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Contraception May 2011This review provides an update of previous estimates of first-year probabilities of contraceptive failure for all methods of contraception available in the United... (Review)
Review
This review provides an update of previous estimates of first-year probabilities of contraceptive failure for all methods of contraception available in the United States. Estimates are provided of probabilities of failure during typical use (which includes both incorrect and inconsistent use) and during perfect use (correct and consistent use). The difference between these two probabilities reveals the consequences of imperfect use; it depends both on how unforgiving of imperfect use a method is and on how hard it is to use that method perfectly. These revisions reflect new research on contraceptive failure both during perfect use and during typical use.
Topics: Contraception; Contraceptive Agents; Contraceptive Devices; Equipment Failure; Female; Humans; Male; Treatment Failure; United States
PubMed: 21477680
DOI: 10.1016/j.contraception.2011.01.021 -
Mayo Clinic Proceedings Jun 2016Emergency contraception (EC) may help prevent pregnancy in various circumstances, such as contraceptive method failure, unprotected sexual intercourse, or sexual... (Review)
Review
Emergency contraception (EC) may help prevent pregnancy in various circumstances, such as contraceptive method failure, unprotected sexual intercourse, or sexual assault, yet it remains underused. There are 4 approved EC options in the United States. Although ulipristal acetate requires a provider's prescription, oral levonorgestrel (LNG) is available over the counter for women of all ages. The most effective method of EC is the copper intrauterine device, which can be left in place for up to 10 years for efficacious, cost-effective, hormone-free, and convenient long-term primary contraception. Ulipristal acetate tends to be more efficacious in pregnancy prevention than is LNG, especially when taken later than 72 hours postcoitus. The mechanism of action of oral EC is delay of ovulation, and current evidence reveals that it is ineffective postovulation. Women who weigh more than 75 kg or have a body mass index greater than 25 kg/m(2) may have a higher risk of unintended pregnancy when using oral LNG EC; therefore, ulipristal acetate or copper intrauterine devices are preferable in this setting. Providers are often unaware of the range of EC options or are unsure of how to counsel patients regarding the access and use of EC. This article critically reviews current EC literature, summarizes recommendations, and provides guidance for counseling women about EC. Useful tips for health care providers are provided, with a focus on special populations, including breast-feeding women and those transitioning to long-term contraception after EC use. When treating women of reproductive age, clinicians should be prepared to counsel them about EC options, provide EC appropriately, and, if needed, refer for EC in a timely manner.
Topics: Administration, Oral; Attitude of Health Personnel; Body Mass Index; Breast Feeding; Contraception, Postcoital; Contraceptive Agents, Female; Contraceptives, Postcoital; Female; Health Knowledge, Attitudes, Practice; Humans; Intrauterine Devices, Copper; Levonorgestrel; Nonprescription Drugs; Norpregnadienes; Ovulation; Patient Education as Topic; Pregnancy; Prescription Drugs
PubMed: 27261868
DOI: 10.1016/j.mayocp.2016.02.018 -
The Journal of Clinical Endocrinology... May 2021The advent of new methods of male contraception would increase contraceptive options for men and women and advance male contraceptive agency. Pharmaceutical R&D for male... (Review)
Review
BACKGROUND
The advent of new methods of male contraception would increase contraceptive options for men and women and advance male contraceptive agency. Pharmaceutical R&D for male contraception has been dormant since the 1990s. The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) has supported a contraceptive development program since 1969 and supports most ongoing hormonal male contraceptive development. Nonhormonal methods are in earlier stages of development.
CONTENT
Several hormonal male contraceptive agents have entered clinical trials. Novel single agent products being evaluated include dimethandrolone undecanoate, 11β-methyl-nortestosterone dodecylcarbonate, and 7α-methyl-19-nortestosterone. A contraceptive efficacy trial of Nestorone®/testosterone gel is underway. Potential nonhormonal methods are at preclinical stages of development. Many nonhormonal male contraceptive targets that affect sperm production, sperm function, or sperm transport have been identified.
SUMMARY
NICHD supports development of reversible male contraceptive agents. Other organizations such as the World Health Organization, the Population Council, and the Male Contraception Initiative are pursuing male contraceptive development, but industry involvement remains limited.
Topics: Contraception; Contraceptive Agents, Male; Female; History, 20th Century; History, 21st Century; Hormonal Contraception; Humans; Male; National Institute of Child Health and Human Development (U.S.); Pregnancy; United States
PubMed: 33481994
DOI: 10.1210/clinem/dgab034 -
Minerva Pediatrica Oct 2017Adolescent pregnancy is a significant cause of global morbidity and mortality. Adolescents who become pregnancy have lower educational attainment, are more likely to... (Review)
Review
Adolescent pregnancy is a significant cause of global morbidity and mortality. Adolescents who become pregnancy have lower educational attainment, are more likely to live in poverty, and have lower wellbeing. Increasing access to hormonal contraceptives and long acting reversible contraception is highly effective in reducing adolescent pregnancies. This narrative review covers key aspects of the provision of contraception to adolescents, including confidentiality, counseling, and data supporting expanded access to adolescents. We provide information for pediatric providers to start adolescent patients on contraceptives, including a detailed description of each method, including effectiveness, use, starting, side effects and benefits. Tools for counseling and prescribing are provided.
