Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors present their findings from the study of adolescents' reasons for discontinuing the use of Norplant and Depo-Provera. Their experiences after method discontinuation were also assessed. 35 adolescents of mean gynecologic age 4.7 years and body mass index (BMI) 24.2 who discontinued Depo-Provera, and 31 adolescents of mean gynecologic age 3.4 years and BMI 24.1 who discontinued Norplant were periodically assessed during use of the methods and up to 12 months after discontinuation. The most common reasons for discontinuation of both Norplant and Depo-Provera after mean periods of 21.8 and 9.2 months use, respectively, were irregular menstrual bleeding (64%), weight gain (41%), and increased headaches (30%). The resumption of menstrual regularity and dysmenorrhea was noted sooner after discontinuation of Norplant, compared to Depo-Provera. The increase in BMI noted at the discontinuation of Depo-Provera persisted up to 6 months after discontinuation of either method. 62% of adolescents reported no break in contraceptive practice. The condom was the most popular method (37%) after discontinuation of Depo-Provera, and oral contraceptives (39%) after discontinuation of Norplant. The authors conclude that health care providers should aggressively manage physical problems associated with Depo-Provera and Norplant use, and expedite the transition to new contraceptive methods in an effort to minimize the high pregnancy rates observed after discontinuation of these methods in adolescents.
 ...
PMID:Adolescents' reasons for and experience after discontinuation of the long-acting contraceptives Depo-Provera and Norplant. 886 83

This study examines early contraceptive implant discontinuation among low-income clinic patients in Dallas, New York, and Pittsburgh and the impact of negative media coverage of Norplant in the press. Interviews were conducted among 786 women during 1993-94 at baseline, prior to insertion, and 6 months later. The explanatory logistic model included sociodemographic characteristics of users, motivation to avoid unintended pregnancy, satisfaction with previous contraceptive methods, and negative media coverage of a method of birth control. The sample population included only 55% who had completed high school, 22% who were currently employed, and 94% with at least one prior pregnancy. 70% had had at least one unintended pregnancy. 29% had experienced two or more unintended pregnancies. 8% had had no live births. 60% of the women were adolescents at the time of their first birth. The cumulative life table 6-month discontinuation rate was 7.6% (58 women out of 786). The removal rate was 1.02 during month 2, 1.55 during month 3, and almost 1.50 during months 4-6. 28% had the implant removed due to menstrual side effects, 19% complained of headaches, and 10% had some arm discomfort. 9% experienced weight changes and early removal. 7% discontinued use due to mood changes, and 5% stated hair loss, chest pains, or negative media reports as the reasons. About 75% of discontinuers and continuers reported side effects due to less regular menstrual periods. Discontinuers were more likely than continuers to report headaches, hair loss, weight gain, and the perception of long-term health problems. Discontinuers were more likely to report arm infection. Among the 33% exposed to intense negative media coverage, only 15% discontinued use. Findings suggest that counselors should explore the fertility desires of a woman and her spouse and refrain from promoting a specific method.
 ...
PMID:Determinants of early implant discontinuation among low-income women. 895 15

Although Thailand's National Family Planning Program introduced Norplant contraceptive implants in 1986, few women infected with human immunodeficiency virus (HIV) select this method, and its efficacy, clinical effects, and side effects in this population have not been investigated. To address these issues, a prospective cohort study was conducted during 1993-96 of 41 asymptomatic HIV-infected women who presented to the Family Planning Clinic at Ramathibodi Hospital in Bangkok, Thailand, and voluntarily accepted Norplant implants. All implants were inserted within 4 weeks after delivery or abortion. 63.4% of acceptors had not used any contraceptive method prior to pregnancy. At 6 and 12 months after insertion, 26% and 23%, respectively, reported irregular menstrual periods and 24.4% and 36.6%, respectively, reported amenorrhea. Side effects, reported by 3-10% of women, included headache, acne/chloasma, anorexia, and nausea. There were no significant changes in body weight, blood pressure, and hemoglobin between insertion and the 12-month follow-up. No pregnancies occurred during the study period. These findings suggest that Norplant implants are an effective, appropriate contraceptive method for HIV-infected women who want to avoid pregnancy but are not interested in sterilization.
 ...
PMID:Use of Norplant implants in asymptomatic HIV-1 infected women. 917 51

