Contraception
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of techniques to assess cervicovaginal irritation and evaluation of the variability between two observers.
Colposcopy is used to evaluate effects of new vaginal products on cervicovaginal epithelium as part of the US Food and Drug Administration-mandated product approval process, yet few aspects of its use have been investigated. ⋯ The colposcopic examination is not burdensome nor does it induce findings. If naked eye observation were used alone in practice, these data suggest that half the colposcopically detected findings would be missed. Using the naked eye observation for screening would minimally reduce the number of magnified observations carried out. For detecting epithelial changes, the colposcope seems to be the most sensitive technique, followed by the AviScope.
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This review provides an update of previous estimates of first-year probabilities of contraceptive failure for all methods of contraception available in the United States. Estimates are provided of probabilities of failure during typical use (which includes both incorrect and inconsistent use) and during perfect use (correct and consistent use). The difference between these two probabilities reveals the consequences of imperfect use; it depends both on how unforgiving of imperfect use a method is and on how hard it is to use that method perfectly. These revisions reflect new research on contraceptive failure both during perfect use and during typical use.
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Women who ingest their oral contraceptive pill (OCP) as part of a daily routine are more likely use their OCPs correctly. This trial examines the feasibility of an electronic-mail (e-mail) reminder system to improve OCP compliance. An e-mail reminder was sent to 50 new OCP users daily for 3 months. ⋯ Most found the daily e-mail somewhat (65%) or very helpful (19%) for OCP compliance. Of those continuing OCPs, 64% wanted to continue receiving e-mail reminders at the completion of the study. Because inconsistent OCP use is a significant cause of unplanned conception, the use of e-mail to improve OCP compliance has the potential to decrease unintended pregnancies.
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Randomized Controlled Trial Clinical Trial
The effect of lorazepam on pain and anxiety in abortion.
In this double-blind study, 104 women were randomized to receive 1 mg lorazepam or placebo prior to a first-trimester abortion. In addition, 262 women were allowed to choose whether or not to take the lorazepam. ⋯ In the observational group, the women who took lorazepam had their mean anxiety score drop from 5.5 to 4.7 while in those who did not take it, the score rose from 3.8 to 4.9. This study indicates that giving oral benzodiazepines preoperatively is neither helping nor hurting our patients but the placebo effect can be helpful to make our patients more comfortable.