods A total of 47 women 18 to 40 years of age with a body mass index (kg/m2) < 30, fasting glucose levels < 100 mg/dl and 2-hour glucose level < 140 mg/dl after a 75-g oral glucose load were submitted to a hyperinsulinemic-euglycemic clamp. The women were distributed in tertiles regarding M-values. The analysed variables were use of combined hormonal/non-hormonal contraception, duration of use, body composition, lipid profile, glucose levels and blood pressure. Results IR was detected in 19% of the participants. The women with low M-values presented significantly higher body fat mass, waist-to-hip ratio, fasting insulin, HOMA-IR and were nulligravida, showed > 1 year of contraceptive use and higher triglyceride levels. IR was more frequent among combined oral contraceptive users, however no association was observed after regression analysis. Conclusions The prevalence of IR was high among healthy women attending a family planning clinic independent of the contraceptive method used with possible long-term negative consequences regarding their metabolic and cardiovascular health. Although an association between hormonal contraception and IR could not be found this needs further research. Family planning professionals should be proactive counselling healthy women about the importance of healthy habits. Chinese 摘要 目的 评估避孕药具使用者胰岛素抵抗（IR）的发生率及其相关因素。 方法 受试者共47名女性，年龄18-40岁，体重指数(kg/m2）<30，空腹血糖水平<100mg/dl，口服75g葡萄糖耐量试验2小时血糖水平<140mg/dl者纳入血糖-胰高血糖素钳夹试验。根据M值将受试者分为3组。分析变量包括使用复合激素/非激素避孕，使用时间，身体组成，血脂，血糖水平和血压。 结果 受试者中19%检测出胰岛素抵抗。低M-值的女性身体脂肪含量、腰臀比、空腹胰岛素、HOMA-IR均明显升高，避孕药使用超过1年的未孕妇女甘油三酯水平较高。在使用复方口服避孕药的妇女IR发生率频繁，但回归分析结果显示无明显相关性。 结论 计划生育门诊的健康妇女IR的高发率不依赖于采用的避孕方法，这些避孕措施的长期应用可能对其代谢和心血管健康产负面影响，虽然激素避孕与IR之间的相关性还没有发现，这需要进一步研究，但是计划生育专家应该主动咨询告知健康妇女健康习惯的重要性。

Mechanical Analysis of Muscle Tissue under Influence of Hormones

In the present study we examined morphometrically and mechanically, muscle of rats subjected to hormone use. We used two groups of wistar rats n = 8. One of them received ethinylestradiol and levonorgestrel every day and other, was a control group and received placebo. The experiment lasted for 60 days to simulate one year of contraceptive use in women. After the experimental period, the animals were euthanized with overdose of anesthetic and the gastrocnemius muscles were dissected to perform the analyzes. Morphometrically, were examined muscle length, and the perimeter of the muscle belly. Were examined mechanically the maximum strength and stiffness of muscles. The results of this study show that, although animals undergoing hormone use have been growing larger longitudinal than in the control group, the mechanical properties of the muscles remained unchanged. It proposes that the number of ligament injuries in women is not due to a decrease in muscle stiffness stabilizer, but by unique mechanical properties of ligaments.

Body weight and composition in users of levonorgestrel-releasing intrauterine system

