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https://www.readbyqxmd.com/read/28188772/two-year-continuation-of-intrauterine-devices-and-contraceptive-implants-in-a-mixed-payer-setting-a-retrospective-review
#1
Jessica N Sanders, David K Turok, Lori M Gawron, Amy Law, Lonnie Wen, Richard Lynen
BACKGROUND: As the popularity of long-acting reversible contraception increases, so does the need for accurate data on method continuation in diverse clinical settings. We determined two-year continuation rates for the levonorgestrel 52mg intrauterine device, the copper T380A intrauterine device, and the 68mg etonogestrel contraceptive implant in an academic healthcare system with mixed-payer reimbursement. OBJECTIVE(S): To examine the proportion and characteristics of women who continue IUD and implant use to two years and relate continuation to device type when controlling for patient characteristics...
February 8, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28176932/intrauterine-levonorgestrel-delivery-with-frameless-fibrous-delivery-system-review-of-clinical-experience
#2
REVIEW
Dirk Wildemeersch, Amaury Andrade, Norman D Goldstuck, Thomas Hasskamp, Geert Jackers
The concept of using a frameless intrauterine device (IUD) instead of the conventional plastic framed IUD is not new. Frameless copper IUDs have been available since the late 1990s. They rely on an anchoring system to retain in the uterine cavity. The clinical experience with these IUDs suggests that frameless IUDs fit better as they are thin and, therefore, do not disturb or irritate the uterus. High tolerance and continuation rates have been achieved as complaints of pain are virtually nonexistent and the impact on menstrual blood loss is minimal...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28147241/prolonged-use-of-the-etonogestrel-implant-and-levonorgestrel-intrauterine-device-two-years-beyond-fda-approved-duration
#3
Colleen McNicholas, Erin Swor, Leping Wan, Jeffrey F Peipert
BACKGROUND: The subdermal contraceptive implant, and the 52mg levonorgestrel intrauterine device (IUD) are currently FDA-approved for three and five years of use respectively. Limited available data has suggested both of these methods are effective beyond that time. Demonstration of prolonged effectiveness will improve the cost-effectiveness of the device, and potentially patient continuation and satisfaction. OBJECTIVE: To evaluate the effectiveness of the contraceptive implant and the 52-mg hormonal intrauterine device (IUD) in women using the method for two years beyond the current FDA-approved duration...
January 29, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28140761/healthcare-provider-attitudes-regarding-contraception-for-women-with-obesity
#4
Tara C Jatlaoui, Lauren B Zapata, Kathryn M Curtis, Suzanne G Folger, Polly A Marchbanks, Michele G Mandel, Denise J Jamieson
BACKGROUND: Whether providers who regularly provide family planning services consider contraceptive methods as unsafe for women with obesity is unknown. METHODS: We analyzed questionnaire responses received from December 2009 to March 2010 from 635 office-based physicians and 1323 Title X clinic providers delivering family planning services, who were randomly sampled (response rate 65%) before the release of national evidence-based contraception guidelines. We examined provider and clinical setting characteristics and clinic patient demographics for association with provider misconceptions about safety of combined oral contraceptives (COCs), depot medroxyprogesterone acetate (DMPA), or intrauterine devices (IUDs) for women with obesity...
January 31, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28041992/changes-in-body-composition-in-women-using-long-acting-reversible-contraception
#5
Priscilla de Nazaré Silva Dos Santos, Tessa Madden, Karen Omvig, Jeffrey F Peipert
OBJECTIVE: Users of hormonal long-acting reversible contraception (LARC) report weight gain as a side effect, but few studies have assessed body composition change among LARC users. We evaluated weight and body composition of healthy women using the levonorgestrel intrauterine system (LNG-IUS), copper intrauterine device (copper IUD) or etonogestrel implant (ENG implant). We hypothesized that weight gain and body composition over 12 months would not differ between copper IUD, LNG-IUS and ENG implant users...
