scholarly journals Discontinuation of Different Contraceptive Methods in Thai Women During a One-year Period: A Cohort Study

2020 ◽  
Author(s):  
Unnop Jaisamrarn ◽  
Monchai Santipap ◽  
Somsook Santibenchakul
Keyword(s):  
Side Effects ◽  
Incidence Density ◽  
Discontinuation Rate ◽  
Contraceptive Methods ◽  
Thai Women ◽  
Contraceptive Discontinuation ◽  
Contraceptive Implant ◽  
History Of ◽  
One Year ◽  
Copper Iud

Abstract BackgroundEven though almost 80% of sexually active Thai women use modern contraceptives, yet unintended pregnancy remains a significant reproductive health issue. One possible explanation is that the women do not use contraceptives or stopped using contraceptives at some point in their lifetime. At present, there is scant information available about contraceptive discontinuation among Thai women. We assessed the discontinuation rate and the reason for discontinuation of the four most common contraceptives used by reproductive aged Thai women: combined oral contraceptive pills (COCs), depot medroxyprogesterone acetate (DMPA), copper IUD, and contraceptive implant(s).MethodsThere were 1,880 women aged 18-45 years recruited from the Family Planning Clinic of the Chulalongkorn Hospital in Bangkok. The participants were followed at months 3, 6 and 12 either by attending the clinic or being interviewed via a phone call. Incidence density and cumulative incidence based on the Kaplan-Meier approach were used to assess contraceptive discontinuation. Cox proportional hazards model was used to determine significant personal risks of discontinuing contraceptive.ResultsAmong all, 839 (44.6%) women initiated COCs; 494 (26.3%) initiated DMPA; 280 (14.9%) initiated copper IUD and 267 (14.2%) initiated contraceptive implant(s). The incidence density for discontinuation of COCs, DMPA, copper IUD, and contraceptive implant(s) were 21.33, 9.21, 4.36, and 2.26 / 100 person-year, respectively. Most of the women (185/222) discontinued their contraceptives because of the side effects. Compared to the contraceptive implant(s) users, adjusted HR (95% CI) of discontinuing COCs, DMPA, and copper IUD were 9.92 (4.38-22.46), 4.25 (1.81-9.98), 2.16 (0.81-5.76), respectively. Lower-income, higher parity numbers, history of miscarriage, and history of abortion were independent predictors of contraceptive discontinuation in a multivariable model.ConclusionsThe discontinuation rate of COCs, the most popular contraceptive method for Thai women, was the highest during the one-year period of the study. The primary reason for discontinuing the use of the various contraceptive methods was the side effects.

scholarly journals Patterns and determinants of modern contraceptive discontinuation among women of reproductive age: Analysis of Kenya Demographic Health Surveys, 2003–2014

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241605
Author(s):  
Susan Ontiri ◽  
Vincent Were ◽  
Mark Kabue ◽  
Regien Biesma-Blanco ◽  
Jelle Stekelenburg
Keyword(s):  
Side Effects ◽  
Health Surveys ◽  
Contraceptive Use ◽  
Reproductive Age ◽  
Modern Contraceptive ◽  
Discontinuation Rate ◽  
Women Of Reproductive Age ◽  
Short Term ◽  
Younger Women ◽  
Contraceptive Discontinuation

