Objective: To evaluate different methods' efficacy of controlling acute bleeding and managing long-term menstruation in patients with heavy menstrual bleeding (HMB) associated with antithrombotic therapy. Methods: The clinical data of 22 cases with HMB associated with antithrombotic therapy admitted to Peking University People's Hospital from January 2010 to August 2022 were analyzed, aged 39 years old (26-46 years). Changes in menstrual volume, hemoglobin (Hb), and quality of life were collected after control of acute bleeding and long-term menstrual management. Menstrual volume was assessed by pictorial blood assessment chart (PBAC), and quality of life was assessed by menorrhagia multi-attribute scale (MMAS). Results: (1) Treatment of acute bleeding: of the 22 cases with HMB associated with antithrombotic therapy, 16 cases were treated in our hospital and 6 in other hospital for emergency bleeding; of the 16 cases treated in our hospital, 3 underwent emergency intrauterine Foley catheter balloon compression due to severe bleeding (Hb decreased by 20 to 40 g/L within 12 hours). Of the 22 cases with antithrombotic therapy-related HMB, 15 (including 2 cases with severe bleeding) underwent emergency aspiration or endometrial resection, and intraoperative placement of levonorgestrel-releasing intrauterine system (LNG-IUS) followed by a significant reduction in bleeding volume; 3 cases had controlled acute bleeding after rivaroxaban dose reduction and continued observation; 2 cases were given gonadotropin-releasing hormone agonists to control acute bleeding in other hospital, of which 1 case was temporarily treated with periodic blood transfusion, and the other one patient underwent total hysterectomy; and 2 cases had temporary amenorrhea with oral mifepristone after intrauterine balloon compression or oral norethindrone. (2) Long-term menstrual management: of the 22 cases with antithrombotic therapy-related HMB, 15 had LNG-IUS placement and 12 had LNG-IUS placement for 6 months, and menstrual volume was significantly reduced [PBAC scores were 365.0 (272.5-460.0) vs 25.0 (12.5-37.5), respectively; Z=4.593, P<0.001], Hb was significantly increased [91.5 g/L (71.8-108.2 g/L) vs 128.5 g/L (121.2-142.5 g/L); Z=4.695, P<0.001], and quality of life was significantly improved [MMAS scores were 415.0 (327.5-472.5) vs 580.0 (570.0-580.0), respectively; Z=-3.062, P=0.002] before placement compared with 6 months after placement. Three rivaroxaban dose reduction patients' PBAC scores decreased by 20 to 35 but remained >100, and perceived quality of life did not change significantly. Two cases with temporary amenorrhea treated with oral mifepristone felt significantly improved quality of life, and the MMAS scores increased by 220 and 180, respectively. Conclusion: Intrauterine Foley catheter balloon compression, aspiration or endometrial ablation could be used to control acute bleeding in patients with antithrombotic therapy-related HMB, and LNG-IUS for long-term management could reduce menstrual volume, increase hemoglobin, and improve the quality of life of patients.
Female ; Humans ; Adult ; Menorrhagia/etiology* ; Fibrinolytic Agents/adverse effects* ; Levonorgestrel/adverse effects* ; Amenorrhea/drug therapy* ; Mifepristone/therapeutic use* ; Quality of Life ; Rivaroxaban/therapeutic use* ; Hemoglobins ; Intrauterine Devices, Medicated/adverse effects* ; Contraceptive Agents, Female

This paper introduces the basic content of the compulsory national standard ISO 7439:2015 Copper-bearing contraceptive intrauterine devices--Requirements and tests standard analysis, and expounds the reasons for revising part of the standard during the conversion process according to the actual market situation of intrauterine contraceptive device containing copper in China. As a compulsory basic universal standard, it has a guiding significance for the manufacturers of IUD and can promote the improvement of product quality.
China ; Contraceptive Agents ; Copper ; Female ; Humans ; Intrauterine Devices

