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Lőczi LL, Török M, Vezér M, Gerszi D, Gyarmathy VA, Ács N, Várbíró S, Keszthelyi M. Motivators for emergency contraception: Previous pregnancy and condom rupture. Heliyon 2024; 10:e23757. [PMID: 38192856 PMCID: PMC10772218 DOI: 10.1016/j.heliyon.2023.e23757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 12/02/2023] [Accepted: 12/12/2023] [Indexed: 01/10/2024] Open
Abstract
Objectives Little is known about the motivations to apply for emergency contraception (EC). Our first aim was to explore the motivating circumstances to use EC as fast as possible. Our second aim was to explore the contraceptive method of the population seeking EC. Study design This present retrospective observational study between July 2021 and September 2021 is embedded in the MEEC (Motivation and Epidemiology of Emergency Contraceptive Pill) based on the study cohort of a Hungarian data bank containing follow-up data of 455 women applied for EC telemedicine consultation. Variables assessed were: age, gynecological history (pregnancies, abortions, miscarriages), data of the intercourse (elapsed time, contraceptive method), and data of the menstrual cycle, and relationship status. Results Of all patients, 59.3 % reported condom rupture, 29.5 % no protection, and 11.2 % other. Patients using condom applied for EC significantly sooner than those using no protection and using other protective methods. A significantly shorter elapsed time was observed in patients with a history of a previous pregnancy. No significant relationship was seen between the way of protection, previous pregnancies, and surprisingly the time of ovulation despite the obvious intention of avoiding pregnancy. Conclusions This is the first study to examine the potential role of epidemiologic factors as motivators for EC on the basis of a large patient cohort. Our study demonstrates the significant role of condom rupture/use and the history of previous pregnancies to be the strongest motivators for EC.
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Affiliation(s)
- Lotti Lúcia Lőczi
- Department of Obstetrics and Gynecology, Semmelweis University, Üllői út 78/a, 1082, Budapest, Hungary
| | - Marianna Török
- Department of Obstetrics and Gynecology, Semmelweis University, Üllői út 78/a, 1082, Budapest, Hungary
- Workgroup for Science Management Doctoral School, Semmelweis University, Üllői út 22., 1085, Budapest, Hungary
| | - Márton Vezér
- Department of Obstetrics and Gynecology, Semmelweis University, Üllői út 78/a, 1082, Budapest, Hungary
| | - Dóra Gerszi
- Department of Obstetrics and Gynecology, Semmelweis University, Üllői út 78/a, 1082, Budapest, Hungary
| | - V. Anna Gyarmathy
- EpiConsult LLC, 8 The Green, STE A, Dover, DE, 19904, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, 615 N Wolfe St, Baltimore, MD, 21205, USA
| | - Nándor Ács
- Department of Obstetrics and Gynecology, Semmelweis University, Üllői út 78/a, 1082, Budapest, Hungary
| | - Szabolcs Várbíró
- Department of Obstetrics and Gynecology, Semmelweis University, Üllői út 78/a, 1082, Budapest, Hungary
- Workgroup for Science Management Doctoral School, Semmelweis University, Üllői út 22., 1085, Budapest, Hungary
| | - Márton Keszthelyi
- Department of Obstetrics and Gynecology, Semmelweis University, Üllői út 78/a, 1082, Budapest, Hungary
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Palma F, Costa AR, Neves J, Pacheco A, Almeida MC, Bombas T, Silva DP. Perception of oral contraception – do women think differently from gynaecologists? EUR J CONTRACEP REPR 2023; 28:125-131. [PMID: 36971323 DOI: 10.1080/13625187.2023.2185482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
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.
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Ból K, Brudzińska A, Wybrańczyk Ł, Właszczuk A. EFFECT OF HORMONAL CONTRACEPTION ON DEPRESSION IN WOMEN. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:1062-1067. [PMID: 37326090 DOI: 10.36740/wlek202305126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Oral contraceptives are the most frequently chosen method of preventing pregnancy in Poland. Mood changes are one of the most common reasons why young women quit therapy. Depression is a severe disorder that affects millions of people around the world. Some long-term studies suggest an increased relative risk of antidepressant use during contraceptive use compared to non-users. Scientists note an increased risk of suicide as well. Other researchers suggest that there is insufficient evidence to support these findings. Some indicate strong correlation between most hormonal contraceptives and following usage of antidepressant drugs in female adolescents. There is still no consensus in the scientific community. Analyzes of many studies provide ambiguous information. Large-scale studies with properly selected test groups and particular therapies taken into consideration are required in order to accurately assess the risk of depression and mood disorders. In this article, we try to present different approaches to the subject of effects of various types of hormonal contraception methods on depression in women.
