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Adams E, Boog K, Hardman SM. What is new in breast cancer and contraception? A statement from the Faculty of Sexual & Reproductive Healthcare (FSRH). BMJ Sex Reprod Health 2024; 50:73-75. [PMID: 38575169 DOI: 10.1136/bmjsrh-2024-202304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 04/06/2024]
Affiliation(s)
- Ellen Adams
- King's College Hospital NHS Foundation Trust, London, UK
| | - Katie Boog
- Chalmers Sexual Health, NHS Lothian, Edinburgh, UK
- Clinical Effectiveness Unit, Royal College of Obstetricians and Gynaecologists Faculty of Sexual & Reproductive Healthcare, Edinburgh and London, UK
| | - Sarah Margaret Hardman
- Chalmers Centre, Edinburgh, UK
- Royal College of Obstetricians and Gynaecologists Faculty of Sexual & Reproductive Healthcare, London, UK
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Lassi ZS, Rahim KA, Stavropoulos AM, Ryan LM, Tyagi J, Adewale B, Kurji J, Bhaumik S, Meherali S, Ali M. Use of contraceptives, empowerment and agency of adolescent girls and young women: a systematic review and meta-analysis. BMJ Sex Reprod Health 2024:bmjsrh-2023-202151. [PMID: 38479786 DOI: 10.1136/bmjsrh-2023-202151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/19/2024] [Indexed: 04/21/2024]
Abstract
INTRODUCTION The evidence on adolescent empowerment, which involves access to personal and material resources for reproductive autonomy and economic equity, is limited. This systematic review assesses the use of contraceptives in empowering and strengthening the agency and vice versa among adolescents and young women. METHODS We ran the searches in six electronic databases: Cochrane Database of Systematic Reviews (CDSR) and the Cochrane Central Register of Controlled Trials (CENTRAL), The Campbell Library, MEDLINE (PubMed), EMBASE, Cumulated Index to Nursing and Allied Health Literature (CINAHL) and Web of Science. The methodological quality of studies was assessed using ROBINS-I and ROB-II tools as appropriate. Meta-analysis was performed using Review Manager 5.4. RESULTS Forty studies that assessed the impact of empowerment on contraceptive use were included. Of these, 14 were non-randomised studies for intervention (NRSIs), and the remaining 26 were randomised controlled trials (RCTs). The results from RCTs show a significant effect of the sexual and reproductive health empowerment in increasing ever use of contraception (RR 1.22; 95% CI 1.02, 1.45; n=9; I²=77%; GRADE: Very Low), and insignificant effect on unprotected sex (RR 0.97; 95% CI 0.74, 1.26; n=5; I²=86%; GRADE: Very Low) and adolescent pregnancy (RR 1.07; 95% CI 0.61, 1.87; n=3; I²=36%; GRADE: Very Low). None of the studies assessed impact of contraceptive use on empowerment. CONCLUSIONS Empowerment of adolescents and young women certainly improves contraceptive use in the immediate or short-term period. However, more robust studies with low risk of bias, longer-term outcomes, and impact of contraceptive use on empowerment and agency-strengthening are required. To increase contraceptive use uptake, tailored policies and delivery platforms are necessary for youth in low- and middle-income countries.
