Pub Date : 2016-10-05DOI: 10.1080/13625187.2016.1237629
J. Bitzer, Virginia Abalos, D. Apter, Ricardo Martin, A. Black
Abstract Introduction: Sexual and reproductive health care should empower and enable all individuals to have a sex life that is as safe and pleasurable as possible. Achievement of this goal for adolescents is often impeded by regional and sociocultural barriers. Objectives: To review global barriers to provision of effective counselling and care of adolescents seeking advice on contraception and sexual and reproductive health and identify elements of best practice that can be adapted to meet their needs at regional level. Methods: Experts with clinical experience and a scholarly background in the provision of contraceptive services to adolescents participated in a stepwise process of literature review and discussion according to the agreed objectives. Results: The Global CARE (Contraception: Access, Resources, Education) group identified barriers to the access, availability and acceptance of contraception by adolescents, not only at the political and sociocultural level but also within health care practice. The group collected and summarized successful local strategies and tools suitable for adaptation in other regions. Elements of best practice for providing contraception regardless of setting or regional constraints, including required skills, knowledge, and attitudes, were also proposed. Conclusion: Sharing of evidence-based best practice in delivering contraceptive services, improvements in health care provider education, and sharing of experience between countries will hopefully help to overcome the barriers to appropriate and effective counselling and care of adolescents.
{"title":"Targeting factors for change: contraceptive counselling and care of female adolescents","authors":"J. Bitzer, Virginia Abalos, D. Apter, Ricardo Martin, A. Black","doi":"10.1080/13625187.2016.1237629","DOIUrl":"https://doi.org/10.1080/13625187.2016.1237629","url":null,"abstract":"Abstract Introduction: Sexual and reproductive health care should empower and enable all individuals to have a sex life that is as safe and pleasurable as possible. Achievement of this goal for adolescents is often impeded by regional and sociocultural barriers. Objectives: To review global barriers to provision of effective counselling and care of adolescents seeking advice on contraception and sexual and reproductive health and identify elements of best practice that can be adapted to meet their needs at regional level. Methods: Experts with clinical experience and a scholarly background in the provision of contraceptive services to adolescents participated in a stepwise process of literature review and discussion according to the agreed objectives. Results: The Global CARE (Contraception: Access, Resources, Education) group identified barriers to the access, availability and acceptance of contraception by adolescents, not only at the political and sociocultural level but also within health care practice. The group collected and summarized successful local strategies and tools suitable for adaptation in other regions. Elements of best practice for providing contraception regardless of setting or regional constraints, including required skills, knowledge, and attitudes, were also proposed. Conclusion: Sharing of evidence-based best practice in delivering contraceptive services, improvements in health care provider education, and sharing of experience between countries will hopefully help to overcome the barriers to appropriate and effective counselling and care of adolescents.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"170 1","pages":"417 - 430"},"PeriodicalIF":0.0,"publicationDate":"2016-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73659242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-10-03DOI: 10.1080/13625187.2016.1238893
Maria Sumia, N. Lindberg, M. Työläjärvi, R. Kaltiala-Heino
Abstract Objectives: The aim of our study was to explore whether gender dysphoria in adolescent girls is associated with early pubertal timing. Methods: We compared menarcheal timing among 52 adolescent girl-to-boy sex reassignment (SR) applicants with that of 644 adolescent girls who participated in an adolescent population mental health survey. Results: Of the population girls, 21% presented with early (≤11 years), 61% with normative (12–13 years) and 19% with late (≥14 years) menarcheal timing; among the SR applicants, 42% presented with early, 46% with normative and 12% with late menarcheal timing (p = 0.003). The odds ratio for SR applicant girls to have early menarcheal timing was 2.7 (95% confidence interval (CI) 1.3, 5.7), controlling for age and family structure. Conclusion: Like emotional and behavioural disorders, gender dysphoria in adolescence is associated in girls with early pubertal timing. The finding is discussed in the light of literature related to pubertal maturation and mental health.
