Contraceptive Agents

Background: Choosing the contraception method remains one of the most critical decisions made by women of reproductive age. Not only does this have a direct impact on women's reproductive health, it also affects their social and economic well-being. This study was carried out to determine the factors affecting choice of contraceptives among women of reproductive age in Lagos State, Nigeria. Methods: This descriptive cross-sectional study was conducted on 200 women aged 15-45 years who visited the family planning clinic at the Lagos State University Teaching Hospital in Nigeria in 2019. The subjects were enrolled through a convenience sampling method. Data were collected using a demographic information form and a self-structured questionnaire on knowledge about family planning methods (n=9), the choice of contraceptives (n=8) and factors influencing the choice of family planning (n=15). Data were analyzed using descriptive statistics (frequency and percentage) and the Pearson correlation coefficient at significance level of 0.05. Results: We found that 82.8% of the respondents had good knowledge about the contraceptives. The most commonly used methods of contraception were birth control pills (38.3%) and implants (36.1%), while the least commonly used methods were tubal ligation (29.4%) and withdrawal (29.4%). The choice of contraceptives was significantly correlated with level of knowledge (r=-0.564, P=0.001) and religion (r=-0.173, P=0.020) of the subjects. Conclusion: The majority of women in the study area have good knowledge about contraceptives, and factors such as parity and fear of injury from contraceptives affect their choice of contraceptives. This study recommends implementation of extensive health education and counseling sessions to assist women in contraceptive decision making.

Demographic methods provide an invaluable foundation for population program planning by giving quantitative expression to present and future characteristics of a population. It must be recognized that, while the formulas may be precise, the validity of the outputs are constrained by the quality of input data available and the assumptions required. Fertility projections present special problems because of the multiplicity of factors that can independently influence reproductive performance. The estimation of births averted by family planning programs is particularly tenuous. Population planners must be cognizant of all the dimensions of population change if effective programs are to be developed.

Sexual and reproductive health care should empower and enable all individuals to have a sex life that is as safe and pleasurable as possible. Achievement of this goal for adolescents is often impeded by regional and sociocultural barriers. To review global barriers to provision of effective counselling and care of adolescents seeking advice on contraception and sexual and reproductive health and identify elements of best practice that can be adapted to meet their needs at regional level. Experts with clinical experience and a scholarly background in the provision of contraceptive services to adolescents participated in a stepwise process of literature review and discussion according to the agreed objectives. The Global CARE (Contraception: Access, Resources, Education) group identified barriers to the access, availability and acceptance of contraception by adolescents, not only at the political and sociocultural level but also within health care practice. The group collected and sum...

To evaluate pharmacy staff perspectives of a 2-year pharmacy intervention aimed at reducing unintended pregnancy in 18- to 30-year-old women. Pharmacy staff completed a 48-item, self-administered paper survey consisting of scaled and open-ended questions. 55 community pharmacies in 12 Iowa counties. All pharmacy staff participated, including pharmacists, pharmacy technicians, and other pharmacy employees. Online continuing education (CE) training was made available to all pharmacy staff. Promotional materials including posters, brochures, and shelf talkers were displayed in all of the pharmacies. Pharmacy staff perceptions and self-reported behaviors related to displaying posters, brochures, and shelf talkers in their pharmacies and providing contraceptive information and counseling to patients/customers. A total of 192 (43% return rate) pharmacy staff responded. Only 44% of respondents consistently provided contraceptive information and counseling, yet more than 90% felt that talki...

Several studies support the need for effective interventions to reduce HIV transmission risk behaviors among people living with HIV/AIDS (PLWHAs). Cross-sectional nationally representative demographic health survey of Kenya (2003) and Malawi (2004-2005) that included HIV testing for consenting adults. We analyzed demographic health survey data for awareness of HIV status and sexual behaviors of PLWHAs (Kenya: 412; Malawi: 664). The analysis was adjusted (weighted) for the design of the survey and the results are nationally representative. Eighty-four percent of PLWHAs in Kenya and 86% in Malawi had sex in the past 12 months and in each country, 10% reported using condoms at last intercourse. Among sexually active PLWHAs, 86% in Kenya and 96% in Malawi reported their spouse or cohabiting partner as their most recent partner. In multivariate logistic regression models, married or cohabiting PLWHAs were significantly more likely to be sexually active and less likely to use condoms. Over 80% of PLWHAs were unaware of their HIV status. Of HIV-infected women, nearly three-quarters did not want more children either within the next 2 years or ever, but 32% in Kenya and 20% in Malawi were using contraception. In 2003-2005, majority of PLWHAs in Kenya and Malawi were unaware of their HIV status and were sexually active, especially married or cohabiting PLWHAs. Of HIV-infected women not wanting more children, few used contraception. HIV testing should be expanded, prevention programs should target married or cohabiting couples and family planning services should be integrated with HIV services.