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Affiliation(s)
- Zohra S Lassi
- School of public health, Faculty of health and medical sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Komal Abdul Rahim
- Dean's Office, Medical College, Aga Khan University, Karachi, Pakistan
- Center of Excellence in Trauma and Emergencies, Aga Khan University, Karachi, Pakistan
| | | | - Lareesa Marie Ryan
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Jyoti Tyagi
- George Institute of Global Health, New Delhi, India
| | - Bisi Adewale
- University of Alberta, Edmonton, Alberta, Canada
| | - Jaameeta Kurji
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Soumyadeep Bhaumik
- Meta-Research and Evidence Synthesis Unit, Health Systems Science, George Institute of Global Health, New Delhi, India
- George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales (UNSW Sydney), Sydney, New South Wales, Australia
| | | | - Moazzam Ali
- Department of Sexual and Reproductive Health, World Health Organization, Geneva, Switzerland
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Carrandi A, Bull C, Hu Y, Grzeskowiak LE, Teede H, Black K, Callander E. Patterns in the provision of government-subsidised hormonal postpartum contraception in Queensland, Australia between 2012 and 2018: a population-based cohort study. BMJ Sex Reprod Health 2024; 50:13-20. [PMID: 37353310 DOI: 10.1136/bmjsrh-2023-201830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/07/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Short birth intervals and unintended pregnancy are associated with poorer maternal and infant outcomes. There is a risk of pregnancy during the immediate postpartum period unless contraception is initiated. This retrospective cohort study aimed to capture the current patterns of hormonal contraceptive provision within 12 months postpartum in a high-income country. METHODS We used a linked administrative dataset comprising all women who gave birth in Queensland, Australia between 1 July 2012 and 30 June 2018 (n=339 265 pregnancies). We described our cohort by whether they were provided with government-subsidised hormonal contraception within 12 months postpartum. The associations between hormonal postpartum contraceptive provision and demographic and clinical characteristics were examined using univariate and multivariate logistic regression and presented in terms of crude and adjusted odds ratios with 95% confidence intervals. RESULTS A majority of women (60.2%) were not provided with government-subsidised hormonal postpartum contraception within 12 months postpartum. Women who were younger (<25 years), were overweight or obese, smoked, were born in Australia, were non-Indigenous, gave birth in a public hospital, or were in the lowest socioeconomic status group were more likely to be provided with postpartum contraception after adjusting for other covariates, compared with their counterparts. CONCLUSIONS Strategies to increase the provision and uptake of contraception in the immediate postpartum period are needed to prevent short birth intervals and unintended pregnancy and ensure women's fertility intentions are enacted. Ongoing research is needed to examine the factors influencing women's access to contraceptive services and, further, the types of contraception provided.
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Affiliation(s)
- Alayna Carrandi
- Monash Centre for Health Research and Implementation, Clayton, Victoria, Australia
| | - Claudia Bull
- Monash Centre for Health Research and Implementation, Clayton, Victoria, Australia
| | - Yanan Hu
- Monash Centre for Health Research and Implementation, Clayton, Victoria, Australia
| | - Luke E Grzeskowiak
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Monash University Faculty of Pharmacy and Pharmaceutical Sciences, Parkville, Victoria, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, Clayton, Victoria, Australia
| | - Kirsten Black
- Faculty of Medicine and Health, The University of Sydney School of Medicine, Sydney, New South Wales, Australia
| | - Emily Callander
- School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
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Hofmeyr GJ, Ryan RJ, Mussa A, Bame B, Malima S, Moloi T, Luckett R, Memo NB, Moreri-Ntshabele B, Nassali MN, Jamieson M, Kime KM, Morroni C. Improving postpregnancy contraceptive method choice and long-acting reversible contraception provision in Botswana: a quality improvement pilot. BMJ Sex Reprod Health 2023; 49:293-297. [PMID: 36854611 DOI: 10.1136/bmjsrh-2022-201748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Affiliation(s)
- G Justus Hofmeyr
- Effective Care Research Unit (ECRU), University of the Witwatersrand Johannesburg, Johannesburg, South Africa
- Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana
| | - Rebecca Jane Ryan
- Botswana Sexual and Reproductive Health Initiative, Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Aamirah Mussa
- Botswana Sexual and Reproductive Health Initiative, Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Bame Bame
- Botswana Sexual and Reproductive Health Initiative, Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Sifelani Malima
- Department of Health Services Management, Ministry of Health and Wellness, Gaborone, Botswana
| | - Thabo Moloi
- Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana
| | - Rebecca Luckett
- Botswana Sexual and Reproductive Health Initiative, Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Obstetrics and Gynaecology, Princess Marina Hospital, Gaborone, Botswana
| | - Ndiwo B Memo
- Department of Obstetrics and Gynaecology, Princess Marina Hospital, Gaborone, Botswana
| | - Badani Moreri-Ntshabele
- Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana
- Department of Obstetrics and Gynaecology, Princess Marina Hospital, Gaborone, Botswana
| | - Mercy Nkuba Nassali
- Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana