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Affiliation(s)
- Klaudia Ból
- DEPARTMENT OF PHYSIOLOGY, MEDICAL UNIVERSITY OF SILESIA, FACULTY OF MEDICAL SCIENCES IN KATOWICE, POLAND
| | - Aleksandra Brudzińska
- DEPARTMENT OF PHYSIOLOGY, MEDICAL UNIVERSITY OF SILESIA, FACULTY OF MEDICAL SCIENCES IN KATOWICE, POLAND
| | - Łukasz Wybrańczyk
- DEPARTMENT OF PHYSIOLOGY, MEDICAL UNIVERSITY OF SILESIA, FACULTY OF MEDICAL SCIENCES IN KATOWICE, POLAND
| | - Adam Właszczuk
- DEPARTMENT OF PHYSIOLOGY, MEDICAL UNIVERSITY OF SILESIA, FACULTY OF MEDICAL SCIENCES IN KATOWICE, POLAND
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Orwa J, Gatimu SM, Ngugi A, Agwanda A, Temmerman M. Factors associated with use of long-acting reversible and permanent contraceptives among married women in rural Kenya: A community-based cross-sectional study in Kisii and Kilifi counties. PLoS One 2022; 17:e0275575. [PMID: 36201509 PMCID: PMC9536593 DOI: 10.1371/journal.pone.0275575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/20/2022] [Indexed: 11/18/2022] Open
Abstract
Long-acting and permanent contraceptive methods (LAPM) are effective and economical methods for delaying or limiting pregnancies, however they are not widely used. The Kenya government is promoting the use of modern methods of family planning through various mechanisms. This study aimed to determine the prevalence and factors associated with the use of LAPM among married women of reproductive age in targeted rural sub-counties of Kilifi and Kisii counties, Kenya. Baseline and end line Data from a program implemented on improving Access to Quality Care and Extending and Strengthening Health Systems (AQCESS) in Kilifi and Kisii counties of Kenya were used. Multi-stage sampling was used to sample 1117 and 1873 women for the end line and baseline surveys, respectively. Descriptive analysis was used to explore the respondents' characteristics and use of LAPM on a self-weighted samples. Univariable and multivariable binary logistic regression models using svy command were used to assess factors associated with the use of LAPM. A total of 762 and 531 women for the baseline and end line survey, respectively were included in this study. The prevalence of use of LAPM for baseline and end line survey were 21.5% (95% CI: 18.7-24.6%) and 23.2% (95% CI: 19.6%-27.0%), p-value = 0.485. The use of LAPM in Kisii and Kilifi counties was higher than the national average in both surveys. The multivariable analysis for the end line survey showed having 3-5 number of children ever born (aOR = 2.04; 95% CI: 1.24-3.36) and future fertility preference to have another child (aOR = 0.50; 95% CI: 0.26-0.96) were significantly associated with odds of LAPM use. The baseline showed that having at least secondary education (aOR = 1.93; 95%CI: 1.04-3.60), joint decision making about woman's own health (aOR = 2.08; 95%CI: 1.36-3.17), and intention to have another child in future (aOR = 0.59; 95%CI: 0.40-0.89) were significantly associated with the use of LAPM. Future fertility preference to have another child was significantly associated with the use of LAPM in the two surveys. Continued health promotion and targeted media campaigns on the use of LAPM in rural areas with low socioeconomic status is needed in order to improve utilization of these methods. Programs involving men in decision making on partner's health including family planning in the rural areas should be encouraged.
