- Email: [email protected]
M125 COMBINED ORAL CONTRACEPTIVES ON EXTENDED REGIMENS: EFFECTS ON INSULIN RESISTANCE ACCORDING TO TYPE OF PROGESTAGEN
S572
Poster presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S531–S867
and frequent bleeding occurred more often than was expected. One third of women experienced amenorrhoea; about half the number who expected it. In these women, over 80% reported their amenorrhoea had a positive impact on overall satisfaction. Bleeding pattern was similar or slightly worse for completers compared to women who discontinued due to other reasons. Women discontinuing due to bleeding irregularities had the worst bleeding pattern, with frequent and prolonged bleeding occurring much more often than expected (~90% vs expected 26%) and 2–3 times more often than in the other groups; these 2 aspects had a negative impact on overall satisfaction. Overall, 65% of women were satisfied with the implant at removal, (39% in discontinuers; 88% in completers). Conclusions: Bleeding aspects such as light and infrequent bleeding and amenorrhea had a positive impact on satisfaction. Expectations about bleeding were sometimes misaligned with actual changes. Better counselling and more realistic expectations prior to insertion may improve long-term continuation rates. The majority of the Implanon NXT users were satisfied with the implant. M125 COMBINED ORAL CONTRACEPTIVES ON EXTENDED REGIMENS: EFFECTS ON INSULIN RESISTANCE ACCORDING TO TYPE OF PROGESTAGEN F. Barreiros2 , M. Barbieri1 , R. Barbosa3 , T.F. Guazzelli1 , M.R. Torloni1 , F.F. Araujo1 , C.A. Guazzelli1 . 1 S˜ ao Paulo Federal University, S˜ ao Paulo, S˜ ao Paulo, Brazil; 2 Oeste Paulista University, Presidente Prudente, S˜ ao Paulo, Brazil; 3 School of Nursing, S˜ ao Paulo University, S˜ ao Paulo, S˜ ao Paulo, Brazil Objectives: The effects of extended regimens of combined oral contraception on clinical symptoms have been extensively studied but there are comparatively few studies on their metabolic effects. We aimed to assess and compare the effect of the use of two different types of progestagens on the insulin resistance of women taking combined oral contraceptives in extended regimens. Materials: This study enrolled 150 adult women (18–40 years) managed in 2011 at the same gynecology clinic of Oeste Paulista Universtity. Methods: Participants were randomized to take daily pills containing 30 mcg ethinylestradiol and either 75 mcg gestodene (Gr 1) or 150 mcg desonogestrel (Gr 2), continuously for 84 consecutive days followed by a 7 days pill-free interval, during 6 months. Exclusion criteria followed the WHO recommendations. Blood was collected at baseline and after three and six months to assess fasting glucose and insulin levels and perform the homeostatic model assessment (HOMA) test. The ANOVA test was used to compare results of these exams over time. Results: Patient characteristics (age, parity, age at menarche and sexual initiation, previous contraceptive methods) did not differ significantly between the two groups and the number of dropouts was similar (16% and 12%). There were no pregnancies during the study period. Mean fasting glucose concentration remained practically unchanged while insulin levels and HOMA test values increased slightly after 90 and 120 days of contraceptive use, but these results did not differ significantly from baseline values and between the two groups. Conclusions: Fasting plasma glucose concentration, insulin levels and HOMA test results of women using combine oral contraceptive on an extended regimen did not change significantly over a 6 month period, regardless of the type of progestagen used.