Field research conducted in 24 rural townships in four counties (Zunhua and Leting in Hebei Province and Boshan and Yiyuan in Shandong Province) in China identified potential local-level obstacles to widespread use of Norplant contraceptive implants. A total of 1556 women received the implants between June 1992 and June 1993. In 1992, Norplant represented 20% of total contraceptive use in the study area; however, in 1993, this statistic dropped to 10% in 3 of the 4 counties. About 49% of Norplant acceptors experienced at least 1 side effect in the first 6 months, primarily menstrual disorders, headache, vertigo, and nausea. The gross discontinuation rate due to menstrual disorder was 1% at 6 months, 3% at 12 months, and 8% at 24 months; the overall discontinuation rates were 2%, 4%, and 10%, respectively. There were only 3 pregnancies due to method failure in the 24-month study period. Despite the high acceptability and effectiveness of this method, family planning workers complained that the required acceptor screening, insertion, follow-up visits, counseling, and treatment of side effects associated with Norplant increased their work loads. The decline in the method's popularity from 1992 to 1993 is presumed due to local program-related factors such as decreased implementation of an informed choice policy, unavailability of daily Norplant insertion services, the slow response of family planning workers to requests for treatment of side effects or capsule removal, and the improved availability of alternative contraceptive choices. However, demand for Norplant remained stable in Yiyuan County, where there was widespread resistance to sterilization and a willingness on the part of family planning workers to accept the increased work load associated with this method.
 ...
PMID:Acceptance, efficacy, and side effects of Norplant implants in four counties in north China. 921 32

Norplant was first introduced in Ethiopia in 1994. This study examines the safety, efficacy, tolerance, and acceptability of Norplant among 364 patients of reproductive age who obtained implants from the Family Planning Department of the Gandhi Memorial Hospital during June-December, 1994. During the study period, 608 patients were provided with information about family planning methods. 110 accepted injectables, and 115 accepted oral pills. 96.7% of patients were married, 84.3% were urbanites, 84.9% were educated, 70.1% were housewives, and 91.5% were Christians. The mean age was 27.9 years. Ages ranged from 17 to 45 years. The mean body weight was 53.5 kg. Blood pressure readings were low for most women. The mean number of living children was 3.1. 70.3% of Norplant patients switched from other family planning methods. The mean duration of contraceptive use was 23.5 months. The average duration of Norplant implants since insertion was 25.3 months. The range was 3-30 months. 33.0% women were lactating at the time of insertion. The mean time of insertion was 12.5 minutes. Times ranged from 5 to 20 minutes. Insertion was made in the medial aspect of the upper left arm for right-handed women. A 2 mm incision was made, and six flexible capsules were inserted in a fan-shaped pattern with the help of a trocar. Insertion was performed under aseptic conditions and local anesthesia. Patients were advised to keep the dressed site clean and dry for a week, at which time dressings were removed and the site was checked for infection. Other check-ups were made at monthly intervals for 3 months. The most frequent complications were irregular bleeding, amenorrhea, headache, weight change, and local pain at the insertion site. The continuation rate was 95.1%. 93.9% rated Norplant highly. Health personnel were the main source of information about Norplant.
 ...
PMID:Norplant implants in Ethiopia. 929 31

Presented in this report are the recommendations of two expert groups, the Technical Guidance/Competence Working Group of the US Agency for International Development's Maximizing Access and Quality Initiative and the World Health Organization's Family Planning and Population Unit, regarding currently available family planning methods. The former group addressed key biomedical questions and formulated recommendations about 11 groups of family planning methods: combined oral contraceptives, progestin-only pills during breast feeding, progestin-only injectables, combined injectable contraceptives, Norplant implants, copper-bearing IUDs, tubal occlusion, vasectomy, lactational amenorrhea method, natural family planning, and barrier methods. A table presents the relative importance, by method, of procedures such as pelvic exam, blood pressure reading, breast exam, and screening for sexually transmitted diseases and cervical cancer. The medical eligibility recommendations for each method are also presented in tabular form, with four categories for temporary methods: 1) no restrictions on use, 2) advantages generally outweigh theoretical or proven risks, 3) theoretical or proven risks usually outweigh the advantages, and 4) unacceptable health risks. Included among the 41 conditions for which eligibility criteria are specified are age, smoking, thromboembolic disorder, headaches, irregular vaginal bleeding, family history of breast cancer, obesity, drug interactions, parity, breast feeding, postpartum, and postabortion. The new guidance presented in this report enables providers to give family planning clients expanded contraceptive choices while ensuring method safety and effectiveness.
 ...
PMID:Family planning methods: new guidance. 934 75