BackgroundThere is little information about body weight and body composition (BC) among users of the levonorgestrel-releasing intrauterine system (LNG-IUS). The aim of this study was to evaluate body weight and BC in LNG-IUS users compared to users of the TCu380A intrauterine device (IUD). Study DesignA prospective study was done with 76 new users of both contraceptive methods. Women were paired by age (±2 years) and body mass index (BMI, kg/m2, ±2). Body weight and BC (% lean mass and % fat mass) were evaluated by a trained professional at baseline and at 1 year of contraceptive use. The BC measurements were obtained using Lunar DXA equipment. Weight and BC were evaluated in each woman at baseline and at 12 months and analyzed as the mean change within each woman. Then, the changes in weight and BC for each woman were calculated and then compared between LNG-IUS and TCu380A IUD users (paired data for each woman). The central-to-peripheral fat ratio was calculated by dividing trunk fat by the upper and lower limb fat. ResultsThere were no significant differences at time of IUD insertion between LNG-IUS and TCu380A IUD users regarding age (mean±SD) (34.4±7.5 vs. 33.9±8.0 years), BMI (25.3±4.1 vs. 25.9±4.1) and number of pregnancies (1.9±0.2 vs. 1.7±0.2), respectively. Mean body weight gain of 2.9 kg was observed among LNG-IUS users at 12 months (p=.0012), whereas the body weight of TCu380A IUD users only increased by 1.4 kg (p=.067). There was no significant difference in body weight change between the two groups of users at 12 months. The variation in the central-to-peripheral fat ratio was the same between the two groups (−1.6% vs. −0.2%; p=.364). LNG-IUS users showed a 2.5% gain in fat mass (p=.0009) and a 1.4% loss of lean mass, whereas TCu380A IUD users showed a loss of 1.3% of fat mass (p=.159) and gain of 1.0% of lean mass (p=.120). TCu380A IUD users gained more lean mass than LNG-IUS users (p=.0270), although there was no significant difference between the two groups after 12 months of use. ConclusionsAlthough an increase in mean fat mass among LNG-IUS users at 12 months of use was observed, it should be noted that an increase of body weight was also observed in both groups after 1 year of insertion of the device. However, a study with a larger number of women and long-term evaluation is necessary to evaluate these body changes.

Safety, efficacy and patient acceptability of the contraceptive and non-contraceptive uses of the LNG-IUS.

Intrauterine devices (IUDs) provide highly effective, long-term, safe, reversible contraception, and are the most widely used reversible contraceptive method worldwide. The levonorgestrel-releasing intrauterine system (LNG-IUS) is a T-shaped IUD with a steroid reservoir containing 52 mg of levonorgestrel that is released at an initial rate of 20 μg daily. It is highly effective, with a typical-use first year pregnancy rate of 0.1% - similar to surgical tubal occlusion. It is approved for 5 years of contraceptive use, and there is evidence that it can be effective for up to 7 years of continuous use. After removal, there is rapid return to fertility, with 1-year life-table pregnancy rates of 89 per 100 for women less than 30 years of age. Most users experience a dramatic reduction in menstrual bleeding, and about 15% to 20% of women become amenorrheic 1 year after insertion. The device's strong local effects on the endometrium benefit women with various benign gynecological conditions such as menorrhagia, dysmenorrhea, leiomyomata, adenomyosis, and endometriosis. There is also evidence to support its role in endometrial protection during postmenopausal estrogen replacement therapy, and in the treatment of endometrial hyperplasia.

IS LONG-TERM USE OF HORMONAL CONTRACEPTIVES A RISK FACTOR FOR OSTEOPOROSIS ?

