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Acta Obstetricia Et Gynecologica... Jan 2017The aim was to compare contraceptive use in the Nordic countries and to assess compliance with recommendations from the European Medicines Agency regarding the use of...
INTRODUCTION
The aim was to compare contraceptive use in the Nordic countries and to assess compliance with recommendations from the European Medicines Agency regarding the use of combined oral contraception containing low-dose estrogen and levonorgestrel, norethisterone or norgestimate.
MATERIAL AND METHODS
Data on hormonal contraceptive prescriptions and sales figures for copper intrauterine devices were obtained from national databases and manufacturers in Denmark, Finland, Iceland, Norway and Sweden in 2010-2013.
RESULTS
Contraceptive use was highest in Denmark (42%) and Sweden (41%), followed by Finland (40%). Combined oral contraception was the most used method in all countries, with the highest use in Denmark (26%). The second most used method was the levonorgestrel-releasing intrauterine system, with the highest use in Finland (15%) and ≈10% in the other countries. Copper intrauterine devices (7%) and the progestin-only pill (7%) were most often used in Sweden. Combined oral contraception use decreased with increasing age and levonorgestrel-releasing intrauterine system and progestin-only pills use increased. The use of long-acting reversible methods of contraception (=levonorgestrel-releasing intrauterine system, copper intrauterine devices, and implants) increased with time and was highest in Sweden (20%) and Finland (18%). The highest use of European Medicines Agency recommended combined oral contraception was in Denmark, increasing from 13 to 50% between 2010 and 2013. In Finland, recommended combined oral contraception remained below 1%.
CONCLUSIONS
Contraceptive use was highest in Denmark and Sweden, levonorgestrel-releasing intrauterine system use was highest in Finland and all long-acting methods were most common in Sweden. The use of combined oral contraception recommended by the European Medicines Agency was highest in Denmark.
Topics: Adolescent; Adult; Age Factors; Condoms; Contraception Behavior; Contraceptives, Oral, Hormonal; Contraceptives, Oral, Synthetic; Contraceptives, Postcoital; Databases, Factual; Female; Humans; Intrauterine Devices; Levonorgestrel; Middle Aged; Scandinavian and Nordic Countries; Young Adult
PubMed: 27861709
DOI: 10.1111/aogs.13055 -
Contraception Jun 2016High proportion of Japanese uses condoms; lower proportion uses oral contraceptive pills (OCPs). We examined the longitudinal patterns for contraceptive usage in Japan... (Comparative Study)
Comparative Study
OBJECTIVES
High proportion of Japanese uses condoms; lower proportion uses oral contraceptive pills (OCPs). We examined the longitudinal patterns for contraceptive usage in Japan and evaluated differences before and after OCP government approval.
STUDY DESIGN
We accessed nationally representative survey data for women aged 16-49years from 1950 to 2014.
RESULTS
Usage of condoms and OCP was 83.4% and 3.0%, respectively in 2014. OCP use before (1.21%) and after (1.97%) government approval did not differ significantly (p=.58).
CONCLUSIONS
The prevalence of OCP usage remains low in Japan. A wide gap in use between Japan and other developed countries exists.
IMPLICATIONS
Through a wide gap in OCP use between Japan and other countries, we revealed how choices of contraceptive methods and their benefits could be openly available for women of reproductive age, and how health care professionals disseminate appropriate knowledge about contraception for women in need.
Topics: Adolescent; Adult; Condoms; Contraception; Contraception Behavior; Contraceptives, Oral; Female; Health Knowledge, Attitudes, Practice; Humans; Japan; Middle Aged; Reproductive Health; Surveys and Questionnaires; Young Adult
PubMed: 26872717
DOI: 10.1016/j.contraception.2016.02.006 -
The European Journal of Contraception &... Apr 2023This study aimed to assess the experience and satisfaction with contraceptives and use of Combined Oral Contraceptives (COC) by women and compare their perceptions with...
PURPOSE
This study aimed to assess the experience and satisfaction with contraceptives and use of Combined Oral Contraceptives (COC) by women and compare their perceptions with those of gynaecologists.
METHODS
This was a multicentre survey study conducted in Portugal, during April and May, 2021 with women using contraceptives and gynaecologists. Online quantitative questionnaires were carried out.