Dysmenorrhea is the most common gynecologic condition in women during the reproductive period. Severe dysmenorrhea pain affects their social activities, sleep, and quality of life. Nevertheless, the proportion of women with dysmenorrhea do not receive adequate medical counseling or pharmacological treatments. Primary dysmenorrhea is diagnosed clinically, and the secondary causes that can cause pelvic pain should be identified. The treatment of choice for primary dysmenorrhea is non-steroidal anti-inflammatory drugs (NSAIDs). In order to maximize the therapeutic effect, it is necessary to ensure that the appropriate medication is administered in a proper way. NSAIDs can cause adverse effects, including gastrointestinal disorders. If side effects occur or are anticipated with NSAIDs, the use of hormonal contraceptives may be recommended when contraception is considered. In addition to these pharmacological treatments, heat, dietary, and behavioral therapies have been tried and reported to have some effects. However, further research is required for robust conclusions.
Anti-Inflammatory Agents, Non-Steroidal ; Contraception ; Contraceptive Agents ; Counseling ; Dysmenorrhea ; Female ; Hot Temperature ; Humans ; Menstruation ; Pelvic Pain ; Quality of Life ; Reproduction

OBJECTIVES: The perceptions of family-planning (FP) acceptors regarding contraception influence the reasons for which they choose to switch their method of contraception. The objective of this study was to analyze the perceptions of contraception and rationales for switching contraceptive methods among female FP acceptors in West Nusa Tenggara, Indonesia. METHODS: This study involved the analysis of secondary data from the Improve Contraceptive Method Mix study, which was conducted in 2013 by the Center for Health Research, University of Indonesia. The design of the study was cross-sectional. We performed 3 stages of sampling using the cluster technique and selected 4819 women who were FP acceptors in West Nusa Tenggara Province, Indonesia as the subjects of this study. The data were analyzed using multiple logistic regression. RESULTS: The predominant pattern of switching contraceptive methods was switching from one non-long-term method of contraception to another. Only 31.0% of the acceptors reported a rational pattern of switching contraceptive methods given their age, number of children, and FP motivations. Perceptions of the side effects of contraceptive methods, the ease of contraceptive use, and the cost of the contraceptives were significantly associated (at the level of α=0.05) with rational patterns of switching contraceptive methods. CONCLUSIONS: Perceptions among FP-accepting women were found to play an important role in their patterns of switching contraceptive methods. Hence, fostering a better understanding of contraception through high-quality counseling is needed to improve perceptions and thereby to encourage rational, effective, and efficient contraceptive use.
Child ; Contraception ; Contraceptive Agents ; Counseling ; Family Planning Services ; Female ; Foster Home Care ; Humans ; Indonesia ; Logistic Models ; Methods ; Patient Acceptance of Health Care

PURPOSE: The purpose of this study was to explore essences and meanings of using oral contraceptives among adult women. METHODS: The interview was conducted with 20 adult women who lived in Seoul, Gyeongi Province, Jeolla Province, Chungcheong Province, and Gangwon Province. Participants with the experience of using oral contraceptives for contraception were selected by convenience sampling. Semi-structured interviews were conducted for data collection. The data were analyzed using Colaizzi's method. RESULTS: Five themes revealed: ‘Lack of information and knowledge regarding oral contraceptives’, ‘Inconvenient and difficult purchase process of oral contraceptives’, ‘Pressure and fear regarding other people's reaction’, ‘Self-centered thinking toward the use of oral contraceptives’, ‘A need for a change in public awareness and policy’. CONCLUSION: A change in society's perception about oral contraceptives is required for safe contraceptives use. Therefore, it is necessary to educate the correct usage of oral contraceptives, and to develop a program for changing the paradigm of sex education.
Adult* ; Contraception ; Contraceptive Agents ; Contraceptives, Oral* ; Data Collection ; Female ; Gangwon-do ; Humans ; Methods ; Qualitative Research ; Seoul ; Sex Education ; Thinking

