Current Issue : January - March Volume : 2014 Issue Number : 1 Articles : 7 Articles
Background: Over 100 million women worldwide are using oral contraceptives pills (OCP) and mood changes\r\nwere being as the primary reason for OCP discontinuation. The purpose of this study was to determine the\r\nprevalence and predicting factors of mood changes in oral contraceptive pills users.\r\nMethods: This was a cross-sectional study of 500 women aged 15ââ?¬â??49 years old using low dose (LD) pills attending\r\nfamily planning centers in Ahwaz, Iran. Data were collected via face-to-face interviews using a structured\r\nquestionnaire including items on demographic, self-efficacy and mood change. Both univarate and multiple logistic\r\nregression analyses were performed to assess the relationship between reported mood change and the\r\nindependent variables.\r\nResults: In all 406 women reported that they did experience OCP side effects. Of these, 37.7% of women (n =153)\r\nreported mood changes due to OCP use. The results of multiple logistic regression revealed that place of\r\nliving (OR =2.57, 95% CI = 1.06-6.20, p =0.03), not receiving information on OCP side effects (OR =1.80, 95%\r\nCI = 1.15-2.80, p =0.009), and lower self-efficacy (OR = 0.87, 95% CI = 0.80-0.94, p =0.001) were significant predictors\r\nof mood changes.\r\nConclusion: The findings from this study indicated that the prevalence of reported mood changes due to OCP use\r\namong Iranian women appeared to be consistent with other studies. In addition the findings showed that\r\nreceiving information on OCP side effects from health care workers and self-efficacy were important predicting\r\nfactors for mood changes. Indeed implementing educational programs and improving self-efficacy among women\r\nare recommended....
Background: Modern contraceptive use persists to be low in most African countries where fertility, population\r\ngrowth, and unmet need for family planning are high. Though there is an evidence of increased overall\r\ncontraceptive prevalence, a substantial effort remains behind in Ethiopia. This study aimed to identify factors\r\nassociated with modern contraceptive use and to examine its geographical variations among 15ââ?¬â??49 married\r\nwomen in Ethiopia.\r\nMethods: We conducted secondary analysis of 10,204 reproductive age women included in the 2011 Ethiopia\r\nDemographic and Health Survey (DHS). The survey sample was designed to provide national, urban/rural, and\r\nregional representative estimates for key health and demographic indicators. The sample was selected using a\r\ntwo-stage stratified sampling process. Bivariate and multivariate logistic regressions were applied to determine the\r\nprevalence of modern contraceptive use and associated factors in Ethiopia.\r\nResults: Being wealthy, more educated, being employed, higher number of living children, being in a\r\nmonogamous relationship, attending community conversation, being visited by health worker at home strongly\r\npredicted use of modern contraception. While living in rural areas, older age, being in polygamous relationship, and\r\nwitnessing oneââ?¬â?¢s own childââ?¬â?¢s death were found negatively influence modern contraceptive use. The spatial analysis\r\nof contraceptive use revealed that the central and southwestern parts of the country had higher prevalence of\r\nmodern contraceptive use than that of the eastern and western parts.\r\nConclusion: The findings indicate significant socio-economic, urbanââ?¬â??rural and regional variation in modern\r\ncontraceptive use among reproductive age women in Ethiopia. Strengthening community conversation programs\r\nand female education should be given top priority....
