Talk:Contraception (medical methods)/Draft

New Start

new start Nancy Sculerati 13:42, 3 May 2007 (CDT)

Ive made some major changes. I'd also like to fill in the history section, especially regarding the discovery of The Pill. BTW, N, same problems apply to my other recent starts, I'm working on it, but I could use your help just cleaning the closet, so to speak. Then we can add good content.--Peter A. Lipson 13:43, 3 May 2007 (CDT)

You might want to grab the old content about socio-religious issues and paste into a new article.--Peter A. Lipson 14:35, 3 May 2007 (CDT)

im not so sure that expanding into vet science helps the article, but i suppose we could add it and just break it off later if we want. I like the idea of a human contraception article that people can reference easily.--Peter A. Lipson 14:47, 3 May 2007 (CDT)

Is there somewhere we could include sterilization, as tubal ligation and vasectomy are very commonly used in the U.S.Peter A. Lipson 14:54, 3 May 2007 (CDT)

EDIT CONFLICT I would like to break off sterilization as well, now. I would also like to make it clear, in the article that discusses that Sterilization (surgical), that there are methods of stopping transport of germ cells, (tube tying, vasectomy) as well as removal of testes/ovaries that have larger repercussions. Please realize that by doing it this way we are able to have fair articles that are clear cut -medical/veterinary (health science) and contraception with a precise definition, I split off Control of Contraception, since that is not a health science article. Those people interested in exploring "natural birth control methods" such as abstinence and other means done behaviorally may do so in another article, also not health science - without this article having to try to cover what is already plenty- that being methods of contraception in people and animals, MEDICAL methods. I agree, if it gets to be too much even so, we can split off humans from animals, but let's get there first. Nancy Sculerati 14:56, 3 May 2007 (CDT)

I see your point, however I really think we need to include such common surgical methods here. Included elsewhere, or linked, should be discussions of forced sterilization, eugenics, etc.--Peter A. Lipson 15:00, 3 May 2007 (CDT)

Why do you insist on mixing politics and religion in, instead of giving those their own articles? If you would follow my lead we could have a whold series of articles that each would be neutral and fair. Why do we have to decide NOW what thge article needs to contain? I know I could write it in a way that would be really good, and that we could cover everything to everyone's satisfaction. But I am running out of steam just arguing about it. I'll hold off writing anything on these articles under the circumstances, it's a waste of my time. The surgical methods of sterilization can be mentioned as existing, it cxan be expalined how they differ from the definition of contraception that e are using, and they can be linked. I'm taking a break. This is the sort of stuff that maes me wonder why I even try.Nancy Sculerati 16:25, 3 May 2007 (CDT)

Nancy, I do not understand why surgery, as well as NFP, are not considered "medical methods". Stephen Ewen 16:40, 3 May 2007 (CDT)

Medical methods are just that-medical. They are not behavioral, and they are not surgical. They are medical. Is there not another article that is unqualified to be written called Contraception? Could that article not contain whatever you want to put in it? Could it not be a whole slew of workgroups? THIS article, I had hoped, back when I was busy writing it, would contain MEDICAL methods. It has a theme- normal conception would be described, and how medical methods are likely to either stop ovulation, fertilization, or implantation would be described. The hormonal stuff alone is worth paragraphs. Nancy Sculerati 16:46, 3 May 2007 (CDT)

lets keep on topic

It seems medical methods are not seen as such by some of the authors. May I remind all participants to keep within track of the meaning of this article, and if needed spin-off to another article (possibly create it) to elaborate on side steps. Thank you. Robert Tito |  Talk  17:41, 3 May 2007 (CDT)

Emergency contraception

Mittal S. Introduction of emergency contraception in India. Journal of the Indian Medical Association. 104(9):499-502, 504-5, 2006 Sep. Consortium on National Consensus for Emergency Contraception met in New Delhi in January 2001, to reach a consensus on strategies for introduction of emergency contraception in India.