Topics: Adolescent; Confidentiality; Contraception; Contraceptive Agents; Counseling; Female; Health Services Accessibility; Humans; Practice Patterns, Physicians'; Pregnancy; Pregnancy in Adolescence
PubMed: 28643995
DOI: 10.23736/S0026-4946.17.05026-5 -
Fertility and Sterility Jun 2021Despite significant interests in contraception by men, effective methods of male contraception are limited to vasectomy and condoms. Recently, there have been several... (Review)
Review
Despite significant interests in contraception by men, effective methods of male contraception are limited to vasectomy and condoms. Recently, there have been several promising advances in male contraceptive research. This review will update readers on recent research in both hormonal and nonhormonal approaches to male contraception. Hormonal approaches to male contraception have been stymied by adverse effects, formulations requiring injections or implants, a 5% to10% nonresponse rate, as well as poor understanding of user acceptability. In the last several years, research has focused on novel, orally bioavailable androgens such as dimethandrolone undecanoate and 11β-methyl-19-nor-testosterone. Additionally, combinations of a topical testosterone gel combined with a gel containing segesterone acetate, a potent progestin, have shown promise in clinical trials recently. Simultaneously, significant preclinical progress has been made in several approaches to nonhormonal male contraceptives, including compounds that inhibit sperm motility such as eppin, compounds that inhibit retinoic acid binding or biosynthesis, and reversible approaches to obstruction of the vas deferens. It is imperative for these areas of research to continue making strides so that there is a gamut of contraceptive options for couples to choose from. Some of these approaches will hopefully reach clinical utility soon, greatly improving contraceptive choice for couples.
Topics: Animals; Antispermatogenic Agents; Contraceptive Agents, Hormonal; Contraceptive Effectiveness; Female; Fertility; Humans; Male; Men's Health; Pregnancy; Pregnancy, Unplanned; Pregnancy, Unwanted; Spermatogenesis; Treatment Outcome
PubMed: 33931201
DOI: 10.1016/j.fertnstert.2021.03.047 -
Gynecological Endocrinology : the... Dec 2023The debate about contraception has become increasingly important as more and more people seek safe and effective contraception. More than 1 billion women of reproductive... (Review)
Review
The debate about contraception has become increasingly important as more and more people seek safe and effective contraception. More than 1 billion women of reproductive age worldwide need a method of family planning, and wellbeing, socio-economic status, culture, religion and more influence the reasons why a woman may ask for contraception. Different contraceptive methods exist, ranging from 'natural methods' (fertility awareness-based methods - FABMs) to barrier methods and hormonal contraceptives (HCs). Each method works on a different principle, with different effectiveness.FABMs and HCs are usually pitted against each other, although it's difficult to really compare them. FABMs are a valid alternative for women who cannot or do not want to use hormone therapy, although they may have a high failure rate if not used appropriately and require specific training. HCs are commonly used to address various clinical situations, although concerns about their possible side effects are still widespread. However, many data show that the appropriate use of HC has a low rate of adverse events, mainly related to personal predisposition.The aim of this review is to summarize the information on the efficacy and safety of FABMs and HCs to help clinicians and women choose the best contraceptive method for their needs.
Topics: Female; Humans; Contraception; Contraceptive Agents; Drug-Related Side Effects and Adverse Reactions; Family Planning Services; Genotype; Informed Consent; Choice Behavior; Ovulation; Natural Family Planning Methods; Contraceptives, Oral, Combined; Adolescent; Young Adult
PubMed: 37599373
DOI: 10.1080/09513590.2023.2247093 -
Ugeskrift For Laeger Jan 2023This state-of-the-art review evaluates whether contraceptive apps could improve knowledge resulting in greater interest and use of long-acting contraception, what type...
This state-of-the-art review evaluates whether contraceptive apps could improve knowledge resulting in greater interest and use of long-acting contraception, what type of information an app should contain, and who may benefit most from apps. The studies found a high interest in easy accessibility and respect for privacy. Science-based information and facilitation of knowledge about all contraceptives were desired. Contraceptive apps were useful in presenting women with validated information and complement professional advice.
Topics: Female; Humans; Contraceptive Agents; Contraception
PubMed: 36629292
DOI: No ID Found -
Reproductive Health Jan 2021Unintended pregnancies (UIP) have a significant impact on health of women and the health budget of countries. Contraception is an effective way to prevent UIPs. The... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Unintended pregnancies (UIP) have a significant impact on health of women and the health budget of countries. Contraception is an effective way to prevent UIPs. The study objective was to collate evidence on clinical effectiveness of etonogestrel subdermal implant (ESI), continuation rate and side effect profile among eligible women of reproductive age group, as compared to levonorgestrel intrauterine system (LNG-IUS), copper intrauterine device (Cu-IUD) and depot medroxy progesterone acetate injections; other types of contraceptive implants were excluded as comparators.