OBJECTIVES: The postpartum period is a critical period for addressing widespread unmet needs in family planning and for reducing the risks of closely spaced pregnancies. However, contraception during the extended postpartum period has been underemphasized in Ethiopia. Therefore, this study aimed to assess postpartum modern contraceptive use among women in northern Ethiopia and to identify factors associated with modern contraceptive use in the postpartum period. METHODS: A community based cross-sectional study was conducted from March to April, 2015. Data were entered using Epi Info version 7 and then exported into Stata version 12 for analysis. Bivariate and multivariate logistic regression models were fitted to identify the determinants of postpartum modern contraceptive use. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated, and p-values < 0.05 were considered to indicate statistical significance. RESULTS: Nearly half (48.0%) of women used modern contraceptives during the extended postpartum period. Postpartum modern contraceptive use was significantly associated with secondary and tertiary education levels (aOR, 4.25; 95% CI, 1.29 to 14.00; aOR, 5.36 ; 95% CI, 1.14 to 25.45, respectively), family planning counseling during prenatal and postnatal care (aOR, 5.72 ; 95% CI, 2.67, 12.28), having postnatal care (aOR, 2.36; 95% CI, 1.15 to 4.87), resuming sexual activity (aOR, 9.53; 95% CI, 3.74 to 24.27), and menses returning after birth (aOR, 6.35; 95% CI, 3.14 to 13.39). In addition, experiencing problems with previous contraceptive use was negatively associated with modern contraceptive use (aOR, 0.34; 95% CI, 0.16 to 0.72). CONCLUSIONS: Low rate of postpartum modern contraceptive use were found in the study area. Therefore, strengthening family planning counseling during antenatal and postnatal care visits, improving utilization of postnatal care services and improving women's educational status are crucial steps for to enhance modern contraceptive use among postpartum women.
Contraception ; Contraceptive Agents ; Counseling ; Critical Period (Psychology) ; Cross-Sectional Studies ; Education ; Educational Status ; Ethiopia* ; Family Planning Services ; Female ; Humans ; Logistic Models ; Odds Ratio ; Parturition ; Postnatal Care ; Postpartum Period* ; Pregnancy ; Prevalence* ; Sexual Behavior

OBJECTIVES: The postpartum period is a critical period for addressing widespread unmet needs in family planning and for reducing the risks of closely spaced pregnancies. However, contraception during the extended postpartum period has been underemphasized in Ethiopia. Therefore, this study aimed to assess postpartum modern contraceptive use among women in northern Ethiopia and to identify factors associated with modern contraceptive use in the postpartum period.METHODS: A community based cross-sectional study was conducted from March to April, 2015. Data were entered using Epi Info version 7 and then exported into Stata version 12 for analysis. Bivariate and multivariate logistic regression models were fitted to identify the determinants of postpartum modern contraceptive use. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated, and p-values < 0.05 were considered to indicate statistical significance.RESULTS: Nearly half (48.0%) of women used modern contraceptives during the extended postpartum period. Postpartum modern contraceptive use was significantly associated with secondary and tertiary education levels (aOR, 4.25; 95% CI, 1.29 to 14.00; aOR, 5.36 ; 95% CI, 1.14 to 25.45, respectively), family planning counseling during prenatal and postnatal care (aOR, 5.72 ; 95% CI, 2.67, 12.28), having postnatal care (aOR, 2.36; 95% CI, 1.15 to 4.87), resuming sexual activity (aOR, 9.53; 95% CI, 3.74 to 24.27), and menses returning after birth (aOR, 6.35; 95% CI, 3.14 to 13.39). In addition, experiencing problems with previous contraceptive use was negatively associated with modern contraceptive use (aOR, 0.34; 95% CI, 0.16 to 0.72).CONCLUSIONS: Low rate of postpartum modern contraceptive use were found in the study area. Therefore, strengthening family planning counseling during antenatal and postnatal care visits, improving utilization of postnatal care services and improving women's educational status are crucial steps for to enhance modern contraceptive use among postpartum women.
Contraception ; Contraceptive Agents ; Counseling ; Critical Period (Psychology) ; Cross-Sectional Studies ; Education ; Educational Status ; Ethiopia ; Family Planning Services ; Female ; Humans ; Logistic Models ; Odds Ratio ; Parturition ; Postnatal Care ; Postpartum Period ; Pregnancy ; Prevalence ; Sexual Behavior