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Affiliation(s)
- James Orwa
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Population Health Sciences, Aga Khan University, Nairobi, Kenya
- * E-mail:
| | | | - Anthony Ngugi
- Department of Population Health Sciences, Aga Khan University, Nairobi, Kenya
| | - Alfred Agwanda
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Marleen Temmerman
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Centre of Excellence for Women and Child Health, Aga Khan University, Nairobi, Kenya
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Bączek G, Studnicka A, Rychlewicz S, Iwan A, Rzońca E, Rahnama M. A Questionnaire-Based Study to Evaluate Health-Related Behaviors in 602 Women of Reproductive Age in Poland. Med Sci Monit 2021; 27:e935429. [PMID: 34968369 PMCID: PMC8725340 DOI: 10.12659/msm.935429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 11/29/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Women's health and undertaking health behaviors during the reproductive period by women, especially during pregnancy, are an important indicator that is reflected both in their own health and in health of their children. This study aimed to use a questionnaire to evaluate the health-related behaviors in women of reproductive age in Poland. MATERIAL AND METHODS The studies were conducted among 602 women of reproductive age by diagnostic poll method with the use of questionnaire technique. The applied tool was an original on-line questionnaire. A link to the questionnaire was sent to women aged 18-49 years using the snowball sampling technique and was posted on thematic pro-health website forums. RESULTS The majority of women participating in the study exhibited health behaviors on the average level (65.3%; M=7.6). Pro-health behaviors were exhibited mainly by women with higher education (M=7.7; SD=2.6), married women (M=8.0; SD=2.6), and women who were pregnant at the time (M=8.8; SD=2.6). However, single women participating in the study consumed alcohol more often (80.6%). The observed relationships were statistically significant (P<0.05). CONCLUSIONS This survey showed that younger women with no children were significantly less likely to be aware of positive health-associated behaviors and lifestyle when compared with older women with children. This small study supports the importance of health education in young women before they have children.
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Affiliation(s)
- Grażyna Bączek
- Department of Obstetrics and Gynecology Didactics, Medical University of Warsaw, Warsaw, Poland
| | - Anna Studnicka
- Students’ Scientific Association of Midwives at Department of Obstetrics and Gynecology Didactics, Medical University of Warsaw, Warsaw, Poland
| | - Sylwia Rychlewicz
- St. Sophia’s Specialist Hospital, Żelazna Medical Center, Warsaw, Poland
| | - Agnieszka Iwan
- Department of Obstetrics and Gynecology Didactics, Medical University of Warsaw, Warsaw, Poland
| | - Ewa Rzońca
- Department of Obstetrics and Gynecology Didactics, Medical University of Warsaw, Warsaw, Poland
| | - Mansur Rahnama
- The Chair and Department of Oral Surgery, Medical University of Lublin, Lublin, Poland
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Ahmed N, Arshad S, Basheer SN, Karobari MI, Marya A, Marya CM, Taneja P, Messina P, Yean CY, Scardina GA. Smoking a Dangerous Addiction: A Systematic Review on an Underrated Risk Factor for Oral Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111003. [PMID: 34769523 PMCID: PMC8582668 DOI: 10.3390/ijerph182111003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 12/26/2022]
Abstract
Despite growing knowledge of the adverse effects of cigarette smoking on general health, smoking is one of the most widely prevalent addictions around the world. Globally, about 1.1 billion smokers and over 8 million people die each year because of cigarette smoking. Smoking acts as a source for a variety of oral and systemic diseases. Various periodontal issues such as increased pocket depth, loss of alveolar bone, tooth mobility, oral lesions, ulcerations, halitosis, and stained teeth are more common among smokers. This systematic review was conducted according to the guidelines from PRISMA, and research articles were retrieved from the Web database sources on 31 May 2021. The quality of research articles was ensured by the type of evidence from combined schema incorporating as schema-13 evidence type description, Cochrane health promotion and public health field (CHPPHF), and the health gains notation framework-14 screening question for quality assessment of qualitative and quantitative studies. Smokers have been found to have bleeding on probing, periodontal pockets, and clinical attachment loss compared to nonsmokers. Oral and respiratory cancers are among the most lethal known diseases caused by cigarette smoking and other commonly occurring sequelae such as stained teeth, periodontal diseases, etc.
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Affiliation(s)
- Naveed Ahmed
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia;
| | - Sohaib Arshad
- Periodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia;
| | - Syed Nahid Basheer
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Mohmed Isaqali Karobari
- Conservative Dentistry Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
- Department of Conservative Dentistry & Endodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences University, Chennai 600077, India
- Correspondence: (M.I.K.); (C.Y.Y.); (G.A.S.)
| | - Anand Marya
- Department of Orthodontics, University of Puthisastra, Phnom Penh 12211, Cambodia;
- Department of Orthodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences University, Chennai 600077, India
| | - Charu Mohan Marya
- Department of Public Health Dentistry, Sudha Rustagi College of Dental Sciences and Research, Faridabad 121002, India; (C.M.M.); (P.T.)
| | - Pratibha Taneja
- Department of Public Health Dentistry, Sudha Rustagi College of Dental Sciences and Research, Faridabad 121002, India; (C.M.M.); (P.T.)
| | - Pietro Messina
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90133 Palermo, Italy;
| | - Chan Yean Yean
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia;
- Correspondence: (M.I.K.); (C.Y.Y.); (G.A.S.)
| | - Giuseppe Alessandro Scardina
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90133 Palermo, Italy;
- Correspondence: (M.I.K.); (C.Y.Y.); (G.A.S.)
