According to a report, statistics have shown that there is a decrease in the percentage of teens who have had sex and an increase in contraceptive use at first sex among teens. However, it also found that teens are inconsistent in contraceptive use. 1 in every 2 teens surveyed by the National Campaign to Prevent Teen Pregnancy cites pressure from partners as a main reason for not using contraception. Drinking and drug use also play a large role, as noted by more than 50% of the teens. The nationally representative survey questioned 515 teens aged 12-17 years. While the poll showed that nearly 9 of 10 teens believe it is important to use contraception each and every time they have sex, they are not following through in their actions. In addition, the report notes that Hispanic and very young teens are at particularly high risk of unplanned pregnancy. In view of this, it remains challenging to ensure adequate access to contraceptive care, particularly care provided in a confidential and nonjudgmental manner. The priority should always be to encourage teens to delay sexual activity and to protect their physical health, their emotional health, and their opportunities for the future.
This article presents three predictions pertaining to the future of family planning. The most important advance in family planning will be the development of vaginal spermicides that also effectively kill the bacteria and viruses that cause infection. This advancement is extraordinarily important because many women simply cannot count on men to cooperate in the prevention of infection and/or in the prevention of an unintended pregnancy. It is also predicted that a nearly 100% effective approach to preventing pregnancy the day after intercourse will be a very close possibility. The third prediction is the development of hormonal pills or injections for men. However, this method may not work since men are required to use them and there is doubt that pills or injections for men would be received any more positively. Moreover, in order for these advancements in reproductive health to take place, the status of women in the home, in various cultures and ethnic groups, in religious bodies, and in medical communities must improve.
In view of the fact that perimenopausal women experience a higher rate of unintended pregnancies and a higher proportion of miscarriage and abortion, an evaluation of the contraceptive options for perimenopausal women is presented. Combined oral contraceptives (COCs) are a good contraceptive option for perimenopausal women who do not smoke and those who have diabetes, hypertension or cardiovascular risks. For women who smoke or have cardiovascular risks, progestin-only pills, injections, and implants are a much better alternative. On the other hand, barrier methods give greater protection against sexually transmitted diseases, although they have lower efficacy than COCs. Meanwhile, IUDs such as the Copper T-380 offer contraceptive effectiveness equal to that of surgical sterilization. Furthermore, periodic abstinence is a less effective option secondary to perimenopausal cycle irregularity. Finally, method selection should be carefully guided by considering personal and family health history, individual preferences and previous experiences.
In 1999, contraceptive coverage laws proliferated both in the government and private sectors in the US. On September 29, President Clinton signed a bill ensuring federal employees' access to contraceptives. While Congress has been creating initiatives of providing contraceptive coverage for its employees, individuals insured under private employers do not enjoy such coverage. In response to this, the Equity in Prescription Insurance Act was introduced to provide contraceptive coverage in private sector employment-based plans. Between April and September, 9 states enacted an almost similar contraceptive coverage law; these were California, Connecticut, Georgia, Hawaii, Maine, Nevada, New Hampshire, North Carolina, and Vermont. All require private insurance coverage of contraceptives and devices approved by the Food and Drug Administration. California, Connecticut, and Georgia require coverage of contraceptive services. In most states, however, addressing difficult questions concerning the scope of exemption for employers who object to contraceptive coverage was central to the ultimate success of the bill.
This article presents insights on the efficacy of oral contraceptives (OCs) in women who smoke. It presents opinions of three Contraceptive Technology Update board members, namely, Dr. Michael Rosenberg, Dr. Andrew Kaunitz, and Susan Wysocki. Two lines support that the anti-estrogenic effect of smoking reduces the effectiveness of OCs. First, several studies indicate that spotting and bleeding were more frequent in smokers. Smoking reduces estrogen levels in the body; hence smokers experience irregular bleeding with the pill. This is the reason why smokers are at a higher risk of developing osteoporosis in the later years. Breakthrough bleeding also demonstrates higher OC failure rates among smokers. A single study on the efficacy of OCs in smokers revealed a highly diminished effectiveness of the pill in this group. Second, laboratory analysis indicates that estrogen increases the catabolism of estrogen, providing a rationale for these observed effects. The use of low-dose pills in smokers is guided by safety concerns since smoking enhances the development of thrombosis. A balance of the safety and efficacy risks is necessary especially with the increasing use of low-dose OCs.
