| 1. |
- Elgán, Carina, 1962-, et al.
(författare)
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Influence of smoking and oral contraceptives on bone mineral density and bone remodeling in young women : a 2-year study
- 2003
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Ingår i: Contraception. - : Elsevier. - 0010-7824 .- 1879-0518. ; 67:6, s. 439-447
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Tidskriftsartikel (refereegranskat)abstract
- The objective of the study was to explore the influence of menstrual irregularities, oral contraceptives and smoking on bone mineral density (BMD) development and bone turnover with time. Healthy young women (n = 118) were divided into four categories: (a) women neither smoking nor using oral contraceptives; (b) women who were smokers; (c) women using oral contraceptives; (d) women who were smoking and using oral contraceptives. They responded to a validated questionnaire with 34 questions concerning lifestyle and the Sense of Coherence scale (SOC). BMD was measured by dual energy x-ray absorptiometry (DEXA). Deoxypyridinoline (DPD) was measured in urine. Data were analyzed by multiple linear regression analysis. Among smokers, BMD level decreased during a 2-year period and smoking was associated with a larger negative change in BMD. Use of oral contraceptives moderated the negative impact of smoking. Women using oral contraceptives at baseline and with regular bleeding induced by contraceptive pills had a significantly higher BMD at baseline and at follow-up. They also had lower SOC than women who had natural regular bleedings. Use of oral contraceptives in combination with smoking was linked to high alcohol consumption and higher frequency of self-reported body weight reduction, which reduced the negative BMD change in this category. DPD level and difference were strongly associated with estrogen influence. It is concluded that smokers without OCs had a negative BMD development and BMD in young women with irregular menstruations seems to be improved by OC.
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| 2. |
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| 3. |
- Jernström, Helena, et al.
(författare)
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Plasma prolactin in relation to menstrual cycle phase, oral contraceptive use, arousal time and smoking habits
- 1992
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Ingår i: Contraception. - 0010-7824. ; 46:6, s. 543-548
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Tidskriftsartikel (refereegranskat)abstract
- The study was designed to investigate if modern low dosage combined oral contraceptives were associated with changes in plasma prolactin levels in healthy nulliparous women aged 19-25. Plasma prolactin was not significantly correlated to oral contraceptive use, nor to smoking habits. Plasma prolactin was, however, significantly negatively correlated to time since awakening. A significant two-way interaction on prolactin was also seen between smoking and present oral contraceptive use. In our material the mean values of plasma prolactin were higher in the follicular phase than in the luteal phase, although not significantly.
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| 4. |
- Jernström, Helena, et al.
(författare)
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Temporary increase of FSH levels in healthy, nulliparous, young women after cessation of low-dose oral contraceptive use
- 1995
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Ingår i: Contraception. - 0010-7824. ; 52:1, s. 51-56
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Tidskriftsartikel (refereegranskat)abstract
- PIP: At the University Hospital in Lund, Sweden, researchers grouped healthy nulliparous women aged 19-25 into current, former, and never users of low-dose combined oral contraceptives (OCs) to examine the effect of the OCs on the levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH). The subjects were from two independent samples. Based on the day the blood was sampled, their hormone level readings were divided into follicular and luteal phases. Former OC users had higher FSH levels than did never users, regardless of menstrual cycle phase (group 1: 1.9 vs. 1.6 mcg/l for follicular phase, 1.6 vs. 1 mcg/l for luteal phase; p = 0.004) (group 2: 2.05 vs. 1.7 mcg/l, 1.55 vs. 1.25 mcg/l; p = 0.028). The transient increase of FSH levels appeared to peak 12 months after the women stopped using the OC. The researchers found that the temporary increase in FSH levels was still significant after they excluded eight women with low progesterone levels (10 nmol/l in luteal phase and 3.5 nmol/l in follicular phase) and adjusted for age (p = 0.015). LH levels were much higher in former users than never users in the first sample (1.6 vs. 1 mcg/l for follicular phase, 1.8 vs. 1.15 mcg/l for luteal phase; p = 0.014), but not in the second sample. Smoking and time since awakening had no effect on FSH and LH levels. Present users experienced suppressed FSH and LH levels. These findings indicate that former OC users experience a rebound-like phenomenon in FSH levels. Since the sample size was small and only one blood sample was taken from each woman at each of the sampling times, the researchers caution that these findings are preliminary and unconfirmed.