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Eick C, Klinger-König J, Zylla S, Hannemann A, Budde K, Henning AK, Pietzner M, Nauck M, Völzke H, Grabe HJ, Hertel J. Broad Metabolome Alterations Associated with the Intake of Oral Contraceptives Are Mediated by Cortisol in Premenopausal Women. Metabolites 2021; 11:metabo11040193. [PMID: 33805221 PMCID: PMC8064380 DOI: 10.3390/metabo11040193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/16/2021] [Accepted: 03/16/2021] [Indexed: 12/26/2022] Open
Abstract
The use of oral contraceptives (OCs) has been associated with elevated blood cortisol concentrations. However, metabolic downstream effects of OC intake are not well described. Here, we aimed to determine if the blood metabolome is associated with the use of OCs and to estimate if these associations might be statistically mediated by serum cortisol concentrations. Plasma metabolites measured with the Biocrates AbsoluteIDQ p180 Kit and serum cortisol concentrations measured by an immunoassay were determined in 391 premenopausal women (116 OC users) participating in two independent cohorts of the Study of Health in Pomerania (SHIP). After correction for multiple testing, 27 metabolites were significantly associated with OC intake in SHIP-TREND (discovery cohort), of which 25 replicated in SHIP-2. Inter alia, associated metabolites included 12 out of 38 phosphatidylcholines with diacyl residue, 7 out of 14 lysophosphatidylcholines and 5 out of 21 amino acids. The associations with phosphatidylcholines were statistically mediated by cortisol, whereas lysophosphatidylcholines showed no mediation effect. The results represent a step toward a better understanding of the metabolic consequences of OC intake. Connecting cortisol with metabolic consequences of OC intake could help to understand the mechanisms underlying adverse effects. The blood metabolome may serve as a biomarker for identifying users at high risk for developing such adverse effects.
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Affiliation(s)
- Clara Eick
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, D-17489 Greifswald, Germany; (C.E.); (H.J.G.); or (J.H.)
| | - Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, D-17489 Greifswald, Germany; (C.E.); (H.J.G.); or (J.H.)
- Correspondence: ; Tel.: +49-(0)-3834-86-22166
| | - Stephanie Zylla
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, D-17489 Greifswald, Germany; (S.Z.); (A.H.); (K.B.); (A.K.H.); (M.P.); (M.N.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, D-17489 Greifswald, Germany;
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, D-17489 Greifswald, Germany; (S.Z.); (A.H.); (K.B.); (A.K.H.); (M.P.); (M.N.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, D-17489 Greifswald, Germany;
| | - Kathrin Budde
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, D-17489 Greifswald, Germany; (S.Z.); (A.H.); (K.B.); (A.K.H.); (M.P.); (M.N.)
| | - Ann Kristin Henning
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, D-17489 Greifswald, Germany; (S.Z.); (A.H.); (K.B.); (A.K.H.); (M.P.); (M.N.)
| | - Maik Pietzner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, D-17489 Greifswald, Germany; (S.Z.); (A.H.); (K.B.); (A.K.H.); (M.P.); (M.N.)
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, D-17489 Greifswald, Germany; (S.Z.); (A.H.); (K.B.); (A.K.H.); (M.P.); (M.N.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, D-17489 Greifswald, Germany;
| | - Henry Völzke
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, D-17489 Greifswald, Germany;
- Institute for Community Medicine, University Medicine Greifswald, D-17489 Greifswald, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, D-17489 Greifswald, Germany; (C.E.); (H.J.G.); or (J.H.)
- German Center for Neurodegenerative Disease (DZNE), Site Rostock/Greifswald, D-17489 Greifswald, Germany
| | - Johannes Hertel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, D-17489 Greifswald, Germany; (C.E.); (H.J.G.); or (J.H.)