December 30, 2016: Contraception
https://www.readbyqxmd.com/read/27992305/healthcare-provider-attitudes-of-safety-of-intrauterine-devices-in-the-postpartum-period
#6
Lisa A Rauh-Benoit, Naomi K Tepper, Lauren B Zapata, Maura K Whiteman, Kathryn M Curtis, Michele G Mandel, Polly A Marchbanks, Denise J Jamieson
OBJECTIVE: Immediate postpartum intrauterine devices (IUDs) have been underutilized in the United States despite their known safety. Understanding how providers' attitudes contribute to underutilization is important in improving access. Our objective was to examine healthcare providers' perceptions of the safety of immediate postpartum IUDs before publication of United States contraceptive guidelines. MATERIALS AND METHODS: We analyzed survey data collected from December 2009 to March 2010 from 635 office-based physicians and 1368 Title X clinic providers (overall response rate of 64...
December 19, 2016: Journal of Women's Health
https://www.readbyqxmd.com/read/27988268/unscheduled-vaginal-bleeding-with-progestin-only-contraceptive-use
#7
REVIEW
Rachel E Zigler, Colleen McNicholas
Nearly 20% of women using contraception are using progestin-only contraception, including progestin-only pills, depot-medroxyprogesterone acetate, subdermal etonogestrel implants, and levonorgestrel intrauterine devices. This number will continue to grow with the increased provision of long-acting reversible contraception. Although overall satisfaction among women using progestin-only contraception is high, dissatisfaction and discontinuation may be associated with unscheduled bleeding and spotting. The exact etiology of irregular bleeding associated with progestin-containing contraceptives is not completely understood, yet several mechanisms have been suggested...
December 14, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27932442/contraceptive-sales-in-the-setting-of-the-zika-virus-epidemic
#8
Luis Bahamondes, Moazzam Ali, Ilza Monteiro, Arlete Fernandes
STUDY QUESTION: Has there been any influence of the Zika virus (ZIKV) outbreak on the sales of contraceptive methods in Brazil? SUMMARY ANSWER: Contraceptive sales in the 24 months of evaluation showed little variation and no significant change has been observed since the ZIKV outbreak. WHAT IS KNOWN ALREADY: Transmission of ZIKV is primarily by Aedes aegypti mosquitoes; however, sexual transmission has also been described. The association of several birth defects and the ZIKV infection during pregnancy has been established, and it was estimated in Bahia, Brazil that the infection rate could range from 10% to 80%...
January 2017: Human Reproduction
https://www.readbyqxmd.com/read/27861709/contraceptive-use-in-the-nordic-countries
#9
Ingela Lindh, Finn E Skjeldestad, Kristina Gemzell-Danielsson, Oskari Heikinheimo, Helena Hognert, Ian Milsom, Øjvind Lidegaard
INTRODUCTION: The aim was to compare contraceptive use in the Nordic countries and to assess compliance with recommendations from the European Medicines Agency regarding the use of combined oral contraception containing low-dose estrogen and levonorgestrel, norethisterone or norgestimate. MATERIAL AND METHODS: Data on hormonal contraceptive prescriptions and sales figures for copper intrauterine devices were obtained from national databases and manufacturers in Denmark, Finland, Iceland, Norway and Sweden in 2010-2013...
January 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/27836586/intrauterine-contraception-after-medical-abortion-factors-affecting-success-of-early-insertion
#10
Elina Pohjoranta, Satu Suhonen, Maarit Mentula, Oskari Heikinheimo
OBJECTIVE: To assess the success and factors affecting early intrauterine device (IUD) provision after first trimester medical termination of pregnancy (MTOP). STUDY DESIGN: Subgroup analysis of a randomized contraceptive trial assessing the long-term effects of early provision of intrauterine contraception following abortion. Altogether, 606 women undergoing MTOP were included and followed for 3 months. The intervention group (n=307) was offered an IUD (either the levonorgestrel-releasing intrauterine system or copper-IUD) at a follow-up visit 1-4 weeks after MTOP...