Petersen R. Albright JB. Garrett JM. Curtis KM. Acceptance and use of emergency contraception with standardized counseling intervention: results of a randomized controlled trial. [Journal Article. Randomized Controlled Trial. Research Support, Non-U.S. Gov't. Research Support, U.S. Gov't, P.H.S.] Contraception. 75(2):119-25, 2007 Feb. UI: 17241841

Hansen LB. Saseen JJ. Teal SB. Levonorgestrel-only dosing strategies for emergency contraception. [Review] [34 refs] [Journal Article. Review] Pharmacotherapy. 27(2):278-84, 2007 Feb. UI: 17253917

IUD

Archer DF. Reversible contraception for the woman over 35 years of age. [Review] [23 refs] [Journal Article. Review] Current Opinion in Obstetrics & Gynecology. 4(6):891-6, 1992 Dec. UI: 1450355

Condoms

Flannigan J. Promoting sexual health: practical guidance on male condom use. [Review] [30 refs] [Journal Article. Review] Nursing Standard. 21(19):51-7; quiz 58, 60, 2007 Jan 17-23. UI: 17288318

Gallo MF. Grimes DA. Lopez LM. Schulz KF. Non-latex versus latex male condoms for contraception.[update of Cochrane Database Syst Rev. 2003;(2):CD003550; PMID: 12804475]. [Review] [29 refs] [Journal Article. Meta-Analysis. Review] Cochrane Database of Systematic Reviews. (1):CD003550, 2006. UI: 16437459

Hormonal methods

Liu SL. Lebrun CM. Effect of oral contraceptives and hormone replacement therapy on bone mineral density in premenopausal and perimenopausal women: a systematic review. [Review] [104 refs] [Journal Article. Review] British Journal of Sports Medicine. 40(1):11-24, 2006 Jan. UI: 16371485

Bradley LD. Abnormal uterine bleeding. [Review] [23 refs] [Journal Article. Review] Nurse Practitioner. 30(10):38-42, 45-9; quiz 50-1, 2005 Oct. UI: 16217420

Ehrmann DA. Polycystic ovary syndrome.[see comment]. [Review] [144 refs] [Journal Article. Research Support, Non-U.S. Gov't. Research Support, U.S. Gov't, P.H.S.. Review] New England Journal of Medicine. 352(12):1223-36, 2005 Mar 24. UI: 15788499

Khoury-Collado F. Bombard AT. Hereditary breast and ovarian cancer: what the primary care physician should know. [Review] [45 refs] [Journal Article. Review] Obstetrical & Gynecological Survey. 59(7):537-42, 2004 Jul. UI: 15199272

Winkel CA. Evaluation and management of women with endometriosis. [Review] [54 refs] [Journal Article. Review] Obstetrics & Gynecology. 102(2):397-408, 2003 Aug. UI: 12907119

Olive DL. Pritts EA. Treatment of endometriosis. [Review] [94 refs] [Journal Article. Review] New England Journal of Medicine. 345(4):266-75, 2001 Jul 26. UI: 11474666

Moore J. Kennedy S. Prentice A. Modern combined oral contraceptives for pain associated with endometriosis. [Review] [1 refs] [Journal Article. Review] Cochrane Database of Systematic Reviews. (2):CD001019, 2000. UI: 10796731

DeCherney A. Bone-sparing properties of oral contraceptives. [Review] [25 refs] [Journal Article. Review] American Journal of Obstetrics & Gynecology. 174(1 Pt 1):15-20, 1996 Jan. UI: 8571999

Iyer V. Farquhar C. Jepson R. Oral contraceptive pills for heavy menstrual bleeding. [Review] [1 refs] [Journal Article. Review] Cochrane Database of Systematic Reviews. (2):CD000154, 2000. UI: 10796696

Burkman RT. Collins JA. Shulman LP. Williams JK. Current perspectives on oral contraceptive use. [Review] [72 refs] [Journal Article. Review] American Journal of Obstetrics & Gynecology. 185(2 Suppl):S4-12, 2001 Aug. UI: 11521117

Tyrer LB. Current controversies and future direction of oral contraception. [Review] [42 refs] [Journal Article. Review] Current Opinion in Obstetrics & Gynecology. 5(6):833-8, 1993 Dec. nice older summary of oral contraceptives after 30 years of use: in 1993-main questions of safety had to do with exogenous estrogen and posible increased risk of cervical and breast cancer. Oral contraceptves began being widely prescribed in about 1960. Reduction of doses of both estrogen and progesterin lowered clinical incidence of cardiovascular complications.The cardiovascular complications associated with OCP are specific:thromboembolic events, stroke, MI.As far as Breast cancer- the consensus in 1993 was that the overall incidence waqs not greater in women who used OCP, but the acceleration of the growth of early breast cancers (rather than their initiation) is a risk. The incidence of endometrial and ovarian cancer, however, is lower in women using birth control pills.Higher dose pills have some significant effects on CHO metabolism, especially in women who are "pre-diabetic" but do not cause diabetes.Health benefits of OCP : decreased iron deficiency anemia, less dysmennorhea, menometrorraghia, taken correctly combination pills about 100% effective in preventing pregnancy. UI: 8286698

