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Network (Research Triangle Park, N.C.) 1984The standard technique of diaphragm fitting and the use of spermicide with diaphragms have been challenged by Edward Stim, a physician who developed and tested a...
The standard technique of diaphragm fitting and the use of spermicide with diaphragms have been challenged by Edward Stim, a physician who developed and tested a nonspermicide fitfree disphragm (NFFD) method. He suggested that the main cause of diaphragm failure was erratic use, and that occasional nonuse was a result of the irritations caused by overly large diaphragms, the messiness of spermicides, and the need to anticipate intercourse in order to place the diaphragm in advance. From 1974-79, Stim prescribed the Koroflex diaphragm with a rim diameter of 60 mm for all his patients requesting diaphragm contraception. He believed the 1 size produced "an efficient sperm-blocking obstruction in virtually all women." Stim deemphasized spermicide use while carefully instructing the women on correctdiaphragm placement and advising continual use of the device. He reported a high rate of effectiveness for a barrier method, with 1.1 pregnancies/100 woman-years of use. Failure rates ranging from 2-19% have been reported for users of conventional diaphragms with spermicide. In 1981, the Marie Stopes House in London undertook a study to determine the failure rate for the NFFD as compared to that reported for the conventional diaphragm, to ascertain acceptability of NFFD to women and their partners, and to determine whether NFFD offered significant practical advantages for service delivery. Family Health International assisted in the analysis of data. The incidence of pregnancy in the Marie Stopes study was much higher than had been previously reported. A total of 39 (35.5%) of the women remained in the study discontinued use of the NFFD within a 12-month period, 20 (18.2%) because they become pregnant. Of 110 women enrolled in the trial, 22 (20%) were lost to follow-up. The 2nd most common reason for termination of NFFD use was "personal reasons," including lack of confidence in the method. In spite of the reported pregnancy rate of 24.1/100 women at 12 months, a high level of acceptability of the NFFD was demonstrated among the women who had used it successfully. In fact, 48 (43.6%) women refused to discontinue use of the method even after being told of the high risk of pregnancy. Although the diaphragm is a proven contraceptive method, research remains to be done in this area. The NFFD study was not able to distinguish whether lack of fit or nonuse of spermicides caused the failures. A next step may be a small controlled trial of fitted diaphragms with and without spermicides.
Topics: Birth Rate; Contraception; Contraception Behavior; Contraceptive Agents; Contraceptive Agents, Female; Contraceptive Devices, Female; Diagnosis; Evaluation Studies as Topic; Family Planning Services; Patient Acceptance of Health Care; Pregnancy Rate; Spermatocidal Agents; Therapeutics
PubMed: 12279800
DOI: No ID Found -
JAMA Jan 1977
Topics: Contraception; Contraceptive Devices, Female; Evaluation Studies as Topic; Family Planning Services
PubMed: 12259737
DOI: No ID Found -
Australian Family Physician Oct 1988
Topics: Contraceptive Devices, Female; Female; Humans; Menstrual Hygiene Products
PubMed: 3240156
DOI: No ID Found -
Canadian Medical Association Journal Oct 1950
Topics: Abdominal Muscles; Contraceptive Devices, Female; Diaphragm; Female; Hernia; Hernia, Diaphragmatic, Traumatic; Humans
PubMed: 14778079
DOI: No ID Found -
European Journal of Applied Physiology Dec 2012The diaphragm muscle is essential for normal ventilation and it is chronically active throughout the lifespan. In most skeletal muscles, aging is associated with...
The diaphragm muscle is essential for normal ventilation and it is chronically active throughout the lifespan. In most skeletal muscles, aging is associated with increased oxidative stress and myofiber atrophy. Since the diaphragm maintains a unique chronic contractile activity, we hypothesized that these alterations would not occur in senescent diaphragms compared to young diaphragms. In addition, we investigated whether senescence leads to altered diaphragmatic caspase activity and myonuclear domain. We harvested diaphragm muscles from 6 and 24-26 month old male Fisher 344 rats (n = 10 per group). Measurements of protein carbonyls, caspase 2, 3, 9, and 12 activities, DNA fragmentation, myofiber cross-sectional area, and myonuclear domain of diaphragm muscles were performed. No age-related changes (p > 0.05) in diaphragmatic protein oxidation or activities of caspase 2, 3, 9, and 12 were observed between groups. In addition, DNA fragmentation, as detected by the ligation-mediated polymerase chain reaction ladder assay, was not different (p > 0.05) between young and senescent diaphragms. Importantly, the cross-sectional area and myonuclear domain of diaphragm myofibers from senescent animals were also not different (p > 0.05) from young diaphragms. In conclusion, our data show that the senescent diaphragm does not atrophy or exhibit changes in select markers of the apoptotic pathway and this may be a result of the diaphragm's unique continuous contractile activity.