Objectives This study aimed to examine patterns and determinants of modern contraceptive discontinuation among women in Kenya. Methods Secondary analysis was conducted using national representative Kenya Demographic and Health Surveys of 2003, 2008/9, and 2014. These household cross-sectional surveys targeted women of reproductive age from 15 to 49 years who had experienced an episode of modern contraceptive use within five years preceding the surveys from 2003 (n = 2686), 2008/9 (n = 2992), and 2014 (5919). The contraceptive discontinuation rate was defined as the number of episodes discontinued divided by the total number of episodes. Weighted descriptive statistics, multivariable logistic regression analysis, and Cox proportional hazards analysis were used to examine the determinants of contraceptive discontinuation. Results The 12-month contraceptive discontinuation rate for all methods declined from 37.5% in 2003 and 36.7% in 2008/9 to 30.5% in 2014. Consistently across the three surveys, intrauterine devices had the lowest 12-month discontinuation rate (6.4% in 2014) followed by implants (8.0%, in 2014). In 2014, higher rates were seen for pills (44.9%) and male condoms (42.9%). The determinants of contraceptive discontinuation among women of reproductive age in the 2003 survey included users of short-term contraception methods, specifically for those who used male condoms (hazard ratio [HR] = 3.30, 95% confidence interval [CI] = 2.13–5.11) and pills (HR = 2.68; 95CI = 1.79–4.00); and younger women aged 15–19 year (HR = 2.07; 95% CI = 1.49–2.87) and 20–24 years (HR = 1.94; 95% CI = 1.61–2.35). The trends in the most common reasons for discontinuation from 2003 to 2014 revealed an increase among those reporting side effects (p = 0.0002) and those wanting a more effective method (p<0.0001). A decrease was noted among those indicating method failure (p<0.0001) and husband disapproval (p<0.0001). Conclusions Family planning programs should focus on improving service quality to strengthen the continuation of contraceptive use among those in need. Women should be informed about potential side effects and reassured on health concerns, including being provided options for method switching. The health system should avail a wider range of contraceptive methods and ensure a constant supply of commodities for women to choose from. Short-term contraceptive method users and younger women may need greater support for continued use.

Bleeding patterns and weight gain in users of injectable progestogen-only contraceptives: A retrospective study

2015 ◽  
Vol 1 (2) ◽  
pp. 27-34
Author(s):  
JO Sotunsa ◽  
A Inofomoh ◽  
AK Akinseku ◽  
FI Ani ◽  
AO Olatunji
Keyword(s):  
Retrospective Study ◽  
Weight Gain ◽  
Side Effects ◽  
Menstrual Cycle ◽  
Menstrual Bleeding ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
The Mean ◽  
One Year ◽  
Injectable Contraceptives

Objective: Modern contraceptive methods have been very effective in family planning and well-being. The injectable contraceptives, though effective, had been discontinued by some users because of side effects like abnormal menstrual bleeding and weight gain. This study compared the pattern of menstrual bleeding and weight gain in users of Depot Medroxyprogesterone Acetate (DMPA) and Norethisterone-Enanthate (Noristerat) in Sagamu. Method: A retrospective study of 323 patients who used either DMPA or Noristerat over a 7-year period (January 2007 to December 2013). Data extracted from case notes included bio-data, parity, previous contraceptive methods and reasons for discontinuation of the contraceptives. Clients' weights, pattern of menstrual cycle and side effects were also documented for the rst, second and third visits, and up to 1 year after commencing the injectable contraceptives. Results: The mean age of the participants was 32.72± 5.47 years. About 13.5% experienced no change in their menstrual cycle, but 55.9% and 58.9% of those who used Noristerat and DMPA respectively, had amenorrhoea by the end of one year. The mean weight was 62.89kg±12.84 for Noristerat group and  0.93kg±9.94 for DMPA group at commencement and 65.15kg±13.70 for Noristerat group and 64.05kg±10.30 for DMPA group at the end of one year. There was significant weight gain (p<0.05) in both groups by the end of the First year. Weight gain was perceived as a problem by 2% of Noristerat users and 0.9% users of DMPA. Conclusion: There were significant weight changes with use of injectable contraceptives. However, very few clients perceived this as a problem. Amenorrhoea was the commonest menstrual change experienced by clients over the period. 

Correlation of Unmet Need and Discontinuation in Ethiopia: a View

2016 ◽  
Vol 51 (6) ◽  
pp. 656-668
Author(s):  
Yishak A Lailulo ◽  
A Sathiya Susuman
Keyword(s):  
Side Effects ◽  
Research Method ◽  
Quantitative Research ◽  
Contraceptive Use ◽  
Research Question ◽  
Unmet Need ◽  
Discontinuation Rate ◽  
Key Factors ◽  
Factors Affecting ◽  
Contraceptive Discontinuation

A few key factors affecting usage of all methods and contraceptive discontinuation among women whom are currently married in Ethiopia are discussed. What are the factors affecting women’s contraceptive use? The aim is to explore the two regions on the basis of high total fertility rate (TFR) regions (Oromiya (5.6) and Southern Nations, Nationalities, and People’s Region (SNNPR) (4.9)) in the Ethiopian demographic and health survey (EDHS) 2011. A descriptive and comparative study using the quantitative research method is chosen to address the above research question. The study findings show that the contraceptive discontinuation rate for users of all types of methods is 37%. The highest women’s discontinuation rate is for the pill which is 70% due to side effects.