- School of Medicine, National University of Ireland, H91 CF50 Galway, Ireland
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Chawłowska E, Lipiak A, Krzysztoszek J, Krupa B, Staszewski R. Reproductive Health Literacy and Fertility Awareness Among Polish Female Students. Front Public Health 2020; 8:499. [PMID: 33014982 PMCID: PMC7516014 DOI: 10.3389/fpubh.2020.00499] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/04/2020] [Indexed: 11/26/2022] Open
Abstract
The falling fertility indicators and high prevalence of infertility in Poland make it important for people of reproductive age to have good knowledge of their own fertility in order to be able to take care of their reproductive health. This paper examines reproductive health literacy and fertility awareness among Polish female students. It can help identify gaps in reproductive health education in Poland. The study group included 456 women aged 18–29, who were students of 6 public universities located in Poznan, Poland. The method used was a survey using a self-developed questionnaire assessing the students' knowledge of female and male fertility-related physiology and fertility patterns. The respondents' knowledge was assessed on the basis of the percentage of correct answers. Regression analysis and univariate analysis of variance were used to explore relationships between the students' knowledge and their age, year of study, university and source(s) of information. The average score of correct answers was 55.8%. Older students and medical university students were the most knowledgeable. 93.4% of the respondents correctly identified the optimum age for a woman to have the first child from the point of view of achieving pregnancy fast. Over 90% of the respondents knew such fertility-compromising risks as smoking, diseases and psychological distress. There was much poorer awareness of the adverse effect of unbalanced diet, irregular sleep, and long-lasting physical effort. 47.1% of the students reported gaining information from a number of sources, but as many as 28.3% said their only source was primary or middle school classes. Reproductive health knowledge among the young female students is incomplete, especially as regards lifestyle-related risks. They should be encouraged to supplement it by consulting reliable sources such as health professionals. It is advisable to ensure that the curricula of medical university students provide thorough knowledge in this area, and to arrange suitable electives for students from other universities. As primary and secondary school classes remain an important source of information, quality teaching at these levels should be offered with a focus on making the knowledge as practical and operational as possible. Relevant graduate, postgraduate and in-service courses should be available to professionals responsible for spreading reproductive health knowledge.
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Affiliation(s)
- Ewelina Chawłowska
- Laboratory of International Health, Department of Preventive Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Agnieszka Lipiak
- Laboratory of International Health, Department of Preventive Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Jana Krzysztoszek
- Department of Physical Activity Teaching, Poznan University of Physical Education, Poznań, Poland
| | | | - Rafał Staszewski
- Department of Hypertensiology, Angiology and Internal Diseases, Poznan University of Medical Sciences, Poznań, Poland
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Zgliczynska M, Kocaj K, Szymusik I, Dutsch-Wicherek MM, Ciebiera M, Kosinska-Kaczynska K. Levonorgestrel-Releasing Intrauterine System as a Contraceptive Method in Nulliparous Women: A Systematic Review. J Clin Med 2020; 9:jcm9072101. [PMID: 32635369 PMCID: PMC7408997 DOI: 10.3390/jcm9072101] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/15/2020] [Accepted: 06/29/2020] [Indexed: 01/16/2023] Open
Abstract
The aim of this review was to summarize the available evidence about the use of levonorgestrel-releasing intrauterine system (LNG-IUS) as a contraceptive method in nulliparous women. For this purpose, studies evaluating the efficacy, safety, bleeding pattern, satisfaction and discontinuation of the levonorgestrel-releasing intrauterine system in nulliparous women were analyzed. Only original research articles published in English between 1990–27th March 2020 were considered eligible. Reviews, book chapters, case studies, conference papers, opinions, editorials and letters were excluded. The systematic literature search of PubMed/MEDLINE, Scopus, Embase and Cochrane Library databases identified 816 articles, 23 of which were analyzed. The available evidence indicates that LNG-IUS is an effective and safe contraceptive method for nulliparous women that achieves high levels of satisfaction among patients. Moreover, nulliparous women seem to experience fewer expulsions than parous ones. Bleeding pattern is acceptable for the majority of patients, and bleeding disorders mainly occur in the first months after the insertion. More in-depth, long-term prospective studies are needed in this patient group to determine risk factors for the occurrence of side effects and associated discontinuations, which should not, however, delay the wider use of the method in this group, given the number of advantages.
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Affiliation(s)
- Magdalena Zgliczynska
- 2nd Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-809 Warsaw, Poland; (M.Z.); (K.K.-K.)
| | - Karol Kocaj
- Medical University of Silesia, 40-055 Katowice, Poland;
| | - Iwona Szymusik
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland;
| | | | - Michal Ciebiera
- 2nd Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-809 Warsaw, Poland; (M.Z.); (K.K.-K.)
- Correspondence: ; Tel.: + 48-22-5690274
| | - Katarzyna Kosinska-Kaczynska
- 2nd Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-809 Warsaw, Poland; (M.Z.); (K.K.-K.)
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