contraceptives--postcoital and Genital-Diseases--Female

The potential that ongoing contraception and emergency contraception (EC) offer to reduce unplanned pregnancy and abortion is diminished by many barriers. Even when women seek care, their acute needs for those interventions may not be assessed.. This is a retrospective chart review of charts of women potentially at risk for unplanned pregnancy who were provided care in an OB-GYN urgent care clinic in a tertiary care, training hospital. Information was collected about the patient's age group, her presenting complaint, the specialty of the resident who saw her and whether or not her needs for EC and ongoing contraception were assessed and/or met.. Charts of 1006 visits were assessed; the visits of 666 potentially at-risk women were included. Slightly more than one third (37.5%) of women were asked about contraception. Only 11% of women were asked about recent unprotected intercourse; 20% of women with recent unprotected intercourse were given EC.. Even in centers dedicated to women's reproductive health, the acute need for fertility control and EC is not adequately assessed. Many opportunities to reduce unintended pregnancy are missed.

Topics: Adolescent; Adult; California; Contraception; Contraceptives, Oral; Contraceptives, Postcoital; Emergency Service, Hospital; Female; Genital Diseases, Female; Gynecology; Humans; Medical Records; Middle Aged; Needs Assessment; Obstetrics; Outcome Assessment, Health Care; Retrospective Studies; Women's Health Services

Many aspects of sexual health relate to either preventative medicine (contraception) or managing normal physiological states (pregnancy, menopause). This article looks at some of the emergency aspects of female sexual health including genital tract trauma and genital infections.

Topics: Contraceptives, Postcoital; Emergency Medical Services; Female; Genital Diseases, Female; Genitalia, Female; Humans; Sexual Behavior; Sexually Transmitted Diseases

The spectrum of progestin therapy has changed and expanded during the last few years. 1. The drug-therapy of choice in endometriosis is the medication of progestins for at least six months, for instance ethinyl-testosterone. If a patient wants additional children the "more gentle" dydrogesterone should be considered. 2. In the treatment of dysmenorrhea combination pills should be given, sequentials should be avoided. In the case of incompatibility of estrogens or in danger of oversuppression syndrome dydrogesterone should be applicated. 3. Dysfunctional bleedings should lead to an intense search for their cause. The treatment consists in an estrogen-progestin combination for 9 days and in cyclic continuation of this therapy for at least a further three months. In the case of hemorrhagic diathesis progestin treatment should be continued. 4. Cyclic adequate progestins have proofed to be successful in handling of hirsutism. The choice of the preparation depends on the patient's wish for children. 5. The progestin test is still the first step in diagnosis of amenorrhea. 6. Progestin therapy is indicated in progressive endometrial carcinoma. Some medical centres treat carcinoma of the mamma successfully with progestins. 7. Nowadays fast and early hormonal pregnancy tests are available. The progestin-pregnancy-test is limited to cases of premenopause. 8. The so-called short luteum phase has received considerable attention as a possible cause of infertility. In these cases a substitutional therapy of progestins should follow. Clomiphene or HCG-therapy is advisable. In short luteum phase and premenstrual spottings potent progestins should be given. 9. High dosage of progestins are in common use in the treatment of abortus imminens. 10. Combination pills and sequentials are widely used, the possible methods of a pure progestin contraception are: minipills, three-month-injections, implanted silastic capsules with progestional compounds, progestin impregnated intrauterine devices, vaginal silastic rings impregnated with progestional compounds. 11. Carcinogenesis of progestins was not detectable. 12. Some progestins are teratogenic.

Topics: Abortion, Threatened; Contraception; Contraceptives, Oral, Combined; Contraceptives, Oral, Sequential; Contraceptives, Postcoital; Corpus Luteum; Estrogens; Female; Genital Diseases, Female; Humans; Pregnancy; Progesterone Congeners; Progestins