Background: Lack of male involvement and support for sexual and reproductive health services is seen by many\r\nPapua New Guinean women as a barrier to accessing services. Poor utilization of services by both men and women\r\nis reflected in high maternal mortality and high rates of HIV/AIDS and sexually transmitted infections in the\r\nSouthern Highlands Province. It is therefore important to understand the type of services provided, men�s\r\nperceptions of these services and the Health Sector�s capacity to involve men in its programs.\r\nMethods: Information from interviews of married men, officers in charge of health facilities, and information from a\r\nfocus group discussion with village leaders was collected to assess possible constraints to reproductive and sexual\r\nhealth care delivery.\r\nResults: Although many men had heard about antenatal care, supervised births, family planning and sexually\r\ntransmitted infections including, HIV/AIDS, many were unaware of their importance and of the types of services\r\nprovided to address these issues. There was a very strong association between men�s literacy and their knowledge\r\nof Sexual and Reproductive Health (SRH) issues, their discussion of these issues with their wives and their wives�\r\nutilisation of sexual and reproductive health services. Some men considered SRH services to be important but gave\r\npriority to social obligations. Although men made most decisions for sexual and reproductive issues, pregnancy,\r\nchild birth and rearing of children were regarded as women�s responsibilities. Knowledge of HIV/AIDS appeared to\r\nhave changed sexual behaviour in some men. Services for men in this rural setting were inadequate and service\r\nproviders lacked the capacity to involve men in reproductive health issues.\r\nConclusion: Poor knowledge, socio-cultural factors and inadequate and inappropriate services for men hampered\r\nutilization of services and impaired support for their wives� service utilization. Programmatic and policy initiatives\r\nshould focus on improving service delivery to accommodate men in sexual and reproductive health....
PCOS (Poly Cystic Ovarian Syndrome) is the most common endocrine disorder in females with high prevalence. The\r\nsyndrome was originally described by Stein and Levanthal as Stein and Levanthal syndrome in 1935 as a triad consisting of\r\namenorrhea, hirsutism and obesity in women who had multiple cysts on their ovaries. Over the last decade or so the\r\nunderstanding of this syndrome has changed and the emphasis is often on the long term consequences that may occur.\r\nWorldwide PCOS is a common endocrine disorder where there is an imbalance in the hormones produced in women�s body with\r\nan incidence of 5-10%. The condition causes a wide range of problems ranging from acne to infertility. PCOS is associated with\r\nvarious risk factors like obesity, hereditary factors, sedentary life style, Hormonal imbalance, Family history of Diabetes. Medical\r\nmanagement of PCOS is aimed at the treatment of metabolic derangements, anovulation, hirsutism and menstrual irregularity.\r\nPCOS clinical features include oligomennorgea, infertility, dyslipidaemia, obesity, hyperandrogenism etc. Although there are\r\nmany diagnostic procedures for PCOS, the most efficacious procedure was ultrasound scanning. The use of insulin-sensitizing\r\ndrugs like metformin to improve insulin sensitivity is associated with a reduction in circulating androgen levels, as well as\r\nimprovement in both the ovulation rate and glucose tolerance. First-line medical therapy usually consists of an oral\r\ncontraceptive to induce regular menses. The contraceptive not only inhibits ovarian androgen production but also increases sex\r\nhormone-binding globulin (SHBG) production. First-line treatment for ovulation induction when fertility is desired is\r\nclomiphene citrate. Comprehensive evidence-based guidelines are needed to aid early diagnosis, appropriate investigation,\r\nregular screening and treatment of this common condition. This review focuses on overview of disease, etiology, clinical features\r\nand treatment of PCOS....
Background: Sexually transmitted infections (STIs) such as chlamydia and gonorrhoea are largely symptomless\r\ndiseases which, left untreated, can result in serious complications including infertility. Fertility problems currently\r\naffect approximately one in seven couples in the UK and there is increasing demand for couples seeking\r\nreproductive technologies. Young people are at greatest risk of contracting STIs, therefore this study aimed to\r\nidentify young peopleââ?¬â?¢s knowledge and beliefs about the link between untreated STIs and infertility.\r\nMethods: Focus groups were conducted with participants aged 16ââ?¬â??24 years old inclusive in college or university\r\nsettings in the SE of England. Groups were quota sampled on the basis of age and gender. A topic guide was used.\r\nThe data were analysed using a framework analysis approach.\r\nResults: Ten single-sex focus groups were conducted with sixty participants: six groups of college students and\r\nfour groups of university students. Participants were generally aware of the link between STIs and potential\r\ninfertility and considered the discussion of this subject very relevant at their age. Knowledge about how and why\r\nSTIs potentially lead to fertility complications was poor. The issues of blame relating to infertility following an STI\r\nemerged, although most participants did not think that access to free reproductive technologies after an untreated\r\nSTI should be limited.\r\nConclusions: Young people would benefit from more education in order to improve their understanding of the\r\nlong-term consequences of untreated STIs, such as infertility. Participants in our sample felt these were extremely\r\nrelevant and important issues for them to understand alongside current education about STIs....
