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Long-acting Reversible contraception

X Yao, E A Stewart, S K Laughlin-Tommaso, H C Heien, B J Borah
OBJECTIVES: To report patterns and patient characteristics associated with initiation of and persistence with medical therapies for uterine fibroid-related heavy menstrual bleeding. DESIGN: Retrospective cohort study. SETTING: US commercial insurance claims database. POPULATION: 41 561 women aged 18-54 years with uterine fibroids and heavy menstrual bleeding who initiated medical therapies from January 2000 through December 2013...
October 21, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Mary Anne Armstrong, Debbie A Postlethwaite, Jeanne A Darbinian, Mark McCoy, Amy Law
BACKGROUND: In 2007, high-deductible plans were added to the primarily nondeductible Kaiser Permanente Northern California (KPNC) integrated health plan, which had covered 100% of device and procedure costs of long-acting reversible contraception (LARC) for members regardless of prescription/visit copay amount. We hypothesized that nondeductible plans and prior LARC use decreased unintended pregnancy. OBJECTIVE: The purpose of this study was to determine if health plan design (nondeductible vs...
October 18, 2016: Journal of Women's Health
Mandira Paul, Sharad D Iyengar, Birgitta Essén, Kristina Gemzell-Danielsson, Kirti Iyengar, Johan Bring, Marie Klingberg-Allvin
BACKGROUND: Post-abortion contraceptive use in India is low and the use of modern methods of contraception is rare, especially in rural areas. This study primarily compares contraceptive use among women whose abortion outcome was assessed in-clinic with women who assessed their abortion outcome at home, in a low-resource, primary health care setting. Moreover, it investigates how background characteristics and abortion service provision influences contraceptive use post-abortion. METHODS: A randomized controlled, non-inferiority, trial (RCT) compared clinic follow-up with home-assessment of abortion outcome at 2 weeks post-abortion...
October 17, 2016: BMC Public Health
Camille Clare, Mary-Beatrice Squire, Karem Alvarez, Julia Meisler, Candice Fraser
OBJECTIVE: The United States has the highest rate of adolescent pregnancy of the industrialized nations. Previously reported patient barriers to the use of contraception included an ambivalence about pregnancy; method side effects; difficulty using methods; lack of satisfaction with methods; concerns about safety; expense; and a lack of knowledge about long-acting reversible contraception (LARC). This survey aims to determine if there are additional barriers to contraception use and adherence among an ethnically diverse urban population...
October 15, 2016: International Journal of Adolescent Medicine and Health
Jenny A Higgins, Jessica N Sanders, Mari Palta, David K Turok
OBJECTIVE: To document how long-acting reversible contraception (LARC) affects women's sexual outcomes. METHODS: In this prospective, observational cohort study, we enrolled new-start intrauterine device and contraceptive implant users attending four family planning clinics. Data collection occurred at baseline, 1 month, and 3 months. Primary outcomes were the Female Sexual Function Index, New Sexual Satisfaction Scale, and perceived sexual effects of method (positive, negative, or none)...
October 6, 2016: Obstetrics and Gynecology
Kurt T Barnhart
The science of contraceptive medicine and reproductive medicine are similar. At present contraceptive medicine has moved beyond understanding the mechanism of action of steroid hormones with the introduction of many safe and effective methods. Long-acting reversible contraceptives are increasing in acceptance and providing very high efficacy. The science has pivoted toward optimization of family planning in selected high-risk populations, such as those with a high-risk of thrombosis, as well as addressing the challenge of obesity...
October 5, 2016: Fertility and Sterility
David K Turok, Lori M Gawron, Samantha Lawson
After decades of having the developed world's highest rates of unintended pregnancy, the United States finally shows signs of improvement. This progress is likely due in large part to increased use of highly effective long-acting reversible methods of contraception. These methods can be placed and do not require any maintenance to provide years of contraception as effective as sterilization. Upon removal, fertility returns to baseline rates. This article addresses advances in both software-improved use and elimination of barriers to provide these methods; and hardware-novel delivery systems and devices...
