Contraception
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Postponement of menses is widely practised by women using oral contraceptives. One-hundred volunteers, consisting of three groups of women, each group using a different extensively used contraceptive regimen, were tested and compared. ⋯ Based on daily records of vaginal bleedings as well as on the results of a questionnaire, it could be concluded that postponement of the withdrawal bleeding for twenty extra days was generally effective; the occurrence of the bleedings was related to the duration of postponement of menses and to the contraceptive regimen that was used. However, the introduction of a seven-week cycle pill is not yet a promising alternative since the majority of the volunteers preferred the inconvenience of a monthly withdrawal bleeding.
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A multi-compartment contraceptive vaginal ring system has been designed for the simultaneous zero-order release of contraceptive steroids, the rates of which can be programmed independently. This vaginal ring system consists of two or more drug-containing Silastic tubes with an outer diameter of 5 mm. The tubes with different lengths, with a total length of 16.5 cm are connected with specially-shaped glass stoppers to obtain a ring with an outer diameter of 60 mm. ⋯ Multicompartment vaginal rings were made and tested with 3-keto-desogestrel and ethinylestradiol. The rings had an outer diameter of 60 mm, and were fabricated with independent in vitro release rates ranging from 75 to 300 micrograms/day and 10 to 30 micrograms/day for, respectively, 3-keto-desogestrel and ethinylestradiol. Using the multi-compartment vaginal ring system, contraceptive devices can be fabricated relatively simply with pre-programmed release rates for a progestogen and an estrogen to investigate the optimal daily doses for vaginal hormonal contraception.
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Detailed information was collected from 666 cohorts of pill, injectable-DMPA and IUD acceptors at 14 Bangkok Metropolis Health Clinics (MHCs). The contraceptive status at 12-month follow-up home interview shows that 47% of pill acceptors, 39% of DMPA acceptors and 55% of IUD acceptors were still using the same contraceptive method and receiving them from the original source. The women who initially adopted the pill could seek the oral contraceptive from other sources with a higher significant percentage (14%) than was found in the DMPA and IUD group. ⋯ Those who switched clinic gave the three important reasons of distance inconvenience, opening hour inconvenience and disagreeable health effects. Service-related factors are likely to play a less important role in determining discontinuation of the pill and DMPA, while the reasons on doctors objecting to removing the IUD appear to be the major service-related factor in discontinuation of IUD (19%). The decision to stop using any contraceptive appeared to be related to dissatisfaction with the method and side effects was the primary reason and the secondary reason was that they wanted another child.(ABSTRACT TRUNCATED AT 250 WORDS)
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This paper reviews trials of the effectiveness of barrier contraception with and without spermicide, and discusses the advantages and disadvantages of using spermicides with barriers. There is very little evidence to allow comparison of the effectiveness of barriers with and without spermicide. ⋯ The lack of scientific data on this subject has prompted us to recommend research in specific areas. Until the findings of such research are available, the information which has emerged from this review suggests that the recommendations issued to users of barrier contraception should be brought up-to-date.
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Because they seemed to be an overlooked, underutilized, and underdeveloped means of contraception, cervical caps were offered to patients in a private gynecological practice and the first 413 acceptors were sent a detailed questionnaire about their experiences. The 371 who responded provided generous amounts of information helpful in assessing not only cap safety and effectiveness, which are dealt with herein, but also in assessing acceptability which is dealt with in the companion article that follows. With regard to safety considerations, "cervical erosion" was not found to contraindicate cap use and no other significant safety hazards were encountered, although two concerns were suggested for further evaluation. ⋯ The role of cap dislodgement as a cause of method failures is analyzed. It is concluded that caps are as safe and effective as diaphragms and that for many women they are the most suitable form of contraception available. It is reasonable to expect that they will soon be able to be approved for general use.