{"title":"Early pubertal timing is common among adolescent girl-to-boy sex reassignment applicants","authors":"Maria Sumia, N. Lindberg, M. Työläjärvi, R. Kaltiala-Heino","doi":"10.1080/13625187.2016.1238893","DOIUrl":"https://doi.org/10.1080/13625187.2016.1238893","url":null,"abstract":"Abstract Objectives: The aim of our study was to explore whether gender dysphoria in adolescent girls is associated with early pubertal timing. Methods: We compared menarcheal timing among 52 adolescent girl-to-boy sex reassignment (SR) applicants with that of 644 adolescent girls who participated in an adolescent population mental health survey. Results: Of the population girls, 21% presented with early (≤11 years), 61% with normative (12–13 years) and 19% with late (≥14 years) menarcheal timing; among the SR applicants, 42% presented with early, 46% with normative and 12% with late menarcheal timing (p = 0.003). The odds ratio for SR applicant girls to have early menarcheal timing was 2.7 (95% confidence interval (CI) 1.3, 5.7), controlling for age and family structure. Conclusion: Like emotional and behavioural disorders, gender dysphoria in adolescence is associated in girls with early pubertal timing. The finding is discussed in the light of literature related to pubertal maturation and mental health.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"22 1","pages":"483 - 485"},"PeriodicalIF":0.0,"publicationDate":"2016-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85616717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-09-29DOI: 10.1080/13625187.2016.1237630
C. Bastianelli, Elena Rosato, M. Farris, G. Benagiano
Abstract Objectives: The aim of the study was to retrieve data on the characteristics and profile of women attending an emergency service (ES) to receive a prescription (mandatory until May 2015) for emergency contraception (EC). Methods: In a retrospective study the following data were collected for all women requesting EC between January 2014 and June 2015: demographic characteristics, time between unprotected sexual intercourse (USI) and arrival at the ES, time between the last menstrual period and the USI, and type of EC prescribed. In a prospective study starting January 2015, a questionnaire was administered requesting the following information: reasons for requiring EC, previous EC use, source of knowledge about EC, prior contraception and age at first intercourse. Results: During the whole study period, 1773 women requested EC: their mean age was 26.0 years; 78.5% were Italian; 91.5% were unmarried; 55.2% were still studying and 51.9% had high school education; 61.2% reached the ES within 12 h of the USI; and 42.4% had a USI during days 9–16 of their menstrual cycle. Levonorgestrel was prescribed in 81.4% of women and ulipristal acetate in 17.7%. In the prospective part of the study (382 women), the majority (57.9%) requested EC for condom rupture; 49.5% reported previous use of EC; and 41.6% received information on the subject through friends. The vast majority (83.8%) reported prior use of contraception; in 25.4% the reason for not using it was the absence of a relationship. Conclusion: An exact profile of women requesting EC can help women in their choice of permanent contraception, and help clinicians in counselling women on appropriate contraception.
{"title":"Emergency contraception: a survey of 1773 women","authors":"C. Bastianelli, Elena Rosato, M. Farris, G. Benagiano","doi":"10.1080/13625187.2016.1237630","DOIUrl":"https://doi.org/10.1080/13625187.2016.1237630","url":null,"abstract":"Abstract Objectives: The aim of the study was to retrieve data on the characteristics and profile of women attending an emergency service (ES) to receive a prescription (mandatory until May 2015) for emergency contraception (EC). Methods: In a retrospective study the following data were collected for all women requesting EC between January 2014 and June 2015: demographic characteristics, time between unprotected sexual intercourse (USI) and arrival at the ES, time between the last menstrual period and the USI, and type of EC prescribed. In a prospective study starting January 2015, a questionnaire was administered requesting the following information: reasons for requiring EC, previous EC use, source of knowledge about EC, prior contraception and age at first intercourse. Results: During the whole study period, 1773 women requested EC: their mean age was 26.0 years; 78.5% were Italian; 91.5% were unmarried; 55.2% were still studying and 51.9% had high school education; 61.2% reached the ES within 12 h of the USI; and 42.4% had a USI during days 9–16 of their menstrual cycle. Levonorgestrel was prescribed in 81.4% of women and ulipristal acetate in 17.7%. In the prospective part of the study (382 women), the majority (57.9%) requested EC for condom rupture; 49.5% reported previous use of EC; and 41.6% received information on the subject through friends. The vast majority (83.8%) reported prior use of contraception; in 25.4% the reason for not using it was the absence of a relationship. Conclusion: An exact profile of women requesting EC can help women in their choice of permanent contraception, and help clinicians in counselling women on appropriate contraception.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"12 1","pages":"455 - 461"},"PeriodicalIF":0.0,"publicationDate":"2016-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84205978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-09-28DOI: 10.1080/13625187.2016.1237631
