Young Nursing and Medical Students’ Knowledge and Attitudes Toward Contraceptive Methods

Background: Living sexuality fully and without risk to one's health is an international priority. The youth age group has specific characteristics that make it a particularly vulnerable group for adverse consequences such as unwanted pregnancies or sexually transmitted infections. Health professionals are an important group to address this issue; however, to achieve a good result, sufficient knowledge is required to solve all the issues. This study aimed to assess the level of knowledge of young university students studying toward a nursing or medical degree.Methods: A descriptive cross-sectional study of young medical and nursing students was conducted. The Sexuality and Contraceptive Knowledge Instrument scale was used to measure knowledge level. A bivariate analysis was conducted using the Mann–Whitney U test or the Kruskal–Wallis H test, depending on the number of categories of the independent variable. Finally, a multivariate analysis was conducted using a multiple linear regression model, establishing the level of knowledge as the dependent variable and all variables that obtained statistical significance in the bivariate analysis as predictors.Results: Participants had a good level of knowledge, with 77.9% answering 50% of the questions correctly. Before training, 34.15% of the participants did not pass 50% of the questions asked. This percentage decreased to 12.87% after receiving sexuality training during the university degrees. The main training gaps were found for the items on hormonal contraceptive methods. The bivariate analysis showed that female participants had significantly higher knowledge scores, as did those who had used a hormonal contraceptive method during the most recent intercourse or were aware of family planning centers. These variables maintained their significant effect at the multivariate level, obtaining two models with good explanatory power for participants of both university degrees. Conclusion: The general level of knowledge of the healthcare students was high and sufficient after receiving training during the university degree. The main training gap was found for items on hormonal contraceptive methods, which should be emphasized in future training programs.

New Contraception Update — Annovera, Phexxi, Slynd, and Twirla

Purpose of Review In this review, we discuss the efficacy, safety, and benefits of four new contraceptive products available in the USA, specifically Annovera, Phexxi, Slynd, and Twirla. Recent Findings Annovera is a vaginal ring releasing ethinyl estradiol and segesterone acetate that can be used for up to one year (13 cycles), offering patients an effective, user-controlled option that may improve contraceptive access for those in low-resource settings or those with barriers to retrieving monthly prescriptions; however, given limited efficacy and safety data in people with body mass index (BMI) > 29 kg/m2, clinicians may consider whether Annovera is an appropriate contraceptive method for obese patients if there are other acceptable alternatives. Phexxi prescription-only vaginal gel is a user-controlled, non-hormonal, on-demand contraceptive method that represents a novel addition to the market with its additional uses as a personal lubricant and as a potential microbicide for urogenital infection prevention. Slynd, a drospirenone-only pill, provides more flexibility for delayed or missed pills while maintaining efficacy and a more favorable bleeding profile compared with previously available progestin-only pills. Lastly, Twirla is a transdermal patch releasing ethinyl estradiol and levonorgestrel that offers users an additional option for a user-controlled, combined hormonal contraceptive method without daily dosing; however, prescription is limited to patients with BMI < 30 kg/m2 due to decreased efficacy and VTE events in people with obesity. Summary The addition of these products expands the available options for pregnancy prevention to address unmet contraceptive needs.

Hubungan antara Penggunaan Kontrasepsi Hormonal dengan Kejadian Hipertensi pada Wanita Usia Subur di Indonesia (Analisis Data Indonesian Family Life Survey 5)

Background: The incidence of hypertension in women is 36.9%, allegedly related to hormonal changes triggered by the use of hormonal contraceptives. This study aims to analyze the relationship between the use of hormonal contraception on the incidence of hypertension in women of childbearing age. Methods: This cross-sectional study used IFLS 2014 data and involved 7,097 participants who were selected using multistage random sampling technique. The research variables included age, education, work status, physical activity, stress, use and length of time being a hormonal family planning acceptor, work status, blood pressure and obesity. Data analysis was carried out descriptively and analytically using logistic regression. Results: The incidence of hypertension reached 27.2%, and the multivariate analysis showed the significant correlation with age and duration of hormonal contraceptive use (p=0.000; PR=2.809; 95%-CI=2.516-3.136 and p=0.000; PR=1.002; 95% -CI=1.001-1.003). Conclusion: The incidence of hypertension in hormonal contraceptive users is related to age and period of use. Hormonal family planning acceptors need to regularly control blood pressure with age to monitor the incidence of hypertension.

The effect of hormonal contraceptive on low birth weight baby delivery in Agronursing Area

Babies born with low birth weight (LBW) have a high risk and will have an impact on subsequent development. Studies show that the use of hormonal contraceptives can increase the risk of experiencing subjective health complaints than non-hormonal contraceptives. The study is an analytical descriptive study that aims to identify the effect of hormonal contraceptive used on low birth weight baby delivery. The study was conducted in three agricultural hospitals and three public hospitals in the Agriculture area of Besuki Residency. Data analysis of the sample was carried out by quota sampling. Characteristics of respondents were displayed by univariate analysis. The total number of participants in this study were 441 participants. Participants were divided into several data categories such as age, parity, medical history, previous history of preeclampsia, low birth weight babies, contraceptives used, complications of premature rupture of membranes. There two factors, that can predict the low birth weight baby delivery. They are hormonal contraceptives use and premature rupture of membranes. The test results get the hormonal contraceptive used factor to be the strongest factor (OR 19,12). Thus it was concluded "the hormonal contraceptive used factor is an abdominal factor of low birth weight baby delivery with a significance value of 0.000 (p0.05).