Background: A cultural preference for sons has been well documented in India, resulting in skewed sex ratios,\r\nespecially exhibited in northwest India. Previous research has shown that family sex composition is associated with\r\nfamily planning (FP) use and couplesââ?¬â?¢ desire for more children. This study examines family sex composition and\r\nfertility and FP behaviors in urban Uttar Pradesh, India; little work has examined these issues in urban settings\r\nwhere family sizes are smaller and FP use is common.\r\nMethods: Data for this analysis comes from a 2010 representative survey of married, non-pregnant fecund women\r\naged 15ââ?¬â??49 from six cities in Uttar Pradesh, India. Multivariate analyses are used to examine the association\r\nbetween family sex composition and fertility desires and FP use.\r\nResults: The multivariate results indicate that family sex composition is associated with fertility desires and FP use.\r\nWomen without living children and without at least one child of each sex are significantly less likely to want no\r\nmore children and women with both sons and daughters but more sons are significantly more likely to want no\r\nmore children as compared to women that have both sons and daughters but more daughters. Women with no\r\nliving children and women with daughters but no sons are less likely to be modern FP users than nonusers\r\nwhereas women with both sons and daughters but more sons are more likely to be modern FP users than\r\nnonusers as compared to women with both sons and daughters but more daughters.\r\nConclusions: These findings confirm that family sex composition affects fertility behavior and also reveals that\r\npreference for sons persists in urban Uttar Pradesh. These results underscore the importance of programs and\r\npolicies that work to enhance the value of girl children....
Background: There has been considerable debate in the reproductive health literature as to whether unintended\r\npregnancy influences use of maternal health services, particularly antenatal care. Despite the wealth of studies\r\nexamining the association between pregnancy intention and antenatal care, findings remain mixed and\r\ninconclusive. The objective of this study is to systematically review and meta-analyse studies on the association\r\nbetween pregnancy intention and antenatal care.\r\nMethods: We reviewed studies reporting on pregnancy intention and antenatal care from PubMed, Popline, CINHAL\r\nand Jstor search engines by developing search strategies. Study quality was assessed for biases in selection, definition of\r\nexposure and outcome variables, confounder adjustment, and type of analyses. Adjusted odds ratios, standard errors\r\nand sample size were extracted from the included studies and meta-analyzed using STATA version 11. Heterogeneity\r\namong studies was assessed using Q test statistic. Effect-size was measured by Odds ratio. Pooled odds ratio for the\r\neffects of unintended pregnancy on the use of antenatal care services were calculated using the random effects model.\r\nResults: Our results indicate increased odds of delayed antenatal care use among women with unintended\r\npregnancies (OR 1.42 with 95% CI, 1.27, 1.59) as compared to women with intended pregnancies. Sub-group analysis\r\nfor developed (1.50 with 95% CI, 1.34, 1.68) and developing (1. 36 with 95% CI, 1.13, 1.65) countries showed significant\r\nassociations. Moreover, there is an increased odds of inadequate antenatal care use among women with unintended\r\npregnancies as compared to women with intended pregnancies (OR 1.64, 95% CI: 1.47, 1.82). Subgroup analysis for\r\ndeveloped (OR, 1.86; 95% CI: 1.62, 2.14) and developing (OR, 1.54; 95% CI: 1.33, 1.77) countries also showed a statistically\r\nsignificant association. However, there were heterogeneities in the studies included in this analysis.\r\nConclusion: Unintended pregnancy is associated with late initiation and inadequate use of antenatal care services.\r\nHence, women who report an unintended pregnancy should be targeted for antenatal care counseling and services to\r\nprevent adverse maternal and perinatal outcomes. Moreover, providing information on the importance of planning and\r\nhealthy timing of pregnancies, and the means to do so, to all women of reproductive ages is essential....
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