- Department of Obstetrics and Gynaecology, Princess Marina Hospital, Gaborone, Botswana
| | - Modimowame Jamieson
- Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana
- Department of Obstetrics and Gynaecology, Princess Marina Hospital, Gaborone, Botswana
| | - Kyungu M Kime
- Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana
- Department of Obstetrics and Gynaecology, Princess Marina Hospital, Gaborone, Botswana
| | - Chelsea Morroni
- Botswana Sexual and Reproductive Health Initiative, Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
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Jefferies A, Boog K. Intrauterine devices: a summary of new guidance. BMJ Sex Reprod Health 2023:bmjsrh-2023-201841. [PMID: 37197913 DOI: 10.1136/bmjsrh-2023-201841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/12/2023] [Indexed: 05/19/2023]
Affiliation(s)
- Ashley Jefferies
- Blackpool and Lancashire Sexual Health Services, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
- Obstetrics and Gynaecology, East Lancashire Hospitals NHS Trust, Burnley, UK
| | - Katie Boog
- Chalmers Sexual Health, Lothian Sexual Health, Edinburgh, UK
- Co-Director, Clinical Effectiveness Unit, Faculty of Sexual & Reproductive Healthcare, Edinburgh, UK
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Freeman-Spratt GJ, Botfield JR, Lee GS, Rajiv P, Black KI. Understanding women's views of and preferences for accessing postpartum contraception: a qualitative evidence synthesis. BMJ Sex Reprod Health 2023; 49:129-141. [PMID: 36635069 DOI: 10.1136/bmjsrh-2022-201718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Nearly half of women experience unintended pregnancies. These are associated with increased risk of poor maternal physical and psychosocial health outcomes. Many pregnancies in the first year postpartum are unintended, further increasing risks of poor outcomes and complications. We undertook a qualitative evidence synthesis to evaluate qualitative research on women's views and preferences for accessing postpartum contraception, and identify evidence gaps and opportunities for postpartum contraception provision. METHODS Five databases were searched to identify relevant qualitative studies. Included studies focused on views of, and preferences for, accessing postpartum contraception for women of reproductive age in high-income countries. RESULTS Of 1854 studies identified, 28 full texts were assessed and 19 studies included. These were critically appraised using Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) and analysed using thematic synthesis. Included studies indicated the majority of women desire postpartum contraception, but face a range of financial, health system and personal barriers. Women felt unclear about the ideal interpregnancy interval (IPI) and the rationale for this. Women preferred contraceptive counselling at varying times both antenatally and postnatally, and commonly preferred to receive contraception in the immediate postpartum period before hospital discharge. Women commonly saw their obstetrician or general practitioner for contraceptive counselling, but welcomed midwifery involvement. CONCLUSIONS Most women were interested in postpartum contraception and pregnancy spacing, but felt unclear about the optimal IPI, highlighting the need for further education and support around this issue. Contraceptive counselling was viewed as valuable antenatally and postnatally, and by varying maternal health providers, as was the provision of immediate postpartum contraception.
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Buckingham PLM, Hussainy S, Soon J, Norman WV, Bateson D, Mazza D. Improving access to quality contraceptive counselling in community pharmacy: examining the knowledge, attitudes and practices of community pharmacists in Australia. BMJ Sex Reprod Health 2023; 49:87-96. [PMID: 36410765 DOI: 10.1136/bmjsrh-2022-201623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Across most of Australia, the role of community pharmacists in contraceptive care has been unchanged since 2004. To understand their current scope of practice and potential for practice advancements, we examined community pharmacists' contraceptive knowledge and their attitudes, practices and perceived barriers to and benefits of contraceptive counselling provision. METHODS A nationwide postal survey was conducted between September and December 2020. We contacted a state/territory-stratified sample of 2149 community pharmacies and limited eligibility to one pharmacist per pharmacy. Summary statistics of respondent characteristics and parametric (χ2, linear regression) and non-parametric (Mann-Whitney, logistic regression) tests were computed for the outcomes: practices, knowledge (reported and tested), confidence, attitudes, barriers and benefits. RESULTS Eligible responses were received from 366 pharmacies (19%). Pharmacists' median age was 34. Most (85% of) pharmacists agreed that contraceptive counselling fits within their current professional activities and emphasised benefits to their patients, including improved access to contraceptive decision support (80%), as being key motivators of counselling. A lack of payment mechanisms (66%), training opportunities (55%) and technical assistance tools (54%) were the most important barriers. Self-rated knowledge and confidence were highest for combined oral contraceptive pills and lowest for the copper intrauterine device (IUD). When tested, pharmacists were very knowledgeable about method, dosage, frequencies and costs, and relatively less knowledgeable about side-effects and IUD suitability for adolescents. CONCLUSIONS Community pharmacists provide contraceptive information and counselling but lack the necessary resources and support to be able to consistently provide quality, person-centred care. Remuneration mechanisms, training opportunities and pharmacy-specific professional resources need to be explored.