B. Pinter, M. Hakim, D. Seidman, A. Kubba, M. Kishen, C. Di Carlo
Abstract Religion is embedded in the culture of all societies. It influences matters of morality, ideology and decision making, which concern every human being at some point in their life. Although the different religions often lack a united view on matters such contraception and abortion, there is sometimes some dogmatic overlap when general religious principles are subject to the influence of local customs. Immigration and population flow add further complexities to societal views on reproductive issues. For example, present day Europe has recently faced a dramatic increase in refugee influx, which raises questions about the health care of immigrants and the effects of cultural and religious differences on reproductive health. Religious beliefs on family planning in, for example, Christianity, Judaism, Islam and Hinduism have grown from different backgrounds and perspectives. Understanding these differences may result in more culturally competent delivery of care by health care providers. This paper presents the teachings of the most widespread religions in Europe with regard to contraception and reproduction.
{"title":"Religion and family planning","authors":"B. Pinter, M. Hakim, D. Seidman, A. Kubba, M. Kishen, C. Di Carlo","doi":"10.1080/13625187.2016.1237631","DOIUrl":"https://doi.org/10.1080/13625187.2016.1237631","url":null,"abstract":"Abstract Religion is embedded in the culture of all societies. It influences matters of morality, ideology and decision making, which concern every human being at some point in their life. Although the different religions often lack a united view on matters such contraception and abortion, there is sometimes some dogmatic overlap when general religious principles are subject to the influence of local customs. Immigration and population flow add further complexities to societal views on reproductive issues. For example, present day Europe has recently faced a dramatic increase in refugee influx, which raises questions about the health care of immigrants and the effects of cultural and religious differences on reproductive health. Religious beliefs on family planning in, for example, Christianity, Judaism, Islam and Hinduism have grown from different backgrounds and perspectives. Understanding these differences may result in more culturally competent delivery of care by health care providers. This paper presents the teachings of the most widespread religions in Europe with regard to contraception and reproduction.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"35 1","pages":"486 - 495"},"PeriodicalIF":0.0,"publicationDate":"2016-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77690686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-09-27DOI: 10.1080/13625187.2016.1234034
A. Islam, M. Mostofa, Mohammad Amirul Islam
Abstract Objectives: The aim of our study was to explore the factors associated with unmet need for contraception among currently married fecund women under age 25, in Bangladesh. Methods: This study utilised a cross-sectional data (n = 4982) extracted from the Bangladesh Demographic and Health Survey (BDHS) 2011. Multinomial logistic regression was used to identify the determinants of unmet need for contraception among currently married fecund young women. Results: The unmet need for contraception was 17% and contraceptive prevalence was 54% in this young group. Total demand for contraception was 71% and the proportion of demand satisfied was 77%. The results suggest that region, place of residence, religion, husband’s desire for children, visits of FP workers, decision-making power on child health care, reading about FP in newspaper/magazine and number of births in three years preceding the survey were significant predictors of unmet need for contraception. Conclusions: The BDHS of 2011 found that unmet need for contraception among currently married, fecund women under 25 years old is higher than the national level, and hence different or more intensive programme initiatives are required for them than for older women. The present study identifies important predictors of unmet need for contraception among fecund married Bangladeshi women under age 25.
