Satisfaction among women: Differences between current users of barrier (male condom) and non-barrier methods

Objectives To determine the differences in and factors related to satisfaction between barrier (male condom) and non-barrier method users.

Methods A semi-structured questionnaire was used for collecting data for this cross-sectional survey. The questionnaires were completed via one-on-one interviews by the researchers. The study group was selected using stratified random sampling. Exclusion criteria were, being unmarried, pregnant, in postmenopausal status and using traditional methods. A total of 434 currently married women using modern contraceptive methods participated in the study. Contraceptive users were dichotomized into two groups as non-barrier method users and barrier method users.

Results About half of the participants (n = 191, 44%) were barrier method users. Their mean age was 33.7 ± 7.3 years, 66.6% (n = 131) were well educated and reported significantly less pregnancies, given births, living children and abortions (reproductive history events) than non-barrier users. Barrier method users were significantly more likely to be satisfied with their contraceptive method of choice (OR: 2.4; 95% CI 1.2–5.2). Among barrier method users, deciding the type of the contraceptive method themselves had significant effect on satisfaction.

Conclusion In our study, satisfaction was mostly affected by heavy side effects and health risks of the methods resulting in less satisfaction with the contraceptive method among non-barrier method users. Other factors which may influence satisfaction deserve further investigation.     

Condom practices of urban teens using Norplant contraceptive implants, oral contraceptives, and condoms for contraception

OBJECTIVES: The availability of long-acting hormonal birth control methods has created new contraceptive options for adolescents. The purpose of this study was to determine whether teens initiating these methods use condoms less frequently than teens using oral contraceptive pills or condoms alone and may therefore be at an increased risk of acquiring sexually transmitted infections. STUDY DESIGN: To investigate ongoing condom behavior in teens using levonorgestrel (Norplant) contraceptive implants, oral contraceptives, and condoms alone, we examined data from a 2-year prospective cohort study of 399 urban teens. The study consisted of 3 clinic-based cohorts of adolescent female contraceptive users: Norplant contraceptive implants (n = 200), oral contraceptives (n = 100), and condoms alone (n = 99). Data were collected at an admission interview and at 1- and 2-year follow-up from method continuers. RESULTS: Norplant contraceptive implant users were less likely than oral contraceptive or condom users to report condom use at last sex or consistent condom use at 1- and 2-year follow-up. The implant group showed a significant decrease in condom use from admission to 2 years after method initiation. The proportion of implant users self-reporting new sexually transmitted infections at 2-year follow-up, however, was not significantly greater than that of oral contraceptive or condom users. CONCLUSIONS: Our findings indicate that teen users of Norplant contraceptive implants are less likely to use condoms than teens who choose oral contraceptives but, probably because of differences in sexual behavior, are no more likely to self-report sexually transmitted infections. Our findings also indicate that teens who choose oral contraceptives and condoms do not use them consistently enough to avoid pregnancies or sexually transmitted infections.     

Differences in contraceptive methods used by women with physical disabilities compared to women without disabilities

Women with physical disabilities face unique challenges often not addressed by gynecologists regarding choices of contraceptive method. Interactions between some hormonal methods of contraception and disability-related medications, inability to use barrier methods because of limitations in manual dexterity, potentially elevated risk for DVT, and need for menstrual management are factors that complicate decisions about contraceptive methods for this growing population.Objective: This study assessed similarities and differences in the use of and satisfaction with different methods of birth control between women with disabilities and women without disabilities, while controlling for age at onset and severity of disability.Methods: As part of a national survey, 616 women of childbearing age (315 with a variety of physical disabilities, 301 without disabilities) reported their use of and satisfaction with various forms of contraception.Results: Women with physical disabilities were significantly less likely than women without disabilities to use hormonal (11.7%/19.6%) or barrier methods (11.1%/17.6). They were significantly more likely to have had a hysterectomy (8.9%/4.3%) or use no method (41.9%/33.4%). There were no significant differences in the use of surgical methods (22.9%/22.6%) or natural methods (3.5%/2.7%). Women with more severe disabilities were significantly more likely to have had hysterectomies or use surgical or no method of contraception. Women with disabilities were least satisfied with barrier methods.Conclusion: Women with disabilities are more likely to use permanent methods or no method of contraception. Further research is needed to understand the impact of functional limitations and other disability-related factors on the use of other contraceptive methods in this population.     