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Affiliation(s)
| | - Safeera Hussainy
- Monash University Department of General Practice, Notting Hill, Victoria, Australia
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Judith Soon
- The University of British Columbia Faculty of Pharmaceutical Sciences, Vancouver, British Columbia, Canada
| | - Wendy V Norman
- Dept of Family Practice, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
- Public Health, Environments and Society, London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - Deborah Bateson
- Faculty of Medicine and Health, The University of Sydney, The Daffodil Centre, Sydney, New South Wales, Australia
- Family Planning New South Wales, Ashfield, New South Wales, Australia
| | - Danielle Mazza
- Monash University Department of General Practice, Notting Hill, Victoria, Australia
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Vianello M, Reynolds-Wright JJ, Cameron S. Self-reported contraceptive use and satisfaction among women accessing telemedicine medical abortion at the onset of the COVID-19 pandemic at 3-6-month follow-up. BMJ Sex Reprod Health 2023; 49:21-26. [PMID: 35777953 DOI: 10.1136/bmjsrh-2022-201493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Changes in legislation due to COVID-19 led to the introduction of telemedicine for early medical abortion (EMA) at home in Scotland. The opportunity to provide contraception at presentation may be more limited with this model of care. We compared contraceptive use immediately post-abortion with 3-6 months later to determine if contraceptive needs were being met. METHODS We contacted 579 women by telephone call or text message who agreed to be involved in a service evaluation of telemedicine EMA in NHS Lothian at 3-6 months post-abortion. A research nurse administered a questionnaire on the women's current contraception use. The research nurses also offered women support in switching or initiating contraception via the abortion service if desired. RESULTS The response rate to the contact was 57% (331/579). Under a third of the women (30%, 98/331) were using the progestogen-only pill (POP) at 3-6 month follow-up, a significant decrease (p<0.00) compared with 65% (215/331) who were provided with POP at the time of abortion. Thirty-nine women (12%) were provided with contraception through this telephone contact, leading to a significant increase in the proportion using subdermal implants, the progestogen injectable or intrauterine contraception. CONCLUSIONS This study shows that there was a decrease in the use of the POP 3-6 months after telemedicine EMA during the COVID-19 pandemic. Telephone contact at 3-6 months to facilitate obtaining contraception may be a promising strategy to improve access to effective methods with this model of abortion care.
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Affiliation(s)
| | - John Joseph Reynolds-Wright
- Queen's Medical Research Institute, MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
- Chalmers Centre, NHS Lothian, Edinburgh, UK
| | - Sharon Cameron
- Queen's Medical Research Institute, MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
- Chalmers Centre, NHS Lothian, Edinburgh, UK
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Latham-Cork HC, Nicol C. Progestogen only pills commentary. BMJ Sex Reprod Health 2023; 49:3-6. [PMID: 36198480 DOI: 10.1136/bmjsrh-2022-201666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Harriett Charlotte Latham-Cork
- Obstetrics and Gynaecology, University of Nottingham, Nottingham, UK
- Integrated Sexual Health Services, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Claire Nicol
- Lothian SRH Services, Chalmers Sexual Health Centre, Edinburgh, UK
- Deputy Director, Clinical Effectiveness Unit, Faculty of Sexual and Reprodctive Healthcare, Edinburgh, UK
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Grindlay K, Key K, Zuniga C, Wollum A, Grossman D, Blanchard K. Experiences using a progestin-only pill in an over-the-counter environment in the United States: a cross-sectional survey. BMJ Sex Reprod Health 2023; 49:27-34. [PMID: 36270780 DOI: 10.1136/bmjsrh-2022-201637] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Efforts are underway to make a progestin-only pill (POP) over the counter (OTC) in the United States (US); however, little is known about POP user experiences, which could impact uptake and continuation. METHODS From January 2020-September 2021, we conducted a cross-sectional online survey with individuals who used OTC POPs in a US trial. We calculated descriptive statistics and Pearson chi-square and Fisher's exact