M126 TRENDS IN CONTRACEPTIVE UPTAKE AT A TEACHING HOSPITAL IN NORTHERN NIGERIA K.A. Tunau1 , A.A. Panti1 , E.I. Nwobodo1 , Y. Ahmed1 , B.A. Ekele2 . 1 Fertilty research Unit, departement of Obstetrics and Gynaecology Usm anu Danfodiyo University Teaching Hospital Sokoto, Northern Nigeria, Sokoto, Sokoto, Northwest region, Nigeria; 2 Department of Obstetrics and Gynaecology University of Abuja teaching hospital, Abuja Nigeria, Abuja, Northwest, Nigeria Objectives: Access to service delivery sites is said to be a major factor in health care delivery generally and family planning services in particular. The study objective was to determine the pattern of contraceptive uptake before and after the establishment of a second family planning clinic within the same hospital. Materials: A retrospective study on acceptors of contraception in two family planning clinics located within the same health facility – the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. The first clinic was established about 20 years ago; family planning services are provided only once weekly and the clinic is managed by staff of the Department of Community Medicine. The second clinic was established in 2007; runs daily; supervised and managed by staff of the Department of Obstetrics and Gynaecology, and offers services that include implants and surgical methods of contraception. The study period was from January 2004 to December 2011. Methods: The case notes of all the new acceptors of family planning were retrieved and relevant information obtained. Data was analysed and compared. Results: There were a total of 4,632 new acceptors of contraception and 21,594 maternities during the study period. In the four years preceding the establishment of a second unit the average contraceptive prevalence rate (CPR) was 12.9%, however this more than doubled to 26.6% four years later, with the establishment of the second clinic. There was a near-plateau state on the number of new clients in the first clinic at an average of 300 acceptors per annum; the second clinic however, has had a progressive increase in new acceptors from 57 in the year 2007 to 705 in the year 2011. The most popular methods before the establishment of the second clinic were pills (917; 38.7%) and injectables (864; 36.5%) but in the second clinic the implants (1,128; 49.8%) and injectables (557; 24.6%) were the most popular methods. Conclusions: The contraceptive prevalence in the study group has increased. An improvement in access to family planning services and choice of methods can truly lead to higher uptake of contraception. However, when and where uptake is perceived to be low, an audit is first recommended before taking necessary measures. M127 ADHERENCE TO A COMBINED HORMONAL CONTRACEPTIVE (INJECTABLE AND ORAL) IN WOMEN AGED 14 TO 24: QUALITATIVE-QUANTATIVE STUDY, COLOMBIA, 2010 1 1 P.I. Gomez-S ´ anchez ´ . National University of Colombia, Bogota, Colombia
Objectives: Determining young women’ adherence to a hormonal contraceptive and the effect of administration route, adjusted according to associated factors. Materials: A mixed study (concurrent cohorts and in-depth interviews) of females aged 14 to 24, who wished to use combined oral and injectable hormonal contraceptive methods was carried out between January 2008 and June 2009. Methods: Women who were pregnant, nursing, suffering neoplastic diseases or psychiatric alterations or who were drug addicts or mentally-retarded were excluded; WHO category 3 and 4 eligibility criteria were used. Sample size was 335 females: 85 for injectable
Poster presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S531–S867
and frequent bleeding occurred more often than was expected. One third of women experienced amenorrhoea; about half the number who expected it. In these women, over 80% reported their amenorrhoea had a positive impact on overall satisfaction. Bleeding pattern was similar or slightly worse for completers compared to women who discontinued due to other reasons. Women discontinuing due to bleeding irregularities had the worst bleeding pattern, with frequent and prolonged bleeding occurring much more often than expected (~90% vs expected 26%) and 2–3 times more often than in the other groups; these 2 aspects had a negative impact on overall satisfaction. Overall, 65% of women were satisfied with the implant at removal, (39% in discontinuers; 88% in completers). Conclusions: Bleeding aspects such as light and infrequent bleeding and amenorrhea had a positive impact on satisfaction. Expectations about bleeding were sometimes misaligned with actual changes. Better counselling and more realistic expectations prior to insertion may improve long-term continuation rates. The majority of the Implanon NXT users were satisfied with the implant. M125 COMBINED ORAL CONTRACEPTIVES ON EXTENDED REGIMENS: EFFECTS ON INSULIN RESISTANCE ACCORDING TO TYPE OF PROGESTAGEN F. Barreiros2 , M. Barbieri1 , R. Barbosa3 , T.F. Guazzelli1 , M.R. Torloni1 , F.F. Araujo1 , C.A. Guazzelli1 . 1 S˜ ao Paulo Federal University, S˜ ao Paulo, S˜ ao Paulo, Brazil; 2 Oeste Paulista University, Presidente Prudente, S˜ ao Paulo, Brazil; 3 School of Nursing, S˜ ao Paulo University, S˜ ao Paulo, S˜ ao Paulo, Brazil Objectives: The effects of extended regimens of combined oral contraception on clinical symptoms have been extensively studied but there are comparatively few studies on their metabolic effects. We aimed to assess and compare the effect of the use of two different types of progestagens on the insulin resistance of women taking combined oral contraceptives in extended regimens. Materials: This study enrolled 150 adult women (18–40 years) managed in 2011 at the same gynecology clinic of Oeste Paulista Universtity. Methods: Participants were randomized to take daily pills containing 30 mcg ethinylestradiol and either 75 mcg gestodene (Gr 1) or 150 mcg desonogestrel (Gr 2), continuously for 84 consecutive days followed by a 7 days pill-free interval, during 6 months. Exclusion criteria followed the WHO recommendations. Blood was collected at baseline and after three and six months to assess fasting glucose and insulin levels and perform the homeostatic model assessment (HOMA) test. The ANOVA test was used to compare results of these exams over time. Results: Patient characteristics (age, parity, age at menarche and sexual initiation, previous contraceptive methods) did not differ significantly between the two groups and the number of dropouts was similar (16% and 12%). There were no pregnancies during the study period. Mean fasting glucose concentration remained practically unchanged while insulin levels and HOMA test values increased slightly after 90 and 120 days of contraceptive use, but these results did not differ significantly from baseline values and between the two groups. Conclusions: Fasting plasma glucose concentration, insulin levels and HOMA test results of women using combine oral contraceptive on an extended regimen did not change significantly over a 6 month period, regardless of the type of progestagen used.