Being on the Safe Side: A Qualitative Study of Condom Use Motivations According to Contraceptive Type among Adolescents in Atlanta,Georgia

Study ObjectiveQuantitative data suggest that adolescent users of long-acting reversible contraception (LARC), compared with short-acting methods (pill, patch, ring, depot medroxyprogesterone acetate [DMPA]), might be less likely to use condoms. We qualitatively describe and explain adolescent contraceptive users’ motivations for condom use, including variation according to contraceptive type.DesignIndividual, in-depth qualitative interviews, analyzed thematically.SettingParticipants were recruited from public family planning clinics and an adolescent medicine clinic, as well as university and other community settings in Atlanta, Georgia.ParticipantsSexually active contraceptive users aged 17-19 years old (n = 30), including LARC (n = 10), DMPA (n = 10), and oral contraceptive (n = 10) users.ResultsOf the 30 participants, most (n = 25; 83%) used condoms with their more effective contraceptive method, although 11 of 25 used them inconsistently (44%). Oral contraceptive users were particularly motivated to use condoms for pregnancy prevention, because of concerns about contraceptive method efficacy and a desire to be on “the safe side.” In contrast, LARC users were primarily motivated by sexually transmitted infection (STI) prevention. DMPA users’ motivations were more mixed. Across contraceptive type, factors influencing condom use motivations included sexual health education, personal awareness and/or experience, and perceived consequences and risk.ConclusionBecause all participants were using an effective contraceptive method, it is notable that pregnancy prevention was a prominent motivator for using condoms, although LARC users reported STI prevention to be a more important motivation. Parental and school-based sexual health education that clearly addresses STI prevention in addition to pregnancy prevention has the potential to influence condom use motivations and behavior.     

Intimate Partner Violence and Contraception among Adolescent Girls and Young Women: A Longitudinal Analysis of the Girl Power-Malawi Cohort

PurposeIn sub-Saharan Africa, sexually active adolescent girls and young women (AGYW) experience high rates of intimate partner violence (IPV) and low levels of contraceptive use, but the effect of IPV on contraceptive use is not well understood.MethodsIn the Girl Power-Malawi study, AGYW aged 15-24 were recruited from 4 health centers in Lilongwe, Malawi, and followed for 1 year. At baseline, AGYW were assessed for IPV using the modified Conflict Tactics Scale. AGYW reported contraceptive method use at 6 and 12 months, characterized as barrier, non-barrier, or any modern method. Modified Poisson regression was implemented to estimate risk ratios (RRs) and 95% confidence intervals (CIs) to examine the effect of IPV on contraceptive use.ResultsOne thousand AGYW were enrolled, and 954 non-pregnant participants were included. Baseline prevalence of IPV with the most recent partner was 35.5% (physical), 46.2% (sexual), and 76.9% (emotional). Baseline IPV did not affect contraceptive use at 6 months (aRR [95% CI]: physical 0.98 [0.91-1.05]; sexual 1.00 [0.94-1.07]; emotional 1.03 [0.94-1.12]) or 12 months (physical 0.95 [0.89-1.02]; sexual 0.96 [0.90-1.02]; emotional 0.98 [0.91-1.05]). None of the 3 IPV categories affected contraceptive use when the outcome was restricted to either barrier or non-barrier methods.ConclusionsIn this cohort, IPV was not a key driver of contraceptive use in longitudinal analyses. Interventions are needed to address the alarming rates of IPV in this population, but addressing IPV alone might be insufficient to address low contraceptive use, and multifaceted youth-friendly health services might be necessary.     