tests to assess menstrual bleeding acceptability, how OTC POP experiences compared with prior contraceptive methods, and preferred ways to get answers to questions during OTC POP use. RESULTS Among 550 adult and 115 adolescent participants, 80% (n=531) felt their menstrual bleeding was acceptable. Participants reported a range of menstrual bleeding experiences compared with prior long-acting or hormonal methods used; 58% (n=84) said the POP bleeding was similar or better and 36% (n=53) said it was worse. Among participants who used contraception in the month prior to the trial, 77% (n=201) said their overall OTC POP experience was similar or better. Top benefits compared with prior methods included less worry about pregnancy, ease of access, fewer side effects, and greater decision-making power. Adults preferred to get answers about OTC POPs via webpage or app, whereas teens preferred asking pharmacists or other healthcare providers. CONCLUSIONS Overall, OTC POP users in a trial setting found the menstrual bleeding acceptable and the method similar to or better than previous methods. POP labelling should provide clear messaging about bleeding changes users may experience.
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Affiliation(s)
- Kate Grindlay
- Ibis Reproductive Health, Cambridge, Massachusetts, USA
| | - Katherine Key
- Ibis Reproductive Health, Cambridge, Massachusetts, USA
| | | | | | - Daniel Grossman
- Department of Obstetrics, Gynecology and Reproductive Sciences, Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, University of California San Francisco, Oakland, California, USA
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Abstract
For a continuous monitoring and evaluation of drug safety problems in Sweden, the Department of Drugs of the National Board of Health and Welfare has access to a number of computerised patient-, drug-, and disease-oriented registers. The usefulness and limitations of these registers are presented by examples. A recent increase in asthma deaths is presently being analysed by comparing information from death certificates and case records with drug sales and prescription data. A recent analysis of the cancer register showed no increased risk of malignant thyroid tumors after diagnostic or therapeutic doses of I 131. Similarly no increased risk of malformations after occupational exposure to hexachlorophene could be detected by analysing the malformation and medical birth-record registers in relation to hospital hexachlorophene use. The register of patient discharge diagnoses has been repeatedly used to analyse the incidence and pattern of drug induced blood dyscrasias and thromboembolism associated with oral contraceptives (OC). These analyses have resulted i.a. in the withdrawal of dipyrone and tenalidine and a decrease of the estrogen-content of OCs. At the same time about 1/3 of these serious adverse drug reactions (ADR) was found to have been reported to the ADR-register. By combining sales and prescription data with ADR-reports the risk of inducing lactic acidosis was found to be significantly higher for phenformin than for metformin. Also the incidence of tardive dyskinesia from longterm use of metoclopramide was found to be much higher than hitherto recognized. By use of these registers it is possible to obtain valuable information about the safety of drugs. The raw data must, however, be interpreted with care and often be supplemented with in depth studies of the various problems.
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Salonen JT. Oral contraceptives, smoking and risk of myocardial infarction in young women. A longitudinal population study in eastern Finland. Acta Med Scand 2009; 212:141-4. [PMID: 7148505 DOI: 10.1111/j.0954-6820.1982.tb03186.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The use of oral contraceptives (OC) and smoking habits were studied by using a questionnaire in a random population sample of women from two counties of Eastern Finland in 1972. The participation rate was 95%. Data on use of OC and smoking were collected for 2,653 women aged 35-49 years. During the next seven years, 27 of them had developed an acute myocardial infarction (AMI). Smokers had a 2.6-fold (95% confidence interval (CI)=1.2-6.0) crude risk of developing AMI compared with non-smokers. Women taking OC had a 1.3-fold (95% CI = 0.4-6.9) risk of developing AMI compared with those who did not. Women who both smoked and used OC had a 7.2-fold (95% CI = 2.1-24.7) risk of AMI compared with non-smokers and non-users of OC. The results indicate that use of OC is associated with an excessive risk of AMI among female smokers.