RESULTS
A total of 1508 women and 100 gynaecologists were included. Cycle control was the pill non-contraceptive benefit most valued by gynaecologists and women. For gynaecologists, the main pill concern was the risk of thromboembolic events, but they believed that weight gain was the main concern for their patients. The pill was the most used contraceptive (70%) and women were largely (92%) satisfied. The pill was associated with health risks for 85% of users, mainly thrombosis (83%), weight gain (47%), and cancer (37%). The attributes of the pill most valued by women are contraceptive efficacy (82%), followed by low risk of thromboembolic events (68%), good cycle control (60%), non-interference with libido and mood (59%) and weight (53%).
CONCLUSION
Most women use contraceptive pills and are generally satisfied with their contraceptive. Cycle control was the most valued non-contraceptive benefit for gynaecologists and women, agreeing with physicians' beliefs about women. On the other hand, contrary to physicians' beliefs, that women's main concern is weight gain, women are mainly concerned with risks associated with contraceptives. Thromboembolic events are women's and gynaecologists most valued risk. Finally, this study indicates the need for physicians to better understand what COC users really fear.
Topics: Humans; Female; Male; Contraception; Contraceptives, Oral, Combined; Contraceptive Devices; Weight Gain; Perception
PubMed: 36971323
DOI: 10.1080/13625187.2023.2185482 -
Contraception Dec 2023This study aimed to compare contraceptive efficacy and safety of drospirenone 4 mg in a 24/4-day regimen in nonobese and obese users and describe pharmacokinetics... (Comparative Study)
Comparative Study
OBJECTIVES
This study aimed to compare contraceptive efficacy and safety of drospirenone 4 mg in a 24/4-day regimen in nonobese and obese users and describe pharmacokinetics according to bodyweight.
STUDY DESIGN
We analyzed data from three drospirenone 4 mg trials (2 European and 1 United States) to report outcomes in nonobese (body mass index <30 kg/m) and obese (body mass index ≥30 kg/m) users. We used data from the US trial to calculate the Pearl Index (pregnancies per 100 woman-years) in nonbreastfeeding participants aged ≤35 years at enrollment for confirmed pregnancies. We assessed safety outcomes from all trials based on reported treatment-emergent adverse events. We evaluated pharmacokinetics by bodyweight in the US trial.
RESULTS
The three trials combined comprised 2152 nonobese and 425 obese participants, including 590 nonobese and 325 obese participants in the US trial. Eight nonobese and four obese participants had confirmed pregnancies in the US trial, resulting in Pearl Indices of 3.0 (95% CI: 1.3-5.8) and 2.9 (95% CI: 0.8-7.3), respectively. Two-hundred forty-four (11.3%) nonobese and 39 (9.2%) obese participants discontinued due to a treatment-emergent adverse event. The pharmacokinetic analysis included 814 participants with a median weight of 73 (interquartile range 61-89) kg and median plasma drospirenone exposure (AUC) of 661.3 (interquartile range 522-828) ng∙h/mL. Changing bodyweight from the median to the fifth percentile (51 kg) or 95th percentile (118 kg) changed drospirenone exposure (AUC) by 22.2% and -23.6%, respectively.
CONCLUSIONS
Drospirenone 4 mg demonstrated similar contraceptive efficacy for both nonobese and obese users despite a difference in exposure based on bodyweight.
IMPLICATIONS
Our limited comparison between obese and nonobese users of drospirenone-only oral contraception demonstrated no evidence that efficacy or discontinuation for adverse events differs between groups. Serum drospirenone levels vary by bodyweight and may correlate with bleeding outcomes.
Topics: Female; Humans; Pregnancy; Contraception; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Estrogens; Obesity
PubMed: 37544572
DOI: 10.1016/j.contraception.2023.110136 -
MMW Fortschritte Der Medizin Mar 2016
Topics: Abnormalities, Drug-Induced; Contraceptives, Oral; Female; Humans; Pregnancy
PubMed: 27119883
DOI: 10.1007/s15006-016-7875-z -
Zhonghua Yi Shi Za Zhi (Beijing, China... Mar 2021The creation of oral contraceptives goes back 60 years. It has gone through a long and complex process from the discovery of sex hormones to their development into drugs...
