The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception最新文献

{"title":"Asked but not received: postpartum contraception access in opioid-using pregnant patients.","authors":"Emily R Root, Elizabeth A Farabee, Katherine B Byrket, Justin M Jatczak, Tanya Franklin, Jessica Kline, Tiffany Tonismae, Edward E Miller","doi":"10.1080/13625187.2025.2542483","DOIUrl":"10.1080/13625187.2025.2542483","url":null,"abstract":"<p><strong>Purpose: </strong>To identify differences between desired and received postpartum contraception in opioid-using pregnant patients.</p><p><strong>Materials and methods: </strong>This single-centre retrospective study included pregnant patients who reported current opioid use, with a positive urine drug screen (UDS) for opioids, and a documented contraceptive plan in the medical record who delivered between December 1, 2016, and December 31, 2020. Patients who delivered outside the sponsoring institution and those taking medications for opioid use disorder (MOUD) or hospital-administered opioids were excluded. Descriptive statistics were performed including counts, percentages, and means.</p><p><strong>Results: </strong>A total of 101 patients met the criteria for inclusion. Over two-thirds of patients did not receive their desired form of contraception at the time of hospital discharge. Long-acting reversible contraception (LARC) was the most preferred form of contraception at the time of admission. Depot medroxyprogesterone acetate (DMPA) was the most common contraceptive received at the time of hospital discharge, with around one-third of patients receiving DMPA. Only 25 patients (24.8%) presented for a postpartum follow-up appointment. Of the women who did not receive their desired form of contraception at the time of discharge, 19 (27.9%) were pregnant again within two years.</p><p><strong>Conclusions: </strong>Increased focus is needed on the prevention of unintended pregnancies in opioid-using patients, including policies to increase access to contraception, including LARCs.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"335-343"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144987097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inpatient postpartum contraception provision among individuals with opioid use disorder in Maine, 2016-2023.","authors":"Catherine Gelsinger, Alane B O'Connor, Katherine A Ahrens","doi":"10.1080/13625187.2025.2546485","DOIUrl":"10.1080/13625187.2025.2546485","url":null,"abstract":"<p><strong>Purpose: </strong>To compare trends in inpatient postpartum (IPP) long-acting reversible contraception (LARC) and permanent contraception provision among women with and without opioid use disorder (OUD) in Maine, which has recently seen a decrease in prevalence of maternal OUD.</p><p><strong>Materials and methods: </strong>We used diagnosis codes recorded in hospital discharge data to identify deliveries with and without OUD in Maine during 2016-2023. We calculated trends in annual rates per 1000 deliveries of IPP LARC or permanent methods of contraception (LAPM), permanent contraception, and LARC. We ran tests of coincidence to compare trends between deliveries with and without OUD.</p><p><strong>Results: </strong>Among the 87,339 delivery hospitalisations identified, 2604 (3.0%) had an OUD diagnosis code. Women with OUD had higher IPP contraception provision (LAPM: 12.1%, permanent contraception: 9.0% LARC: 3.1%) than those without OUD (LAPM: 6.2%, permanent contraception: 5.4%, LARC: 0.9%). Annual rate increases per 1000 deliveries were larger over the study period for women with OUD (LAPM: 11.8 [<i>p</i> = 0.02], permanent contraception: 3.96 [<i>p</i> = 0.20], LARC: 6.48 [<i>p</i> = 0.04]) as compared to those for women without OUD (LAPM: 0.46 [<i>p</i> = 0.25], permanent contraception: -0.91 [<i>p</i> = 0.05], LARC: 1.48 [<i>p</i> < 0.01]); all tests of coincidence were significant (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Among deliveries in Maine during 2016-2023, provision of IPP LAPM, permanent contraception, and LARC were higher and increased at a greater rate over time among deliveries with OUD compared to those without OUD. Our findings suggest that IPP contraceptive use could be one of many factors in the recent decrease in maternal OUD and NAS rates in Maine.