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Abstract
1. Steroid hormones can affect spermatogenesis and thereby fertility directly and/or indirectly. All antigonadotropically active steroids inhibit spermatogenesis via inhibition of gonadotropin secretion, mainly that of H. Androgens and steroids occurring in the biosynthetic chain of testosterone synthesis have a direct promoting effect on spermatogenesis if applied in high doses. It has not been possible as yet to make clinical use of this positive effect since it is obviously not possible to achieve the necessary intratesticular androgen concentrations. 2. As concerns the different androgens and the steroids in the androgen biosynthetic chain, and also all synthetic anabolics, there is no parallelism between the direct spermatogenic activity, the androgenic activity and the antigonadotropic activity. 3. Estrogens and synthetic gestagens do not inhibit spermatogenesis directly at the testicular level. All effects of estrogens can be abolished experimentally by adequate substitution with gonadotropins or androgens, or a combination of androgens and gonadotropins. 4. Only those antiandrogens inhibit spermatogenesis with additional antigonadotropic properties (e.g. cyproterone acetate). Pure antiandrogens, like flutamide or cyproterone, have a slight and transient influence on spermatogenesis at the most. If at all, they merely cause transient subfertility. 5. Beside steroids and several centrally active pharmaceutics (e.g. psychotropic drugs and several antihypertensive compounds), only siloxanes and methallibur seem to affect spermatogenesis via inhibition of gonadotropin secretion. Other antispermatogenic agents act by inhibition of mitosis (Colchicine, alkylating agents) or presumably via damage of the Sertoli cells. 6. Based on present knowledge, contraception in men could be principally managed by administration of a) androgens alone, b) gestagen/androgen combinations, c) estrogen/androgen combinations, d) certain antiandrogens. 7. The difficulties of contraception in men by steroid hormones or steroid hormone combinations have been pointed out. As regards the usefulness of antiandrogens for contraception, no definite conclusions can be drawn at the moment. All non-steroidal inhibitors of spermatogenesis which have been found up to the present are not suitable because of toxic effects.
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Le Vier RR, Boley WF. The antigonadotropic activity of an organosiloxane in the male rat: 2,6-cis-diphenylhexamethylcyc otetrasiloxane. Acta Pharmacol Toxicol (Copenh) 2009; 36:55-67. [PMID: 1080335 DOI: 10.1111/j.1600-0773.1975.tb03084.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Abstract
In healthy subjects the ESR is higher in women than in men, and in both sexes a rise with age occurs. It is well established that pathological elevation of the ESR may be due to elevation of the fibrinogen level. The present study has shown that in normal subjects the ESR correlates not only inversely with the haemoglobin level but also directly with the fibrinogen level. These two factors together explain the difference in ESR between men and women, and the major part of the age-related increase in the ESR. Fibrinogen levels were found to be significantly higher in male smokers than male non-smokers, and in women were inversely correlated with alcohol consumption; despite this the ESR did not differ in smokers and non-smokers, nor was it related to alcohol intake. Oral contraceptive intake influenced neither the fibrinogen level nor the ESR. The correlation of ESR and fibrinogen concentration in healthy subjects suggests that physiological variation in the ESR is determined by the fibrinogen concentration as well as the haemoglobin level.