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| 5. |
- Aneblom, Gunilla, et al.
(författare)
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Women's voices about emergency contraceptive pills "over-the-counter" : a Swedish perspective
- 2002
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Ingår i: Contraception. - 0010-7824 .- 1879-0518. ; 66:5, s. 339-343
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to describe women’s experiences with the emergency contraceptive pill (ECP) as a prescription-free over-the-counter (OTC) product. Women (median age 24) who had bought ECP as an OTC product were interviewed in focus groups. Data were analyzed by content analysis. All participants appreciated the OTC availability. Timesaving aspects were seen as important benefits and pharmacies were seen as the right place to sell ECP. The media was the main source of information about OTC, probably due to the debates of the introduction of ECP as an OTC product in Sweden. All women discussed the mechanism of action. The women’s experiences of interacting with the pharmacists were both positive and negative. Inconsistencies in routines with regard to providing ECP and different attitudes toward use of ECP among the pharmacists, were identified. The women expected up-to-date information about ECP and the OTC availability from gynecologists and other health professionals.
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| 6. |
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| 7. |
- Diczfalusy, E
(författare)
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The contraceptive revolution
- 2000
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Ingår i: Contraception. - : Elsevier BV. - 0010-7824. ; 61:1, s. 3-7
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 8. |
- Falk, G, et al.
(författare)
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Young women requesting emergency contraception are, despite contraceptive counseling, a high risk group for new unintended pregnancies
- 2001
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Ingår i: Contraception. - 0010-7824 .- 1879-0518. ; 64:1, s. 23-27
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Tidskriftsartikel (refereegranskat)abstract
- Since its introduction in Sweden in 1994, emergency contraception has become a welcome addition to the campaign against unwanted pregnancy. In addition to an unplanned pregnancy, unprotected sexual intercourse may also involve the risk of contracting sexually transmitted diseases (STD). The aim of this study was to assess the short- and long-term risk of unintended pregnancy and to determine the frequency of chlamydia infections in women receiving emergency contraception. Between September 1998 and February 1999 young women aged 15-25 years had the opportunity to obtain emergency contraception (Yuzpe method) at a youth clinic in the city of Orebro where the opening hours were extended to include Saturdays and Sundays. A follow-up visit 3 weeks after treatment, which included contraceptive counseling, was offered to all participants. At both visits, a pregnancy test and a chlamydia test were performed, and the women completed a questionnaire. After the initial visit, the young women where monitored for new pregnancies during the following 12 months. One pregnancy occurred in the 134 young women who received emergency contraception during the study period. None of the women had a positive chlamydia test. Of those requesting emergency contraception, 54% did so because no contraception was used, 32% because of a ruptured condom, 11% because of missed oral contraceptives (OC), and 5% had mixed reasons. At long-term follow-up 1 year after the initial visit, 10 of the 134 young women had experienced an unplanned pregnancy that terminated in legal abortion in 9 women. All these women had either started and terminated OC or had never commenced the prescribed OC. Young women who request emergency contraception are, despite a planned follow-up with contraceptive counseling, a high risk group for new unintended pregnancies. In Sweden they do not seem to be a high risk group for STD.
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| 21. |
- Wreje, U, et al.