{"title":"Factors affecting unmet need for contraception among currently married fecund young women in Bangladesh","authors":"A. Islam, M. Mostofa, Mohammad Amirul Islam","doi":"10.1080/13625187.2016.1234034","DOIUrl":"https://doi.org/10.1080/13625187.2016.1234034","url":null,"abstract":"Abstract Objectives: The aim of our study was to explore the factors associated with unmet need for contraception among currently married fecund women under age 25, in Bangladesh. Methods: This study utilised a cross-sectional data (n = 4982) extracted from the Bangladesh Demographic and Health Survey (BDHS) 2011. Multinomial logistic regression was used to identify the determinants of unmet need for contraception among currently married fecund young women. Results: The unmet need for contraception was 17% and contraceptive prevalence was 54% in this young group. Total demand for contraception was 71% and the proportion of demand satisfied was 77%. The results suggest that region, place of residence, religion, husband’s desire for children, visits of FP workers, decision-making power on child health care, reading about FP in newspaper/magazine and number of births in three years preceding the survey were significant predictors of unmet need for contraception. Conclusions: The BDHS of 2011 found that unmet need for contraception among currently married, fecund women under 25 years old is higher than the national level, and hence different or more intensive programme initiatives are required for them than for older women. The present study identifies important predictors of unmet need for contraception among fecund married Bangladeshi women under age 25.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"83 1","pages":"443 - 448"},"PeriodicalIF":0.0,"publicationDate":"2016-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89851322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-09-26DOI: 10.1080/13625187.2016.1234599
Marta Simó González, J. Alsina, Núria Terribas Sala, Nerea Luqui Scarcelli, Juliana Plana Borrás, A. Ramos
We present the case report of a 66-year-old woman who was attended at our gynaecology department at a tertiary university hospital in Barcelona, Spain for a high-risk pregnancy and comment on the obstetric implications and bioethical issues. We retrospectively analysed clinical data about the case and bibliographic references related to the issue. The woman underwent in vitro fertilisation of donated embryos in a private centre and came to our unit at 27 weeks of gestation for pregnancy care. At 33 weeks, she presented pre-eclampsia and a caesarean section was performed. She gave birth to healthy twin boys. Four months later, she returned to our centre with the diagnosis of ovarian cancer and died 30 months after delivery. We present the clinical course and management of this pregnancy and comment on the obstetric implications, the impact on maternal and neonatal health, and bioethical issues related to assisted reproduction techniques in pregnancies beyond the natural reproductive age.
{"title":"Pregnancy beyond 65: report of a unique case and discussion of a controversial issue.","authors":"Marta Simó González, J. Alsina, Núria Terribas Sala, Nerea Luqui Scarcelli, Juliana Plana Borrás, A. Ramos","doi":"10.1080/13625187.2016.1234599","DOIUrl":"https://doi.org/10.1080/13625187.2016.1234599","url":null,"abstract":"We present the case report of a 66-year-old woman who was attended at our gynaecology department at a tertiary university hospital in Barcelona, Spain for a high-risk pregnancy and comment on the obstetric implications and bioethical issues. We retrospectively analysed clinical data about the case and bibliographic references related to the issue. The woman underwent in vitro fertilisation of donated embryos in a private centre and came to our unit at 27 weeks of gestation for pregnancy care. At 33 weeks, she presented pre-eclampsia and a caesarean section was performed. She gave birth to healthy twin boys. Four months later, she returned to our centre with the diagnosis of ovarian cancer and died 30 months after delivery. We present the clinical course and management of this pregnancy and comment on the obstetric implications, the impact on maternal and neonatal health, and bioethical issues related to assisted reproduction techniques in pregnancies beyond the natural reproductive age.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"25 1","pages":"496-498"},"PeriodicalIF":0.0,"publicationDate":"2016-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78709118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-09-16DOI: 10.1080/13625187.2016.1229765
S. Kalams, L. Rogers, Rita M. Smith, L. Barnett, Katie Crumbo, Shonda Sumner, Naomi Prashad, K. Rybczyk, G. Milne, S. Dowd, E. Chong, B. Winikoff, D. Aronoff
Abstract Objectives: The aim of the study was to assess the extent to which misoprostol alters mucosal or systemic immune responses following either buccal or vaginal administration. Methods: This was a prospective, crossover pilot study of 15 healthy, reproductive-age women. Women first received 800 μg misoprostol either via buccal or vaginal administration and were crossed over 1 month later to receive the drug via the other route. Cervicovaginal lavage samples, cervical Cytobrush samples, cervicovaginal swabs, urine and blood were obtained immediately prior to drug administration and the following day. Parameters assessed included urine and cervicovaginal misoprostol levels, whole blood cytokine responses (by ELISA) to immune stimulation with lipopolysaccharide, peripheral blood and cervical lymphocyte phenotyping by flow cytometry, cervicovaginal antimicrobial peptide measurement by ELISA and vaginal microbial ecology assessment by 16S rRNA sequencing. Results: Neither buccal nor vaginal misoprostol significantly altered local or systemic immune and microbiological parameters. Conclusion: In this pilot study, we did not observe significant alteration of mucosal or systemic immunology or vaginal microbial ecology 1 day after drug administration following either the buccal or vaginal route.