Topics: Aging; Animals; Caspases; DNA Fragmentation; Diaphragm; Male; Myofibrils; Protein Carbonylation; Rats; Rats, Inbred F344
PubMed: 22434253
DOI: 10.1007/s00421-012-2380-2 -
The Medical Journal of Australia Sep 1980
Topics: Contraceptive Devices, Female; Female; Humans; Patient Education as Topic; Posture
PubMed: 7432308
DOI: 10.5694/j.1326-5377.1980.tb131844.x -
The Australian & New Zealand Journal of... Aug 1986The prevalence of asymptomatic bacteriuria was assessed in women using different contraceptive methods. Three hundred and twenty women attending a family planning centre...
The prevalence of asymptomatic bacteriuria was assessed in women using different contraceptive methods. Three hundred and twenty women attending a family planning centre were studied, 80 in each of the following groups: diaphragms, intrauterine contraceptive devices (IUCDs), oral contraceptives (OCs) and no contraception. The numbers with asymptomatic bacteriuria in the 4 groups were as follows: diaphragm - 12 (all E coli); IUCD - 3 (E coli; P mirabilis; S saprophyticus); OC - 5 (all E coli); no contraception - 4 (3 E coli; 1 S saprophyticus). The prevalence of Gram-negative bacteriuria in women using diaphragms was significantly higher than for women in the other groups (chi 2 = 8.98; p less than 0.05). Factors such as parity, numbers of sexual partners and frequency of sexual intercourse had no apparent effect. The use of diaphragms may contribute to the risk of Gram-negative urinary tract infections in sexually active women.
Topics: Adolescent; Adult; Bacteriuria; Child; Contraceptive Devices, Female; Contraceptives, Oral, Synthetic; Escherichia coli Infections; Female; Humans; Intrauterine Devices; Middle Aged; Parity; Prospective Studies; Sexual Behavior
PubMed: 3545172
DOI: 10.1111/j.1479-828x.1986.tb01572.x -
The Nurse Practitioner Mar 1984The diaphragm is becoming the more popular method of birth control in the United States. When used properly, it is a safe and effective alternative for those women who...
The diaphragm is becoming the more popular method of birth control in the United States. When used properly, it is a safe and effective alternative for those women who are unable to take birth control pills or prefer another method. The protocol presented here is a comprehensive approach to diaphragm fitting, client instruction and follow-up. The practitioner utilizing such an approach will insure a safe and highly effective method of birth control to those patients who choose the diaphragm as their method of contraception.
Topics: Contraceptive Devices, Female; Female; Humans; Nurse Practitioners; Patient Care Planning; Patient Education as Topic
PubMed: 6709245
DOI: No ID Found -
The Medical Journal of Australia Aug 1950
Topics: Aged; Contraceptive Devices, Female; Diaphragm; Echinococcosis; Female; Humans
PubMed: 14779572
DOI: 10.5694/j.1326-5377.1950.tb81081.x -
Contraception May 1995Standard instructions for diaphragm use call for an individually sized latex diaphragm, used in conjunction with spermicide jelly. However, some investigators have... (Clinical Trial)
Clinical Trial
Standard instructions for diaphragm use call for an individually sized latex diaphragm, used in conjunction with spermicide jelly. However, some investigators have reported that the diaphragm can be effective without a spermicide. A non-randomized trial designed to measure the contraceptive effectiveness of the diaphragm used without spermicide was conducted. A total of 110 self-selected women were enrolled to use a non-spermicide fit-free (60mm) diaphragm for a period of one year. They were advised to wear the diaphragm continuously, removing it once each day for washing but not within six hours after intercourse. Product-related problems related to insertion, retention and removal were few at both the 6- and 12-month follow-up visits, most commonly odor. The 12-month life table accidental pregnancy rate during typical use was 24.1 per 100 women (29.5 per 100 women without female barrier experience and 17.9 per 100 women with barrier experience). Over 85% of the women who returned for follow-up visits reported using the diaphragm during every act of intercourse. Until better data refute the traditional recommendations, users should be advised to add spermicide to fitted latex diaphragms.
Topics: Adult; Contraceptive Devices, Female; Female; Humans; Pregnancy; Spermatocidal Agents
PubMed: 7628202
DOI: 10.1016/0010-7824(95)00075-l