The creation of oral contraceptives goes back 60 years. It has gone through a long and complex process from the discovery of sex hormones to their development into drugs to market. A correct understanding of the developmental history of oral contraceptives is of great importance for human reproduction. Gregory G Pincus successfully synthesized the first oral contraceptive Enovid based on research by Carl Djerassi, this was approved for marketing by the US Federal Drug Administration (FDA) in May 1960. However, due to the severe side effects of Enovid, the safer and more effective second generation oral contraceptives - Levonorgestrel and the third generation oral contraceptives - Pregnene are widely used and continue to be used to this day. The introduction of oral contraceptives not only dampened the explosive growth of the world's population, but also improved the social status of women, and catalyzed the sexual liberation movement.
Topics: Contraceptives, Oral; Female; Humans; Levonorgestrel
PubMed: 34098701
DOI: 10.3760/cma.j.cn112155-20200902-00136 -
Medicine Jul 2016Oral contraceptives (OCs) following induced abortion offer a reliable method to avoid repeated abortion. However, limited data exist supporting the effective use of OCs... (Meta-Analysis)
Meta-Analysis Review
Oral contraceptives (OCs) following induced abortion offer a reliable method to avoid repeated abortion. However, limited data exist supporting the effective use of OCs postabortion. We conducted this systematic review and meta-analysis in the present study reported immediate administration of OCs or combined OCs postabortion may reduce vaginal bleeding time and amount, shorten the menstruation recovery period, increase endometrial thickness 2 to 3 weeks after abortion, and reduce the risk of complications and unintended pregnancies.A total of 8 major authorized Chinese and English databases were screened from January 1960 to November 2014. Randomized controlled trials in which patients had undergone medical or surgical abortions were included. Chinese studies that met the inclusion criteria were divided into 3 groups: administration of OC postmedical abortion (group I; n = 1712), administration of OC postsurgical abortion (group II; n = 8788), and administration of OC in combination with traditional Chinese medicine postsurgical abortion (group III; n = 19,707).In total, 119 of 6160 publications were included in this analysis. Significant difference was observed in group I for vaginal bleeding time (P = 0.0001), the amount of vaginal bleeding (P = 0.03), and menstruation recovery period (P < 0.00001) compared with the control groups. Group II demonstrated a significant difference in vaginal bleeding time (P < 0.00001), the amount of vaginal bleeding (P = 0.0002), menstruation recovery period (P < 0.00001), and endometrial thickness at 2 (P = 0.003) and 3 (P < 0.00001) weeks postabortion compared with the control group. Similarly, a significant difference was observed in group III for reducing vaginal bleeding time (P < 0.00001) and the amount of vaginal bleeding (P < 0.00001), shortening the menstruation recovery period (P < 0.00001), and increasing endometrial thickness 2 and 3 weeks after surgical abortion (P < 0.00001, all).Immediate administration of OCs postabortion may reduce vaginal bleeding time and amount, shorten the menstruation recovery period, increase endometrial thickness 2 to 3 weeks after abortion, and reduce the risk of complications and unintended pregnancies.
Topics: Abortion, Induced; Contraceptives, Oral; Female; Humans; Postoperative Complications; Pregnancy
PubMed: 27399060
DOI: 10.1097/MD.0000000000003825 -
Contraception Oct 2020To determine progestin-only pill (POP) use at 3 and 6 months postpartum among women who chose POPs at the postpartum visit. (Observational Study)
Observational Study
OBJECTIVES
To determine progestin-only pill (POP) use at 3 and 6 months postpartum among women who chose POPs at the postpartum visit.
STUDY DESIGN
Secondary data analysis of a prospective observational study with telephone interviews at 3 and 6 months postpartum to assess contraceptive use.
RESULTS
Of 440 women who attended the postpartum visit, 92 (20.9%) chose POPs. Current POP use was 44/84 (52.4%) at 3 months, 33/76 (43.4%) at 6 months, and 32/76 (42.1%) at both 3- and 6-month follow-up assessments.