{"title":"Neither vaginal nor buccal administration of 800 μg misoprostol alters mucosal and systemic immune activation or the cervicovaginal microbiome: a pilot study","authors":"S. Kalams, L. Rogers, Rita M. Smith, L. Barnett, Katie Crumbo, Shonda Sumner, Naomi Prashad, K. Rybczyk, G. Milne, S. Dowd, E. Chong, B. Winikoff, D. Aronoff","doi":"10.1080/13625187.2016.1229765","DOIUrl":"https://doi.org/10.1080/13625187.2016.1229765","url":null,"abstract":"Abstract Objectives: The aim of the study was to assess the extent to which misoprostol alters mucosal or systemic immune responses following either buccal or vaginal administration. Methods: This was a prospective, crossover pilot study of 15 healthy, reproductive-age women. Women first received 800 μg misoprostol either via buccal or vaginal administration and were crossed over 1 month later to receive the drug via the other route. Cervicovaginal lavage samples, cervical Cytobrush samples, cervicovaginal swabs, urine and blood were obtained immediately prior to drug administration and the following day. Parameters assessed included urine and cervicovaginal misoprostol levels, whole blood cytokine responses (by ELISA) to immune stimulation with lipopolysaccharide, peripheral blood and cervical lymphocyte phenotyping by flow cytometry, cervicovaginal antimicrobial peptide measurement by ELISA and vaginal microbial ecology assessment by 16S rRNA sequencing. Results: Neither buccal nor vaginal misoprostol significantly altered local or systemic immune and microbiological parameters. Conclusion: In this pilot study, we did not observe significant alteration of mucosal or systemic immunology or vaginal microbial ecology 1 day after drug administration following either the buccal or vaginal route.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"87 1","pages":"436 - 442"},"PeriodicalIF":0.0,"publicationDate":"2016-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81153172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-09-16DOI: 10.1080/13625187.2016.1230667
P. Tsikouras, Z. Koukouli, N. Psarros, B. Manav, N. Tsagias, G. Galazios
Abstract Objectives: The aims of the study were to compare the contraceptive behaviour of Christian and Muslim adolescents who had an abortion in Thrace, Greece, and to examine whether extensive contraceptive counselling at the time of abortion modified their subsequent contraceptive practices. Methods: Adolescents, aged 14–19 years, who had undergone an elective abortion in our department, were included in a prospective 12-year study. Extensive contraceptive counselling was offered before discharge from the hospital. Attitudes to contraception were assessed by means of a simple questionnaire at the time of abortion and at 1-year follow-up. Results: The study population comprised of 95 Christian Orthodox adolescents (Group A) and 79 Muslim adolescents (Group B). At the time of abortion, contraceptive behaviour differed significantly between the two groups (p = .004). Contraceptive methods used in Group A in comparison with Group B were as follows: oral contraceptives (27.4% vs. 12.7%), condoms (22.1% vs. 38.0%), interrupted coitus (18.9% vs. 20.3%), periodic abstinence (16.8% vs. 25.3%) and emergency contraception (14.7% vs. 3.8%). The commonest source of information on contraception in Group A was the gynaecologist (17.9%) and family planning clinic (15.8%), whereas in Group B it was the individual’s partner (25.3%) and parents (16.4%). Contraceptive behaviour was significantly modified in both groups at post-abortion follow-up (both p < .001). The original difference between the groups, however, persisted (p = .006). In Group A, oral contraceptives were the dominant method (48.4%), followed by condoms (30.5%), whereas in Group B, the order was still the reverse (24.1% and 46.8%, respectively). Conclusion: Cultural differences significantly affect the contraceptive behaviour. Nevertheless, interventions that promote contraception can still be successful in different populations.
