Causes and consequences of oral contraceptive noncompliance

Rosenberg, Michael J.; Waugh, Michael S.

doi:10.1016/s0002-9378(99)70718-0

Cited by 141 publications

(68 citation statements)

References 14 publications

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“…(1)(2)(3)(4)(5) But these oral contraceptives have some unavoidable disadvantages like first-pass metabolism, large fluctuations in serum hormone levels and poor compliance in some users (6)(7)(8) for which non-oral hormonal methods have been tried with their own drawbacks. (9,10) One of the advances in the contraceptive field has been the development of combined contraceptive vaginal rings (CCVRs).…”

Section: Introductionmentioning

confidence: 99%

To Study the Acceptability and Efficacy of Combined Contraceptive Vaginal Ring Amidst Indian Women

Dam¹,

Paul²,

Banerjee³

et al. 2015

jemds

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OBJECTIVES:To study the efficacy, and acceptability and reasons for discontinuity of CCVRs in Indian women along with cycle control, safety aspects, local and systemic adverse effects, chances of spontaneous expulsion and partner compliance. METHODS: This interventional longitudinal study included 45 married women aged between 18-45 years seeking reversible means of contraception but with no history of usage of any form of hormonal contraceptives in the previous 6 months. The outcome variables were measured in terms of contraceptive efficacy, cycle regularity, systemic effects on blood pressure, liver function, body weight, lipid parameters and blood sugar along with local effect on cervix and vagina. Patient compliance, acceptability and spouse compliance was also measured by questionnaires. RESULTS: In this study there were no unwanted pregnancies in women amongst 117 exposed cycles. The incidence of intended bleeding pattern was 95%, the effect of CCVR on liver function, blood pressure, etc. was not clinically relevant. It was not associated with an increased risk of cervical or vaginal abnormalities, 96% women were satisfied with the ring usage and 97% would recommend it to others, 70% of women and 82% of their partners never/ rarely felt the ring during intercourse. CONCLUSION: From the present study, it can be concluded that CCVR is an effective contraceptive with good cycle control, minimal systemic or local adverse effects along with low incidence of spontaneous expulsion and higher level of user and partner acceptability.

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Section: Introductionmentioning

confidence: 99%

To Study the Acceptability and Efficacy of Combined Contraceptive Vaginal Ring Amidst Indian Women

Dam¹,

Paul²,

Banerjee³

et al. 2015

jemds

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“…The first is the hepatic first-pass metabolism of the oral contraceptives and the second is the reduced uptake because of vomiting or food interactions. Also, due to the daily pill intake of all combined oral contraceptives, there is fluctuation in hormone levels and poor compliance in some users [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Efficacy, User Acceptability, Tolerability, and Cycle Control of a Combined Contraceptive Vaginal Ring: The Indian Perspective

Shet¹,

Seeru²,

Bangar³

2013

J Obstet Gynecol India

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Objective To assess the contraceptive efficacy, user acceptability, cycle control, and tolerability of a combined contraceptive vaginal ring for up to 13 cycles. Materials and Methods Healthy women coming to the OPD for contraceptive advice were enrolled in this oneyear study. Each ring was used for three weeks followed by a one-week ring-free period. Results A total of 184 women started treatment forming the intent to treat population. Subjects were followed for 13 cycles. Compliance was good with 99 % of cycles in full compliance with specified criteria. In the intent to treat population, no pregnancies occurred giving a Pearl Index of 0. The mean incidence of withdrawal bleeding was 99 % in all cycles. There was 0.16 % incidence of intermenstrual bleeding and 2 % incidence of early withdrawal bleeding. The ring was well tolerated with a low incidence of adverse events. Conclusion The ring is an effective contraceptive that is convenient, well tolerated with excellent cycle control, and highly acceptable to users.