CONCLUSION
About half of women who plan POP use at the postpartum visit are not using this method at 3 months after delivery.
IMPLICATIONS
About half of women with a prescription for progestin-only pills will be not using this method at 3 months postpartum; further understanding of continued sexual activity and breastfeeding may clarify pregnancy risk for those not reporting modern contraception use during the postpartum period.
Topics: Breast Feeding; Contraception; Contraceptives, Oral, Hormonal; Family Planning Services; Female; Health Services Accessibility; Humans; Lactation; Postpartum Period; Pregnancy; Progestins; Prospective Studies
PubMed: 32544400
DOI: 10.1016/j.contraception.2020.06.004 -
Akusherstvo I Ginekologiia 2015Oral contraceptives are used since more than 50 years and are very popular due to offering more than 99% confidence in preventing pregnancy. Over 100 million women... (Review)
Review
Oral contraceptives are used since more than 50 years and are very popular due to offering more than 99% confidence in preventing pregnancy. Over 100 million women worldwide use oral contraceptives. In the UK 27% of women between 16 and 49 y. use pills. In the United States they are about 30%, in Germany - 40%, and in The Netherlands - 60%. According to a study by B. Pehlivanov, 2008, in Bulgaria only 4% of women use OC. (1) Despite the convenience and security, in the U.S.A. 29% of women taking OC interrupt prematurely their use (2), while the percentage of adolescents appears to be higher (3) Earlier studies of the reasons for refusal of OC focus on their influence on the menstrual cycle, as well as on some physical side effects such as the appearance of hair growth, weight gain, bloating etc. They paid very little attention to their impact on mood and sexual behavior of women (4). Newer studies suggest that the side effects associated with mood and sexual behavior proved more powerful factor leading to early termination of the use of OC (5). This paper is a review of the literature and evaluation of the facts presented in studies from different countries. They found a high incidence of symptoms such as anxiety, susceptibility to stress, mood changes, incl. depression, anxiety, increased irritability and affection of sexual desire of women. (6) There are many indications that OC-users are at increased risk of suicide and mental illnesses. (9).
Topics: Affect; Anxiety; Contraceptives, Oral; Depression; Female; Humans; Menstrual Cycle; Sexual Behavior
PubMed: 26411194
DOI: No ID Found -
Contraception Aug 2014To summarize evidence regarding current demand for on-demand oral contraception. (Review)
Review
OBJECTIVE
To summarize evidence regarding current demand for on-demand oral contraception.
STUDY DESIGN
We used Medline and collegial contacts to find published and unpublished studies conducted or reported in the past 15 years with information assessing women's interest in using any oral drug preparation, including emergency contraceptive pills, in a coitus-dependent manner either repeatedly or as a primary or planned pregnancy prevention method.
RESULTS
We found 19 studies with relevant information. The studies were conducted in 16 countries. Eight studies provided data on women's attitudes regarding a coitus-dependent oral contraceptive; all suggested substantial interest in using it. Nine studies assessed actual use of oral tablets on demand for primary contraception. In these studies, 9-97% of women in the analysis populations reported using the pills on demand as main method, although frequency and consistency of use varied. Reported reasons for interest in or use of this contraceptive approach included convenience, ease of remembering, ability to conceal use, lack of coital interruption, and infrequent sexual activity. Three studies were clinical trials of investigational on-demand oral contraceptives which reported Pearl indices ranging from 6.8 to 53 pregnancies per 100 woman-years.
CONCLUSION
Data from a variety of settings suggest that demand for an on-demand oral contraceptive may be widespread. The effectiveness of this potential method is not established, however. Considering the seriousness of the unmet need for contraception, further development research into the public health benefits and risks of such a method would be worthwhile.
IMPLICATIONS
Demand for an on-demand oral contraceptive may be widespread. Efforts should be made to further explore the possibility of developing such a method.
Topics: Adult; Attitude to Health; Consumer Behavior; Contraceptives, Oral; Contraceptives, Postcoital; Family Planning Services; Female; Health Services Needs and Demand; Humans; Medication Adherence; Nonprescription Drugs; Patient Acceptance of Health Care; Patient Satisfaction
PubMed: 24835831
DOI: 10.1016/j.contraception.2014.04.008