(författare)
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Collagen metabolism markers as a reflection of bone and soft tissue turnover during the menstrual cycle and oral contraceptive use
- 2000
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Ingår i: Contraception. - 0010-7824 .- 1879-0518. ; 61:4, s. 265-270
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Tidskriftsartikel (refereegranskat)abstract
- Two different groups of women, 23 healthy young adults and 13 women with chronic posterior pelvic pain, were studied before and during use of oral contraceptives (OC). Collagen metabolism markers-here, the amino-terminal propeptide of type I procollagen, the carboxy-terminal telopeptide of type I collagen, and the amino-terminal of procollagen type III-as well as hormones and other endocrine factors indicating the balance between androgen expression/anabolism and catabolism of the subjects (testosterone, sex-hormone binding globulin, and insulin-like growth factor I were measured. Type I procollagen, the carboxy-terminal telopeptide of type I collagen, and the amino-terminal of procollagen type III were all significantly decreased during OC use. These findings implicate OC use-induced changes in collagen type I and III turnover. A shift in the anabolic/catabolic balance was also recorded indicating a less anabolic situation during OC use.
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| 22. |
- Wreje, U., et al.
(författare)
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Collagen metabolism markers as a reflection of bone and soft tissue turnover during the menstrual cycle and oral contraceptive use
- 2000
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Ingår i: Contraception. - : Elsevier. - 0010-7824 .- 1879-0518. ; 61:4, s. 265-270
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Tidskriftsartikel (refereegranskat)abstract
- Two different groups of women, 23 healthy young adults and 13 women with chronic posterior pelvic pain, were studied before and during use of oral contraceptives (OC). Collagen metabolism markers-here, the amino terminal propeptide of type I procollagen, the carboxy-terminal telopeptide of type I collagen, and the amino-terminal of procollagen type III-as well as hormones and other endocrine factors indicating the balance between androgen expression/anabolism and catabolism of the subjects (testosterone, sex-hormone binding globulin, and insulin-like growth factor I were measured. Type I procollagen, the carboxy-terminal telopeptide of type I collagen, and the amino-terminal of procollagen type III were all significantly decreased during OC use. These findings implicate OC use-induced changes in collagen type I and III turnover. A shift in the anabolic/catabolic balance was also recorded indicating a less anabolic situation during OC use.
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| 23. |
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| 24. |
- Abujrais, Sandy, et al.
(författare)
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A sensitive method detecting trace levels of levonorgestrel using LC-HRMS
- 2019
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Ingår i: Contraception. - : Elsevier BV. - 0010-7824 .- 1879-0518. ; 100:3, s. 247-249
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To develop a high resolution mass spectrometry (HRMS) method to quantify levonorgestrel (LNG) in serum. Study design: Levonorgestrel was extracted using solid phase extraction and measured using liquid chromatography (LC) HRMS. Results: Low limit of quantification (LLOQ) was 25 pg/mL and low limit of detection (LLOD) was 12.5 pg/mL. Precision and accuracy bias were <10%. LNG in serum samples from Mirena® users ranged between 37 to 219 pg/mL (n=12). In eight out of 22 patients with suspected intrauterine device (IUD) expulsion LNG was detected (26–1272 pg/mL). Conclusion: A sensitive, fast and simple LC-HRMS method was developed to detect trace levels of LNG. © 2019 Elsevier Inc.
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| 25. |
- Ahrendt, Hans-Joachim, et al.
(författare)
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Efficacy, acceptability and tolerability of the combined contraceptive ring, NuvaRing, compared with an oral contraceptive containing 30 mug of ethinyl estradiol and 3 mg of drospirenone
- 2006
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Ingår i: Contraception. - : Elsevier BV. - 0010-7824. ; 74:6, s. 451-457
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This randomized multicenter, open-label, trial compared efficacy, acceptability, tolerability and compliance of NuvaRing with a combined oral contraceptive (COC), containing 30 mug of ethinyl estradiol (EE) and 3 mg of drospirenone. METHOD: In this 13-cycle study, 983 women were randomized and treated (intent-to-treat population) with NuvaRing or COC. RESULTS: One in-treatment pregnancy occurred with NuvaRing (Pearl Index=0.25) (95% confidence interval [CI]: 0.006, 1.363) and four with the COC (Pearl Index=0.99) (95% CI: 0.269, 2.530). For both groups, compliance (89.2% NuvaRing, 85.5% COC) and satisfaction (84% NuvaRing; 87% COC) were high; the vast majority of women found NuvaRing easy to insert (96%) and remove (97%). Tolerability was similar; the most frequent adverse events with NuvaRing were related to ring use, whereas estrogen-related events were more common with the COC. CONCLUSION: NuvaRing has comparable efficacy and tolerability to a COC containing 30 mug of EE and 3 mg drospirenone. User acceptability of both methods was high.
