Contraceptive Failure Rates: New Estimates from the 1995 National Survey of Family Growth

Fu, Haishan; Darroch, Jacqueline E.; Haas, Taylor; Ranjit, Nalini

doi:10.2307/2991640

Cited by 255 publications

(131 citation statements)

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“…However, imperfect use contributes to failure rates as high as 30% [1]. Effective OCP use requires method commitment (i.e., considering one's birth control method to be OCP) as well as OCP use consistent with the method's pharmacology and mechanism of action (i.e., method adherence).…”

Section: Introductionmentioning

confidence: 99%

Patterns of Oral Contraceptive Pill-taking and Condom Use among Adolescent Contraceptive Pill Users

Woods

Shew

et al. 2006

Journal of Adolescent Health

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Purpose-Imperfect oral contraceptive pill (OCP) regimen adherence may impair contraceptive effectiveness. The purpose of this study was to describe daily adherence patterns of OCP use, to analyze OCP protection on an event level basis, and to examine pill-taking and condom use during method transitions.Methods-Women (n = 123, ages 14-17 years) completed quarterly interviews to classify OCP method choice into four categories: stable, initiated, stopped, and discordant use. Within each OCP category, daily diaries were used to assess occurrence of coitus, condom use, and patterns of day-today OCP use (i.e., consecutive days of OCP use reported with no more than two consecutive days of nonuse). A coital event was OCP protected if pills were used on both the day of the coitus and the day preceding.Results-There were 123 participants who reported at least some OCP use in 210 diary periods (average diary length = 75.5 days). Fifty-three participants categorized as stable users reported 87 diary periods: the average interval of consecutive OCP use in this group was 32.5 days. Among stable users, only 45% of coital events were associated with both OCP and condom use. Over one-fifth of coital events in all groups were protected by no method of contraception.Conclusion-Dual use of OCP and barrier contraception remains an elusive goal. The time during OCP adoption or discontinuation is often unprotected by condoms. However, concurrent missed pills and condom nonuse increase pregnancy and infection risk even among stable OCP users. Understanding motivation for method usage may improve education and prevention techniques. KeywordsAdolescent; OCP; Condom; Coital event Oral contraceptive pills (OCP) have failure rates of less than 1% under perfect-use conditions. However, imperfect use contributes to failure rates as high as 30% [1]. Effective OCP use requires method commitment (i.e., considering one's birth control method to be OCP) as well as OCP use consistent with the method's pharmacology and mechanism of action (i.e., method adherence). Moreover, OCPs provide no protection against sexually transmitted infections *Address correspondence to: Dr. Jennifer L. Woods, [XE 070] OCP method choice is not a fixed characteristic of young women's contraceptive behavior. Over 60% of contraception users switch methods at some time point, and many discontinue a method within the first three months of use [6][7][8][9]. Variable patterns of OCP pill-taking during periods of transition into and out of OCP use may make these especially vulnerable times in terms of method adherence [10]. Condom use during transition periods is especially important for contraceptive as well as STI prevention purposes.Even among women who continue OCP use, daily OCP pill-taking can be difficult. Up to 60% of adult users report missed pill doses and up to 50% miss enough doses to place them at risk for pregnancy [11,12]. Therefore, clinicians must be aware that actual OCP usage differs from the ideal with associated perfect pill usage.Understanding the ...

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Section: Introductionmentioning

confidence: 99%

Patterns of Oral Contraceptive Pill-taking and Condom Use among Adolescent Contraceptive Pill Users

Woods

Shew

et al. 2006

Journal of Adolescent Health

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“…The National Survey of Family Growth estimates that 9% of women using oral contraceptive pills will have an unintended pregnancy within the first year, as compared with only 0.001%, 0.14%, and 0.7% of women who use the subdermal implant, levonorgestrel IUD, or copper IUD, respectively. 8 However, these data were derived from retrospective surveys that asked women to recall their contraceptive use and pregnancies over the past (on average) 3.75 years. 4,8 The failure rate for DMPA injections in our study is lower than other reported rates because we categorized a pregnancy as a contraceptive failure only in users who had returned for injections; thus, these rates represent "perfect use" rather than typical use, given that more than 40% of women who use DMPA will discontinue use in the first year.…”