A retrospective study of 144 US women 14-21 years of age who requested and received the Norplant contraceptive implant system at the Mayo Clinic (Rochester, Minnesota) in 1990-93 analyzed the factors associated with duration of method use. Of the 124 women who reported past use of contraception, 94 (76%) had been pregnant at least once. The method most commonly used before Norplant was oral contraception (57%). The reasons for Norplant selection were its convenience (86%) and problems tolerating the pill (14%). Of the 130 Norplant users who either telephoned or made a clinic appointment after insertion, 60% reported side effects such as breakthrough bleeding, headache, and depression or mood swings. 64 women had the implants removed. The median duration of Norplant use was 29 months. The Kaplan-Meier estimate of the probability of the Norplant system remaining in place for at least 12 months was 83% and 63% for at least 24 months. Age, prior contraceptive use, and timing of insertion had no impact on duration of Norplant use. Multivariate analysis indicated that women with at least 1 prior pregnancy had a two-fold increased risk of Norplant removal compared to those who had never been pregnant. Larger studies are needed to identify additional factors associated with long-term use of injectable contraception among young women and to suggest interventions that would improve compliance with routine follow-up.
 ...
PMID:Levonorgestrel contraceptive implants in female patients 14 to 21 years old. 944 73

Since 1986, Thailand's National Family Planning Program has included the Norplant 6-capsule implant system. The present paper reports the results of a 3-year Phase III clinical trial of the newly developed 2-rod system (Norplant-2). A total of 140 women (mean age, 29 years), in Bangkok, were enrolled and 103 women completed 3 years of method use. The continuation rates at 1, 2, and 3 years were 93.9%, 89.2%, and 82.8%, respectively. There were no accidental pregnancies during the 3-year study period. The 3-year cumulative termination rate was 7.2% for personal reasons (e.g., divorce, husband underwent vasectomy), 4.6% for medical reasons (e.g., acne, headache, pain at the implant site), and 3.8% for menstrual irregularities. A total of 125 acceptors underwent Norplant removal either during or at the end of the study period. The incidence of difficult removals was 8%. In most of these cases, the difficulty involved rod breakage. The average time required for removal was 3.4 minutes. These findings indicate that Norplant-2 is a safe, effective, acceptable contraceptive method appropriate for inclusion in Thailand's family planning program. The potential for fragmentation of the rods during removal requires careful monitoring, however.
 ...
PMID:Experience of Thai women in Bangkok with Norplant-2 implants. 986 3

The newly developed 2-rod levonorgestrel (LNG) implant system has a surface area only 44% that of Norplant yet provides LNG release rates and blood levels similar to the 6-capsule Norplant system. Clinical trials of the 2-rod implant system initiated in 1990 demonstrated an exceptionally low cumulative pregnancy rate (0.8/100) in the first 3 years of use. This paper reports on an extension of the original study for an additional 2 years. 594 women at 4 study sites in the US and the Dominican Republic completed 5 years of method use. No pregnancies occurred in the fourth and fifth years of use. Thus, the 5-year cumulative pregnancy rate was 0.8/100, with an average annual pregnancy rate below 2/1000 women. The mean annual continuation rate during the 5-year study period was 77/100 women, with an average duration of use of 2.96 years. The most frequent reasons for medical removal were prolonged bleeding/spotting (8.2% of women), irregular bleeding (5.6%), headache (4.7%), and weight gain (4.0%). Mean removal time was 5.9 minutes and complications occurred in only 2.3% of removals. Overall, these findings confirm that the 2-rod LNG implant contraceptive has an effectiveness equivalent to the 6-capsule implant for a 5-year period, with good acceptability and a substantially improved ease of removal.
 ...
PMID:Contraception with two levonorgestrel rod implants. A 5-year study in the United States and Dominican Republic. 988 82

This paper presents the 5-year randomized study on the performance of levonorgestrel rod (LNG) and Norplant contraceptive implants in 1198 women in 7 centers. In the first 4 years, no pregnancies occurred. At 5 years, the cumulative pregnancy rate was 1/100 users or less for each regimen. Annual discontinuation rates averaged 11-12/100 users, corresponding to a 5-year continuation rate of 55.1/100 for rods and 53.0/100 for capsules. Mean annual discontinuation rates for menstrual disturbances were 3.5/100 for rod and 4.2/100 for capsule implants. Reasons for discontinuation of use were vaginal spotting or bleeding, irregular bleeding, headache, weight gain and acne. Proportional hazard regression models established that family formation variables, age, parity, and desire for another child, recorded at admission, significantly affected discontinuation rates for major decrement categories and for all reasons combined. Mean rod removal time was half that of Norplant. Complications of rod removal were at a lower rate. This study concludes that there is an extremely high contraceptive effectiveness for LNG rod and Norplant implants; however, LNG rod implants were more preferable than Norplant for its relative ease in removal.
 ...
PMID:The performance of levonorgestrel rod and Norplant contraceptive implants: a 5 year randomized study. 988 17


<< Previous 1 2 3 4 5 6 7 Next >>