The adolescent and contraception: issues and controversies

Reproductive Knowledge, Attitudes and Behaviour of Secondary School Students in Akure, Nigeria

Adolescents are subject to many life changes as their secondary sexual characteristics emerge. Contrary to parents' and society's wishes, these young people are more sexually active then previous generations and thus at greater risk of unwanted pregnancies, sexually transmitted diseases, and related problems. Adolescents enrolled in school have the potential opportunity to learn ways to prevent these reproductive and sexual health problems, but there is concern whether schools are living up to this challenge. Therefore, this study was designed to learn whether adolescents in secondary school in the Ondo State capital of Akure have reproductive health education and are practicing healthy sexual behaviors. The study was based on a sample of six of the twenty-eight secondary schools in Akure that fell under the jurisdiction of the Ondo State Post-Primary Schools' Management Board. Focus was placed on pupils in the final years of both Junior Secondary School (JSS 3) and Senior Secondary School (SSS 3). Overall, 30 percent of the young people reported having sexual intercourse: 21 percent of females and 38 percent of males. Also 39 percent in SSS 3 reported having had sex compared to 21 percent in JSS 3. Forty percent of students in coeducational school compared to 19 percent in boy's school and 8 percent in girl's school had sex. Respondents averaged only 11 points on a 33-point scale of reproductive health knowledge. Students in the senior classes and those in single sex schools scored higher. The mass media was stated to be the major source of reproductive health knowledge; only one-third reported that they had actually talked with someone about their reproductive health concerns. Attitudes toward pre-marital sex were more favorable among male students, pupils in mixed sex schools and those whose parents had lower levels of education. These findings suggest not only that the schools must take a more active role in providing reproductive health education, but that this should be done in the junior secondary years before most pupils become sexually active.

The effect of oral contraceptives on hormone profiles of oligomenorrheic adolescent cycles

Nineteen adolescent girls with oligomenorrhea were studied to evaluate the effect of oral contraceptives (OCs) on hormone profiles, and 19 adolescent girls with regular menstruations served as control subjects. Serum levels of luteinizing hormone and androgens were higher in the oligomenorrheic girls than in the regularly menstruating girls. During the OC treatment the hormone levels of the oligomenorrheic girls decreased, approaching those of the control subjects. During follow-up cycle immediately after stopping the OCs the hormone levels increased rapidly, but in the oligomenorrheic girls the levels of luteinizing hormone, androstenedione, total and free testosterone were still significantly lower at the end of the post-treatment cycle than during the luteal phase of the pre-treatment cycle. The frequency of ovulation decreased to the same magnitude as reported in adults after discontinuation of OCs. No post-pill amenorrhea existed in either group of adolescents.

Contraception among female students in the University of Benin

QESTIONNAIRES WERE distributed amongst a randomly selected sample of 400 female under graduates of the University of Benin, Benin City, Nigeria with the aim of finding out their degree of aware ness of, attitude to, and use of contraceptives.

The mean age of the studied population was 19.6 years. 360 (90%) were single. 372 of them (93%) were aware of contraception, 192 (48%) had used one form of contracep tion or the other, and 104 (26%) had had one or more abortions at the time of the study. Of these 104, 62 (or 60.8% of them) had used no form of contraception prior to the pregnancy.

The most dreaded side effect of contraception among the population studied was infertility.

Sex hormone profiles in oligomenorrheic adolescent girls and the effect of oral contraceptives

The hormonal profiles and the effect of oral contraceptives (OCs) on 16 oligomenorrheic and 10 regularly menstruating adolescent girls were studied. Testosterone, androstenedione, dehydroepiandrosterone, estradiol, progesterone, luteinizing hormone, follicle-stimulating hormone, prolactin, and sex-hormone-binding globulin were determined on blood samples obtained during a control cycle, during OC treatment, and during the follow-up cycle after discontinuation of OC use. The oligomenorrheic girls had significantly higher concentrations of androstenedione and total and free testosterone than regularly menstruating girls during the control cycle. Sex-hormone-binding globulin concentrations were significantly lower in the oligomenorrheic group. Both in oligomenorrheic and regularly menstruating girls OC treatment caused a decrease in the mean concentrations of all hormones, except prolactin, to similar levels. For 2 to 4 weeks after treatment the oligomenorrheic girls had significantly lower levels of androstenedione, total and free testosterone, and luteinizing hormone than before treatment. In the control group there were no significant differences between pretreatment and posttreatment hormone concentrations. The risks and benefits of prescribing OCs for oligomenorrheic adolescent girls are discussed.