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https://www.readbyqxmd.com/read/28624570/effects-of-intrauterine-contraception-on-the-vaginal-microbiota
#1
Christine M Bassis, Jenifer E Allsworth, Heather N Wahl, Daniel E Sack, Vincent B Young, Jason D Bell
OBJECTIVES: There have been conflicting reports of altered vaginal microbiota and infection susceptibility associated with contraception use. The objectives of this study were to determine if intrauterine contraception altered the vaginal microbiota and to compare the effects of a copper intrauterine device (Cu-IUD) and a levonorgestrel intrauterine system (LNG-IUS) on the vaginal microbiota. STUDY DESIGN: DNA was isolated from the vaginal swab samples of 76 women using Cu-IUD (n=36) or LNG-IUS (n=40) collected prior to insertion of intrauterine contraception (baseline) and at 6 months...
June 14, 2017: Contraception
https://www.readbyqxmd.com/read/28617060/levonorgestrel-releasing-intrauterine-system-lng-ius-12-for-prevention-of-pregnancy-for-up-to-five-years
#2
Anita L Nelson
A new five-year low dose, smaller-framed, levonorgestrel-releasing intrauterine contraceptive system (LNG-IUS 12) has been introduced to complement the currently available systems. Areas Covered: This article will provide an overview of this new intrauterine system - its composition and its mechanisms of action as well as the results of the Phase II and III clinical trials of its efficacy, safety and tolerability. Expert Commentary: This new LNG-IUS 12 provides five-year contraceptive protection a pregnancy rate (less than 1%) in first year of use, which puts it into the top tier with the existing LNG-IUS 20 products; however, the LNG-IUS 12 does not have the high rates of amenorrhea often seen with the higher dose devices...
June 19, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28596121/one-year-continuation-of-copper-or-levonorgestrel-intrauterine-devices-initiated-at-the-time-of-emergency-contraception
#3
J N Sanders, D K Turok, P A Royer, I S Thompson, L M Gawron, K E Storck
OBJECTIVE(S): This study compares one-year intrauterine device (IUD) continuation among women presenting for emergency contraception (EC) and initiating the copper (Cu T380A) IUD or the levonorgestrel (LNG) 52 mg IUD plus 1.5 mg oral LNG. STUDY DESIGN: This cohort study enrolled 188 women who presented at a single family planning clinic in Utah between June 2013 and September 2014 and selected either the Cu T380A IUD or LNG 52 mg IUD plus oral LNG for EC. Trained personnel followed participants by phone, text, or email for twelve months or until discontinuation occurred...
June 5, 2017: Contraception
https://www.readbyqxmd.com/read/28595627/trends-in-use-of-and-complications-from-intrauterine-contraceptive-devices-and-tubal-ligation-or-occlusion
#4
Brandon Howard, ElizaBeth Grubb, Maureen J Lage, Boxiong Tang
BACKGROUND: Long-acting reversible contraceptives such as intrauterine devices (IUDs) are highly effective in preventing pregnancy, cost effective, and increasing in popularity. It is unclear whether changes in IUD use are associated with changes in rates of irreversible tubal sterilization. In this analysis, we evaluate changes in rates of tubal sterilization, insertion of copper or levonorgestrel (LNG) IUDs, and related complications over time. METHODS: Data were obtained from a retrospective claims database (Optum(TM) Clinformatics(TM) Data Mart) of women aged 15 to 45 years who underwent insertion of copper or LNG IUD or tubal sterilization between 1/1/2006 and 12/31/2011...
