Maternal and child health
Liam J. Donaldson, Paul D. Rutter in Donaldsons' Essential Public Health, 2017
Ancient methods of contraception include coitus interruptus, which is still used; the natural family planning method, which involves understanding the timing of fertility in a woman’s cycle; and various acidic or alkaline substances inserted into the vagina. Effective male and female barrier methods of contraception were introduced in the nineteenth century. Condoms in particular are still an effective method of contraception, and also protect against sexually transmitted infections. Since the 1960s, the oral contraceptive pill has dominated contraceptive methods, but is increasingly being replaced by new hormonal delivery systems and the intrauterine device. Sterilization for males or females is a permanent method of contraception. There are two methods of emergency contraception: hormonal (levonorgestrel) treatment or the insertion of an intrauterine device. The hormonal method can be used up to 72 hours after sex and the intrauterine device up to 5 days later. While the insertion of an intrauterine device requires professional involvement, the emergency contraceptive pill can be easily obtained, including in most pharmacies.
Cyanotic congenital heart diseases in adulthood
Jana Popelová, Erwin Oechslin, Harald Kaemmerer, Martin G St John Sutton, Pavel Žáček in Congenital Heart Disease in Adults, 2008
Intrauterine devices should not be used (risk of endocarditis and bleeding), nor should oral hormonal high-estrogen contraception. Advisable measures include condoms; combined products with low-dose estrogen (including three-stage combinations), or levonorgestrel-only contraceptives; alternatively, laparoscopic sterilization may be considered, but this procedure carries special risks related to general anesthesia and laparoscopy in this population. Anticonception counseling is crucial and must be performed in collaboration with both a cardiologist and a gynecologist with special expertise in CHD and high-risk pregnancy. Sterilization of the husband or male partner is not recommended as his longevity is much better: he will survive his female partner and may start a new relationship later in life.
Delivering the evidence
Mark Baker, Neal Maskrey, Simon Kirk, Allen Hutchinson in Clinical Effectiveness and Primary Care, 2018
’Reversal of sterilisation’, ‘reversal of sterilization’ and other combinations of terms produced more than 70 references. From the abstracts it appeared that vasovasostomies could achieve a 70–80% pregnancy rate in experienced centres. An operating microscope and patients less than 10 years post-sterilization seemed to be positive influences. Reversal of female sterilization could achieve a 60–70% success rate. Not surprisingly this was age-dependent, with the pregnancy rate declining sharply after the age of 35. A fallopian tube length of more than 4 cm and again the use of an operating microscope seemed to be positive factors. However, only one randomized controlled trial was found which compared the use of an operating microscope with loupe spectacles, in which there was no difference in outcome (only 72 patients). In fact, most reported case series were of small numbers of patients and in view of the potential for bias it was felt that only a tentative report could be produced, with a recommendation for a systematic review to be performed as part of the national R&D programme.
More Than a Physical Burden: Women’s Mental and Emotional Work in Preventing Pregnancy
Published in The Journal of Sex Research, 2018
Katrina Kimport
Clinicians’ encouragement that patients consider LARC must also be examined in light of their discursive focus on patients preserving their fertility (see also Kimport, Dehlendorf, & Borrero, 2017). By promoting LARC and discouraging sterilization, clinicians privileged methods that reduce but do not eliminate patients’ fertility work. And even as this approach may reduce the time and attention women must pay to contraception, it cannot address the stresses some women described, such as fear of side effects and pain at IUD placement. Indeed, male sterilization, as a highly effective male body–based method, is arguably the only method that enables a woman to bypass these stresses and also be highly confident about avoiding pregnancy. Yet unlike in other countries (e.g., the United Kingdom; Moses & Oloto, 2008), vasectomy is underutilized in the United States: Male sterilization is less than half as popular (6%) as reliance on female sterilization (17%) (Shih, Turok, & Parker, 2011). Clinicians should examine their counseling for implicit assumptions about the importance of women preserving their fertility, especially as such counseling could impede women’s selection of sterilization methods.
Social Boundaries in Young Adult Females with Down Syndrome as a Foundation for Sexuality Education
Published in American Journal of Sexuality Education, 2020
Brooke M. Faught, Ginny Moore, Karen A. Hande, Leslie Walker-Hirsch
Historically, healthcare providers (HCPs) and educators avoided addressing the topics of healthy sexuality and romantic intimacy in young adults with ID (Löfgren-Mårtenson, 2012; Servais, 2006). Rather, the management of sexual health in this population focused on sterilization, thereby removing reproductive rights. In a statement made by the World Health Organization (WHO, 1975), everyone deserves “a right to receive sexual information and to consider accepting sexual relationships for pleasure as well as for procreation” (p. 23). Young adults with ID often miss out entirely on sexual education or receive only focused information on personal safety such as the avoidance of predators, exploitation, and sexual abuse. Educationally adapted sex education programs provide individuals with ID with improved sex-related decision-making skills (Dukes & McGuire, 2009; Enow et al., 2015). Educators, including HCPs, and caretakers require improved methods for understanding sexuality and intimacy in young adults with ID (Löfgren-Mårtenson, 2004).
Delivery of progestins via the subdermal versus the intrauterine route: comparison of the pharmacology and clinical outcomes
Published in Expert Opinion on Drug Delivery, 2018
Norman D. Goldstuck, Hung P. Le
All types of non-hormonal contraceptives act locally in the genital tract. This is true for both short-acting male and female methods, like male and female condoms, and for LARC methods, like plastic or copper carrying intrauterine devices. It is also true for both male and female non-reversible methods, e.g. sterilization. All types of hormonal contraception, whether short-acting like oral contraceptives, the contraceptive patch (Ortho-Evra®) or the vaginal ring (NuvaRing©) or of intermediate action like progestin injectables act both centrally in the brain and peripherally in the genital tract. Logically then, the hormone-based LARC contraceptives behave in the same manner. What is different is the degree to which central rather peripheral action predominates and what effect this has on the advantages and disadvantages of the method.
Related Knowledge Centers
- Birth Control
- Ectopic Pregnancy
- Egg Cell
- Surgery
- Tubal Ligation
- Vasectomy
- Uterus
- Pregnancy
- Fallopian Tube
- Reproduction