Objective : To study the effect of long-term use of different forms of hormonal contraceptives on bone mineral density (BMD)Design : A prospective studySetting: Fertility Care Unit, Mansoura University Hospitals.Subjects and Methods: One hundred healthy women aged 25-49 years who chose long term hormonal contraceptives were recruited in the study. Women had to fulfill a set of inclusion and exclusion criteria. Tlio.sc women were categorized into five groups, each comprised twenty women. All groups were well balanced with respect (o age, height, weight and body mass index. Those who used combined oral contraceptives (group l), Norplanl subdcrmal implants (group 2), Implanon subdermal implants (group 3), injectablc Dcpo-Provera (group 4) and Control group used non-hormonal intrauterine contraceptive device Tcu 380A (group 5). After 3 years of contraceptive use, bone mineral density (BMD) of lumber spine (L2-L4) was measured for all women using dual energy X-ray absorpliomclry (DEXA). BMD measurements (g/cm2) were expressed as Z-scores to assist in the interpretation of BMD results. BMD and Z-scores in different groups were compared using Annova Test with Post Hoc Test (Turkey HSD) for multiple comparisons between groups.Results: Of 100 women, 9 women were excluded from analysis and a total of 91 women made up the final sample; 18 used combined oral contraceptives (group 1), 19 used Norplant (group 2), 19 used Implanon (group 3), 18 used Depo-Provera (group 4) and 17 used non-hormonal IUD Tcu 380A (group 5). Age, height and body mass index were not significantly different among the groups. Mean BMD at lumbar spine (L2-L4) was 1.205 (group 1), 1.182 (group 2), 1.11 (group 3) 0.842 (group 4) and 1.113 (group 5). There were significant differences in BMD values at lumber spine between different groups. Depo-Provera group was associated with a lower BMD than the other groups whereas the combined oral contraceptive group was associated with a higher BMD. Mean /.-scores were -0.34 (group 1), -0.37 (group 2), -0.5 (group 3), -2.26 (group 4) and -0.5 (group 5). Multiple comparisons by using Post Hoc Tests (turkey HSD) demonstrated that BMD and Z-scores in Depo-Provera users were significantly lower than that of other groups. All women using Depo-Provera experienced osteoporotic changes with a Z-score ranging from -2.02 to -2.4. Conclusion: Depo-Provera was associated with a significantly lower BMD; hence its long term use is a potential risk factor for osteoporosis. Combined oral contraceptives and Norplant were associated with increased BMD while Implanon had no effect. These results have a great importance in cases of medico-legal examination of women who used Depo-Provera for a long duration as a simple trauma may lead to fractures.

Contraceptive failure rates in France: results from a population-based survey

Despite the widespread use of highly effective contraceptive methods in France, one in every three pregnancies is unintended, of which 65% occur while using contraceptives. In the USA, 49% of pregnancies are unintended, half of which result from contraceptive failure. This study provides estimates of method-specific failure rates among French women. We use data from the 2000 Cocon Study, a population-based cohort, comprising a representative sample of 1689 women aged 18-44 years who described their contraceptive history. Piecewise-constant hazards models were used to estimate method-specific contraceptive failure rates during the first 5 years of contraceptive use. A random effect was introduced to take into account the fact that some women contribute more than 1 contraceptive episode. These same models were used to assess the effects of socio-demographic characteristics on the probability of contraceptive failure among pill, intrauterine device (IUD) and condom users. Overall, 2.9% of women experienced a contraceptive failure in the first year of use and 8.4% in the first 5 years of use. The IUD had the lowest first year failure rate (1.1%), followed by the pill (2.4%), the condom (3.6%), fertility awareness methods (periodic abstinence or safe period by temperature) (7.7%), withdrawal (10.1%) and spermicides (21.7%). These failure rates varied little by user characteristics. Lower failure rates among French women compared with those reported for US women suggest differences in contraceptive practices which need to be further explored.

A prospective study of the effects of oral and injectable contraception on bone mineral density

Objective: To compare the effects of different hormonal contraceptives on bone mineral density (BMD) in reproductive age women.Methods: We conducted a prospective, longitudinal study on 100 women aged 18–33 years who initiated use of injectable depot medroxyprogesterone acetate (DMPA), norethindrone-containing oral contraceptives, or desogestrel-containing oral contraceptives to compare their effects on BMD. Bone mineral density was measured by dual energy X-ray absorptiometry at baseline and after 1 year of contraceptive use. Data on other factors that could affect BMD (smoking status, alcohol use, body mass index, exercise habits, and race) were obtained by interview or examination. An analysis of covariance was performed to test for differences in BMD among the three groups after 1 year of contraceptive use, controlling for potential confounding variables.Results: No significant differences were noted in age, race, body mass index, smoking status, alcohol use, exercise habits, or BMD between the three groups at baseline. After 1 year of contraceptive use, DMPA users experienced a 2.5% decrease in BMD, compared with a 2.8% increase among users of norethindrone-containing pills and a 0.9% increase among users of desogestrel-containing pills (P <0.001). Pairwise comparisons demonstrated that these changes in BMD significantly differed between users of DMPA and norethindrone-containing pills (P <0.001), between users of DMPA and desogestrel-containing pills (P = 0.001) and between users of norethindrone- and desogestrel-containing pills (P = 0.04).Conclusions: These data demonstrate that different methods of hormonal contraception have significantly different effects, at least temporarily, on BMD after only 1 year of use.

