Background. The rate of adolescent pregnancies (15–19 years) in Slovenia have been decreasing in the last twenty years. In 1981 the birth rate was 37/1000 and the abortion rate was 24/1000. In 2000 ...the birth rate was 8/1000 and the abortion rate was 12/1000. The abortion rates have been perisisted around 12/1000 since 1992. Why the abortion rate among adolescents does not decrease?The comparison with European countries, in which abortion rate is low (around 5/1000) shows, that the reasons should be searched in the low prevalence of oral contraceptive (OC) use in Slovenia. In Slovenia OCs are used in only 14% of secondary-school students, but in the countries with the lowest abortion rates OCs are used in 40–60%. Therefore, the use of OCs among adolescents should be encouraged to decrease the number of unintended pregnancies.At the Center for adolescents at University Department of Ob/ Gyn in Ljubljana and in the network for sexual and reproductive health of adolescents a lot of acitivites have been carried out in the last years in the field of education of health workers and teachers, in establishing the communication between health workers and teachers and in delivering information to lay population. However, there has been no rise in the use of effective contraception.Conclusions. We determine that we need wider professional and political support to improve the accessability od adolescent service and to improve the reproductive health of adolescents
Background: Today’s adolescents are prone to earlier biological development and earlier and more frequent sexual activity. Insufficient knowledge and unawareness of safe sex are often the reasons for ...risky sexual behaviour and adverse consequences such as early adolescent pregnancy and unwanted pregnancy. The aim of the article is to present the trends in fertility and abortion rates of adolescents in Slovenia in the last three decades and to present internationally comparable data on fertility and abortion rates of adolescent. Methods: The data from official statistics and the published representative studies on fertility and induced abortion rates are presented. Results: The fertility rate of adolescents aged 15–19 years in Slovenia was 37.2/1000 in 1981 and decreased to 5.1/1000 in 2008. In 2008 the percentage of deliveries to adolescent mothers regarding all deliveries was only 1.3 %. The induced abortion rate in adolescents aged 15–19 years was 24.3/1000 in 1981 and decreased to 7.8/1000 in 2008. Conclusions: The fertility and abortion rates among adolescents show that an intensive progress in the prevention of adolescent pregnancy has been achieved in Slovenia in the last two decades. Today, Slovenia is one of the most successful European and world countries as regards adolescent pregnancy prevention. The accessibility of reproductive health care was sustainable also in the transition period. However, to maintain the favourable low levels of adolescent pregnancy, a systemic approach to reproductive health with the establishment of a national strategy for reproductive health care in Slovenia is urgently needed.
Background. Adolescents represent a risk group for sexually transmitted infections. The aim of this study was to find the incidence of Chlamydia trachomatis (CT) and human papillomavirus (HPV) in ...adolescents. Additionally, we wanted to know, whether the prevalence of CT was so high that antibiotic prophylaxis would be appropriate before termination of pregnancy.Patients and methods. In the study 200 adolescents aged 15 to 19 years were enrolled: 100 came for termination of pregnancy and 100 for a contraceptive method. In all cases the cervical smears were taken for culture and direct immunofluorescence (DIF) for CT. The cervical smear was used also for hybridization test for the detection of HPV 16 and HPV 18. Serologic analysis for hepatitis B, HIV and syphilis were done in all cases.Results. CT was isolated in 6% in the first and in 4% in the second group Using DIF method CT was confirmed in 7% in the first and in 4% in the second group. HPV 16 or 18 was positive in 26% in the first and in 13% in the second group. We did not find any case of syphilis, HIV and hepatitis.Conclusions. A 6% prevalence of CT justifies the use of antibiotic prophylaxis before termination of pregnancy.
With the aim to determine whether bone metabolism in young women using low-dose oral contraception is influenced by vitamin D receptor (VDR) genotype, we designed the prospective clinical study of 41 ...healthy women aged 20–27 years. Twenty-one women of the study group were prescribed an oral contraceptive (30 μg ethynyl estradiol and 150 μg levonorgestrel) and 20 women of the control group a nonhormonal contraceptive or none. Biochemical markers of bone metabolism (bone-specific alkaline phosphatase, osteocalcin, deoxypyridinoline) and VDR genotype, using
BsmI endonuclease, were determined. After 3 months in the study group, the BB genotype subgroup showed significantly decreased osteocalcin (p = 0.010), in the Bb genotype subgroup bone-specific alkaline phosphatase (p = 0.043) and osteocalcin (p = 0.006) decreased, and in the bb genotype subgroup no changes were observed. In the control group, there were no significant changes in markers of bone metabolism regarding VDR genotype. In conclusion, our study shows that in young women VDR gene polymorphism could influence bone metabolism during low-dose oral contraceptive use.
Background: After the law on assisted reproductive technologies (ART) in Slovenia was legalized, donor procedures at the Department of Ob/Gyn, University Medical Center Ljubljana, were started at the ...end of 2001; by September 2005 221 recipient couples have applied for the procedures: 153 couples for donor semen (DS) procedures and 68 couples for donor oocyte (DO) procedures.Methods: Gametes can be donated by healthy men aged 18–55 years and healthy women aged 18 to 35 years. After donation, donor semen is frozen, and donor oocytes are fertilized with the semen of the recipient, after which embryos are frozen. If after a 6-month safety period repeated tests on sexually transmitted infections are negative, thawed semen or embryos can be used for the recipients.Results: Gametes have been donated by 97 men and 30 women. ART using DS was performed in 98 couples. Pregnancy rate per embryo transfer (ET) of fresh embryos has been 30 %; pregnancy rate per ET of thawed embryos has been 20 %. ART using DO have been performed in 46 couples. After a 6-months safety period, embryos of 38 couples have been transferred to recipients. Pregnancy rate on ET of thawed embryos has been 19 %.Conclusions: Our experiences have shown, that gamete donation program can be implemented also in Slovenia and that donor procedures are equally successful as homologous procedures. In the future we intend to consolidate the program.