{"title":"Contraceptive behaviour of Christian and Muslim teenagers at the time of abortion and post-abortion in Thrace, Greece","authors":"P. Tsikouras, Z. Koukouli, N. Psarros, B. Manav, N. Tsagias, G. Galazios","doi":"10.1080/13625187.2016.1230667","DOIUrl":"https://doi.org/10.1080/13625187.2016.1230667","url":null,"abstract":"Abstract Objectives: The aims of the study were to compare the contraceptive behaviour of Christian and Muslim adolescents who had an abortion in Thrace, Greece, and to examine whether extensive contraceptive counselling at the time of abortion modified their subsequent contraceptive practices. Methods: Adolescents, aged 14–19 years, who had undergone an elective abortion in our department, were included in a prospective 12-year study. Extensive contraceptive counselling was offered before discharge from the hospital. Attitudes to contraception were assessed by means of a simple questionnaire at the time of abortion and at 1-year follow-up. Results: The study population comprised of 95 Christian Orthodox adolescents (Group A) and 79 Muslim adolescents (Group B). At the time of abortion, contraceptive behaviour differed significantly between the two groups (p = .004). Contraceptive methods used in Group A in comparison with Group B were as follows: oral contraceptives (27.4% vs. 12.7%), condoms (22.1% vs. 38.0%), interrupted coitus (18.9% vs. 20.3%), periodic abstinence (16.8% vs. 25.3%) and emergency contraception (14.7% vs. 3.8%). The commonest source of information on contraception in Group A was the gynaecologist (17.9%) and family planning clinic (15.8%), whereas in Group B it was the individual’s partner (25.3%) and parents (16.4%). Contraceptive behaviour was significantly modified in both groups at post-abortion follow-up (both p < .001). The original difference between the groups, however, persisted (p = .006). In Group A, oral contraceptives were the dominant method (48.4%), followed by condoms (30.5%), whereas in Group B, the order was still the reverse (24.1% and 46.8%, respectively). Conclusion: Cultural differences significantly affect the contraceptive behaviour. Nevertheless, interventions that promote contraception can still be successful in different populations.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"76 1","pages":"462 - 466"},"PeriodicalIF":0.0,"publicationDate":"2016-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80741855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-09-13DOI: 10.1080/13625187.2016.1225034
E. Weisberg, K. McGeehan, I. Fraser
Abstract Objectives: The aim of the study was to explore Australian women’s experiences of menstruation and effect on quality of life (QoL). Methods: A representative sample of women recruited through a commercial social research sampling organisation completed a detailed online questionnaire about menstruation. Specific detailed questions were asked about perceptions of heavy menstrual bleeding (HMB) and menstrual pain. Results: The questionnaire was completed by 1575 women aged 20–39 years. Most perceived their bleeding to be light (11.6%) or moderate (60.5%); 363 (22.5%) perceived it to be heavy and 86 (5.3%) very heavy. Women who experienced severe or very severe menstrual pain were significantly more likely to report periods as heavy or very heavy (p < .001). The prevalence ratios for being confined to bed during menstruation for women experiencing severe or very severe menstrual pain were 12.02 (95% CI: 5.71–25.31) and 15.93 (95% CI: 7.51–33.78), respectively, compared with women experiencing no pain. The prevalence ratios for being confined to bed were 1.58 (95% CI: 1.11–2.24) and 1.53 (95% CI: 1.04–2.25) for women with heavy or very heavy bleeding, respectively. Women who experienced severe or very severe menstrual pain associated with their HMB were >12 times more likely to be confined to bed for 0.5–1 day during menstruation than if they reported HMB without pain. Conclusion: Severe menstrual pain with HMB has a much more profound effect on all aspects of women’s QoL than HMB alone; it accounts for more days in bed and for loss of productivity.