Hormonal Contraceptive Use Related to Menopausal Age

The change in the pattern and timing of menopause is an exciting and exploratory phenomenon that requires more detailed research to be carried out using hormonal contraception. This study was aimed to explore the relationship between hormonal contraceptive use and menopausal age. This study used a cross-sectional design. The study was conducted at Royal Prima General Hospital Medan from May to August 2021. A total of 68 research subjects participated in this study with the following inclusion criteria: menopausal women, aged 50-60 years, using hormonal contraceptives (pills, injections, implants), able to remember history previous contraceptive use. This study uses primary data obtained directly from guided interviews with respondents. Participants were dominated by ≥ 55 years old women with 57 people (83.81%), 62 Muslims (91.2%), menarche age >13 years as many as 28 people (41.2%). The number of children 2-4 were 32 people (47.1%) with an average menopause age of 51.93 and the smallest for 1 was 8 people (11.8%) with an average menopause age of 50.37. There were 49 users of hormonal contraception (72.1%) and 48 people (70.6%). In conclusion, we found that the use of hormonal contraceptives is significantly related to menopausal age.

Influence of Menstrual Cycle or Hormonal Contraceptive Phase on Physiological Variables Monitored During Treadmill Testing

Purpose: To examine the influence of menstrual cycle (MC) and hormonal contraceptive (HC) cycle phases on physiological variables monitored during incremental treadmill testing in physically active women (eumenorrheic, EUM = 16 and monophasic HC-users, CHC = 12).Methods: Four running tests to exhaustion were performed at bleeding, mid follicular (mid FOL)/active 1, ovulation/active 2, and mid luteal (mid LUT)/inactive. HC and MC phases were confirmed from serum hormones. Heart rate (HR), blood lactate (Bla), and V˙O2 were monitored, while aerobic (AerT) and anaerobic (AnaT) thresholds were determined. V˙O2peak, maximal running speed (RUNpeak), and total running time (RUNtotal) were recorded.Results: No significant changes were observed in V˙O2 or Bla at AerT or AnaT across phases in either group. At maximal effort, absolute and relative V˙O2peak, RUNpeak, and RUNtotal remained stable across phases in both groups. No significant fluctuations in HRmax were observed across phases, but HR at both AerT and AnaT tended to be lower in EUM than in CHC across phases.Conclusion: Hormonal fluctuations over the MC and HC do not systematically influence physiological variables monitored during incremental treadmill testing. Between group differences in HR at AerT and AnaT underline why HR-based training should be prescribed individually, while recording of MC or HC use when testing should be encouraged as phase may explain minor, but possibly meaningful, changes in, e.g., Bla concentrations or differences in HR response.

Size dependent inhibition of sperm motility by copper particles as a path towards reversible male contraception

Effective inhibition of sperm motility using a spermicide can be a promising approach in developing non-invasive male contraceptive agents. Copper is known to have contraceptive properties and has been used clinically for decades as intrauterine contraceptive devices (IUDs) for contraception in females. Beyond that, the spermicidal use of copper has not been explored much further, even though its use could also subdue the harmful effects caused by the hormonal contraceptive agents on the environment. Herein, we study the size, concentration and time dependent in vitro inhibition of bovine spermatozoa by copper microparticles. The effectivity in inhibiting the sperm motility is correlated to the amount of Cu2+ ions released by the particles during incubation. The copper particles cause direct suppression of sperm cell motility upon incubation and thereby show potential as sperm inhibiting, hormone free candidate for male contraception beyond condoms.

The Menstrual Cycle Modulates Whole-Brain Turbulent Dynamics

Brain dynamics have recently been shown to be modulated by rhythmic changes in female sex hormone concentrations across an entire menstrual cycle. However, many questions remain regarding the specific differences in information processing across spacetime between the two main follicular and luteal phases in the menstrual cycle. Using a novel turbulent dynamic framework, we studied whole-brain information processing across spacetime scales (i.e., across long and short distances in the brain) in two open-source, dense-sampled resting-state datasets. A healthy naturally cycling woman in her early twenties was scanned over 30 consecutive days during a naturally occurring menstrual cycle and under a hormonal contraceptive regime. Our results indicated that the luteal phase is characterized by significantly higher information transmission across spatial scales than the follicular phase. Furthermore, we found significant differences in turbulence levels between the two phases in brain regions belonging to the default mode, salience/ventral attention, somatomotor, control, and dorsal attention networks. Finally, we found that changes in estradiol and progesterone concentrations modulate whole-brain turbulent dynamics in long distances. In contrast, we reported no significant differences in information processing measures between the active and placebo phases in the hormonal contraceptive study. Overall, the results demonstrate that the turbulence framework is able to capture differences in whole-brain turbulent dynamics related to ovarian hormones and menstrual cycle stages.