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“…Os contraceptivos hormonais, em geral, se caracterizam por altas taxas de descontinuação e isto deve ser atribuído à pobre aderência, o que pode ser reflexo de efeitos colaterais 5,6 , principalmente por efeitos hormonais indesejáveis ou esquecimento de tomar uma ou mais pílulas 7,8 , o que leva a gravidezes não planejadas ou não desejadas.…”

Section: Introductionunclassified

Fatores associados à descontinuação do uso de anticoncepcionais orais combinados

Bahamondes¹,

Pinho²,

Melo³

et al. 2011

Rev. Bras. Ginecol. Obstet.

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Fatores associados à descontinuação do uso de anticoncepcionais orais combinados Associated factors with discontinuation use of combined oral contraceptives Artigo originalResumo OBJETIVO: Avaliar as razões para descontinuar diversos anticoncepcionais orais combinados entre mulheres brasileiras iniciantes do método, residentes em áreas urbanas. MÉTODOS: Estudo de corte transversal com 400 ginecologistas do Brasil, registrados na Federação Brasileira de Ginecologia e Obstetrícia. Cada médico entrevistou 10 mulheres não grávidas, não lactantes, não em amenorreia, com idades entre 18 e 39 anos que consultavam solicitando anticoncepcional oral combinado (ACO), com um questionário no início de uso e aos 6 meses posteriores. O questionário incluiu dados sociodemográficos, tipo de ACO escolhido ou prescrito e razões para descontinuação, caso ocorresse durante o seguimento. A estratégia de seleção permitiu a inclusão de mulheres de diferentes estratos socioeconômicos, mas somente atendidas em consultórios privados ou de convênios. O tamanho da amostra foi estimado em 1.427 mulheres. RESULTADOS: Foram obtidas 3.465 entrevistas na primeira visita e 1.699 aos 6 meses posteriores. As mulheres tinham predominantemente entre 20 e 29 anos, 57,3% eram solteiras e em proporção quase igual de 45% tinham ensino médio ou superior. A maioria (60,7%) era nuligestas e dentre as que tinham usado algum método contraceptivo anteriormente, 71,8% tinham utilizado ACO. Entre os ACO mais prescritos ou escolhidos, o mais prevalente foram os monofásicos com etinilestradiol (20 µg) e no tocante ao progestágeno, o mais prevalente foi com gestodeno (36,5%), seguido por ACO com drosperinona (22,0%). Aos 6 meses, 63,5% continuavam em uso do ACO. Dentre as que descontinuaram o uso, as principais razões dadas foram: desejo de engravidar (36,5%) e efeitos colaterais (57,3%) como cefaléia (37,6%), aumento de peso (16,6%) e sangramento irregular (23,6%). CONCLUSÕES: A taxa de continuação do uso de ACO foi baixa aos seis meses e este estudo pode contribuir para que os médicos orientem melhor suas pacientes iniciantes no uso de ACO sobre os eventos adversos esperados que são mínimos e temporários e sobre os benefícios não contraceptivos dos ACO.Abstract PURPOSE: Due to the scarce information available in Brazil in relation to the number of women who initiated the use of combined oral contraceptives and prematurely discontinued, the objective was to assess the reasons for discontinuation of the use of several combined oral contraceptives among Brazilian women living in urban areas. METHODS: A crosssectional study with 400 gynecologists registered withy the Brazilian Federation of Obstetricians and Gynecologists. Each physician interviewed 10 non-pregnant, not breastfeeding, not amenorrheic women aged 18 to 39 years who consulted requesting combined oral contraceptive (COC) with a questionnaire at the beginning of use and at six months later. The questionnaire included sociodemographic data, type of COC chosen or prescribed and reasons for discontinuation w...

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Causes and consequences of oral contraceptive noncompliance

Cited by 141 publications

References 14 publications

To Study the Acceptability and Efficacy of Combined Contraceptive Vaginal Ring Amidst Indian Women

To Study the Acceptability and Efficacy of Combined Contraceptive Vaginal Ring Amidst Indian Women

Efficacy, User Acceptability, Tolerability, and Cycle Control of a Combined Contraceptive Vaginal Ring: The Indian Perspective

Fatores associados à descontinuação do uso de anticoncepcionais orais combinados

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