Use of various contraceptive methods and time of conception in a community-based population

AIMS: To investigate the association between method of contraception and time to conception in a normal community-based population. DESIGN: Prospective, cross-sectional, survey. SETTING: Large comprehensive ambulatory women's health center. PATIENTS AND METHODS: One thousand pregnant women at their first prenatal obstetrics visit were asked to complete a self-report questionnaire. The return to fertility was analyzed by type of contraceptive method, duration of use, and other sociodemographic variables. RESULTS: Response rate was 80% (n=798). Mean age of the patients was 29.9+/-5 years. Seventy-five percent had used a contraceptive before trying to conceive: 80% oral contraceptives, 8% intrauterine device, and 7% barrier methods. Eighty-six percent conceived spontaneously. Contraceptive users had a significantly higher conception rate than nonusers in the first 3 months from their first attempt at pregnancy. Type of contraception was significantly correlated with time to conception. Pregnancy rates within 6 months of the first attempt was 60% for oral contraceptive users compared to 70 and 81% for the intrauterine device and barrier method groups, respectively. There was no correlation between time to conception and parity or duration of contraceptive use. Other factors found to be significantly related to time to conception were older age of both partners and higher body mass index. CONCLUSIONS: Contraception use before a planned pregnancy does not appear to affect ease of conception. Type of method used, although not duration of use, may influence the time required to conceive.     

Laparoscopic findings and contraceptive use in women with signs and symptoms suggestive of acute salpingitis

Laparoscopic findings in women with clinical signs and symptoms of pelvic inflammatory disease were correlated with contraceptive use in a case-control study. Of the 738 women, 544 (73.7%) had laparoscopic signs of acute salpingitis, whereas 194 (26.3%) had visually normal fallopian tubes (nonsalpingitis). Acute salpingitis was seen in 59.8% of the 286 patients using oral contraceptives, in 80.6% of the 227 patients using an intrauterine device (IUD), and in 84.4% of the 225 patients using barrier methods or not using contraceptives (reference group). To estimate the relative risk of acute salpingitis, logistic regression analysis adjusting for age and duration of pain before laparoscopy was used. For oral contraceptive users versus the reference group the adjusted relative risk was estimated at 0.24 (95% confidence interval 0.15 to 0.38, P less than .0001), and for IUD users versus the reference group a relative risk was estimated at 0.83 (95% confidence interval 0.49 to 1.38, P = .46). The relative risk of salpingitis among oral contraceptive users versus the reference group was 0.22 (P = .005), and 0.06 (P = .001) for women infected with Chlamydia trachomatis and/or Neisseria gonorrhoeae, respectively. In patients with pelvic inflammatory disease, spread of the inflammation to the fallopian tubes seems to be inhibited in oral contraceptive users.     

Preventing Repeat Teen Pregnancy: Postpartum Depot Medroxyprogesterone Acetate,Oral Contraceptive Pills,or the Patch?

STUDY OBJECTIVE: To prospectively evaluate the repeat teen pregnancy rates, within one year of delivery, among adolescents who choose the contraceptive patch (Ortho Evra) versus oral contraceptive pills (OCP) versus Depot Medroxyprogesterone Acetate (Depo Provera, DMPA) for postpartum contraception. DESIGN: Observational, prospective cohort study. Comparison groups are postpartum teens, who self-select the contraceptive patch (n = 55) versus DMPA (n = 142) versus OCPs (n = 55) immediately postpartum. SETTING: Medical University of South Carolina, a tertiary medical center. PARTICIPANTS: Postpartum teens, 11-19 years old; 72% were African American, and 96% qualified for Medicaid insurance. INTERVENTIONS: A structured telephone interview was performed every 3 months. MAIN OUTCOME MEASURES: The primary outcome measure was a repeat pregnancy within 12 months of the index delivery. Secondary outcome variables were contraceptive continuation rates, reasons for discontinuation, side effects and condom usage. RESULTS: At 1-year follow-up, repeat pregnancy rates were 14.2%, 29.7%, and 31.8% among DMPA, OCP, and patch users respectively (P = 0.02). DMPA users were significantly more likely to be using any form of hormonal contraception 1 year postpartum than patch or OCP users. Condom use was similarly low among all cohorts. CONCLUSION: Adolescents who choose DMPA for postpartum contraception are significantly less likely to become pregnant within 1 year of delivery, as compared to teens who choose OCPs or the patch.     