scholarly journals Contraceptive Use Dropout-adjusted Unmet Need for Family Planning

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 780
Author(s):  
Budi Utomo ◽  
Hariyanti Hariyanti ◽  
Sabarinah Prasetyo ◽  
Robert Magnani ◽  
Sukma Rahayu
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unwanted Pregnancy ◽  
Unmet Need ◽  
Discontinuation Rate ◽  
Study Results ◽  
Unwanted Pregnancies ◽  
Contraceptive Discontinuation ◽  
History Of ◽  
Calendar Data

Background: In the last two decades, unmet need for family planning in Indonesia remains stagnant, and contraceptive discontinuation has increased. These two indicators describe the risk of unwanted pregnancy in a population. Therefore, this study aims to develop an accurate calculation of the unmet need for family planning in Indonesia.  Method: The study uses 2017 IDHS data to compare unmet need at survey-time and five years preceding the survey, measured by contraceptive calendar data that measured history of contraceptive use within five years preceding the survey. Unmet need at five years preceding the survey is measured by calculating the proportion of months not using contraceptive to the duration of months exposed to pregnancy in a period of 69 months. The study population is married women in Indonesia, with a sample size of 35,681.   Results: Unmet need with contraceptive calendar calculation is higher than unmet need at survey-time. A difference of 3% concerns an additional of nearly 1.6 million unwanted pregnancies. This study proves that the high number of contraceptive discontinuations is directly proportional to higher unmet need with contraceptive calendar calculation.  Conclusion: In Indonesia, with a relatively high contraceptive discontinuation rate, the calculation of unmet need using the calendar method is more precise than at survey-time method. The study results suggest the use of unmet need calendar for countries with high contraceptive discontinuation rate and provision of primary health care that is responsive to a potential unwanted pregnancy.

scholarly journals SIDE EFFECTS OF INJECTABLE AND ORAL CONTRACEPTIVE AND UNINTENDED PREGNANCY AMONG REPRODUCTIVE WOMEN IN INDONESIA

2021 ◽  
Vol 10 (2) ◽  
pp. 162
Author(s):  
Maria Gayatri ◽  
Dian Kristiani Irawaty
Keyword(s):  
Side Effects ◽  
Unintended Pregnancy ◽  
Unplanned Pregnancy ◽  
Health Problems ◽  
Counseling Services ◽  
Comprehensive Information ◽  
Contraceptive Discontinuation ◽  
Provider Knowledge ◽  
One Year ◽  
The Impact

Using contraception is essential for protecting women from the risk of unintended pregnancy. However, contraceptive discontinuation, caused by side effects of contraceptives or health problems, is still high. This study aimed to assess the impact of injectable and pill contraception discontinuation due to side effects or health problems on unintended pregnancy among women aged 15-49 years in Indonesia. This study is based on the 2017 Indonesia Demographic and Health Survey. As many as 1,613 women who discontinued their oral contraceptives and 5,022 women who discontinued their injectables were followed retrospectively. Pregnancy rates were tested for differences between categories using survival analysis. It was found that one year after stopping contraceptives due to side effects, almost 16-17% of oral/injectable contraceptive users were already pregnant. The pregnancy rate was higher among women aged less than 25 years. Unplanned pregnancy occurred more frequently among women who were not working than women who were working. Counseling services need to be strengthened by improving provider knowledge and skills to give comprehensive information including contraceptives’ side effects.

scholarly journals Contraceptive Method Information and Method Switching in India

2021 ◽  
Vol 13 (17) ◽  
pp. 9831
Author(s):  
Md. Juel Rana ◽  
Srinivas Goli ◽  
Rakesh Mishra ◽  
Abhishek Gautam ◽  
Nitin Datta ◽  
...  
Keyword(s):  
Side Effects ◽  
Multinomial Logistic Regression ◽  
Unmet Need ◽  
Family Health ◽  
Informed Choice ◽  
Contraceptive Methods ◽  
The Sustainable Development ◽  
Comprehensive Method ◽  
Contraceptive Discontinuation ◽  
Long Acting