Zimbabwe does not feature much on the current debate of fertility transition in sub-Saharan Africa. This article is trying to fill this gap by analysing the ZDHS data. The total fertility rate of Zimbabwe was close to 7 births during independence in 1980. However, it has declined to 3.8 in 2006. This does not only show that fertility in Zimbabwe has been declining over the years, but it is one of the lowest in the region. The fertility trend observed is mainly explained by use of contraception. The contraceptive prevalence rate was 60 percent in 2006. It is noted that the contraceptive uptake has continued to increase even during the years when Zimbabwe was going through serious political, economic, social and health challenges. This is because the groundwork done on the family planning programme soon after independence put a solid foundation in motivating women to use contraception. Le Zimbabwe ne figure pas beaucoup dans le debat actuel sur la transition de la fecondite en Afrique...

A thrombus can come from platelet hyperactivity or too rapid coagulation, or the weakening of the defense mechanisms of an organism which would get rid of it or prevent its formation by slowing of fibrinolytic activity or coagulatory inhibitors. Oral contraceptives do not change the number of platelets but could affect hyperactivity in another way; results are inconclusive. Hypercoaguability is difficult to prove, the classical tests being insufficient. The test for thrombin production shows a surplus is produced under treatment. Another test indicates that fibrinogen products, which are present in thrombic cases, are also present in women using oral contraceptives. Fibrinolytic activity appears to remain the same or be increased by oral contraceptives. The determination of antithrombin 3 (AT-3) seems important as families with a congenital deficiency show a predisposition to thromboembolic problems. The decrease in this inhibitor is very marked in serum. Fibrinolytic activity appears to remain the same or be increased by oral contraceptives. Epidemiological studies have shown that the frequency of thromboembolism depends on the quantity of estrogens. The decrease in AT-3 seems greater with pills containing 75-150 mg estrogen than with those that have 50 mg. The correlation between this abnormality and the occurrence of thrombosisis not yet established.

Health communication and interpersonal skills are increasingly emphasized in the measurement of health care quality, yet there is limited research on the association of interpersonal care with health outcomes. As approximately 50% of pregnancies in the United States are unintended, whether interpersonal communication influences contraceptive use is of public health importance. To determine whether the quality of interpersonal care during contraceptive counseling is associated with contraceptive use over time. The Patient-Provider Communication about Contraception study is a prospective cohort study of 348 English-speaking women seen for contraceptive care, conducted between 2009 and 2012 in the San Francisco Bay Area. Quality of communication was assessed using a patient-reported interpersonal quality in family planning care measure based on the dimensions of patient-centered care. In addition, the clinical visit was audio recorded and its content coded according to the validated Fo...

Neither traditional philosophy nor current applied ethics seem able to cope adequately with the highly dynamic character of our modern technological culture. This is because they have insufficient insight into the moral significance of technological artifacts and systems. Here, much can be learned from recent science and technology studies (STS). They have opened up the black box of technological developments and have revealed the intimate intertwinement of technology and society in minute detail. However, while applied ethics is characterized by a certain “technology blindness,” the most influential approaches within STS show a “normative deficit” and display an agnostic or even antagonistic attitude toward ethics. To repair the blind spots of both applied ethics and STS,the authors sketch the contours of a pragmatist approach. They will explore the tasks and tools of a pragmatist ethics and pay special attention to the exploration of future worlds disclosed and shaped by technolog...

Recent studies suggest that, in female monkeys and rats, estrogens elicit dendritic spine synapse formation in the prefrontal cortex, an area that, similar to the hippocampus, plays a critical role in cognition. However, whether gonadal hormones induce synaptic remodeling in the male prefrontal cortex remains unknown. Here we report that gonadectomy reduced, whereas administration of 5α-dihydrotestosterone or estradiol-benzoate to castrated male rats increased, the number of medial prefrontal cortical (mPFC) spine synapses, with estradiol-benzoate being less effective than 5α-dihydrotestosterone. To investigate whether the androgen receptor contributes to the mediation of these changes, we compared the response of testicular feminization mutant (Tfm) male rats to that of wild-type animals. The number of mPFC spine synapses in gonadally intact Tfm rats and 5α-dihydrotestosterone-treated castrated Tfm males was considerably reduced compared to intact wild-type animals, whereas the syn...