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"344-355"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Onset and recovery from depressive mood changes on progestin treatment - a case series reporting the course and type of depressive symptoms in progestin users with different histories and risks.","authors":"A Muendane, G S Merki-Feld","doi":"10.1080/13625187.2025.2525171","DOIUrl":"10.1080/13625187.2025.2525171","url":null,"abstract":"<p><strong>Objective: </strong>Progestin-only contraceptives are commonly used in women with contraindications for the use of combined hormonal contraception. They are also important treatment options for medical conditions like endometriosis. Although it is well known that progestins may have a negative impact on mood, little is known on how to identify women at risk and the course of such an adverse event after discontinuation. This case series aimed to evaluate the onset and reversibility of depressive symptoms, as well as potential risk factors for the development of mood problems in new-starters of progestins.</p><p><strong>Methods: </strong>Case series of patients, who reported symptoms of depression after initiating use of a synthetic progestin.</p><p><strong>Results: </strong>Seven women reported depressive symptoms after newstart with desogestrel, dienogest or the LNG-IUS 52 mg. Symptom onset was within 3 months in six cases. One woman reported a family history of depression. In all users symptoms resolved soon after discontinuation. Three patients had experienced mood problems with another progestin in the past. After symptoms had resolved two patients tolerated another progestin method.</p><p><strong>Conclusion: </strong>Depressive symptoms after newstart of a progestin came up soon. It is promising that symptoms resolved within few weeks after discontinuation. Close follow-up of all newstarters is recommended.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"272-277"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequential treatment with relugolix combination therapy in women with symptomatic uterine fibroids that were inadequately managed with 52 mg levonorgestrel intrauterine system: the first report.","authors":"Giovanni Grandi, Marta Barretta, Antonio La Marca","doi":"10.1080/13625187.2025.2514746","DOIUrl":"10.1080/13625187.2025.2514746","url":null,"abstract":"<p><strong>Background: </strong>This is the first report aimed to evaluate the clinical impact and safety of sequential treatment with relugolix combination therapy (relugolix CT) in women with symptomatic uterine fibroids that were inadequately managed with 52 mg levonorgestrel intrauterine system (LNG-IUS) monotherapy.</p><p><strong>Materials and methods: </strong>The patients included four women aged 45-52 (mean: 48) years with symptomatic uterine fibroids, sometimes with coexisting adenomyosis, and bleeding persistence despite treatment with the LNG-IUS (52 mg) contraceptive for more than 6 months. The intervention included the combined use of LNG-IUS (52 mg) and relugolix CT (relugolix 40 mg + oestradiol 1 mg + norethisterone acetate 0.5 mg daily).</p><p><strong>Results: </strong>All women (100%) reported complete resolution of bleeding and improved quality of life following the initiation of relugolix CT while maintaining LNG-IUS (52 mg) in place as a contraceptive. No adverse events were observed. The mean followup was 11.2 (range 3-24) months, and satisfaction with the combined treatment was reported as 9.4/10.</p><p><strong>Conclusion: </strong>The sequential combination of the contraceptive LNG-IUS (52 mg) and relugolix CT may offer a safe, well tolerated, and effective non-surgical alternative for the management of symptomatic uterine fibroids, particularly in women who do not completely respond to a 6-month treatment with LNG-IUS (52 mg). These findings support further prospective investigation into this dual therapeutic sequential strategy for symptomatic uterine fibroids.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"278-281"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narratives of men and women from the southeastern region of Brazil on some aspects of sexual and reproductive health, sexual life and contraception: a qualitative study.","authors":"Maria Y Makuch, Vilma Zotareli, Silvana Bento, Karla Simonia de Pádua, Luis Bahamondes","doi":"10.1080/13625187.2025.2506557","DOIUrl":"10.1080/13625187.2025.2506557","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the narratives of men and women from Brazil regarding sexual experiences, perspectives on sexual and reproductive health (SRH) and knowledge and experience with the use of contraceptives.