October 4, 2016: Fertility and Sterility
Katherine He, Vanessa K Dalton, Melissa K Zochowski, Kelli Stidham Hall
BACKGROUND: Family planning research has not adequately addressed women's preferences for different contraceptive methods and whether women's contraceptive experiences match their preferences. METHODS: Data were drawn from the Women's Healthcare Experiences and Preferences Study, an Internet survey of 1,078 women aged 18-55 randomly sampled from a national probability panel. Survey items assessed women's preferences for contraceptive methods, match between methods preferred and used, and perceived reasons for mismatch...
October 6, 2016: Journal of Women's Health
Meike Flore, Xiaoshuang Lilly Chen, Andrew Bonney, Judy Mullan, Bridget Dijkmans-Hadley, Adam Hodgkins, Gina Evans, Haley Frew, Gail Lloyd
BACKGROUND: Women with long-acting, reversible contraceptive devices inserted may choose to remove them prior to their planned expiry dates. OBJECTIVE: The objective of this study was to explore Australian women's experiences with the etonogestrel subdermal contraceptive implant (Implanon NXT) and why they had it removed early. METHODS: Semi-structured interviews were conducted with 18 women between June 2013 and January 2014. Transcriptions of the audio-taped interviews were analysed using a constant comparative analysis framework...
October 2016: Australian Family Physician
Stembile Mugore, Ntapi Tchiguiri K Kassouta, Boniface Sebikali, Laurel Lundstrom, Abdulmumin Saad
High-quality postabortion care (PAC) services that include family planning counseling and a full range of contraceptives at point of treatment for abortion complications have great potential to break the cycle of repeat unintended pregnancies and demand for abortions. We describe the first application of a systematic approach to quality improvement of PAC services in a West African country. This approach-IntraHealth International's Optimizing Performance and Quality (OPQ) approach-was applied at 5 health care facilities in Togo starting in November 2014...
September 28, 2016: Global Health, Science and Practice
Nicola Brodie, Elizabeth A Silberholz, Nancy D Spector, Amy E Pattishall
PURPOSE OF REVIEW: The present article addresses recent research related to three key facets of adolescent preventive care and health maintenance: long-acting reversible contraception, human papillomavirus vaccination, and heavy menstrual bleeding. RECENT FINDINGS: Recent studies suggest that long-acting reversible contraception use results in significantly lower rates of unintended pregnancies, and is well tolerated by nulliparous adolescent females. Additionally, a strong recommendation from a pediatric primary care provider is extremely effective in ensuring human papillomavirus vaccination prior to sexual debut...
September 26, 2016: Current Opinion in Pediatrics
Susannah E Gibbs, Corinne H Rocca, Paula Bednarek, Kirsten M J Thompson, Philip D Darney, Cynthia C Harper
PURPOSE: The majority of pregnancies during adolescence are unintended, and few adolescents use long-acting reversible contraception (LARC) due in part to health care providers' misconceptions about nulliparous women's eligibility for the intrauterine device. We examined differences in LARC counseling, selection, and initiation by age and parity in a study with a provider's LARC training intervention. METHODS: Sexually active women aged 18-25 years receiving contraceptive counseling (n = 1,500) were enrolled at 20 interventions and 20 control clinics and followed for 12 months...
September 21, 2016: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Helena Hognert, Helena Kopp Kallner, Sharon Cameron, Christina Nyrelli, Izabella Jawad, Rebecca Heller, Annette Aronsson, Ingela Lindh, Lina Benson, Kristina Gemzell-Danielsson
STUDY QUESTION: Does a progestin releasing subdermal contraceptive implant affect the efficacy of medical abortion if inserted at the same visit as the progesterone receptor modulator, mifepristone, at medical abortion? SUMMARY ANSWER: A etonogestrel releasing subdermal implant inserted on the day of mifepristone did not impair the efficacy of the medical abortion compared with routine insertion at 2-4 weeks after the abortion. WHAT IS ALREADY KNOWN: The etonogestrel releasing subdermal implant is one of the most effective long acting reversible contraceptive methods...
