Contraception chez les adolescentes Rosenthal, Margot A; McQuillan, Sarah K
Canadian Medical Association journal (CMAJ),
09/2021, Letnik:
193, Številka:
37
Journal Article
Abstract
Background
The advent of new methods of male contraception would increase contraceptive options for men and women and advance male contraceptive agency. Pharmaceutical R&D for male ...contraception has been dormant since the 1990s. The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) has supported a contraceptive development program since 1969 and supports most ongoing hormonal male contraceptive development. Nonhormonal methods are in earlier stages of development.
Content
Several hormonal male contraceptive agents have entered clinical trials. Novel single agent products being evaluated include dimethandrolone undecanoate, 11β-methyl-nortestosterone dodecylcarbonate, and 7α-methyl-19-nortestosterone. A contraceptive efficacy trial of Nestorone®/testosterone gel is underway. Potential nonhormonal methods are at preclinical stages of development. Many nonhormonal male contraceptive targets that affect sperm production, sperm function, or sperm transport have been identified.
Summary
NICHD supports development of reversible male contraceptive agents. Other organizations such as the World Health Organization, the Population Council, and the Male Contraception Initiative are pursuing male contraceptive development, but industry involvement remains limited.
Between 1800 and 1975, sexuality in the West was transformed. Hera Cook shows how the growing effectiveness of contraception gradually eroded the connection between sexuality and reproduction. The ...increasing control over fertility was crucial to the remaking of heterosexual physical sexual behaviour and had a massive impact on women's lives. Dr Cook charts how, why, and when attitudes towards sex changed from the repression of the nineteenth century to the sexual revolution of the 1960s.
Intra uterine devices (IUD) are the second most common accepted methods of contraception worldwide after sterilization. It is a long acting reversible contraceptive (LARC) which is now being promoted ...as a simpler, safer and effective method of contraception for those women who do not want a permanent method of contraception. Missing thread is the most common complaint seen within 6 weeks of insertion and may be the only presentation of misplaced IUD. Most women who spontaneously expel the IUD are unaware of the situation. We are presenting a case of misplaced IUD which was partially expelled and got embedded in the vagina which is a rare site of misplaced IUD.
Long acting reversible and permanent contraception (LARPs) offer promising opportunities for addressing the high and growing unmet need for modern contraception and helps to reduce unintended ...pregnancies and abortion rates in sub-Saharan Africa (SSA). This study examines the contextual factors that influence the use of long acting reversible and permanent contraception among married and fecund women in Ethiopia.
We use data from the 2016 Ethiopian Demographic and Health Survey to examine the contextual factors that influence choice of long acting reversible and permanent contraception among married, non-pregnant and fecund women. The DHS collects detailed information on individual and household characteristics, contraception, and related reproductive behaviors from women of reproductive age. In addition, we created cluster level variables by aggregating individual level data to the cluster level. Analysis was done using a two-level multilevel logistic regression with data from 6994 married (weighted = 7352) women residing in 642 clusters (communities).
In 2016, 12% of married, non-pregnant and 'fecund' women were using long-acting reversible and permanent methods of contraception in Ethiopia. A higher proportion of women with secondary and above education (17.6%), urban residents (19.7%), in the richest wealth quintile (18.3%) and in paid employment (18.3%) were using LARP methods compared to their counterparts. Regression analysis showed that community level variables such as women's empowerment, access to family planning information and services, region of residence and knowledge of methods were significantly associated with use of LARP methods. Age, wealth status, employment status and women's fertility preferences were among the individual and household level variables associated with choice of LARP methods. With regards to age, the odds of using LARP methods was significantly lower among adolescents (OR, 0.53; 95% CI, 0.32-0.85) and women over the age of 40 (OR, 0.63; 95% CI, 0.44-0.90) compared to women in their 20's.
The findings of this study indicate that the demand for long-acting reversible and permanent contraception is influenced not only by women's individual and household characteristics but also by the community's level of women's empowerment, socio-economic development, as well as access and exposure to family planning information and services. Thus, improving knowledge of long-acting reversible and permanent methods, improving women's decision making autonomy and upgrading the capacity and skills of health workers particularly the midlevel providers and community health extension workers on the provision of LARP methods and rights-based approach is important to improve the uptake of LARP methods.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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