</p><p><strong>Material and methods: </strong>We conducted the study at the Centre for Research in Reproductive Health of Campinas (CEMICAMP) and the Department of Obstetrics and Gynaecology, University of Campinas Medical School, Campinas, Brazil. We report on the Brazilian data from a study conducted in 19 countries, coordinated by the World Health Organisation using cognitive interviewing. This qualitative procedure allowed us to collect data on the narratives of participants on the comprehension of a survey instrument during the pre-testing phase and aids researchers in understanding how participants comprehend the questions, the topics discussed in the questionnaire and how they formulate their answers. We report on part of the data collected, among other reproductive health issues, sexual life and experiences and perspectives on sexually transmitted infections (STIs), including HIV prevention and contraceptive use.</p><p><strong>Results: </strong>We recruited 30 persons, and the interviews were conducted face-to-face. The main themes identified for analysis were organised into three categories: talking about sexual experiences, perspectives on STIs and HIV and contraceptive use for both pregnancy prevention and protection against STIs/HIV.</p><p><strong>Conclusion: </strong>Discussion about SRH is vital, and issues such as those presented here must be incorporated into all encounters between patients and healthcare professionals. Moreover, it is imperative that such discussions be incorporated into other locales, such as schools and places of leisure, among others.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"254-261"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraceptive implants removal: a simple and quick procedure in a nonspecialized family planning clinic.","authors":"Juliana T P Soares, Ana C Marcelino, Paula da Cunha Pereira, Ximena Espejo-Arce, Luis Bahamondes, Cassia R T Juliato","doi":"10.1080/13625187.2025.2533950","DOIUrl":"10.1080/13625187.2025.2533950","url":null,"abstract":"<p><strong>Introduction: </strong>Most studies on contraceptive implant removal come from specialised centres, with limited data from general clinical settings. This study aimed to evaluate difficulties in single-rod implant removal in a nonspecialized clinic.</p><p><strong>Material and methods: </strong>We conducted a cross-sectional study of women requesting etonogestrel (ENG) implant removal. Difficulty was assessed using a visual analog scale (VAS), and women rated their pain on a VAS score. Multivariable logistic regression analysed factors associated with removal difficulty.</p><p><strong>Results: </strong>A total of 184 women participated (mean age 31 ± 8.6 years). The implant location was appropriate in most cases (88.1%). Nearly all implants showed a positive scrolling sign (96.7%), four cases were deeply located but above the fascia, and in two cases, the implant was found deep within the muscle. A total of 37 cases (26.4%) showed fibrosis. The median scores for difficulty and pain were low during removal. Nurses removed 21% of implants, with no significant differences in difficulty (<i>p</i> = 0.679) or pain scores (<i>p</i> = 0.582) compared to physicians. Logistic regression showed that implants with absent scrolling sign were 21.2 times more likely to be difficult to remove (OR 21.2, 95% CI 2.32-193.43, <i>p</i> = 0.003), and fibrosis increased difficulty fourfold (OR 4.2, 95% CI 1.26-14.11, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>ENG implant removal is generally a simple and quick procedure with low difficulty and minimal pain. Challenges arise with non-palpable or fibrotic implants, particularly when the scrolling sign is absent. Deeply placed implants can still be successfully removed in a nonspecialized clinic.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"282-290"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating barriers to effective contraceptive use in Sub-Saharan Africa and addressing associated challenges.","authors":"Rowaida Sadat, Koray Gorkem Sacinti, Adeola Dorcas Folorunso, Yetunde Oladejo-Adeseluka, Elif Goknur Topcu, Berna Dilbaz, Bilqis Williams","doi":"10.1080/13625187.2025.2506554","DOIUrl":"10.1080/13625187.2025.2506554","url":null,"abstract":"","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"298-300"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Task sharing in family planning services: findings from 2023 WHO survey of 64 member states of Africa, Eastern Mediterranean, and South-East Asia regions.","authors":"Moazzam Ali, Iqbal H Shah, Ndema Habib, Ayaz Ahmed Baloch, Leopold Ouedraogo, Adeniyi Aderoba, Karima Gholbzouri, Meera Thapa Upadhyay, Anoma Jarathilake","doi":"10.1080/13625187.2025.2513889","DOIUrl":"10.1080/13625187.2025.2513889","url":null,"abstract":"<p><strong>Background: </strong>In 2023, the WHO surveyed 64 countries across Africa, Eastern Mediterranean, and South-East Asia to assess task sharing in family planning (FP) services. The survey aimed to appraise national policies on family planning, task sharing, the availability of FP commodities, and special programmes for vulnerable groups.