Risk populations,complications etc

CARRIE ARMSTRONG:ACOG Releases Guidelines on Hormonal Contraceptives in Women with Coexisting Medical Conditions American Family Physician - Volume 75, Issue 8 (April 2007)

Bushnell, Cheryl D. MD, MHS; Hurn, Patricia PhD; Colton, Carol PhD; Miller, Virginia M. PhD; del Zoppo, Gregory MD, MS; Elkind, Mitchell S.V. MD; Stern, Barney MD; Herrington, David MD; Ford-Lynch, Gwendolyn MD; Gorelick, Philip MD, MPH; James, Andra MD, MPH; Brown, Candice M. PhD; Choi, Emily MD; Bray, Paul MD; Newby, L Kristin MD, MHS; Goldstein, Larry B. MD; Simpkins, James PhD Advancing the Study of Stroke in Women: Summary and Recommendations for Future Research From an NINDS-Sponsored Multidisciplinary Working Group. Stroke. 37(9):2387-2399, September 2006. "Women have poorer outcomes from stroke than men. Women also have risk factors that are unique, including pregnancy and hormone therapy. Hormone therapy for postmenopausal replacement increased the risk of ischemic stroke according to results of the Women’s Health Initiative clinical trials. Based on the current understanding of the mechanisms of action of estrogen, the reasons for this increased risk are uncertain."..."A multidisciplinary workshop was held in August 2005 to summarize the current evidence for estrogen and, more generally, stroke in women, and to provide recommendations for future basic, preclinical, and clinical research studies."

Tozer, Beverly S. MD; Boatwright, Elizabeth A. MD; David, Paru S. MD; Verma, Deepa P. MD; Blair, Janis E. MD; Mayer, Anita P. MD; Files, Julia A. MD Prevention of Migraine in Women Throughout the Life Span. Mayo Clinic Proceedings. 81(8):1086-1092, August 2006. "Migraine is a common disorder in women. The 1-year prevalence of migraine is 18% in women compared with 6% in men. Migraine most commonly occurs during the reproductive years, affecting 27% of women 30 to 49 years of age. " "During the reproductive years, headaches in women are commonly associated with menses, pregnancy, and use of combined oral contraceptives (COCs).".."Oral Contraceptives: Many women with MM also take COCs, which can unpredictably induce, alter, or alleviate migraines. The normal decline in endogenous estradiol concentration in the late luteal phase of the natural menstrual cycle is equivalent to a 20- to 25-µg decline in synthetic ethinyl estradiol (EE).13 Thus, no COC will prevent MM in a woman who has headaches during her natural cycle because even the lowest-dose medication produces a decline equivalent to 20 µg of EE premenstrually. If use of COCs exacerbates migraines throughout the cycle, the initial strategy should be to lower the estrogen content to 20 µg of EE. Persistent headaches despite this intervention may necessitate discontinuing COCs in these patients.20 When a woman experiences prolonged aura, focal neurologic symptoms different from those of her typical aura, or a sudden prolonged headache, use of COCs should be discontinued, and possible secondary causes of headache should be explored.16"

Vaginal ring

Teal SB. Craven WM. Inadvertent vesicular placement of a vaginal contraceptive ring presenting as persistent cystitis. [Case Reports. Journal Article] Obstetrics & Gynecology. 107(2 Pt 2):470-2, 2006 Feb. UI: 16449153

New start

Nancy and Peter, what is the goal of writing this article as opposed to the more general one on contraception? Where does this new start fit into the big picture? Is abstinance to be a separate article or part of the more general contraception article? Chris Day (talk) 15:28, 4 May 2007 (CDT)

Just looking in here, I think that there is an important role for an article that essentially aims to explain exactly how different methods of contraception work. Such an article can really avoid the moral/religious issues altogether. I think it is important to get across a clear account of the principles underlying hormonal use, in a way that will lead to an understanding of the limits of effectiveness and the potential hazards too. Hormonal contraception in men is also physiologically a very interesting (and illuminating) story.