Contraceptive Failure Rates: New Estimates from the 1995 National Survey of Family Growth

Unintended pregnancy remains a major public health concern in the United States. Information on pregnancy rates among contraceptive users is needed to guide medical professionals' recommendations and individuals' choices of contraceptive methods. Data were taken from the 1995 National Survey of Family Growth (NSFG) and the 1994-1995 Abortion Patient Survey (APS). Hazards models were used to estimate method-specific contraceptive failure rates during the first six months and during the first year of contraceptive use for all U.S. women. In addition, rates were corrected to take into account the underreporting of induced abortion in the NSFG. Corrected 12-month failure rates were also estimated for subgroups of women by age, union status, poverty level, race or ethnicity, and religion. When contraceptive methods are ranked by effectiveness over the first 12 months of use (corrected for abortion underreporting), the implant and injectables have the lowest failure rates (2-3%), followed by the pill (8%), the diaphragm and the cervical cap (12%), the male condom (14%), periodic abstinence (21%), withdrawal (24%) and spermicides (26%). In general, failure rates are highest among cohabiting and other unmarried women, among those with an annual family income below 200% of the federal poverty level, among black and Hispanic women, among adolescents and among women in their 20s. For example, adolescent women who are not married but are cohabiting experience a failure rate of about 31% in the first year of contraceptive use, while the 12-month failure rate among married women aged 30 and older is only 7%. Black women have a contraceptive failure rate of about 19%, and this rate does not vary by family income; in contrast, overall 12-month rates are lower among Hispanic women (15%) and white women (10%), but vary by income, with poorer women having substantially greater failure rates than more affluent women. Levels of contraceptive failure vary widely by method, as well as by personal and background characteristics. Income's strong influence on contraceptive failure suggests that access barriers and the general disadvantage associated with poverty seriously impede effective contraceptive practice in the United States.

A practice audit of oral contraceptive users.

The level of care provided to oral contraceptive (OC) users in a general practice in Aberdeen Scotland was evaluated. The records of the 262 current OC acceptors were audited for 1) record of menstrual history 2) blood pressure measurement before starting contraceptive use 3) blood pressure measurement at 1st follow-up visit 4) weight 5) urine analysis 6) pelvic examination and cervical smear and 7) rubella titer. Patients were divided into 2 groups. Group 1 (178 women) included those who had been taking OCs for more than 1 year and Group 2 (84 women) consisted of those who had been using the pill for less than 1 year. Women in both groups were similar in terms of marital status nulliparity and type of preparation prescribed (combined or progesterone only pill). However 30% of the women in Group 1 compared with 50% of those in Group 2 had been prescribed OCs after pregnancy. Moreover higher percentages of women in Group 2 had measurements recorded for the variables under study. These differences were significant in the cases of measurements of pretreatment blood pressure (60.1% in Group 1 vs. 77.3% in Group 2) weight (54.5% vs. 80.9%) urine analysis (44.9% vs. 66.7%) and rubella titer (37.1% vs. 59.5%). This improvement in the more recently treated group may reflect the increase in number of women who are attending for postnatal examination. This examination has been scheduled to coincide with the 6-week pediatric screening visit and attendance has reached 100%. As a result of this study the practice plans to institute the following standards of care: 1) record blood pressure at initial consultation and at each subsequent visit before prescribing oral contraception 2) record weight at initial consultation 3) advise on rubella screening at the initial or 1st review consultation and 4) advise on cervical cytology examination and vaginal examination in the 1st year of contraceptive use. This study will be repeated in 2 years.

