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Contraception Journal
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Contraception Highlights July 2011

This month’s featured editorial

Bringing It Home: Our Imperative To Translate Reproductive Health Research Into Real Practice Change
Wayne C. Shields, Ellen L. Cohen and David Turok
pages 1-3
The majority of the professional communities who read this journal — reproductive health researchers, scientists, health care providers and advocates — are rewarded for their efforts with fresh insights and late-breaking research. Our field has a good handle on what needs to be done, and our research pipeline is bursting: We have identified the gaps, conducted needed research and are constantly seeking funds to do more. read more >

Clinical Guidelines

Labor induction abortion in the second trimester: Release date February 2011 SFP Guideline 20111
Lynn Borgatta, Nathalie Kapp
pages 4-18
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Review Articles

The evolution of combined oral contraception: improving the risk-to-benefit ratio
Shawn Malarcher, Olav Meirik, Elena Lebetkin, Iqbal Shah, Jeff Spieler, John Stanback
pages 19-34
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Original research articles

Effect on pregnancy rates of the delay in the administration of levonorgestrel for emergency contraception: a combined analysis of four WHO trials
Gilda Piaggio, Nathalie Kapp, Helena von Hertzen
pages 35-39
Background: Levonorgestrel is an effective method for emergency contraception (EC) and is used worldwide. Consistent with its mechanism of action in delaying ovulation, the earlier it is administered within 72 h of an unprotected act of intercourse, the more effective it is. There is uncertainty, however, about its effectiveness after 72 h. This analysis explores the effect of 24-h intervals of delay in levonorgestrel administration on pregnancy rates when used until 120 h of an unprotected act of intercourse.
Conclusions: Levonorgestrel for EC should be administered as soon as possible after unprotected intercourse. Delaying levonorgestrel administration until the fifth day after unprotected intercourse increases the risk of pregnancy over five times compared with administration within 24 h. It is uncertain whether levonorgestrel administration on the fifth day still offers some protection against unwanted pregnancy.
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Is the oral contraceptive pill associated with fracture in later life? New evidence from the Royal College of General Practitioners Oral Contraception Study
Sanam Memon, Lisa Iversen, Philip C. Hannaford
pages 40-47
Background: Several studies, including an earlier analysis from the Royal College of General Practitioners (RCGP) Oral Contraception Study, have suggested that ever users of oral contraceptives have an increased risk of fracture when compared with never users. In this paper, we examined a subset of women in the RCGP study living in Scotland to determine whether this risk has persisted.
Conclusion: Ever use of oral contraception was not associated with fracture in this study.
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Effectiveness of a theory-based postpartum sexual health education program on women's contraceptive use: a randomized controlled trial
Jian Tao Lee, Jia Ling Tsai, Tsung Shan Tsou, Min Chi Chen
pages 48-56
Background: The aim of this study was to evaluate the effectiveness of a refined theory-based Interactive Postpartum Sexual Health Education Program to enhance postpartum women's effective contraceptive behavior.
Conclusions: Our theory-based Interactive Postpartum Sexual Health Education Program enhanced postpartum women's contraceptive self-efficacy and effective contraceptive behavior.
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Unintended pregnancy and postpartum contraceptive use in women with and without chronic medical disease who experienced a live birth
Julie Chor, Kristin Rankin, Bryna Harwood, Arden Handler
pages 57-63
Background: Maternal chronic medical disease and unintended pregnancies increase the risk of maternal and infant morbidity and mortality. Little is known regarding the relationship between chronic medical disease status and pregnancy intendedness or contraceptive use
Conclusion: In our study population, age and chronic medical disease were associated with different risks of pregnancy intention in the index pregnancy. Women with and without chronic disease in both age groups reported similar postpartum contraception use.
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Effects of low-dose mifepristone administration in two different 14-day regimens on the menstrual cycle and endometrial development:a randomized controlled trial
Yuezhou Chen, Wen Wang, Yaling Zhuang, Xiuying Chen
pages 64-70
Background: This study was conducted to evaluate the effects of treatment with mifepristone 5 mg given every day or every other day for 14 days, starting 15 days after menses started for endometrial development.
Conclusions: Treatment with low-dose mifepristone every day or every other day starting 15 days after initiation of menses retards endometrial development and impairs endometrial receptivity but has minor effects on the menstrual cycle.