M126 TRENDS IN CONTRACEPTIVE UPTAKE AT A TEACHING HOSPITAL IN NORTHERN NIGERIA K.A. Tunau1 , A.A. Panti1 , E.I. Nwobodo1 , Y. Ahmed1 , B.A. Ekele2 . 1 Fertilty research Unit, departement of Obstetrics and Gynaecology Usm anu Danfodiyo University Teaching Hospital Sokoto, Northern Nigeria, Sokoto, Sokoto, Northwest region, Nigeria; 2 Department of Obstetrics and Gynaecology University of Abuja teaching hospital, Abuja Nigeria, Abuja, Northwest, Nigeria Objectives: Access to service delivery sites is said to be a major factor in health care delivery generally and family planning services in particular. The study objective was to determine the pattern of contraceptive uptake before and after the establishment of a second family planning clinic within the same hospital. Materials: A retrospective study on acceptors of contraception in two family planning clinics located within the same health facility – the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. The first clinic was established about 20 years ago; family planning services are provided only once weekly and the clinic is managed by staff of the Department of Community Medicine. The second clinic was established in 2007; runs daily; supervised and managed by staff of the Department of Obstetrics and Gynaecology, and offers services that include implants and surgical methods of contraception. The study period was from January 2004 to December 2011. Methods: The case notes of all the new acceptors of family planning were retrieved and relevant information obtained. Data was analysed and compared. Results: There were a total of 4,632 new acceptors of contraception and 21,594 maternities during the study period. In the four years preceding the establishment of a second unit the average contraceptive prevalence rate (CPR) was 12.9%, however this more than doubled to 26.6% four years later, with the establishment of the second clinic. There was a near-plateau state on the number of new clients in the first clinic at an average of 300 acceptors per annum; the second clinic however, has had a progressive increase in new acceptors from 57 in the year 2007 to 705 in the year 2011. The most popular methods before the establishment of the second clinic were pills (917; 38.7%) and injectables (864; 36.5%) but in the second clinic the implants (1,128; 49.8%) and injectables (557; 24.6%) were the most popular methods. Conclusions: The contraceptive prevalence in the study group has increased. An improvement in access to family planning services and choice of methods can truly lead to higher uptake of contraception. However, when and where uptake is perceived to be low, an audit is first recommended before taking necessary measures. M127 ADHERENCE TO A COMBINED HORMONAL CONTRACEPTIVE (INJECTABLE AND ORAL) IN WOMEN AGED 14 TO 24: QUALITATIVE-QUANTATIVE STUDY, COLOMBIA, 2010 1 1 P.I. Gomez-S ´ anchez ´ . National University of Colombia, Bogota, Colombia
Objectives: Determining young women’ adherence to a hormonal contraceptive and the effect of administration route, adjusted according to associated factors. Materials: A mixed study (concurrent cohorts and in-depth interviews) of females aged 14 to 24, who wished to use combined oral and injectable hormonal contraceptive methods was carried out between January 2008 and June 2009. Methods: Women who were pregnant, nursing, suffering neoplastic diseases or psychiatric alterations or who were drug addicts or mentally-retarded were excluded; WHO category 3 and 4 eligibility criteria were used. Sample size was 335 females: 85 for injectable