November 9, 2016: Contraception
https://www.readbyqxmd.com/read/27818117/-induced-abortion-guidelines-for-clinical-practice%C3%A2-%C3%A2-text-of-the-guidelines-short-text
#11
C Vayssière, A Gaudineau, L Attali, K Bettahar, S Eyraud, P Faucher, P Fournet, D Hassoun, M Hatchuel, C Jamin, B Letombe, T Linet, M Msika Razon, A Ohanessian, H Segain, S Vigoureux, N Winer, S Wylomanski, A Agostini
OBJECTIVE: Develop recommendations for the practice of induced abortion. MATERIALS AND METHODS: The Pubmed database, the Cochrane Library and the recommendations from the French and foreign Gyn-Obs societies or colleges have been consulted. RESULTS: The number of induced abortions (IA) has been stable for several decades. There are a lot of factors explaining the choice of abortion when there is an unplanned pregnancy (UPP). Early initiation and choice of contraception in connection to the woman's life are associated with lower NSP...
December 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27677612/women-with-epilepsy-initiating-a-progestin-iud-a-prospective-pilot-study-of-safety-and-acceptability
#12
Anne R Davis, Heva J Saadatmand, Alison Pack
OBJECTIVE: Effective contraception enables women with epilepsy (WWE) to plan their pregnancies and improve outcomes for themselves and their children. Although popular among all women, complex drug interactions limit the efficacy and safety of oral contraceptives (OCs) for WWE. We sought to explore the safety, acceptability, and pharmacokinetic impact of a progestin-containing intrauterine device (IUD) in WWE. METHODS: We enrolled 20 women with well-controlled epilepsy and a stable antiepileptic drug (AED) regimen and who were initiating a progestin-containing IUD (levonorgestrel 52 mg) in a prospective, observational study...
November 2016: Epilepsia
https://www.readbyqxmd.com/read/27676405/update-on-emergency-contraception
#13
Wing Kay Fok, Paul D Blumenthal
PURPOSE OF REVIEW: Emergency contraception provides a critical and time-sensitive opportunity for women to prevent undesired pregnancy after intercourse. Both access and available options for emergency contraception have changed over the last several years. RECENT FINDINGS: Emergency contraceptive pills can be less effective in obese women. The maximum achieved serum concentration of levonorgestrel (LNG) is lower in obese women than women of normal BMI, and doubling the dose of LNG (3 mg) increases its concentration maximum, approximating the level in normal BMI women receiving one dose of LNG...
December 2016: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27671673/extended-use-up-to-5-years-of-the-etonogestrel-releasing-subdermal-contraceptive-implant-comparison-to-levonorgestrel-releasing-subdermal-implant
#14
Moazzam Ali, Ayse Akin, Luis Bahamondes, Vivian Brache, Ndema Habib, Sihem Landoulsi, David Hubacher
STUDY QUESTION: Is it possible to extend the use of the 3-year one-rod etonogestrel (ENG)-releasing subdermal contraceptive implant to 5 years? SUMMARY ANSWER: The extended use of the one-rod ENG-releasing subdermal contraceptive implant showed 100% efficacy in years 4 and 5. WHAT IS KNOWN ALREADY: The initial regulated trials on the ENG-releasing subdermal contraceptive implant conducted in the 1990 s were designed to measure cumulative 3-year efficacy...
November 2016: Human Reproduction
https://www.readbyqxmd.com/read/27607867/levonorgestrel-intrauterine-device-as-an-endometrial-cancer-prevention-strategy-in-obese-women-a-cost-effectiveness-analysis
#15
Joseph A Dottino, Vic Hasselblad, Angeles Alvarez Secord, Evan R Myers, Junzo Chino, Laura J Havrilesky
OBJECTIVE: To estimate the cost-effectiveness of the levonorgestrel intrauterine device (IUD) as an endometrial cancer prevention strategy in obese women. METHODS: A modified Markov model was used to compare IUD placement at age 50 with usual care among women with a body mass index (BMI, kg/m) 40 or greater or BMI 30 or greater. The effects of obesity on incidence and survival were incorporated. The IUD was assumed to confer a 50% reduction in cancer incidence over 5 years...