I guess I see that there are potential problems in having an article that covers both the reproductive cience aspects and the ethical/societal aspects. For the moment it seems a good idea to develop these separately, though perhaps later they can be merged or linked.Gareth Leng 11:55, 5 May 2007 (CDT)

disclaimer font

It may just be my macbook pro, but I can't read the font/type-size/font-color/letter spacing of the disclaimer. Changing just one of those variables would make it easier to read. -Tom Kelly (Talk) 18:17, 5 May 2007 (CDT)

it's your browser settings- make the text bigger. I'll put the font up 1, bit it will probably be too big, It's not a disclaimer- it's a guide. Nancy Sculerati 19:19, 5 May 2007 (CDT)

I think in general it's better to let the user's browser choose the font. Html tags such as <big>, <small> etc. can be used to gently suggest what type of font to use without forcing it on the user. I would just use italics and not make the font smaller. Remember that people might have to read this stuff on various types of devices: devices for blind people; tiny handheld devices with limited screen size and resolution, etc. --Catherine Woodgold 19:30, 7 May 2007 (CDT)

Contraception versus birth control

My understanding of the word "contraception" is that it means methods that prevent conception, and that conception is the joining of egg and sperm. Therefore methods that prevent implantation are not contraception, except euphemistically. If such methods are to be discussed, perhaps "birth control" would be a better name for the article. --Catherine Woodgold 19:25, 7 May 2007 (CDT)

---

That understanding is not a physician's understanding, and one reason that certain articles, including this one have been broken off from the main article Contraception is exactly to prevent conflicts in approaches and understanding from rendering all the articles useless. For example, for some religious views- contraception does not include prevention of implantation, but only of conception- but that is not a health science view:

According to the Medline-Mirriam Webster on line Medical dictionary:Main Entry: con·tra·cep·tion Pronunciation: kän-tr-sep-shn Function: noun

deliberate prevention of conception or impregnation

- con·tra·cep·tive /-sep-tiv/ adjective or noun

Contraception includes the deliberate prevention of pregnancy. This is also how the topic is treated in every OB-GYN textbook I have ever read, and all the ones that are referenced here. However, it would be absolutely inaccurate to use this definition for groups who are not health scientists and do not agree with it, and we will strive to make this health science definition clearer in the article.

Since it makes a great deal of difference to many patients EXACTLY how contraceptives work, that information is being provided in this article- to the best of the current health science information.

A discussion of contraception from a different perspective than health sciences, as well as health sciences, is the main focus of Contraception, an article that needs authors. The different ways contraception are defined and the implications seem to belong there, as a full an unabbreviated discussion. Nancy Sculerati 11:16, 8 May 2007 (CDT)

Comments on the introduction

Re link to natural family planning: "abstinence methods" is too narrow; for example, the withdrawal method is also a method of natural family planning (depending on the definition of natural family planning). How about "natural methods"? Re "failure rate": I prefer the term "pregnancy rate" for two reasons. For one thing, "failure rate" can be interpreted to mean a number of things, such as the rate of breakage of condoms, for example, whether or not anyone becomes pregnant as a result. (When something other than pregnancy rate is actually meant, some other less ambiguous term can be used.) For another thing, "pregnancy rate" is more polite, in my opinion, especially when the article is read by a person who knows that their own existence resulted even though their parents were using a birth control method. Re of the group of women who were supposedly using it. I suggest changing to "group of women" to "couples" to avoid seeming to support the idea that contraception is women's sole responsibility. Other methods have a rate of effectiveness that is independent of compliance. They can't be completely independent of compliance, or else the people could be not using the method at all and still achieve the effectiveness. (Unless possibly you mean something like the lactation amennhorea method.) Oh, wait, it could be getting shots every few months. Still, one has to comply insofar as getting the shot in the first place. I haven't thought of a better wording yet, though. --Catherine Woodgold 20:05, 5 May 2007 (CDT)

In this health science article the rate of pregnancy is referred to in the standard manner as in the published medical literature- when discussing any method of contraception, the "failure rate" is ordinarily reported as as the percentage of women in a group that reports using a particular contraceptive method that become pregnant in the course of one year. Because of how the statistics are done for large studies, individuals placed in a group- such as "condoms" are counted in that group's results- EVEN if they are admittedly non-compliant most (or all) of the time. Similarly, if a woman had an IUD placed, and the IUD came out the next day (expelled) her one-year results would be reported in the IUD results, generally speaking. That's where the "supposedly" comes from- and it will have have more development. The "withdrawal method" is NOT a recognized form of medical contraception, nor a recognized "health science" method of effective birth control, but instead is a "traditional" or "alternative medical" method that is sometimes used as a control when reporting health science statistics. In fact, the use of condoms in a medically advised manner (see article here) unequivically states that the condom must be applied before contact such that it contains any pre-ejaculate. Should you wish to discuss traditional or alternative medical methods of reducing or influencing the pregnancy rate , there are other articles to do so Natural Family Planning, and Contraception- including any new articles that you (or others) might like to start. This article legitimately focuses on medical methods only. Nancy Sculerati 11:24, 8 May 2007 (CDT)