{"title":"Effect of perceptions of menstrual blood loss and menstrual pain on women’s quality of life","authors":"E. Weisberg, K. McGeehan, I. Fraser","doi":"10.1080/13625187.2016.1225034","DOIUrl":"https://doi.org/10.1080/13625187.2016.1225034","url":null,"abstract":"Abstract Objectives: The aim of the study was to explore Australian women’s experiences of menstruation and effect on quality of life (QoL). Methods: A representative sample of women recruited through a commercial social research sampling organisation completed a detailed online questionnaire about menstruation. Specific detailed questions were asked about perceptions of heavy menstrual bleeding (HMB) and menstrual pain. Results: The questionnaire was completed by 1575 women aged 20–39 years. Most perceived their bleeding to be light (11.6%) or moderate (60.5%); 363 (22.5%) perceived it to be heavy and 86 (5.3%) very heavy. Women who experienced severe or very severe menstrual pain were significantly more likely to report periods as heavy or very heavy (p < .001). The prevalence ratios for being confined to bed during menstruation for women experiencing severe or very severe menstrual pain were 12.02 (95% CI: 5.71–25.31) and 15.93 (95% CI: 7.51–33.78), respectively, compared with women experiencing no pain. The prevalence ratios for being confined to bed were 1.58 (95% CI: 1.11–2.24) and 1.53 (95% CI: 1.04–2.25) for women with heavy or very heavy bleeding, respectively. Women who experienced severe or very severe menstrual pain associated with their HMB were >12 times more likely to be confined to bed for 0.5–1 day during menstruation than if they reported HMB without pain. Conclusion: Severe menstrual pain with HMB has a much more profound effect on all aspects of women’s QoL than HMB alone; it accounts for more days in bed and for loss of productivity.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"90 1","pages":"431 - 435"},"PeriodicalIF":0.0,"publicationDate":"2016-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89264241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-09-02DOI: 10.1080/13625187.2016.1217987
F. Bacopoulou, Despoina Apostolaki, R. Pons
Abstract Objective: To report unusual gynaecological features associated with Sanfilippo syndrome, a rare progressive multisystem storage disorder. Case: A 10-year-old adolescent girl with Sanfilippo syndrome type B, presented to the Center for Adolescent Medicine accompanied by her mother. Maternal anxiety was related to a palpable mass over the adolescent’s external genitalia that had been causing her discomfort and exacerbation of her behavioural problems when wearing trousers. The mass was also a site of blood accumulation during her menstruation causing hygiene issues. Gynaecological examination revealed hypertrophy and thickening of the adolescent’s hymen, labia minora and the posterior fourchette, that protruded like a mass in her perineum. These findings were attributed to the accumulation of heparan sulphate in the connective tissue of her external genitalia and perineal area. Reassurance as well as counselling about hygiene and avoidance of tight clothes were provided to the mother. Conclusion: Girls with mucopolysaccharidoses need monitoring for evolving gynaecological problems in order to improve their quality of life.
{"title":"External genitalia hypertrophy in an adolescent girl with Sanfilippo syndrome","authors":"F. Bacopoulou, Despoina Apostolaki, R. Pons","doi":"10.1080/13625187.2016.1217987","DOIUrl":"https://doi.org/10.1080/13625187.2016.1217987","url":null,"abstract":"Abstract Objective: To report unusual gynaecological features associated with Sanfilippo syndrome, a rare progressive multisystem storage disorder. Case: A 10-year-old adolescent girl with Sanfilippo syndrome type B, presented to the Center for Adolescent Medicine accompanied by her mother. Maternal anxiety was related to a palpable mass over the adolescent’s external genitalia that had been causing her discomfort and exacerbation of her behavioural problems when wearing trousers. The mass was also a site of blood accumulation during her menstruation causing hygiene issues. Gynaecological examination revealed hypertrophy and thickening of the adolescent’s hymen, labia minora and the posterior fourchette, that protruded like a mass in her perineum. These findings were attributed to the accumulation of heparan sulphate in the connective tissue of her external genitalia and perineal area. Reassurance as well as counselling about hygiene and avoidance of tight clothes were provided to the mother. Conclusion: Girls with mucopolysaccharidoses need monitoring for evolving gynaecological problems in order to improve their quality of life.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"31 1","pages":"412 - 413"},"PeriodicalIF":0.0,"publicationDate":"2016-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76940893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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