Patient satisfaction with 3 methods of postpartum contraceptive counseling: a randomized, prospective trial

OBJECTIVE: To compare patient satisfaction with 3 different postpartum contraceptive counseling methods. STUDY DESIGN: Randomized, prospective trial in an urban medical center. Patients were randomized to receive physician-patient counseling, written literature or an educational video. The main outcome variable was patient satisfaction with the contraceptive teaching method. Patient satisfaction was analyzed as a categorical variable and compared with chi2 tests. Secondary outcomes were compared with chi2 tests and ANOVA. RESULTS: Greater than 90% of patients in each arm were satisfied with the contraceptive counseling that they received. Patients receiving physician-patient counseling expressed a 99% satisfaction rate (p = 0.044). African American (98.2%) and Hispanic (93.5%) patients were more satisfied than Caucasian (83.3%) patients (p = 0.026). Satisfaction with contraceptive counseling decreased with age. CONCLUSION: An organized program of contraceptive counseling provides adequate information for patients to be comfortable with their decision about their postpartum contraceptive method. Patients were most satisfied with physician counseling.     

High levels of women's satisfaction and compliance with transdermal contraception: results from a European multinational, 6-month study

Objective.?To investigate compliance, satisfaction, and preference in women using a transdermal contraceptive patch.

Methods.?Women (18–46 years) from eight European countries used contraceptive patches (norelgestromin 6?mg, ethinylestradiol 600?μg) for six, 4-week treatment cycles. Compliance, satisfaction, and preference were assessed after 3 and 6 cycles and study completion using self-report methods.

Results.?Of the 778 participants, 36.8% (n?=?287) used no contraception at baseline. The most common methods were oral contraceptives (67.9%, n?=?334) and barrier methods (21.5%, n?=?106). Of oral contraception users, 63.5% (n?=?212) were satisfied or very satisfied with their previous method, but compliance was poor with 77.8% (n?=?260) reporting missed doses. After 3 and 6 cycles, >80% of all included women were satisfied or very satisfied with the patch. At study completion, most participants (73.7%) reported a preference for the patch compared to their previous method. Of 4107 cycles, 3718 (90.5%) were completed with perfect compliance. Two pregnancies occurred during this study, representing a Pearl Index of 0.63. No new safety issues were identified and the patch was well tolerated.

Conclusion.?Women were highly satisfied with transdermal contraception and preferred this form of family planning over their previous method. Transdermal contraception represents a valuable addition to contraceptive options with potential to offer high compliance and efficacy.     

Determinants of abortion among women undergoing artificial termination of pregnancy.

OBJECTIVES: In order to determine factors involved in the contraceptive practice of women undergoing artificial abortion, a prospective questionnaire survey was carried out. METHODS: Women (n = 800) requesting artificial abortion were compared with women (n = 1000) admitted to or visiting the department for reasons other than abortion. The SPSS program was used for statistical analysis between 1998 and 1999. Multiple logistic regression analysis was applied to evaluate the factors influencing the contraceptive practice of the aborters. RESULTS: Reliable contraceptive methods were used significantly less frequently by the aborters than by the control group (19.1% vs. 55%, p < 0.001, adjusted odds ratio (AOR), 0.46; 95% confidence interval (CI), 0.3-0.7). The contraceptive choice of the aborters depended significantly on their low income (AOR, 1.87; 95% CI, 1.5-2.4). The likelihood of abortion was significantly lower among those informed by a health-care provider (AOR, 0.56; 95% CI, 0.4-0.8) or the media (AOR, 0.51; 95% CI, 0.4-0.7). Awareness of reliable methods was also an important factor (AOR, 0.25; 95% CI, 0.1-0.5). CONCLUSIONS: It appears that a further decrease of the abortion ratio could be attained through an intensive media campaign and improved education.     