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| 30. |
- Berger, Cecilia, et al.
(författare)
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Molecular characterization of PRM-associated endometrial changes, PAEC, following mifepristone treatment
- 2018
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Ingår i: Contraception. - : Elsevier. - 0010-7824 .- 1879-0518. ; 98:4, s. 317-322
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The progesterone receptor modulator (PRM) mifepristone holds the potential to be developed for regular contraception. However, long-term treatment can cause thickening of the endometrium and PRM-associated endometrial changes (PAEC). The objective of this study was to explore the molecular expression of endometrium displaying PAEC after mifepristone treatment in order to understand the future implications of PAEC and safety of long-term use. Study design: Endometrial biopsies were obtained from premenopausal women following 3 months of continuous mifepristone treatment. The biopsies were evaluated regarding occurrence of PAEC and followed up by a comparative analysis of gene expression in PAEC endometrium (n=7) with endometrium not displaying PAEC (n=4). Methods used included microarray analysis, Ingenuity Pathway Analysis (IPA) and real-time polymerase chain reaction. Results: Three genes relevant within endometrial function were up-regulated with PAEC: THY1 (p=.02), ADAM12 (p=.04) and TN-C (p=.04). The proliferation marker MKi67 was not altered (p=.31). None of the differentially regulated genes were involved in the endometrial cancer-signaling pathway (based on IPA knowledge database). Conclusion: The genes altered in endometrium displaying PAEC after 3 months of mifepristone exposure are mainly involved in the structural architecture of tissue. Implications: PAEC features may be explained by the altered genes and their networks affecting tissue architecture although not involved in endometrial cancer signaling pathways, and thus, treatment with mifepristone at this dosage does not show any adverse effect at endometrial level.
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| 36. |
- Ehn, Bodil, et al.
(författare)
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The process of opting for female permanent contraception : A qualitative study of women's experiences in Sweden
- 2021
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Ingår i: Contraception. - : Elsevier. - 0010-7824 .- 1879-0518. ; 103:1, s. 48-52
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: We aimed to explore Swedish women's decision-making experiences regarding permanent contraception. Study design: In this study, we included 17 women aged 30–48 who were scheduled to undergo female permanent contraceptive procedures. We conducted semistructured interviews using two broad open-ended questions. We analyzed these data using systematic text condensation based on the principles of psychological phenomenological analysis. Results: The interviewees experienced no counseling or support from health care workers regarding permanent contraception until they specifically asked for it. Participants reported that they themselves place the responsibility of permanent contraception solely on women. Consequently, our participants described feeling hesitancy and ambivalence in the process of deciding to have the procedure. Once the decision was made and the women were on the waiting lists for surgery, they experienced relief and empowerment. Conclusions: Our findings suggest that health care providers in Sweden miss opportunities to support patient-centered decision-making regarding permanent contraception. This study indicates that women make deliberate and considered decisions regarding permanent contraception and are best positioned to know when the procedure should take place in their reproductive lives. Implication statements: Health care professionals should discuss permanent contraception as an option with all women desiring contraception to allow them to decide if that method is right for them. © 2020 Elsevier Inc.
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| 37. |
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| 39. |
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| 40. |
- Envall, Niklas, 1984-, et al.
