contraceptives--postcoital and Headache

To review new evidence regarding ten controversial issues in the use of contraceptive methods among women with special conditions and to present World Health Organization recommendations derived in part from this evidence.. We searched MEDLINE and PREMEDLINE databases for English-language articles, published between January 1995 and December 2001, for evidence relevant to ten key contraceptive method and condition combinations: combined oral contraceptive (OC) use among women with hypertension or headaches, combined OC use for emergency contraception and adverse events, progestogen-only contraception use among young women and among breast-feeding women, tubal sterilization among young women, hormonal contraception and intrauterine device use among women who are human immunodeficiency virus (HIV) positive, have AIDS, or are at high risk of HIV infection. Search terms included: "contraception," "contraceptives, oral," "progestational hormones," "medroxyprogesterone-17 acetate," "norethindrone," "levonorgestrel," "Norplant," "contraceptives, postcoital," "sterilization, tubal," "intrauterine devices," "hypertension," "stroke," "myocardial infarction," "thrombosis," "headache," "migraine," "adverse effects," "bone mineral density," "breast-feeding," "lactation," "age factors," "regret," and "HIV.". From 205 articles, we identified 33 studies published in peer-reviewed journals that specifically examined risks of contraceptive use among women with pre-existing conditions.. Combined OC users with hypertension appear to be at increased risk of myocardial infarction and stroke relative to users without hypertension. Combined OC users with migraine appear to be at increased risk of stroke relative to nonusers with migraine. The evidence for the other eight method and condition combinations was either insufficient to draw conclusions or identified no excess risk.. Of ten contraceptive method and condition combinations assessed, the evidence supported an increased risk of cardiovascular complications with combined OC use by women with hypertension or migraine. As new evidence becomes available, assessment of risk and recommendations for use of contraceptive methods can be revised accordingly.

Topics: Cardiovascular Diseases; Contraceptives, Oral; Contraceptives, Oral, Combined; Contraceptives, Postcoital; Evidence-Based Medicine; Female; Headache; HIV Infections; Humans; Hypertension; Lactation; Myocardial Infarction; Progestins; Risk Factors; Stroke

Emergency contraception was introduced in Nigeria over two decades ago, but few women have used this method even in emergency situations because of the side effects. To find an acceptable levonorgestrel regimen for emergency contraception in our community, the two-dose regimen 0.75-mg levonorgestrel 12 h apart (group A) and the single dose 1.5-mg levonorgestrel (group B) were studied in 1118 volunteers. Mild side effects such as nausea, vomiting, lower abdominal pains, menorrhagia, dizziness, headache, and breast tenderness were reported. Significantly more women in the high-dose group reported headache, breast tenderness, and heavy menstrual flow. Eleven pregnancies (1.0%) were reported (7 in group A and 4 in group B). The crude relative risk of pregnancies was similar in the two groups (RR = 0.71, 95% CI = 0.32-1.55; p > 0.05) [corrected]. On the other hand, the estimated effectiveness rate of 86.80% in group A was significantly lower than the 92.99% for group B (p < 0.05). The pregnancy rates increased with delay in starting treatment and if further acts of unprotected sexual intercourse took place after treatment. It was concluded that both regimens were effective and safe.

Topics: Abdominal Pain; Adult; Contraceptives, Postcoital; Double-Blind Method; Female; Headache; Humans; Levonorgestrel; Menorrhagia; Nausea; Nigeria; Placebos; Pregnancy; Safe Sex; Vomiting

Topics: Adult; Contraception, Postcoital; Contraceptives, Postcoital; Ethinyl Estradiol; Female; Headache; Humans; Levonorgestrel; Magnetic Resonance Imaging; Stroke

Topics: Behavior; Breast Diseases; Cardiovascular Diseases; Central Nervous System Diseases; Contraception; Contraceptives, Oral; Contraceptives, Postcoital; Diabetes Mellitus; Female; Headache; Humans; Hypertension; Jaundice; Libido; Liver Diseases; Menstruation Disturbances; Mental Disorders; Nausea; Pain; Progestins; Skin Diseases

Topics: Contraceptives, Oral; Contraceptives, Postcoital; Diethylstilbestrol; Female; Headache; Humans; Menstruation; Statistics as Topic