Parity and use-effectiveness with the contraceptive sponge

The results of a randomized United States study indicated that the Today contraceptive sponge was less effective than the diaphragm (1-year cumulative life-table rate of 17.4 versus 12.9 pregnancies per 100 women, p = 0.01). However, this overall comparison is misleading. Using univariate and multivariate analyses to account for the effects of user characteristics we found parity to be the most important single determinant of effectiveness for users of the sponge, but parity was unimportant as a risk factor for pregnancy among diaphragm users. For nulliparous women the sponge was as effective as a physician-prescribed barrier method (13.9 for sponge, 12.8 for diaphragm, p = 0.45); however, parous women using the sponge were twice as likely to become pregnant (28.3 for sponge, 13.4 for diaphragm, p = 0.001). The effect of parity among sponge users is consistent with the results of international studies of the contraceptive sponge.     

无痛人工流产者避孕知识与行为的调查

目的:了解无痛人工流产者对避孕知识的知晓程度与实际使用情况及影响因素。方法:采用横断面调查的方法,对因非意愿妊娠而自愿要求无痛人工流产者进行面对面的问卷调查,探究她们对于避孕方法的知与行的异同及其原因,并采用单因素和多因素非条件Logistic回归法分析每种避孕方法使用情况的影响因素。结果:在609名无痛人工流产者中,平均年龄为28.3±5.2岁,重复人工流产率为50.1%,首次性生活年龄为22.0±2.8岁。知道≥3种避孕方法者占95%以上。对某种避孕方法,使用者与知晓者的比例总体上从高到低顺序为避孕套(91.0%)、紧急避孕药(71.2%)、安全期(63.3%)、体外排精(58.8%)、杀精剂(21.1%)、口服避孕药(OC)(19.2%)、宫内节育器(IUD)(8.9%);目前使用者与曾经使用者的比例总体上从高到低顺序为安全期(83.4%)、避孕套(79.0%)、体外排精(71.2%)、杀精剂(50.0%)、紧急避孕药(36.1%)、IUD(11.4%)、OC(10.0%)。IUD和OC的停用和不愿使用的比例较高,主要原因是顾虑其副作用。未婚无分娩史者对安全期、体外排精、IUD和OC的知晓率较低,有分娩史者使用安全期、避孕套和IUD的比例最高,使用OC的比例最低;年龄、收入、流产次数对未婚无分娩史者选用避孕方法的影响比较大。结论:妇女对避孕方法的知晓度较高,但多未使用高效的避孕方法,避孕失误多,应加强流产后服务及避孕知情选择工作,指导妇女正确地选择和使用避孕方法,提高避孕效率。     

Dual method use among long-acting reversible contraceptive users

Objective: To compare rates of dual method use (concurrent use of condoms and an effective method of contraception) in long-acting reversible contraceptive (LARC) and non-LARC hormonal contraceptive users, and to determine factors associated with dual method use.

Methods: We conducted a secondary analysis of the Contraceptive CHOICE Project, an observational, prospective cohort study of 9256 women in St. Louis, MO, USA. Our sample included 6744 women who initiated a contraceptive method within 3 months of enrollment, continued use at 6 months post-enrollment, and responded regarding dual method use. Our primary outcome was the rate of dual method use at 6 months post-enrollment.