</p><p><strong>Methods: </strong>WHO Headquarters and Regional Offices designed a questionnaire administered via SurveyMonkey. Regional offices collected data from Ministry of Health officials. Descriptive analysis was conducted on the collected data.</p><p><strong>Results: </strong>A total of 64 out of 79 member states (81% response rate) participated in the WHO survey, revealing significant regional differences in the availability and task sharing of FP services. Countries in Regional Office for South-East Asia (SEARO) had higher prevalence of modern contraceptives (mCPR), while task sharing was more widespread in the Regional Office for Africa (AFRO). For example, 81% of AFRO countries had lay health workers, like community health workers, providing FP counselling, compared to just 30% in the Regional Office for the Eastern Mediterranean (EMRO). Despite WHO recommendations, most countries had limited application of task sharing for oral and emergency contraceptives, and few reported the provision of injectable contraceptives by pharmacists or auxiliary nurses.</p><p><strong>Conclusion: </strong>Our study demonstrates regional variabilities in task sharing as well as the availability of opportunities for mainstreaming WHO recommendations on task sharing into practice to ensure access to family planning. This study provides evidence for programmes addressing policies that optimise the role of health workers in increasing access and successful delivery of FP services.</p><p><strong>Short condensation: </strong>In 2023, WHO surveyed 64 countries across Africa, Eastern Mediterranean, and South-East Asia to assess task sharing in family planning services. The survey revealed regional differences in task sharing and contraceptive availability, with higher task sharing in the Regional Office for Africa (AFRO) and higher contraceptive prevalence in Regional Office for South-East Asia (SEARO). The Regional Office for the Eastern Mediterranean (EMRO) was lagging most both in provision FP and in task sharing. Despite WHO guidelines, task sharing for certain methods remains limited, highlighting opportunities to improve access to family planning services.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"239-246"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does universal healthcare coverage ensure equal access to contraception? Socioeconomic inequalities on contraceptive use in a young-adult population in Porto, Portugal.","authors":"Joana Galvão, Teresa Leão","doi":"10.1080/13625187.2025.2533933","DOIUrl":"10.1080/13625187.2025.2533933","url":null,"abstract":"<p><strong>Introduction: </strong>Access to effective and safe contraception is important to women, individually, and to the population's health and well-being. Universal free access to family planning is provided in Portugal, yet it is unknown if socioeconomic inequalities remain in access and use of contraceptives.</p><p><strong>Purpose: </strong>To study the association between socioeconomic status and use of contraceptives by young Portuguese women, and whether healthcare use contributes to socioeconomic inequalities.</p><p><strong>Material and methods: </strong>We analysed data from 552 young-adult women from the EPITeen cohort. We regressed use and method of contraception against individual net monthly income, education level, and the number of medical appointments in the past year.</p><p><strong>Results: </strong>Most women (84.1%) currently used contraceptives. Though, contraceptive use was less frequent among women with lower incomes [adjusted OR (aOR) = 0.340, <i>p</i> < 0.005] especially the vaginal ring or contraceptive patch (aOR = 0.164, <i>p</i> < 0.05). Women with lower education status were less likely to use contraceptives (aOR = 0.402, <i>p</i> < 0.05). The number of medical appointments in the last year was not associated with the use and method of contraception. Similar results were found for the ever use of contraceptives.</p><p><strong>Conclusions: </strong>Despite universal health coverage policies in Portugal, contraceptive use is still socioeconomically patterned. To achieve their full potential, family planning programs and policies must be revised, ensuring equitable access for all.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"262-271"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing access, evidence, and equity in abortion care.","authors":"Kristina Gemzell Danielsson","doi":"10.1080/13625187.2025.2538354","DOIUrl":"10.1080/13625187.2025.2538354","url":null,"abstract":"","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"237-238"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}