The stagnation in the unmet need for family planning and rise in contraceptive discontinuation rates are major concerns among researchers and policymakers in India. This study attempts to investigate the association between method information received by the users at the time of initiation and the switching of contraceptive methods in India. Using the fourth round of National Family Health Survey (NFHS) data (2015–2016), a multinomial logistic regression model has been applied to assess the net effects of method information received by the users on switching of contraceptive methods. The reuse of contraceptive methods is higher among those who were not provided any method information. The reuse is also higher among those who were informed only about the side effects. Overall, the users who received comprehensive method information are more likely to switch. Particularly, the users who were informed about how to manage side effects either alone or along with other method information have a higher likelihood of switching especially to long-acting reversible contraceptives (LARC). The findings call for program intervention to provide comprehensive method information to the users because it gives them the freedom to switch to more suitable methods. Thus, it would help in achieving the sustainable development goal (3.7) of informed choice of contraceptive methods.

Preliminary Report on Comparative Study of Side Effects of Progestin-Only Contraceptive Methods between Thai Women Using DMPA and a Single-Rod Sub-Dermal Implant at Siriraj Hospital, Bangkok, Thailand

2020 ◽  
Vol 103 (7) ◽  
Keyword(s):  
Side Effects ◽  
Adverse Events ◽  
Comparative Study ◽  
Gastrointestinal Symptoms ◽  
Contraceptive Methods ◽  
Bleeding Events ◽  
Thai Women ◽  
Significant Difference ◽  
Siriraj Hospital

Objective: To compare the side effects or specific adverse events except bleeding pattern reported between women using depo-medroxy progesterone acetate (DMPA) and a single-rod sub-dermal etonogestrel implant (Implanon). Materials and Methods: This comparative study assessed women returning for follow-up visit at the Unit of Family planning, Siriraj Hospital between January and December 2019. Women aged 18 to 45 years old who used one of the progestin-only contraceptive methods, either DMPA or Implanon, as a birth control for six months were invited in the present study. Any adverse effects were recorded and analyzed. Results: Fifty-nine women were in the Implanon group and 52 women were in the DMPA group. More women in the DMPA group were older [34.5 (27.5 to 38) versus 25 (22 to 31) years] and less single (26.9% versus 61.0%), p=0.001. The reported side effects in both groups were similar in degree and extent with no statistical significant difference except the symptom of flushing where more women in the Implanon group observed this event, p=0.004. There was borderline significance that women using Implanon had higher incidence of headache, gastrointestinal symptoms, and depression. Conclusion: Both groups of women observed comparable adverse events except bleeding events. Flushing, headache, gastrointestinal symptoms, and depression were more reported by women using Implanon. Close method counseling during the course of use is essential to prolong continuing use to meet their contraceptive goal. Keywords: DMPA, Implanon, Side effects, Thai women

scholarly journals Efficacy of Cefpodoxime with Clavulanic Acid in the Treatment of Recurrent Pyoderma in Dogs

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
B. Sudhakara Reddy ◽  
K. Nalini Kumari ◽  
V. Vaikunta Rao ◽  
V. C. Rayulu
Keyword(s):  
Side Effects ◽  
Clavulanic Acid ◽  
Tick Infestation ◽  
Response To Therapy ◽  
Skin Infections ◽  
Laboratory Findings ◽  
History Of ◽  
Associated Conditions ◽  
One Year ◽  
Excellent Improvement

In the present study on recurrent pyoderma, dogs with a history of more than three episodes of skin infections in a period of one year were selected. The associated conditions and (or) underlying factors revealed upon thorough investigation were demodicosis, Malassezia dermatitis, flea infestation, hypothyroidism, keratinization disorder (seborrhea), combination of Malassezia dermatitis and tick infestation, and a combination of scabies and tick infestation. Therapy was given with cefpodoxime with clavulanic acid along with appropriate simultaneous medication for the underlying associated conditions. In all the cases response to therapy was excellent. Improvement was noticed by 9 to 19 days and 17 to 21 days in recurrent superficial and deep pyoderma, respectively. In one dog, relapse occurred by 45 days due to the associated condition of hypothyroidism which was confirmed through laboratory findings. Cefpodoxime with clavulanic acid proved to be an effective, safe, and convenient antibiotic for the treatment of recurrent pyoderma in dogs without any side effects.