METHODS
The protocol of the systematic review was registered in Prospero (registration number: CRD42018116580). MEDLINE via PubMed, Cochrane library and web of science were the electronic databases searched. A search strategy was formulated and studies from 1998 to 2019 were included. Clinical trial registries and grey literature search was done. Critical assessment of included studies was done using appropriate tools. A qualitative synthesis of included studies was done and a meta-analysis was conducted in RevMan software for continuation rates of ESI as compared to other long acting reversible contraceptives (LARC) e.g. LNG IUS and Cu-IUD.
RESULTS
The search yielded 23,545 studies. After excluding 467 duplicates, 23,078 titles were screened and 51 studies were included for the review. Eight of the 15 studies reporting clinical effectiveness reported 100% effectiveness and overall pearl index ranged from 0 to 1.4. One-year continuation rates ranged from 57-97%; 44-95% at the end of second year and 25-78% by 3 years of use. Abnormal menstruation was the most commonly reported side effect. There was no significant difference in bone mineral density at 1 year follow-up. The meta-analyses showed that odds ratio (OR) of 1-year continuation rate was 1.55 (1.36, 1.76) for LNG-IUS vs. ESI and 1.34 (1.13, 1.58) for copper-IUD vs. ESI; showing that continuation rates at the end of one-year were higher in LNG-IUS and copper-IUD as compared to ESI.
CONCLUSION
ESI is clinically effective and safe contraceptive method to use, yet 1-year continuation rates are lower as compared to LNG-IUS and copper-IUD, mostly attributed to the disturbances in the menstruation.
Topics: Adolescent; Adult; Contraception Behavior; Contraceptive Agents, Female; Contraceptive Agents, Hormonal; Desogestrel; Female; Humans; Intrauterine Devices, Copper; Pregnancy; Treatment Outcome; Young Adult
PubMed: 33407632
DOI: 10.1186/s12978-020-01054-y -
Annals of Biomedical Engineering Jul 2020The present state of reproductive and sexual health around the world reveals disparities in contraceptive use and effectiveness. Unintended pregnancy and sexually... (Review)
Review
The present state of reproductive and sexual health around the world reveals disparities in contraceptive use and effectiveness. Unintended pregnancy and sexually transmitted infection transmission rates remain high even with current prevention methods. The 20th century saw a contraceptive revolution with biomedical innovation driving the success of new contraceptive technologies with central design concepts and materials. Current modalities can be broadly categorized according to their mode of function: reversible methods such as physical/chemical barriers or hormonal delivery devices via systemic (transdermal and subcutaneous) or localized (intrauterine and intravaginal) administration, and nonreversible sterilization procedures such as tubal ligation and vasectomy. Contraceptive biomaterials are at present dominated by well-characterized elastomers such as polydimethylsiloxane and ethylene vinyl acetate due to their favorable material properties and versatility. Contraceptives alter the normal function of cellular components in the reproductive systems to impair fertility. The purpose of this review is to highlight the bioengineering design of existing methods, explore novel adaptations, and address notable shortcomings in current contraceptive technologies.
Topics: Biocompatible Materials; Bioengineering; Contraception; Contraceptive Agents; Drug Delivery Systems; Humans
PubMed: 31701311
DOI: 10.1007/s10439-019-02402-1 -
Pharmacological Reviews Dec 2023Despite the widely demonstrated public health benefits of contraception, limited contraceptive options are available for men, placing both the contraceptive burden and... (Review)
Review
Despite the widely demonstrated public health benefits of contraception, limited contraceptive options are available for men, placing both the contraceptive burden and opportunity solely on women. This review outlines the need for an increased focus on male contraceptive development and highlights several related topics, including the perspectives of women and men on male contraceptives, historical challenges, and reasons behind the persistent delays in male contraceptive development. It also discusses the importance of serendipitous observations in drug discovery and the limitations of depleting sperm or spermatogenic cells as a contraceptive approach. It further provides an overview of ongoing research and development on novel methods, with a goal to offer insights into the multifaceted aspects of nonhormonal male contraceptive development, addressing its implications for the health of men and women. SIGNIFICANCE STATEMENT: Despite well over half a century of effort in developing male contraceptives, there are no approved male contraceptive drugs on the market. This review aims to present strategies for progress in nonhormonal male contraception based on lessons learned from history, with the hope of expediting development and bringing a male contraceptive drug closer to reality.
Topics: Male; Humans; Female; Contraceptive Agents, Male; Semen; Contraception; Contraceptive Agents; Contraceptive Devices
PubMed: 38101934
DOI: 10.1124/pharmrev.122.000787