September 22, 2016: Human Reproduction
David Hubacher, Hannah Spector, Charles Monteith, Pai-Lien Chen, Catherine Hart
BACKGROUND: Measures of contraceptive effectiveness combine technology and user-related factors. Observational studies show higher effectiveness of long-acting reversible contraception compared with short-acting reversible contraception. Women who choose long-acting reversible contraception may differ in key ways from women who choose short-acting reversible contraception, and it may be these differences that are responsible for the high effectiveness of long-acting reversible contraception...
September 20, 2016: American Journal of Obstetrics and Gynecology
Helena Kopp Kallner, Kristina Gemzell Danielsson
Preservation of fertility and optimizing health before pregnancy is becoming increasingly important in societies where childbirth often is postponed. Research shows that as women postpone childbirth they achieve higher levels of education and higher incomes. This leads to advantages for their children and for society. However, as women postpone childbearing they are at risk for contracting conditions which may affect fertility and/or pregnancies, pregnancy outcome, and the newborn child. Preconception counseling is therefore becoming increasingly important...
September 20, 2016: Upsala Journal of Medical Sciences
Elise D Berlan, Nicole M Pritt, Alison H Norris
PURPOSE: Adolescents are at high risk for unintended pregnancy. Given pediatricians' potential role in contraceptive counseling, understanding their attitudes and beliefs and counseling practices about use of long acting reversible contraceptives (LARC) [i.e., etonogestrel implant and intrauterine devices (IUDs)] is vital. METHODS: We interviewed primary care pediatricians (N=23) in a Midwestern city in June-August 2014. We transcribed the interviews, developed a coding schema, and analyzed these qualitative data using a priori and open coding of transcripts...
September 14, 2016: Journal of Pediatric and Adolescent Gynecology
Jenny A Higgins, Renee D Kramer, Kristin M Ryder
Long-acting reversible contraception (LARC) is effective and acceptable. However, concern exists about potential provider bias in LARC promotion. No study has documented contraceptive users' attitudes toward or experiences with provider influence and bias regarding LARC. We collected qualitative data in 2014 to address this gap. Participants were 50 young adult women with any history of contraceptive use (including LARC) in Dane County, Wisconsin. Women often described providers as a trusted source of contraceptive information...
November 2016: American Journal of Public Health
Yasamin Kusunoki, Jennifer S Barber, Elizabeth J Ela, Amelia Bucek
This study examines black-white and other sociodemographic differences in young women's sexual and contraceptive behaviors, using new longitudinal data from a weekly journal-based study of 1,003 18- to 19-year-old women spanning 2.5 years. We investigate hypotheses about dynamic processes in these behaviors during early adulthood in order to shed light on persisting racial differences in rates of unintended pregnancies in the United States. We find that net of other sociodemographic characteristics and adolescent experiences with sex and pregnancy, black women spent less time in relationships and had sex less frequently in their relationships than white women, but did not differ in the number of relationships they formed or in their frequency or consistency of contraceptive use within relationships...
October 2016: Demography
Kalpesh Bhuva, Jennifer L Kraschnewski, Erik B Lehman, Cynthia H Chuang
OBJECTIVE: Overweight and obese women may avoid contraceptive methods they believe are associated with weight gain. The objective of this study was to examine the role of weight and weight perception on contraceptive use. STUDY DESIGN: Using cross-sectional data from the MyNewOptions study, we analyzed contraceptive use among 987 privately insured, sexually active women aged 18-40 years. Contraception was categorized into three groups: (1) long-acting reversible contraceptives (LARCs), (2) non-LARC prescription methods and (3) nonprescription methods/no method...
September 9, 2016: Contraception
Anne L Dunlop, Esther Kathleen Adams, Jonathan Hawley, Sarah C Blake, Peter Joski
PURPOSE: We sought to assess the impact of Georgia's family planning demonstration waiver upon access to and use of contraceptive and preventive health services within Title X and Medicaid. PROCEDURES: Georgia Title X and Medicaid data for January 2009 through December 2013 (before and after the waiver), restricting Title X data to women targeted by the waiver (18-44 years, incomes from 25% and 50% through 200% of the federal poverty level [FPL]) was assembled by quarter and marginal effects of the changes before and after waiver implementation were derived using multivariate regression models...
September 3, 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
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