scholarly journals Discontinuation rates of different contraceptive methods in Thai women up to 1-year after method initiation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Unnop Jaisamrarn ◽  
Monchai Santipap ◽  
Somsook Santibenchakul
Keyword(s):  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Intrauterine Device ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Oral Contraceptive Pills ◽  
Thai Women ◽  
Hazards Model ◽  
Contraceptive Implant ◽  
History Of

AbstractWe assessed the discontinuation rate and the reason for discontinuation of common contraceptives used by reproductive-aged Thai women. We recruited 1880 women aged 18–45 years from the Family Planning Clinic of the Chulalongkorn Hospital in Bangkok. The participants were followed at three, six and twelve months. A Cox proportional hazards model was used to determine personal risks of discontinuing contraceptives. The incidence rate for discontinuation of combined oral contraceptive pills (COCs), depot medroxyprogesterone acetate (DMPA), copper intrauterine device (IUD), and contraceptive implant(s) were 21.3, 9.2, 4.4, and 2.3/100 person-years, respectively. Most of the women who discontinued (185/222) discontinued contraceptives due to side effects. Compared to contraceptive implant users, the adjusted hazard ratios (aHRs) [95% confidence intervals (CIs)] of discontinuing COCs, DMPA, and the copper IUD were 9.6 (4.3–21.8), 4.2 (1.8–10.0), and 2.2 (0.8–5.9), respectively. Lower income, higher parity, history of miscarriage, and history of abortion were independent predictors of contraceptive discontinuation in a multivariable model.

Treatment of varicose tributaries with sclerotherapy with polidocanol 0.5 % foam

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Reich-Schupke ◽  
Weyer ◽  
Altmeyer ◽  
Stücker
Keyword(s):  
Scientific Evidence ◽  
Daily Practice ◽  
Severe Adverse Effect ◽  
Safe Procedure ◽  
Efficacy And Safety ◽  
Foam Sclerotherapy ◽  
History Of ◽  
One Year ◽  
Additional Therapy

Background: Although foam sclerotherapy of varicose tributaries is common in daily practice, scientific evidence for the optimal sclerosant-concentration and session-frequency is still low. This study aimed to increase the knowledge on foam sclerotherapy of varicose tributaries and to evaluate the efficacy and safety of foam sclerotherapy with 0.5 % polidocanol in tributaries with 3-6 mm in diameter. Patients and methods: Analysis of 110 legs in 76 patients. Injections were given every second or third day. A maximum of 1 injection / leg and a volume of 2ml / injection were administered per session. Controls were performed approximately 6 months and 12 months after the start of therapy. Results: 110 legs (CEAP C2-C4) were followed up for a period of 14.2 ± 4.2 months. Reflux was eliminated after 3.4 ± 2.7 injections per leg. Insufficient tributaries were detected in 23.2 % after 6.2 ± 0.9 months and in 48.2 % after 14.2 ± 4.2 months, respectively. Only 30.9 % (34 / 110) of the legs required additional therapy. In 6.4 % vein surgery was performed, in 24.5 % similar sclerotherapy was repeated. Significantly fewer sclerotherapy-sessions were required compared to the initial treatment (mean: 2.3 ± 1.4, p = 0.0054). During the whole study period thrombophlebitis (8.2 %), hyperpigmentation (14.5 %), induration in the treated region (9.1 %), pain in the treated leg (7.3 %) and migraine (0.9 %) occurred. One patient with a history of thrombosis developed thrombosis of a muscle vein (0.9 %). After one year there were just hyperpigmentation (8.2 %) and induration (1.8 %) left. No severe adverse effect occurred. Conclusions: Foam sclerotherapy with injections of 0.5 % polidocanol every 2nd or 3rd day, is a safe procedure for varicose tributaries. The evaluation of efficacy is difficult, as it can hardly be said whether the detected tributaries in the controls are recurrent veins or have recently developed in the follow-up period. The low number of retreated legs indicates a high efficacy and satisfaction of the patients.

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