Results: Dual method use was reported by 32% of LARC and 45% of non-LARC hormonal contraceptive users (p?adj 0.76, 95% CI 0.70–0.83). Factors associated with dual method use in our multivariable analysis were age <25 years, black race, lower education, single relationship status, baseline dual method use, baseline diagnosis of sexually transmitted infection (STI), greater partner willingness to use a condom, and higher condom self-efficacy score.

Conclusions: LARC users are less likely to report dual method use compared to non-LARC hormonal contraceptive users, but other factors also impact dual method use. Further studies should be performed to determine whether this lower dual method use increases the risk of STI.

Clinical trials registration: Clinicaltrials.gov Identifier NCT01986439.     

Effects of smoking and oral contraception on plasma beta-carotene levels in healthy women

Oral contraceptive use and smoking have been known to affect plasma vitamin levels. Total carotenoids have been studied with spectrophotometry, a relatively insensitive technique. In this study plasma concentrations of beta-carotene and retinol were measured in coded samples by sensitive high-pressure liquid chromatography in a cross-sectional study of 149 normal healthy women attending a family planning clinic. At the time of recruitment in the morning, a general health questionnaire was administered for patient age, methods of contraception, smoking habits, and food intake at breakfast. Of the 149 enrolled volunteers, 88 were oral contraceptive users and 61 were not users. Among users, 21 smoked cigarettes, and there were 18 smokers among nonusers. Oral contraceptive users had significantly lower plasma concentrations of beta-carotene (p less than 0.001) and higher retinol levels (p less than 0.0001). Plasma beta-carotene or retinol levels did not differ among users of intrauterine contraceptive devices or barrier methods of contraception. No association was noted between the plasma levels of these two micronutrients and age greater than or less than 30 years. Cigarette smoking alone was associated with significantly reduced plasma beta-carotene levels in nonusers (p less than 0.001). Combined cigarette smoking and oral contraceptive usage were associated with low plasma beta-carotene levels; the results appear to be additive. These findings suggest a possible synergistic effect on plasma beta-carotene levels from the use of both cigarette smoking and oral contraception.     

The role of contraception in the development of postmolar gestational trophoblastic tumor.

From January 1974 to June 1988, 299 evaluable patients were referred to the John I. Brewer Trophoblastic Disease Center of Northwestern University Cancer Center for treatment and/or follow-up of a hydatidiform mole (N = 162) or postmolar gestational trophoblastic tumor (N = 137). The type of contraception and other prognostic factors before and after evacuation were correlated with the development of gestational trophoblastic tumor using both univariate and multivariate analysis. There was no relationship between pre-hydatidiform mole contraception and the development of gestational trophoblastic tumor. Oral contraceptives (OCs) were used by 139 patients (46%), barrier methods by 141 patients (47%), intrauterine devices (IUDs) by two patients (1%), and no contraception by 17 patients (6%). The risk of developing gestational trophoblastic tumor was compared between patients using versus not using: OCs--33 versus 57% (P less than .001), barrier methods--53 versus 40% (P = .30), IUD--100 versus 46% (P = .21), and any contraceptive method--43 versus 88% (P less than .001). The dose of estrogens could be determined in 75 patients taking OCs; 14 of 49 (29%) of the patients taking less than 50 micrograms versus nine of 26 (35%) taking 50 micrograms or more developed gestational trophoblastic tumor (P = .78). Stepwise logistic regression analysis demonstrated that the type of contraceptive used was the most important prognostic factor in gestational trophoblastic tumor development (P less than .0001), followed by the occurrence of theca-lutein cysts (P less than .0001), Asian maternal race (P = .02), lesser time from the last menstrual period (P = .005), and greater maternal age (P = .04).(ABSTRACT TRUNCATED AT 250 WORDS)     

Induced abortion,contraceptive use,and dual protection among female sex workers in Moscow,Russia