Studies on the Role of Oral Contraceptive Use in the Etiology of Benign and Malignant Liver Tumors

PIP: Studies involving the role of OCs (oral contraceptives) in the etiology of benign and malignant liver tumors are reviewed. Although the number of reported cases is comparatively small (1 study cited an incidence rate of 1 case in 10,000 users after 5-10 years of contraceptive use), the available evidence strongly suggests that there is a relationship between the use of OCs and benign liver tumors. The acutal risk seems to be related to duration of usage, age of the woman, and type of contraceptive steroid used. 1 study showed the risk to be greater for those users who took pills with high doses of estrogens and progestogens. Analysis of liver tumors histologically showed the tumors among nonusers to be distributed among all the histologic types; there was a preponderance of hepatic cell adenomas (HCA) and focal modular hyperplasia (FNH) among users. Further evidence for an etiologic role for OCs in liver tumor formation can be derived from several cases of tumor regression or dormancy following OC discontinuance. Further etiologic studies should focus on other factors, e.g., female hormone balance, number of pregnancies, and liver disease. It is possible that FNH develops in women susceptible to hormonal stimulation. The malignant potential of benign tumors should also be studied.

DEMOGRAPHIC TECHNIQUES IN DESCRIBING CONTRACEPTIVE USE APPLIED ON THE SITUATION IN SWEDEN

The authors suggest expressing the amount of use of contraceptives in a female population in the same terms as used to denote the occurrence of births, with one year of contraceptive use regarded as an event in the same sense as a birth. If the prevalence of contraceptives in a population can be expressed in the same terms as other events associated with reproduction, such as births and abortions, it may help to clarify the relationships between these events. Applying the method used to calculate the total fertility and abortion rates on the use of oral contraceptives and intrauterine devices in Sweden in 1975, they noted 1.8 deliveries, 0.6 legal abortions and seven years' use of oral contraceptives and six years' use of intrauterine device per women.

Estimation of Births Averted by Family Planning Programs: the Parity Approach

To illustrate the parity approach in calculating the number of births prevented by family planning programs data gathered in 1969 was taken from a public Puerto Rican clinic for 204 women using oral contraceptives. The parity approach measures age-specific fertility rates indirectly as estimates from parity data. Analysis showed that the parity function is linear and does not vary with method (revealed when comparisons were made with 146 IUD acceptors). Estimates of the continuation functions showed that 26% dropped contraception immediately after acceptance. The parity approach also revealed that for 100 women 30 years of age 21 births would be prevented as a result of 1 year of contraceptive use; 14 births could be prevented during the second year 9 during the third. This method has advantages over other methods now in use in that it provides a greater degree of accuracy while at the same time being simpler and more practical relying on only a few demographic variables readily available in most clinics such as age parity and the continuation rate.

Selective Fecundability and Contraceptive Effectiveness

A study based on an extended model using the Type I-geometric distribution fitted by Jain to a sample of 2190 Taichung women was conducted to confirm Tietzes findings that in the absence of contraception the fecundability composition of a group of women changes rapidly by a selective process whereby more fecund women become pregnant leaving behind an increasingly subfecund group. Tabulated results show that the process becomes progressively slower with increasingly effective contraception. Mean values of fecundability are given according to effectiveness of contraception and months of fecundable exposure without pregnancy. The proportion of women accidentally conceiving within 2 years of contraceptive use decreases with increasing contraceptive effectiveness and with the length of preceding period of nonprotection during which the proportion of subfecund women is increased. After 4 years of nonprotection the rate of accidental pregnancy is reduced by a factor of 3. Potential sources of bias facing any comparison of contraceptive methods such as unequal length of observation of women using various methods and amount of overlap or interval between time of contraceptive initiation and amenorrhea are discussed with respect to family planning programs. IUD effectiveness for different age groups of women (under 24-39) in Taichung is discussed. An extensive appendix describes mathematical details relating to the model.