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Attitudes and prescribing patterns of extended-cycle oral contraceptives
Divya L. Seval, Terry Buckley, Thomas J. Kuehl, Patricia J. Sulak
pages 71-75
Background: The survey was conducted to assess attitudes and patterns of health care providers (HCPs) prescribing extended regimen oral contraceptives (OCs).
Conclusion: While HCPs appear to be recommending extended OC regimens more often, monthly cyclic regimens are the most commonly prescribed.
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Predictors of intimate partner violence in women seeking medication abortion
Lauren Roth, Jeanelle Sheeder, Stephanie B. Teal
pages 76-80
Background: High rates of intimate partner violence (IPV) have been reported among women seeking surgical abortion. Women seeking medication abortion differ from surgical abortion patients on many measures. The rate of IPV among medication abortion patients is unknown.
Conclusions: The rate of IPV in this study was similar to the background US rate. Few demographic variables are predictive of IPV among women seeking medication abortion. Gynecologic variables associated with IPV are consistent with less control over reproductive health.
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Premenstrual dysphoric disorder symptom cluster improvement by cycle with the combined oral contraceptive ethinylestradiol 20 mcg plus drospirenone 3 mg administered in a 24/4 regimen
Joachim Marr, Minoo Niknian, Lee P. Shulman, Richard Lynen
pages 81-86
Background: A combined oral contraceptive comprising ethinylestradiol (EE) 20 mcg/drospirenone 3 mg in a 24/4 regimen has been clinically shown to alleviate the symptoms associated with premenstrual dysphoric disorder (PMDD). However, previous studies did not report data according to cycle-by-cycle improvement.
Conclusions: Ethinylestradiol 20 mcg/drospirenone 3 mg 24/4 improved commonly recognizable PMDD symptom clusters relating to negative emotions, food cravings and water retention-related symptoms to a significantly greater extent than placebo during all three cycles of treatment.
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A comparison of women with induced abortion, spontaneous abortion and ectopic pregnancy in Ghana
Hilary M. Schwandt, Andreea A. Creanga, Kwabena A. Danso, Richard M.K. Adanu
pages 87-93
Background: Despite having one of the most liberal abortion laws in sub-Saharan Africa, complications from induced abortion are the second leading cause of maternal mortality in Ghana.
Conclusions Identifying the individual and relationship characteristics of induced abortion patients is the first step toward targeted policies and programs aimed at reducing unsafe abortion in Ghana.
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Contraception choices in a cohort of HIV+ women in the era of highly active antiretroviral therapy
Echezona E. Ezeanolue, Paul G. Stumpf, Evelen Soliman, George Fernandez
pages 94-97
Background: The study was conducted to determine whether increased desire for fertility coupled with increased awareness of reduction in mother-to-child HIV transmission (MTCT) with increased availability and use of highly active antiretroviral therapy (HAART) has been associated with reduction in use of tubal sterilization as a form of contraception among women infected with HIV.
Conclusions: Initiation of ARV and awareness that maternal treatment can reduce MTCT may explain lower use of female sterilization as a form of contraception among a cohort of HIV+ women in the post HAART era.
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Evaluation of reversible contraceptive activities of Cuminum cyminumin male albino rats
Radhey S. Gupta, Poonam Saxena, Rajnish Gupta, Jai B.S. Kachhawa
pages 98-107
Background: The aim of the present study was to evaluate the contraceptive efficacy of Cuminum cyminum (jeera) seeds in male albino rats.
Conclusion: The present study shows that C. cyminum treatment resulted in the inhibition of spermatogenesis and fertility without producing apparent toxic effects.
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Letters to the Editor

Time to trim the loose ends of the tailstring debate
Corina Tennant, Courtney A. Schreiber
pages 108
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The Dalkon Shield and pelvic infection
Richard Lyus, Patricia Lohr, Sarah Prager
pages 108-109
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Family planning methods in peripartum cardiomyopathy
James D. Fett
pages 109
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Reply
Corina Tennant, Courtney A. Schreiber
pages 108
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Does bupivacaine in laparoscopic ports not reduce postsurgery pain in tubal ligation?
Ali Yuceaktas, Seza Apiliogullari
pages 110-111
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Does bupivacaine in laparoscopic ports not reduce postsurgery pain in tubal ligation? Author reply
Ricardo Francalacci Savaris
pages 111
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