ObjectiveTo describe abortion history and current contraceptive use among female sex workers (FSWs) in Moscow, Russia.MethodsA clinic-based survey was conducted among 147 FSWs in Moscow during an 8-month period in 2005.ResultsIn total, 83 of 143 (58.0%) FSWs reported a history of abortion, with 45 of 143 (31.5%) indicating multiple abortions. Condoms were the primary form of contraception (145/146 [99.3%]); just 17 of 142 (12.0%) FSWs reported using non-barrier modern contraception. All women who reported using a non-barrier modern method also indicated condom use (i.e. dual protection). Non-barrier contraceptive use was associated with inconsistent condom use (odds ratio [OR] 3.10; 95% confidence interval [CI], 1.07–9.02) and multiple abortions (OR 4.71; 95% CI, 1.19–18.62).ConclusionThe results illustrate substantial risk for unintended pregnancy among FSWs. Further research is needed regarding the dynamics of non-barrier contraception and condom use. Efforts to improve the health and wellbeing of FSWs should include access to safe and effective contraception, in addition to HIV prevention.     

Contraceptive use and behavior in the 21st century: a comprehensive study across five European countries.

OBJECTIVE: The choice of currently available contraceptive methods has increased considerably in recent years, offering women of reproductive age a variety of different methods dependent on their needs and lifestyle. In order to determine the pattern of use of current methods in contraception, a survey was conducted in a large population of women drawn from five European countries (France, Germany, Italy, Spain and the United Kingdom). METHOD: More than 12,000 randomly selected women, aged 15-49 years, were interviewed using a standardized questionnaire which addressed the use of current methods of contraception. The responses were analyzed for the total study population, and, where appropriate, by country and age. RESULTS: An oral contraceptive (OC) was confirmed as the most widely used method of contraception for women in the European study population, with an estimated 22 million users in the five countries. Women using an OC reported very high levels of satisfaction (>90%). Male and female sterilization were the main methods of contraception in women aged 40 years and older. One-half of the women had undergone their sterilization before the age of 35 years. More than 50% of the women who had undergone sterilization had not been adequately informed and counselled about alternative reversible contraceptive options. No method of contraception was being used currently by 23% of the European study population, and unreliable methods of contraception (including cap/diaphragm, chemical, and natural and withdrawal methods) were being used by a further 6% of the population. Although valid reasons (e.g. not in a sexual relationship, wish to become pregnant) were given by many women who were not using contraception, there still remains a large number of women who need counselling regarding the importance of using reliable contraceptive methods. The number of women aged 15-49 years in the five European countries who are considered at risk of an unwanted pregnancy is estimated to be 4.7 million (6.5%). CONCLUSIONS: Differences in the use pattern of contraceptive methods were demonstrated that emphasize the social and cultural differences between the countries. The findings in the current study can be used as a baseline from which to monitor trends in contraceptive use and behavior in subsequent studies.     

Tubal pathology: the role of hormonal contraception, intrauterine device use and Chlamydia trachomatis infection

BACKGROUND: The aim of the present study was to identify a possible association between tubal pathology and the contraceptive methods previously used, especially third generation copper intrauterine devices (IUDs). METHOD: In this retrospective unmatched case-control study, use of contraceptive methods and Chlamydia trachomatis antibody titres were compared in women with tubal occlusion (n = 84) and infertile women with tubal patency (n = 253) demonstrated by hysterosalpingography. Contraceptive methods were also compared to primiparous women with natural pregnancy. RESULTS: A significantly higher percentage of women with tubal occlusion had previously used an IUD. Positive C. trachomatis antibody testing was found significantly more often in women with tubal occlusion. Neither hormonal contraceptives nor condoms were associated with an increased risk for uni- or bilateral tubal occlusion. CONCLUSION: In the present study, we observed an increased rate of tubal occlusions in previous IUD users. This should be considered in the contraceptive counseling of young and nulliparous women.