Background. We designed the study to determine the frequency of perimenopausal symtoms among women in Slovenia and the need for their treatement.Methods. In the research 578 women aged 45–54 years ...were included during their visit at one of 24 participating outpatient department clinics for women’s health in Slovenia. The women were interwieved by one of 31 gynecologists participating in the study.Results. The mean age of women was 49.6 years. Almost a half (48%) have still had regular periods, 29% were postmenopausal. The median age at menopause was 52.4 years. The major perimenopausal features were nervouseness (72%), anxiety (64%), sweating (63%), insomnia (60%) and headache (56%), less frequent were stomach pressure (35%), skin changes (32%) and dispareunia (24%). One-fifth (21%) of women were smokers (smokers had lower age at menopause as non-smokers, p = 0.01). One third (39%) currently took analgetics, 19% antihypertensives, 16% tranquillisers and 22% hormonal replacement therapy (HRT). The majority (81%) of women on HRT have found the HRT effects positive or very positive.Conclusions. The high rate of perimenopausal features among perimenopausal women in Slovenia deserves special attention. The study has also shown that the use of HRT is justified when indicated.
Background: In order the aim to evaluate the risk-taking behaviour, a representative study on sexual behaviour of secondary-school students in Slovenia was performed.Methods: In the spring of 2004, ...2380 1st and 3rd grade students from 48 randomly selected secondary schools in Slovenia anonymously completed a self-administered questionnaire. Descriptive statistics was used for data analysis.Results: The average students’ age was 15.4 years (1st grade) and 17.4 years (3rd grade). Sexual intercourse had ever had 24 % of boys and 21 % of girls from the 1st grade, and 52 % of boys and 54 % of girls from the 3rd grade. At first sexual intercourse condom was used by 74 % of sexually active 1st grade and by 75 % of 3rd grade students; 6 % of 1st grade and 7 % of 3rd grade students used contraceptive pill. At last sexual intercourse condom was used by 65 % of sexually active 1st grade and by 50 % of 3rd grade students; 11 % of 1st grade and 32 % of 3rd grade students used the pill. Contraceptive methods and sexually transmitted infections are not sufficiently known to the students. Most students (34 %) prefer professionals to be the source of information on sexuality. Two percent of boys and 10 % of girls had ever had at least one sexual contact with the same sex.Conclusions: The percentage of sexually active secondary-school students in Slovenia is high. The use of contraceptive pill is favourable, but the condom use needs to be further promoted.
Background. The acceptability of ultra low-dose oral contraception (OC) among young females after three and six cycles of treatment was assessed.Methods. In the clinical prospective study, carried ...out in 10 outpatient clinics in Slovenia, 240 healthy women aged 16– 30 years choosing ultra low-dose OC (20 µg ethinyl estradiol and 75 µg gestodene) were included.Results. The average age was 20.6 (± 3.5) years. After three cycles (N = 228) there were no changes in body weight or blood pressure; one tenth (9.6%) of women reported irregular bleeding and 3.9% weight gain while other side effects occurred rarely. After three cycles 88.3% of the women initially included continued OC use (5% discontinued the use due to side effects). After six cycles (N = 195) there were no changes in blood pressure; body weight statistically significantly increased for 0.5 kg providing the weight changes during the time were not considered. Fewer women reported side effects (3.6% irregular bleeding, 2.6% weight gain and rarely other side effects). After six cycles 75.0% of the women initially included continued the OC use (7.5% discontinued the use due to the side effects).Conclusions. The study has shown good clinical acceptability of ultra low-dose OC by young females.
Povzetek Izhodisca. Zeleli smo ugotoviti, kaksna je sprejemljivost jemanja ultranizkodozne oralne kontracepcije (OKC) med mlajsimi zenskami po treh in sestih ciklusih jemanja tablet. Metode. V ...klinicno prospektivno raziskavo smo v 10 ginekoloskih ambulantah v Sloveniji vkljucili 240 zdravih preiskovank, starih od 16 do 30 let, ki so za kontracepcijsko metodo izbrale ultranizkodozno OKC z 20 µg etinilestradiola in 75 µg gestodena v dnevnem odmerku. Rezultati. Povprecna starost preiskovank je bila 20,6 (± 3,5) leta. Po treh ciklusih jemanja OKC (N = 228) se telesna teza in krvni tlak nista spremenila; 9,6% preiskovank je navajalo motnje ciklusa in 3,9% povecanje telesne teze, drugi nezeleni ucinki so bili redkejsi. Z jemanjem OKC je nadaljevalo 88,3% vseh vkljucenih preiskovank (5,0% preiskovank je prenehalo jemanje zaradi nezelenih ucinkov). Po sestih ciklusih jemanja OKC (N = 195) se krvni tlak ni spremenil; telesna teza se je, ce ne upostevamo spreminjanja teze s starostjo, znacilno povecala za 0,5 kg. Drugi nezeleni ucinki so bili redkejsi (3,6% motnje ciklusa, 2,6% povecanje telesne teze in redkeje drugi ucinki). Po sestih ciklusih je jemanje OKC nadaljevalo 75,0% vseh vkljucenih preiskovank (zaradi nezelenih ucinkov je prenehalo jemanje 7,5% vseh preiskovank). Zakljucki. V raziskavi smo ugotovili dobro klinicno sprejemljivost ultranizkodozne OKC med mladimi zenskami.
