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Review Articles
Mifepristone: ten years later
Eric A. Schaff
pages 1-7
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Review of clinical experience with estradiol in combined oral contraceptives
Franca Fruzzetti, Johannes Bitzer
pages 8-15
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Original research articles
Postmarketing study of ORTHO EVRA® and levonorgestrel oral contraceptives containing hormonal contraceptives with 30 mcg of ethinyl estradiol in relation to nonfatal venous thromboembolism
Susan S. Jick, Katrina W. Hagberg, Rohini K. Hernandez, James A. Kaye
pages 16-21
Background: Concern has been raised that the risk of venous thromboembolism (VTE) in users of the ORTHO EVRA® patch is higher compared to users of oral contraceptives (OCs).
Conclusion: These results provide evidence that the risk of idiopathic VTE in users of the patch is not materially different than that of users of levonorgestrel-containing OCs in women aged 39 years or younger. We cannot rule out some increase in the risk in women aged 40 years or older.
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Oral contraceptive discontinuation and its aftermath in 19 developing countries
Mohamed M. Ali, John Cleland
pages 22-29
Background: The purpose of the article was to document oral contraceptive (OC) discontinuation and switching in a large number of low- and middle-income countries, and to assess the effects of women's education and reason for use (spacing vs. limitation). An attempt was made to explain intercountry variations.
Conclusions: Both discontinuation of use and inadequate switching to alternative methods are major but neglected problems in the family planning services of many developing countries.
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Prospective study of weight change in new adolescent users of DMPA, NET-EN, COCs, nonusers and discontinuers of hormonal contraception
Mags E. Beksinska, Jenni A. Smit, Immo Kleinschmidt, Cecilia Milford, Timothy M.M. Farley
pages 30-34
Background: Weight gain is commonly reported as a side effect of hormonal contraception and can lead to method discontinuation or reluctance to initiate the method. The purpose of this study was to investigate weight change in adolescent (aged 15–19 years) users of depot-medroxyprogesterone acetate (DMPA), norethisterone enanthate (NET-EN), combined oral contraceptives (COCs) and discontinuers of these methods as compared to nonusers of hormonal contraception.
Conclusion: There is fairly strong evidence that adolescent contraceptive hormonal injectable users appear to gain more weight than COC users, discontinuers and nonusers of contraception.
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Oral contraceptive use and bone density in adolescent and young adult women
Delia Scholes, Laura Ichikawa, Andrea Z. LaCroix, Leslie Spangler, Jeannette M. Beasley, Susan Reed, Susan M. Ott
pages 35-40
Background: Most of the millions of oral contraceptive (OC) users are under 30 years of age and in the critical period for bone mass accrual.
Conclusions: Prolonged use of today's OCs, particularly <30 mcg EE, may adversely impact young adult women's bone density while using these agents.
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The efficacy and safety of a low-dose, 91-day, extended-regimen oral contraceptive with continuous ethinyl estradiol
Robin Kroll, Kathleen Z. Reape, Marya Margolis
pages 41-48
Background: This clinical trial was conducted to demonstrate the efficacy and safety of a 91-day extended-regimen, low-dose combination oral contraceptive (OC) consisting of 84 days of ethinyl estradiol (EE) 20 mcg/levonorgestrel (LNG) 100 mcg, followed by 7 days of 10 mcg EE in place of placebo.
Conclusions: This study demonstrated effective prevention of pregnancy with a 20-mcg EE, 91-day extended-regimen OC. In addition, the regimen was well tolerated and incidence of adverse events were consistent with what has been reported with other low-dose OCs.
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Efficacy of the low-dose combined oral contraceptive chlormadinone acetate/ethinylestradiol: physical and emotional benefits
Marie-Luise S. Heskamp, Georg A.K. Schramm
pages 49-56
Background: This study investigated the effects of the low-dose combined oral contraceptive (COC) 2.0 mg chlormadinone acetate (CMA)/0.03 mg ethinylestradiol (EE) (Belara®, Balanca®) on cycle-related physical and emotional disorders in women ≥25 years of age.
Conclusions: The results of this study in women ≥25 years of age support previous findings that 2.0 mg CMA/0.03 mg EE is an effective low-dose COC, with an excellent tolerability profile, with the additional benefits of significantly reducing both cycle-related physical and emotional symptoms (p≤.001); women with the respective preexisting symptoms may, therefore, benefit from CMA/EE contraceptive treatment. Further research is warranted.
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Effects of an oral contraceptive containing 30 mcg ethinyl estradiol and 2 mg dienogest on lipid metabolism during 1 year of conventional or extended-cycle use
Inka Wiegratz, Skadi Stahlberg, Torsten Manthey, Nicole Sänger, Katrin Mittmann, Ernesta Palombo-Kinne, Uwe Mellinger, Evelyn Lange, Herbert Kuhl
pages 57-61
Background: The effects of extended regimens of combined oral contraceptives (COC) on lipid parameters are largely unknown. The present study compared the effects of a COC containing 30 mcg ethinyl estradiol and 2 mg dienogest (EE/DNG) in conventional and extended-cycle regimen over 1 year.