(författare)
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Intrauterine mepivacaine instillation for pain relief during intrauterine device insertion in nulliparous women: a double-blind, randomized, controlled trial
- 2019
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Ingår i: Contraception. - : Elsevier BV. - 0010-7824 .- 1879-0518. ; 99:6, s. 335-39
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate whether intrauterine mepivacaine instillation before intrauterine device (IUD) insertion decreases pain compared to placebo.STUDY DESIGN: We performed a double-blind, randomized, controlled trial comparing mepivacaine 1% 10 mL versus 0.9% NaCl intrauterine instillation using a hydrosonography catheter 5 min before IUD insertion in women 18 years of age or older. Participants completed a series of 10-cm visual analogue scales (VAS) to report pain during the procedure. The primary outcome was the difference in VAS scores with IUD insertion between intervention group and placebo. Secondary outcomes included VAS before and after insertion and analgesia method acceptability.RESULTS: We randomized 86 women in a 1:1 ratio; both groups had similar baseline characteristics. In the intention-to-treat analysis, the primary outcome, median VAS with IUD insertion, was 4.8 cm in the intervention group [n=41, interquartile range (IQR) =3.1-5.8] and 5.9 cm in the placebo group (n=40, IQR=3.3-7.5, p=.062). In the per-protocol analysis, the median VAS with IUD insertion was 4.8 cm (IQR=3.1-5.5) and 6.0 cm (IQR=3.4-7.6) for the intervention and placebo groups, respectively (p=.033). More women in the intervention group reported the procedure as easier than expected (n=26, 63.4% vs. n=15, 37.5%), and fewer reported it as worse than expected (n=3, 7.3% vs. n=14, 35%, p=.006).CONCLUSION: Intrauterine mepivacaine instillation before IUD insertion modestly reduces pain, but the effect size may be clinically significant.IMPLICATIONS STATEMENT: While the reduction in VAS pain scores did not meet our a priori difference of 1.3 points for clinical significance, participants' favorable subjective reaction suggests that this approach merits further study.Copyright © 2019 Elsevier Inc. All rights reserved.KEYWORDS: Contraception; Intrauterine devices; Mepivacaine; Pain; VAS
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| 41. |
- Falk, Gabriella, 1955-, et al.
(författare)
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Teenage mothers : a high-risk group for new unintended pregnancies
- 2006
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Ingår i: Contraception. - : Elsevier BV. - 0010-7824 .- 1879-0518. ; 74:6, s. 471-475
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: One of the targets of national health programs is to prevent unintended pregnancies, especially among teenagers. It is well established that these often lead to abortion. Preventive programs aimed at decreasing abortion rates should identify target groups at risk for unintended pregnancies.PURPOSE: This study was conducted to determine whether young mothers under 20 years of age constitute a group at risk for new unintended pregnancies.METHODS: A retrospective cohort study comprising teenagers giving birth to their first child from 1996 to 2000 was performed at Orebro University Hospital, Sweden. Data were collected from antenatal and medical records with particular regard to compliance with the postpartum visit and to whether a contraceptive method was prescribed. Information concerning repeat pregnancies during the 12 months after delivery was obtained.RESULTS: A total of 250 deliveries were recorded; 70% of the mothers attended the postpartum visit, and 71% received contraceptive prescriptions. At the 12-month follow-up, 56 (25%) had a new pregnancy, and of those, 20 (36%) had a legal abortion, making the abortion rate fivefold higher than expected in this age group.
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| 42. |
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| 43. |
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| 44. |
- Gainer, Erin, et al.
(författare)
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Bringing emergency contraception over the counter : experiences of nonprescription users in France, Norway, Sweden and Portugal.
- 2003
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Ingår i: Contraception. - 0010-7824 .- 1879-0518. ; 68:2, s. 117-24
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Tidskriftsartikel (refereegranskat)abstract
- Emergency contraceptive pills are now available on a nonprescription basis in over 25 countries worldwide. In an effort to learn about women's experiences with this new means of emergency contraception (EC) service delivery, we conducted focus-group discussions with nonprescription EC users from France, Norway, Portugal and Sweden. Participants from these countries overwhelming supported pharmacy access to EC, explaining that pharmacy delivery facilitated rapid access to the method. Despite expressing mixed reviews of the counseling given by the providing pharmacists, participants reported that they knew how use the method safely and properly. Most indicated that the package insert was easy to understand and adequately answered the majority of their questions. Participants described the EC experience as a motivating factor that, in many cases, has led to more consistent use of regular contraceptive methods. These data are valuable to policy-makers and institutions interested in learning more about the safety and acceptability of nonprescription access to emergency contraceptive pills.
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