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Gidwani GP, Purandare BN. Clinical trial with oral contraceptives. J Obstet Gynaecol India 2002; 19:202-7. [PMID: 12332058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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Di Domizio G, Muscarella A. [Practical method to isolate diethylstilbestrol by thin-layer chromatography. Technical note]. Nuova Vet 2002; 46:203-6. [PMID: 12334538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Murray J. Teen pregnancy: an international perspective. Plan Parent Rev 2002; 6:20-1. [PMID: 12340616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Loch EG, Tenhaeff D, Lohmeyer H. [The cytohormonal diagnosis under various oral contraceptives]. Z Geburtshilfe Gynakol 2002; 172:261-6. [PMID: 12156325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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United States. California. Court of Appeal, Second District. Brownfield v. Daniel Freeman Marina Hospital [2 March 1989]. Annu Rev Popul Law 1989; 16:17. [PMID: 12344209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Emergency contraception: it can change our world. An interview with James Trussell. Fam Life Matters 1999;:3-5. [PMID: 12321921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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23
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FPA withdraws from CSM project in Guatemala. Soc Mark Forum 1984; 1:1, 7-8. [PMID: 12340330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Chinnatamby S. The effect of oral contraceptives on nutritional status and metabolism of the Asian woman (Sri Lanka). Future 2002; 5:10-1. [PMID: 12335420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Martinez-manautou J. Continuous low dose progestagen for contraception. IPPF Med Bull 2002; 2:2-3. [PMID: 12155573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Kissling F. A callous and coercive policy. Conscience 2002; 20:12-4. [PMID: 12178901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Dialogues in Contraception Consensus Conference (1995: Chicago). Oral contraceptives and venous thromboembolism: consensus conference statement. Dialogues Contracept 1996;:1-8. [PMID: 12320455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Manganelli F, Tomei F, Bergamini V. [Update on mechanical methods of postcoital contraception. Pt. 2]. Ginecol Clin 2002; 8:189-90. [PMID: 12342486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Brown S, Cropfield O. The case for a lower dose pill. Assessing the impact of estrogen dose. ORGYN 2002:36-9. [PMID: 12319251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Van Look PF. Emergency contraception: a brighter future? Entre Nous Cph Den 2002:4-5. [PMID: 12222301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Vaginal contraceptives: worldwide use remains low but methods have potential. Netw Res Triangle Park N C 1986; 7:1, 5. [PMID: 12340618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Zheng SH, Wang HZ, Shen WX, Sun ZD, Gao SM. [Application of the assays for progesterone and estradiol in saliva in family planning research]. Shengzhi Yu Biyun 2002; 7:35-8. [PMID: 12341308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Consortium for Emergency Contraception. Emergency contraceptive pills: what you need to know. Brochure for programs providing combined ECPs. Entre Nous Cph Den 1998;:8. [PMID: 12222303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Barnett B. Fertility awareness affects method use. Netw Res Triangle Park N C 2002; 17:9. [PMID: 12320448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Szapiro N. [Oral contraception with Moneva: findings of a cohort study of 6000 women]. C R Ther Pharmacol Clin 2002:3-7. [PMID: 12318672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Egypt/FOF reorganize. Soc Mark Forum 1984; 1:3. [PMID: 12340331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Andrade AT. [Information on advances in sciences and technology. Advances in contraceptive technology]. Bol Cent Biol Reprod 2002; 12:51-2. [PMID: 12345521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Recio R, Garza-flores J. Monthly injectable contraceptives. Adv Contracept Deliv Syst 2002; 4:329-47. [PMID: 12342245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Beck P, Venable RL, Hoff DL. Mutual modification of glucose-stimulated serum insulin responses in female rhesus monkeys by ethinyl estradiol and nortestosterone derivatives. J Clin Endocrinol 2002; 41:44-53. [PMID: 12334063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Helles AA. [Oral contraception]. Arch Pharm Chem (Kbh) 2002; 78:2-9. [PMID: 12334380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Iizuka R, Hayashi M, Kamouchi Y, Yamanaka K. Evaluation of a low-dose progestagen as a contraceptive. Nihon Funin Gakkai Zasshi 2002; 16:68-82. [PMID: 12158578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Matlin SA. Perspectives for the development of new contraceptives. Soc Biol Hum Aff 2002; 49:43-57. [PMID: 12340738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Improving methods of emergency contraception. Prog Hum Reprod Res 1999;:1. [PMID: 12349414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Emergency contraception: how effective is it? Prog Hum Reprod Res 1999;:2. [PMID: 12349415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Pill research results in new guidance from CSM. Fam Plann Today 1995;:1. [PMID: 12319465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Kesseru E, Larranaga A. [Mechanism of action of prolonged-action injectable contraceptives]. Ginecol Obstet (Lima) 2002; 14:339-59. [PMID: 12331776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Jimenez Vargas J. [Contraceptives]. Pers Derecho 2002; 1:375-409. [PMID: 12333292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Grubb G. Long-acting steroid contraceptive technology. Health Sex 2002; 2:1-5, 7, 16. [PMID: 12343643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Valle G. [The problem of postcoital contraception using oral progestins]. Aggiorn Ostet Ginecol 2002; 8:127-8. [PMID: 12334868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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