birth control
Helping patients handle accusations of infidelity.

[No authors listed]

You may have experience with women patients who assume their partners are being unfaithful if they try to use condoms because that behavior could indicate they are trying to prevent potential sexually transmitted diseases (STDs). These same women may believe the same will be assumed of them if they begin to use the new female condom. If women present the device to their partners in the context of a birth control product rather than a device to prevent STDs, men might be more willing to accept it, says sexuality expert Beverly Wipple, PhD, RN, an associate professor at Rutgers State University of New Jersey in Newark and the author of Safe Encounters: How a Woman Can Say Yes to Pleasure and No to Unsafe Sex (Pocketbooks, 1990). Wipple has been a leader in female sexuality research since 1979, having conducted the original research on the "G-spot" (Dell Publishers, 1983). Wipple bases her hypothesis on a presentation about the male condom given at the 1992 annual meeting of the International Society for the Scientific Study of Sex, held in San Diego. The presenter showed that if women were using the male condom as their only form of contraception, then the male was more likely to use it. If the woman was taking oral contraceptives or using another form of contraception--and was only relying on the condom or STD protection--then the male was less likely to use the condom. "I think the same thing might apply to the female condom," Wipple suggests. "If she identifies that this is her method of birth control. I think it is much more likely to be accepted than if she says she is using it to prevent the spread of diseases." Wipple says practitioners should tell women to emphasize the birth control angle and downplay the STD angle. "It may not be the only method they are using, but they don't have to tell him that." she says. "This way, it is not putting an accusation [of infidelity] on him." While she acknowledge and dislikes the lack of honesty inherent in this practice, she says the end justifies the means. "Although it is not addressing the issues that should be addressed, we have to recognize there are people in situations where it is just impossible for them to address the issues," Wipple explains. She says this inability to communicate has led to the spread of STDs. full text

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12286996&dopt=Abstract birth control



birth control
[Fertility transition in Japanese rural villages (author's transl)]

[Article in Japanese]

Watanabe Y.

PIP: There has been some debate as to whether family limitation or parity-dependent birth control was practiced or not prior to fertility decline; i.e., whether European fertility was an innovation or adjustment process. It is not entirely clear whether parity-dependent control was practiced in rural villages prior to Japanese fertility transition. This is a case study of fertility transition in 2 rural villages, 1 in the Iwate prefecture and the other in the Akita prefecture, both located in the northeastern region of Japan. These were the major findings. There had been little or no parity-dependent birth control in either village prior to the fertility decline. Accordingly, we can say the fertility decline in both villages was, on the whole, an innovation process. There were some important specific differences between the fertility transition in the 2 villages. Concerning the speed of fertility decline, Tamayama-mura had a relatively moderate decline in contrast to Aikawa-machi which experienced a very rapid decline in a short period. As for the dissemination of birth control in the process of fertility decline, in Tamayama-mura the level of fertility preference fell slowly and still remains high as compared with the Japanese average, and the methods of birth control (induced abortion and contraception) had very gradually diffused cohort by cohort. In Aikawa-machi, the level of fertility preference quickly declined and methods of birth control diffused very quickly from the earliest to the latest cohorts. (author's modified)

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12155100&dopt=Abstract birth control



birth control
The relationship between barriers to birth control use and actual birth control use among Mexican-American adolescents.

Pesa JA, Mathews J.

Department of Physical Education, Indiana University--Purdue University Indianapolis, 46202, USA. jpesa iupui.edu

This study examined the relationship between barriers to using birth control and actual use of birth control among a national sample of Mexican-American adolescents. Participants were either over age 15 or sexually active (regardless of age). They responded to survey items on birth control use. Chi-square analysis and t tests were used to investigate whether barriers to using birth control were related to actual use during first intercourse and most recent sexual intercourse. It was found that nonusers had significantly higher barrier scores compared with users of birth control. The results indicate that attitudes toward birth control are associated with actual birth control use among Mexican-American adolescents. Additionally, males and females may have distinct barriers to using birth control. It was concluded that a better understanding of the sexual attitudes and beliefs associated with birth control is needed in order to improve programs seeking to increase the use of birth control among this rapidly expanding, high-risk population.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11214208&dopt=Abstract birth control



birth control
Women's issues of migraine in tertiary care.

Kelman L.

Headache Center of Atlanta, GA, USA.