June 8, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28536231/pregnant-with-a-perforated-levonorgestrel-intrauterine-system-and-visible-threads-at-the-cervical-os
#5
David L Howard, Lauren M Beasley
We present a case in which a patient presented with a pregnancy of unknown location and normally rising human chorionic gonadotropin (hCG) levels but with a levonorgestrel intrauterine device (LNG-IUD) present. The LNG-IUD had been placed 4.5 years ago. Although unintended, this pregnancy was desired. Strings were clearly visible and initial 2D ultrasound suggested intrauterine location of the LNG-IUD. The LNG-IUD could not be removed however. The patient was managed expectantly with close follow-up, serial beta-hCGs and serial ultrasounds until definitive diagnosis of the location of the pregnancy...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28485895/with-smart-strategies-immediate-postpartum-larc-is-possible
#6
Ara Aiken
No abstract text is available yet for this article.
May 9, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28373471/continuation-of-a-levonorgestrel-intrauterine-device-during-hematopoietic-stem-cell-transplant-a-case-report
#7
Paula C Brady, Robert J Soiffer, Elizabeth S Ginsburg
BACKGROUND: During treatment of hematologic malignancies in premenopausal women, both menstrual suppression and contraception are crucial. Continuation of hormonal intrauterine devices (IUDs) - widely used and highly effective contraceptives that also decrease menstrual flow - is controversial during hematopoietic stem cell transplants (SCTs) due to infectious and vaginal bleeding concerns. CASE REPORT: A 23-year-old nulligravid female was diagnosed with acute myeloid leukemia (AML, positive for FLT3-ITD, DNMT3A and RUNX1, with normal cytogenetics)...
April 2017: Anticancer Research
https://www.readbyqxmd.com/read/28342716/immediate-postpartum-intrauterine-device-and-implant-program-outcomes-a-prospective-analysis
#8
Jennifer L Eggebroten, Jessica N Sanders, David K Turok
BACKGROUND: In-hospital placement of intrauterine devices and contraceptive implants following vaginal and cesarean delivery is increasingly popular and responds to maternal motivation for highly effective postpartum contraception. Immediate postpartum intrauterine device insertion is associated with higher expulsion than interval placement, but emerging evidence suggests that the levonorgestrel intrauterine device may have a higher expulsion rate than the copper intrauterine device. OBJECTIVE: This study evaluated in-hospital provision, expulsion, and 6-month continuation of immediate postpartum copper T380 intrauterine devices, levonorgestrel intrauterine devices, and contraceptive implants...
March 23, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28322770/iud-use-among-parous-women-and-risk-of-uterine-perforation-a-secondary-analysis
#9
Klaas Heinemann, Clare Barnett, Suzanne Reed, Sabine Möhner, Thai Do Minh
OBJECTIVE: The objective of the study was to determine if delivery and lactation are risk factors for complete intrauterine device perforations. STUDY DESIGN: We performed a reanalysis of the European Active Surveillance Study on Intra-Uterine Devices data set using complete penetration of the myometrium as the definition for perforation. RESULTS: Of the 61,448 women enrolled (70% levonorgestrel, 30% copper devices), we identified 58 complete perforations, 30 of which occurred in lactating women...
March 16, 2017: Contraception
https://www.readbyqxmd.com/read/28315664/continuation-of-copper-and-levonorgestrel-intrauterine-devices-a-retrospective-cohort-study
#10
Sharon J Phillips, Lisa G Hofler, Anna M Modest, Lara F B Harvey, Lily H Wu, Michele R Hacker
BACKGROUND: Studies conflict on whether the duration of use of the copper intrauterine device is longer than that of the levonorgestrel intrauterine device, and whether women who continue using intrauterine devices differ from those who discontinue. OBJECTIVE: We sought to assess continuation rates and performance of levonorgestrel intrauterine devices compared with copper intrauterine devices over a 5-year period. STUDY DESIGN: We performed a retrospective cohort study of 1164 individuals who underwent intrauterine device placement at an urban academic medical center...