Section: Discussionmentioning

confidence: 99%

“…8 However, these data were derived from retrospective surveys that asked women to recall their contraceptive use and pregnancies over the past (on average) 3.75 years. 4,8 The failure rate for DMPA injections in our study is lower than other reported rates because we categorized a pregnancy as a contraceptive failure only in users who had returned for injections; thus, these rates represent "perfect use" rather than typical use, given that more than 40% of women who use DMPA will discontinue use in the first year. 10 Half of all pregnancies in the United States are unintended, and half of those result from con- Bars depict the cumulative percentage of participants who had a contraceptive failure with long-acting reversible contraception (LARC), depot medroxyprogesterone acetate (DMPA), or pill, patch, or ring (PPR) at 1, 2, or 3 years.…”

Section: Discussionmentioning

confidence: 99%

“…Annual failure rates with typical use of oral contraceptive pills are estimated at 9% for the general population, 13% for teenagers, and 30% or higher for some high-risk subgroups. 4,8 Prior estimates of the failure rates with typical oralcontraceptive use have relied on retrospective survey data, primarily from the National Survey of Family Growth. 9 Long-acting reversible contraceptive methods, including intrauterine devices (IUDs) and subdermal implants, are not user-dependent and have very low failure rates (less than 1%), which rival those with sterilization.…”

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confidence: 99%

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Effectiveness of Long-Acting Reversible Contraception

Winner¹,

Peipert²,

Zhao³

et al. 2012

Obstetrical &Amp; Gynecological Survey

101

126

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“…Although condoms are essential to prevent sexually transmitted diseases, the efficacy and effectiveness depends on the correct use and the possible occurrence of physical complications such as breakage and slippage. Thus, it is not surprising that some reports reveal estimations showing that pregnancy rate may be as high as 14% in the first year [195] during condom use. There are several other methods that can be used by men to avoid pregnancy, but there is an urgent need for an effective reversible male contraceptive.…”

Section: Future Perspectivesmentioning

confidence: 99%

Metabolic Cooperation in Testis as a Pharmacological Target: From Disease to Contraception

Alves¹,

Dias²,

Silva³

et al. 2015

CMP

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Abstract:The development of a "male pill" to control fertility is still a major challenge. Although women have several options to play an active role in the couple family planning, men are very limited in terms of contraceptive methods. Several approaches have been proposed to develop a male contraceptive and can be divided in two major groups: hormonal and non-hormonal methods. Within the testis, the somatic Sertoli cell (SC) is known as the "nurse cell" since it provides the physical and nutritional support for the developing germ cells. Moreover, adjacent SCs form the Sertoli/blood testis barrier (BTB), which divides the seminiferous epithelium into the basal and the apical compartments, controlling the passage of substances to the site where germ cells develop. Among the several functions of SC, its metabolism and the production of lactate, acetate and other metabolic factors are essential for the normal occurrence of spermatogenesis. In the last years, several works have highlighted that the metabolic cooperation established between SCs and developing germ cells is compromised in several diseases associated with male subfertility/infertility. Notably, several metabolismassociated proteins are specifically expressed in the testis. Thus, there are several evidences illustrating that the control of male fertility can be achieved by targeting testicular cells metabolism. Herein, we discuss the metabolic cooperation in testis as a potential pharmacological target to counteract subfertility/infertility promoted by several diseases, particularly metabolic diseases. We also discuss how it can contribute to the development of a male contraceptive.

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Contraceptive Failure Rates: New Estimates from the 1995 National Survey of Family Growth

Cited by 255 publications

References 10 publications

Patterns of Oral Contraceptive Pill-taking and Condom Use among Adolescent Contraceptive Pill Users

Patterns of Oral Contraceptive Pill-taking and Condom Use among Adolescent Contraceptive Pill Users

Effectiveness of Long-Acting Reversible Contraception

Metabolic Cooperation in Testis as a Pharmacological Target: From Disease to Contraception

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