This study evaluated the efficacy of a stepwise regimen of estradiol valerate for height control in girls with Marfan syndrome. Eight girls with Marfan syndrome who had completed estrogen treatment for height control were included. Estradiol valerate was started at a dose of 2 mg/day, and then was increased. The projected final height was estimated using the initial height percentile (on a disease-specific growth curve for Korean Marfan syndrome [gcPFHt]), and the initial bone age (baPFHt). After the estrogen treatment, the projected final height was compared to the actual final height (FHt). The median baseline chronological and bone age were 10.0 and 10.5 years, respectively. After a median of 36.5 months of treatment, the median FHt (172.6 cm) was shorter than the median gcPFHt (181.0 cm) and baPFHt (175.9 cm). In the six patients who started treatment before the age of 11 years, the median FHt (171.8 cm) was shorter than the median gcPFHt (181.5 cm) and baPFHt (177.4 cm) after treatment. The median differences between the FHt and gcPFHt and baPFHt were 9.2 and 8.3 cm, respectively. In two patients started treatment after the age of 11, the differences between FHt and gcPFHt, and baPFHt after treatment were -4 and 1.4 cm, and -1.2 and 0 cm for each case, respectively. A stepwise increasing regimen of estradiol valerate may be an effective treatment for height control in girls with Marfan syndrome, especially when started under 11 years old.
Body Height ; Child ; Contraceptive Agents/*therapeutic use ; Estradiol/*analogs & derivatives/therapeutic use ; Female ; Growth Disorders/pathology ; Humans ; Marfan Syndrome/diagnosis/*drug therapy ; Treatment Outcome

BACKGROUND: There is a dearth of studies that explore the perceptions of male partners of adolescent females towards the intention of pursuing contraception.

OBJECTIVE: To determine the role of male partner perceptions in the intention to use of contraception among female adolescents to prevent unplanned repeat pregnancies.

MATERIALS AND METHODS: An urban sample of 102 male partners of female adolescents with previous pregnancy experience coming from the out-patient department and selected barangay health center responded to a two-part questionnaire that explored their perceptions towards contraception. Demographic data and their positive and negative views, attitudes and actual practice of contraception as it affects future intention to engage in family planning methods were determined.

RESULTS: Male sexual partners have positive perceptions towards contraception. Despite this, utilization rate was still low (56.8%). Positively correlated with contraceptive intention include the male partner's advanced age and high level of education. Perceptions that favor strong intention include careful pregnancy planning in the future, not wanting a pregnancy too soon, knowledge of a specific method, its perceived benefits, "shared decision" making, feeling "happy" when contraceptives are offered rather than forced and when a woman lacks trust in him. Forcing contraception by the female adolescent partner was negatively correlated with contraceptive intention.

CONCLUSION: Shared decision making towards contraception in order to reduce unintended pregnancies should engage the male partner's participation by correcting prevailing misperceptions.

Human ; Male ; Female ; Young Adult ; Adolescent ; Pregnancy ; Family Planning Services ; Contraceptive Agents ; Sexual Partners ; Outpatients ; Contraception ; Pregnancy, Unplanned ; Contraceptive Devices

The extraction of third molars is a common task carried out at dental/surgery clinics. Postoperative pain is one of the two most common complications of this surgery, along with dry socket. Knowledge of the frequent risk factors of this complication is useful in determining high-risk patients, planning treatment, and preparing the patients mentally. Since the risk factors for postoperative pain have never been summarized before while the risk factors for dry socket have been highly debated, this report summarizes the literature regarding the common predictors of postextraction pain. Except for surgical difficulty and the surgeon's experience, the influences of other risk factors (age, gender and oral contraceptive use) were rather inconclusive. The case of a female gender or oral contraceptive effect might mainly be associated with estrogen levels (when it comes to dry socket), which can differ considerably from case to case. Improvement in and unification of statistical and diagnostic methods seem necessary. In addition, each risk factor was actually a combination of various independent variables, which should instead be targeted in more comprehensive studies.
Contraceptive Agents ; Dry Socket ; Estrogens ; Female ; Humans ; Molar, Third* ; Pain, Postoperative* ; Risk Factors*