March 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28315609/the-levonorgestrel-releasing-intrauterine-device-potentiates-stress-reactivity
#11
Jurate Aleknaviciute, Joke H M Tulen, Yolanda B De Rijke, Christian G Bouwkamp, Mark van der Kroeg, Mirjam Timmermans, Vincent L Wester, Veerle Bergink, Witte J G Hoogendijk, Henning Tiemeier, Elisabeth F C van Rossum, Cornelis G Kooiman, Steven A Kushner
BACKGROUND: The levonorgestrel-releasing intrauterine device (LNG-IUD) is currently recommended as a first-line contraceptive with an exclusively local intrauterine influence. However, recent clinical trials have identified side effects of LNG-IUD that appear to be systemically mediated, including depressed mood and emotional lability. METHODS: We performed two experimental studies and a cross-sectional study. For each study, women were included from three groups: LNG-IUD (0...
June 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28290977/actinomyces-related-tubo-ovarian-abscess-in-a-poorly-controlled-type-ii-diabetic-with-a-copper-intrauterine-device
#12
Ashley L Sawtelle, Nicole P Chappell, Caela R Miller
BACKGROUND: The historic association of Actinomyces israelii infection with intrauterine devices (IUDs) has long been recognized. In recent years, the risk of developing pelvic inflammatory disease with a copper or levonorgestrel IUD has been less than 1% in women who are low risk for sexually transmitted infections. IUD-related pelvic infections secondary to actinomyces have largely vanished from contemporary practice. CASE: A 49-year-old using a copper IUD for contraception with poorly controlled type II diabetes mellitus was admitted for suspected tubo-ovarian abscess on the basis of abdominopelvic pain, leukocytosis, and computed tomography findings...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28256913/family-planning-and-zika-virus-need-for-renewed-and-cohesive-efforts-to-ensure-availability-of-intrauterine-contraception-in-latin-america-and-the-caribbean
#13
Moazzam Ali, Kelsey Miller, Rodolfo Federico Gómez Ponce de Leon
OBJECTIVES: The advantages of intrauterine contraception (IUC) are well established (highly effective, low discontinuation rate, easy to use, low cost, and suitable for immediate postpartum use), but low levels of use in many countries and declining use in others are causes for concern. Due to the ongoing Zika virus outbreak, public health officials are calling for the continued practice of safe sex and the delay of pregnancy. Our study was conducted to assess the current situation of IUC availability and provision in Latin America and to determine the role of national policies in meeting the contraceptive needs of the populations in these countries...
April 2017: European Journal of Contraception & Reproductive Health Care
https://www.readbyqxmd.com/read/28188772/two-year-continuation-of-intrauterine-devices-and%C3%A2-contraceptive-implants-in-a-mixed-payer-setting-%C3%A2-a%C3%A2-retrospective-review
#14
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 2-year continuation rates for the levonorgestrel 52-mg intrauterine device, the copper T380A intrauterine device, and the 68-mg etonogestrel contraceptive implant in an academic healthcare system with mixed-payer reimbursement. OBJECTIVE: The purpose of this study was to examine the proportion and characteristics of women who continue intrauterine device and implant use to 2 years and to 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
#15
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-2-years-beyond-food%C3%A2-and%C3%A2-drug-administration-approved-duration
#16
Colleen McNicholas, Erin Swor, Leping Wan, Jeffrey F Peipert
BACKGROUND: The subdermal contraceptive implant and the 52-mg levonorgestrel intrauterine device are currently Food and Drug Administration approved for 3 and 5 years of use, respectively. Limited available data 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: We sought to evaluate the effectiveness of the contraceptive implant and the 52-mg hormonal intrauterine device in women using the method for 2 years beyond the current Food and Drug Administration-approved duration...
June 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28140761/healthcare-provider-attitudes-regarding-contraception-for-women-with-obesity
#17
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
#18
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...
April 2017: Contraception
https://www.readbyqxmd.com/read/27992305/healthcare-provider-attitudes-of-safety-of-intrauterine-devices-in-the-postpartum-period
#19
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
#20
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...
May 2017: American Journal of Obstetrics and Gynecology
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