Conclusion: Use of EE/DNG in conventional or extended-cycle regimen resulted in comparable changes of lipid parameters.
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Timing and indication for curettage after medical abortion in early pregnant women with prior uterine incision
Guoyun Wang, Dong Li, Frank Manconi, Baihua Dong, Yuncun Zhang, Bingcui Sun
pages 62-66
Background: Termination of pregnancy is an important and necessary back-up method for family planning services in many countries. The combination of mifepristone and misoprostol is a widely used alternative to surgical evacuation of the uterus in early pregnancy; however, there are few reports about medical abortion in women with a prior uterine incision and few studies have described curettage occurring as part of the procedure and an indication for the intervention. Curettage in a prior uterine incision can increase operative complications. The purpose of this study was to investigate whether vaginal bleeding intervals, routine ultrasound scan and serum β-hCG test after medical abortion could accurately identify women with uterine scars who would require curettage.
Conclusions: The combination of mifepristone and misoprostol was found to be a safe and effective method to terminate early pregnancy in women with a previous cesarean delivery. If a woman with a prior uterine incision experienced vaginal bleeding intervals ≥21 days and/or had a bilayer endometrial thickness ≥15 mm and/or serum β-hCG ≥500 IU/L after a medical abortion, then she should undergo curettage.
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A randomized pilot study on the effectiveness and side-effect profiles of two doses of digoxin as fetocide when administered intraamniotically or intrafetally prior to second-trimester surgical abortion
Deborah Nucatola, Nitzan Roth, Mary Gatter
pages 67-74
Background: Digoxin is commonly used to facilitate second-trimester surgical abortion despite limited data regarding its safety and effectiveness for this indication. We conducted a pilot study to determine the incidence of side effects after digoxin administration and whether effectiveness can be improved with variations in dose and technique.
Conclusions: IA or IF injection of digoxin is safe and effective for inducing fetal death prior to second-trimester surgical abortion. Doses greater than 1.0 mg may not be necessary.
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Cancer risk after sterilization with transcervical quinacrine: updated findings from a Chilean cohort
David C. Sokal, Valentin Trujillo, Sergio C. Guzmán, Rene Guzman-Serani, Angie Wheeless, David Hubacher
pages 75-78
Background: Dating back to the 1970s, thousands of women worldwide have voluntarily been sterilized with transcervical insertion of quinacrine pellets. The safety and efficacy of the technology are still being assessed today; in particular, better estimates on the incidence of human cancers are now feasible.
Conclusion: Rates of cancer among women exposed to intrauterine quinacrine are similar to population-based rates.
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A randomized, double-blind, placebo-controlled Phase II extended safety study of two Invisible Condom® formulations in Cameroonian women
Francois-Xavier Mbopi-Keou, Sylvie Trottier, Rabeea F. Omar, Ngoh N. Nkele, Séraphin Fokoua, Enow R. Mbu, Marc-Christian Domingo, Jean-Francois Giguère, Jocelyne Piret, Anthony Mwatha, Benoît Mâsse, Michel G. Bergeron
pages 79-85
Background: Invisible Condom® gel formulations being developed as microbicides to prevent the sexual transmission of HIV are advancing through the phases of clinical trials. The objectives of this study were to evaluate, after 8 weeks of vaginal application, the extended safety and acceptability of two Invisible Condom® vaginal gel formulations: (i) the polymer alone and (ii) the polymer containing sodium lauryl sulfate (SLS) compared to placebo.
Conclusion: This extended safety study showed that the Invisible Condom® gel formulations and applicator were well tolerated and acceptable when applied intravaginally twice daily for 8 weeks. Thus, further phases of clinical development of Invisible Condom® as a potential microbicide to prevent sexual transmission of HIV are warranted.
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Case Report
Loop electrosurgical excision procedure to treat cervical stenosis at the time of surgical abortion
Britt Lunde, Maureen Paul, Alejandro Treszezamsky, Janine Popot, Gillian Dean, Adam Jacobs
pages 86-87
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Letters to the Editor
Effects of the contraceptive vaginal ring, the contraceptive transdermal patch and combined oral contraceptives on markers of hemostasis
Huib A.A.M. van Vliet, Frits R. Rosendaal, Kathrin Fleischer, Jan Rosing, Frans M. Helmerhorst
pages 88-89
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Response to the Letter to the Editor
Jeffrey T. Jensen
pages 89-90
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Erratum
Erratum to “Advancing scope of practice for advanced practice clinicians: more than a matter of access” [Contraception 80 (2009) 105–107]
Tracy Weitz, Patricia Anderson, Diana Taylor
page 91
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