OBJECTIVES: To document the frequency and types of symptoms of migraine in a large group of female migraineurs in tertiary care. Background.-Hormonal changes remain a significant accompaniment in the life cycle of the female migraineur. Little is documented on the relationship of women's issues to other features of migraine or to the lives of patients with migraine. Successful management of migraine mandates attention to women's issues from menarche to beyond menopause. The more information available to this end, the more confidently the clinician can prognosticate, guide, and treat the female patient. METHODS: Women's issues were evaluated in 504 women with migraine diagnosed according to the criteria of the International Headache Society (codes 1.1 and 1.2). The variables graded on a scale of 0 to 3 at the initial visit included premenstrual syndrome, menopausal symptoms, use of birth control pills, use of hormone replacement therapy, hormonal triggering of headaches, worsening of headaches with birth control pills or hormone replacement therapy, headaches with menses only, headaches with menses and at other times, headaches in pregnancy, headaches unchanged in pregnancy, headaches worse in pregnancy, and headaches better in pregnancy. These variables were stratified by age and headache diagnosis. RESULTS: Premenstrual syndrome was reported in 68.7% of patients, menopausal symptoms in 29.0%, and headaches attributed to birth control pills or hormone replacement therapy in 24.4% of patients. Sixty-four point nine percent of women had headaches with menses as well as at other times, while 3.4% of women had headaches exclusively with menses. A pregnancy was reported in 61.3% of the women; 20.4% did not experience headache in pregnancy. Of the 79.6% who did experience headache, 17.8% reported that headaches improved in pregnancy, 27.8% reported headaches to be unchanged, and 34% reported a worsening of headaches. Hormone replacement therapy or birth control pills triggered headaches in 64% of the study group. Patients with 100% aura were significantly different from patients with 0% aura, being less likely to have headaches worsening with birth control pills or hormone replacement therapy (P <.01) and more likely to have headaches occurring during pregnancy (P <.05). When patients with 100% aura were matched for age, headache frequency, use of birth control pills or hormone replacement therapy, and use of prophylactic medications with patients having 0% aura, the former were significantly less likely to have menopausal symptoms (P <.05), less likely to have headaches worsening with birth control pills or hormone replacement therapy (P <.01), and more likely to have headaches occurring only during pregnancy (P <.05). CONCLUSIONS: This study provides a documentation of women's issues in a large cohort of patients. Stratification by headache type, presence of aura, and age refine the study.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14979877&dopt=Abstract birth control



birth control
Transactional price of an expected child and its application in birth control.

Li X.

PIP: The theoretical presentation of the impact of the transactional price of an expected child (TPEC) on birth control led to the conclusion that successful birth control was a combination of birth utility theory and TPEC theory. In a hypothetical market, the assumption can be made that an expected price can be attached to a desired child or a transactional price can be attached for giving up the reproductive right to have an excess child. A consumer equilibrium model can characterize the changes in financial resources necessary in deciding on an appropriate number of children. In a general equilibrium model, couples would have to be compensated a certain amount as an inducement to forgo the right to have a second child. Prices of children can be determined by a distributional curve of this transactional price of expected excess children and the estimated marginal price for couples with two children. Under circumstances of limited resources, it would be cheaper to buy some couple's rights to forgo a child, and this price would vary with parity. The exact transactional price of each child by parity by each couple could be theoretically determined, if all couples told the truth about desired number of children. However, the complication is that this condition may not be possible, and couples may charge more for forgoing the right to a subsequent child that what they would actually accept. Also, the seller could ask one price and then charge more. A compromise would be to set prices only for lower parities and to set prices subject to the total funds available to the buyer. Very low prices would also decrease the effectiveness of birth control. The government could be a buyer or seller. Taxing couples for additional children would make the government a seller. When the government is the buyer, couples would be compensated for not having an additional child. Another possibility is a reward for having only a certain number of children and a tax for excess children, which would be a mixed transactional price. The transactional price must be contractual, and breach of contract would mean forfeiture of profit or required sterilization.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12287289&dopt=Abstract birth control



birth control
Association between birth control pills and voice quality.

Amir O, Kishon-Rabin L.

Department of Communication Disorders, Tel-Aviv University, The Chaim Sheba Medical Center, Tel-Hashomer, Israel.

OBJECTIVES/HYPOTHESIS: The objective was to extend our knowledge of the effect of birth control pills on voice quality in women based on various acoustic measures. STUDY DESIGN: A longitudinal comparative study of 14 healthy young women over a 36- to 45-day period. METHODS: Voices of seven women who used birth control pills and seven women who did not were recorded repeatedly approximately 20 times. Voice samples were analyzed acoustically, using an extended set of frequency perturbation parameters (jitter, relative average perturbation, pitch period perturbation quotient), amplitude perturbation parameters (shimmer, amplitude average perturbation quotient), and noise indices (noise-to-harmonics ratio, voice turbulence index). RESULTS: Voice quality and stability were found to be better among the women who used birth control pills. Lower values were found for all acoustic measures with the exception of voice turbulence index. Results also provided preliminary indication for vocal changes associated with the days preceding ovulation. CONCLUSION: In contrast to the traditional view of oral contraceptives as a risk factor for voice quality, and in keeping with the authors' previous work, the data in the present study showed that not only did oral contraceptives have no adverse effect on voice quality but, in effect, most acoustic measures showed improved voice quality among women who used the birth control pill. The differences in the noise indices between groups may also shed light on the nature of the effect of sex hormones on vocal fold activity. It was suggested that hormonal fluctuations may have more of an effect on vocal fold regulation of vibration than on glottal adduction.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15179206&dopt=Abstract birth control



birth control
Prevalence of pregnancy related oral granuloma in a Nigerian population group and the possible role of contraceptives.

Lawoyin JO, Lawoyin DO, Arowojolu MO, Lawoyin T, Akande OO.

Department of Oral Pathology/Oral Medicine, University College Hospital, Ibadan, Nigeria.

A clinicopathological survey on pregnancy related tumours was carried out on 400 randomly selected pregnant Nigerian women. Fifteen (15) cases of pregnancy granuloma or 'epulis gravidanum' were found. Of these subjects, 287 representing 71.8 percent were on birth control before conception, while 113 or 28.2 percent were not. Nine (9) cases of pregnancy tumour were found in the group on birth control pills and six (6) in the group not on birth control representing an incidence of 3.1 and 5.3 percent respectively. Literature review indicate a general incidence of between 0-2.5 percent. Five of the granuloma regressed post partum, while ten were excised. Patients were followed 1-2 years post partum and no recurrence was recorded, even in patients who have re-commenced on contraceptives.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15259928&dopt=Abstract birth control