The low contraceptive prevalence rate and the existence of unmet demand for family planning services present a challenge for parties involved in family planning research in Tanzania. The observed situation has been explained by the demand-side variables such as socioeconomic characteristics and cultural values that maintain the demand for large families. A small, but growing body of research is examining the effect of supply-side factors such as quality of care of family planning services on the demand for contraceptives. This paper analyses the demand and supply factors determining contraceptive use in Tanzania using the Tanzania Service Availability Survey (1996) and the Tanzania Demographic and Health Survey (1996) data sets. The results show that access to family planning services and quality of care of services are important determinants of contraceptive use in Tanzania even after controlling for demand-side factors.

Use of modern contraceptive methods has been shown to reduce unwanted pregnancy, high parity and maternal mortality. Intrauterine contraceptive devices which are among the safest and most effective reversible contraceptives available, are particularly suitable for women in developing countries as they are affordable, convenient to use, do not require re -supply visits and are very cost-effective. The aim of this study is to determine the socio-demographic characteristics of intrauterine contraceptive device acceptors, the pattern of insertions and complications at the University of Uyo Teaching hospital, Uyo. The record cards of all clients who had intrauterine contraceptive device inserted at the family planning clinic over a six-year period were reviewed. During the study period, there were 852 new contraceptive acceptors out of which 39.7% accepted the intrauterine contraceptive device. The modal age group of the clients was 25-29 years (32.5%). Acceptance of intrauterine contrac...

Despite permissive laws and a well-developed network of facilities, the incidence of unsafe abortion and the resulting maternal mortality is unacceptably high in Central and Eastern Europe and Central Asia, with one-quarter of all maternal deaths reported to occur as a consequence of abortion. Among the reasons that oblige women to submit themselves to risky procedures are new legislative barriers to accessing pregnancy termination, the unequal distribution of abortion services and healthcare providers, the increased costs of abortion services or unofficial payments, coupled with an increase in the number of impoverished and disadvantaged individuals. The quality of abortion services remains very poor. Safe abortion techniques, including manual vacuum aspiration under local anesthesia and medical abortion, are slowly being implemented. Less safe methods such as dilatation and curettage and general anesthesia are widely used. Unsafe techniques are also practiced extensively in the ca...

To address low contraceptive use in Tanzania, a pilot intervention using a mobile job aid was developed to guide community health workers (CHWs) to deliver integrated counseling on family planning, HIV, and other sexually transmitted infections (STIs). In this article, we describe the process of developing the family planning algorithms and implementation of the mobile job aid, discuss how the job aid supported collection of real-time data for decision making, and present the cost of the overall system based on an evaluation of the pilot. The family planning algorithm was developed, beginning in June 2011, in partnership with the Tanzania Ministry of Health and Social Welfare based on a combination of evidence-based tools such as the Balanced Counseling Strategy Plus Toolkit. The pilot intervention and study was implemented with 25 CHWs in 3 wards in Ilala district in Dar es Salaam between January 2013 and July 2013. A total of 710 family planning users (455 continuing users and 255...

Fluctuating asymmetry (FA) is the small random deviations from a perfect bilateral symmetry in a morphological trait. It is considered as an indicator of biological quality and developmental stability of individual. Adverse environmental conditions and high levels of sex steroids may increase FA. Symmetry in women was found to be related with phases of the menstrual cycles (MC). This cross sectional study aimed to compare facial symmetry between women using and not using hormonal contraceptives with reference to the phases of their fertile and non-fertile phases of MC. Participants were 150 young adult Polish female students in Wrocław, Poland. Facial photograph of each woman was taken and information on the use of hormonal contraception, date of menarche, number of days past since the last menstruation (beginning of bleeding) were collected. Measurements of facial asymmetry were taken digitally in pixels on facial photographs by using ImageJ software. The results revealed that the ...

Fluctuating asymmetry (FA) is the small random deviations from a perfect bilateral symmetry in a morphological trait. It is considered as an indicator of biological quality and developmental stability of individual. Adverse environmental conditions and high levels of sex steroids may increase FA. Symmetry in women was found to be related with phases of the menstrual cycles (MC). This cross sectional study aimed to compare facial symmetry between women using and not using hormonal contraceptives with reference to the phases of their fertile and non-fertile phases of MC. Participants were 150 young adult Polish female students in Wrocław, Poland. Facial photograph of each woman was taken and information on the use of hormonal contraception, date of menarche, number of days past since the last menstruation (beginning of bleeding) were collected. Measurements of facial asymmetry were taken digitally in pixels on facial photographs by using ImageJ software. The results revealed that the ...