October 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27591814/temporary-removal-use-of-intrauterine-devices-in-nulliparous-women
#16
Patricia A Lohr, Richard Lyus, Sarah Prager
No abstract text is available yet for this article.
August 31, 2016: Contraception
https://www.readbyqxmd.com/read/27540128/expanding-access-to-a-new-more-affordable-levonorgestrel-intrauterine-system-in-kenya-service-delivery-costs-compared-with-other-contraceptive-methods-and-perspectives-of-key-opinion-leaders
#17
Kate H Rademacher, Marsden Solomon, Tracey Brett, John H Bratt, Claire Pascual, Jesse Njunguru, Markus J Steiner
BACKGROUND: The levonorgestrel intrauterine system (LNG IUS) is one of the most effective forms of contraception and offers important non-contraceptive health benefits. However, it is not widely available in developing countries, largely due to the high price of existing products. Medicines360 plans to introduce its new, more affordable LNG IUS in Kenya. The public-sector transfer price will vary by volume between US$12 to US$16 per unit; for an order of 100,000 units, the public-sector transfer price will be approximately US$15 per unit...
August 11, 2016: Global Health, Science and Practice
https://www.readbyqxmd.com/read/27437931/the-effects-of-hormones-and-vaginal-microflora-on-the-glycome-of-the-female-genital-tract-cervical-vaginal-fluid
#18
Bernard J Moncla, Catherine A Chappell, Brian M Debo, Leslie A Meyn
In this study, we characterized the glycome of cervical-vaginal fluid, collected with a Catamenial cup. We quantified: glycosidase levels; sialic acid and high mannose specific lectin binding; mucins, MUC1, MUC4, MUC5AC, MUC7; and albumin in the samples collected. These data were analyzed in the context of hormonal status (day of menstrual cycle, hormonal contraception use) and role, if any, of the type of the vaginal microflora present. When the Nugent score was used to stratify the subjects by microflora as normal, intermediate, or bacterial vaginosis, several important differences were observed...
2016: PloS One
https://www.readbyqxmd.com/read/27421765/the-safety-of-intrauterine-devices-in-breastfeeding-women-a-systematic-review
#19
REVIEW
Erin N Berry-Bibee, Naomi K Tepper, Tara C Jatlaoui, Maura K Whiteman, Denise J Jamieson, Kathryn M Curtis
OBJECTIVES: To investigate levonorgestrel (LNG)-releasing and copper-bearing (Cu) intrauterine device (IUD) safety among breastfeeding women and, for Cu-IUD use, breastfeeding performance and infant health. STUDY DESIGN: Systematic review. METHODS: We searched PubMed, Embase, Cochrane Library and clinicaltrials.gov for articles through January 2016. We included studies of Cu-IUD or LNG-IUD users comparing IUD-specific (perforation, expulsion) and other contraceptive-related (infection, removal/cessation due to bleeding/pain and other adverse events) outcomes for breastfeeding vs...
December 2016: Contraception
https://www.readbyqxmd.com/read/27374735/immunologic-evaluation-of-the-endometrium-with-a-levonorgestrel-intrauterine-device-in-solid-organ-transplant-women-and-healthy-controls
#20
Caron R Kim, Otoniel Martinez-Maza, Larry Magpantay, Clara Magyar, Jeffrey Gornbein, Radhika Rible, Peggy Sullivan
OBJECTIVES: To describe the endometrial milieu of stable transplant patients and healthy women before and after levonorgestrel intrauterine system (LNG-IUS) insertion. STUDY DESIGN: Women between 18-45 years of age desiring LNG-IUS insertion were enrolled with a 2:1 ratio of healthy to stable solid organ transplant patients. The first visit entailed a blood draw, uterine lavage and endometrial biopsy followed by LNG-IUS insertion. Follow-up visit involved a repeat serum draw, uterine lavage and endometrial biopsy...
June 30, 2016: Contraception
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