Risk of contraceptive discontinuation among adolescents

Balassone, Mary Lou

doi:10.1016/0197-0070(89)90016-8

Cited by 93 publications

(25 citation statements)

References 21 publications

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“…Previous studies show that 50% of young women report imperfect pill use during a pill cycle [11,28]. Approximately 25% of OCP users miss two or more pills during a pill cycle, placing them at increased pregnancy risk [12,29]. These figures are similar to those seen for the stable OCP method use group in our study where 27% of coital events occurred during a period of two or more missed pills.…”

supporting

confidence: 80%

“…In fact, many participants who identified themselves as OCP users were in method transition, associated with less consistent pill-taking and condom use. Thus, earlier research with less-well-specified identification of OCP method use may overestimate the degree of protection among adolescent OCP users [11,12,17,28,29]. However, it does appear that the stable OCP method use group is slightly more likely to cover coital events with condoms, although the extent to which condoms were utilized correctly was not specifically investigated.…”

Section: Discussionmentioning

confidence: 90%

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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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supporting

confidence: 80%

Section: Discussionmentioning

confidence: 90%

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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“…Much of the existing evidence for relations between social skills and problems related to adolescent sexual activity has been extrapolated from studies that did not actually assess specifi c sexual-interaction skills (e.g., Balassone, 1989;Burger & Inderbitzen, 1985;Cvetkovich & Grote 1981;Muehlenhard & Linton, 1987;Murnen et al, 1989;Weisman, Plichta, Nathanson, Ensminger, & Robinson, 1991). Most of these studies employed self-report measures to examine a number of factors, including social behavior, thought to infl uence contraceptive behavior (e.g., Balassone, 1989;Burger & Inderbitzen, 1985;Cvetkovich & Grote, 1981;Weisman et a]., 1991). However, the use of global selfreport measures (e.g., ratings of "general sexual communication") does not provide information about specifi c sexual-interaction skills.…”

Section: Assessment Of Sexual-interaction Skillsmentioning

confidence: 99%

“…These include defi cits in (a) communication skills (e.g., Burger & Inderbitzen, 1985;Cvetkovich & Grote, 1981 ;Hynes & Bruch, 1985;Muehlenhard & Linton, 1987;Murnen et al, 1989;Schinke et al, 1981); (b) assertion skills (e.g., Hynes & Bruch, 1985;Muehlenhard & Linton, 1987;Murnen et al, 1989;Schinke et al, 1981;Weisman et al, 1991); and (c) problemsolving skills (e.g., Balassone, 1989;Hynes & Bruch, 1985;Schinke et al, 1981).…”

Section: Current Issues In Sexual-interaction Skills Trainingmentioning

confidence: 99%

Relations Between Social Skills and High-Risk Sexual Interactions among Adolescents

Nangle

Hansen²

1993

Behav Modif

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Researchers have begun to employ social-skills training in efforts to change the sexual behavior of adolescents. However, despite the promise of social-skills training, little is known about how social skills are related to the sexual practices of adolescents. The present article reviews the current literature and proposes a conceptual framework for understanding the relations between social skills and sexual behavior of adolescents by (a) examining the relationship between sexual activity and social skills, (b) examining the development of sexual-interaction skills and deficits, (c) summarizing what is currently known about the relations between social skills and sexual behavior, (d) discussing current issues in the assessment and treatment of sexual-interaction skills deficits, and (e) proposing some directions for needed research that will add both to our current knowledge base and to the effectiveness of applied intervention efforts.

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“…This may be due to insufficient sex-steroid concentrations to maintain the endometrium or due to inconsistent pill-taking, with adolescents missing three pills per month on average. 3 The newer, third-generation COCs have been designed to contain less androgenic progestogen and often lower doses of oestrogen than the older, second-generation preparations, thereby giving more acceptable bleeding patterns. 4 Irregular bleeding is a more frequent occurrence with use of the progestogen-only preparations, presumably due to partial suppression of ovarian activity, allowing a periodic variation of the circulating oestradiol level and resulting in loss of stability of the endometrium.With perseverance the bleeding irregularity usually subsides.…”

Section: Hormonal Contraceptionmentioning

confidence: 99%

Nonmenstrual bleeding in women under 40 years of age

Connolly¹,

Jones

2004

The Obstetric & Gynaecologis

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The complaint of nonmenstrual bleeding, either intermenstrual or postcoital, is a common symptom among women. This complaint is often the result of minor alterations of physiological events caused by the influence of endogenous or exogenous hormones. It is often also associated with a high degree of anxiety. This review briefly outlines the causes of this symptom in this younger age group of women and recommends an evidence‐based approach to their investigation and subsequent management. It is important to ensure that the investigations are rational, relevant and streamlined in order to give reassurance or to begin appropriate treatment without undue delay. Premature ovarian failure is not included in this review. Women in this group who present with bleeding should be investigated as for postmenopausal bleeding.

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Risk of contraceptive discontinuation among adolescents

Cited by 93 publications

References 21 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

Relations Between Social Skills and High-Risk Sexual Interactions among Adolescents

Nonmenstrual bleeding in women under 40 years of age

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