British teens frequently misuse condoms
A survey of over 1300 British teens aged 16-18 years revealed that many of them do not use condoms correctly. The participants were asked to keep a six month sex diary, noting events in which oral, vaginal, and/or anal sex occurred. Forty-seven percent of the participants had had vaginal sex, and 62% of these individuals had used a condom the last time they had intercourse (n=375). At the most recent episode of intercourse, six per cent responded that they had penetrative intercourse before putting on a condom, and another 6 per cent said they removed the condom but continued to have intercourse. Overall, 31 per cent had at least one episode in the previous six months where a condom was put on after penetrative intercourse had begun.
Participants listed reasons for putting condoms on late, and these included “better intimacy without a condom”, “other contraception was being used”, and “they got carried away”.
Another interesting finding was that condoms were three times more likely to be used incorrectly if the couple was using another form of contraception (such as the birth control pill).
SHORT REPORT:
Bethan Hatherall, Roger Ingham, Nicole Stone, and Juliet McEachran. How, not just if, condoms are used: the timing of condom application and removal during vaginal sex among young people in England
Sex. Transm. Inf., Nov 2006; doi:10.1136/sti.2006.021410
US adolescents concerned about possible side effects of the birth control pill
Researchers in Philadelphia interviewed 72 teenage girls about their beliefs and understanding regarding different types of contraception, including the birth control pill, Depo Provera, and Norplant. The majority of the girls were African-American and from the city. Half of the girls were sexually active.
Four main themes were expressed:
- Menstruation is natural and should not be altered in any way
- The menstrual period is necessary for cleansing of the body
- “Spotting”, bleeding between periods, and having no periods cause doubts about the method’s effectiveness and worries about pregnancy
- Any type of menstrual irregularity causes worry about the effect on one’s physical health and fertility
Many misconceptions about these contraceptive methods were also mentioned. These included the beliefs that pregnancy was safer than being on the Pill because you can get blood clots on the Pill; that spotting means the method is not working; and that the ability to have children in the future would be permanently affected by using hormonal contraception. The main sources for information about contraception were friends and family members.
Although the teens were from a narrow cross section of society, their thoughts and opinions are common among women looking for contraception. It is another reminder that women of all ages need reliable information about contraception. When providing women with a new prescription, it is important to counsel them to correct any misconceptions or misinformation they may have received. This is particularly important for young women who may have received misinformation from their friends.
Clark LR, Barnes-Harper KT, Ginsburg KR, Holmes WC, Schwarz DF. Menstrual irregularity from hormonal contraception: a cause of reproductive health concerns in minority adolescent young women. Contraception. 2006 Sep;74(3):214-9.
Health Canada follows the United States in changing Evra labels.
In late September 2006, the United States Food and Drug Administration announced that it was updating the product label on the Ortho-Evra (US version) contraceptive patch to indicate that it may have an increased risk of causing blood clots compared to a birth control pill.
This label change was based on information from two studies, one which found a doubling in the risk of blood clots with Ortho-Evra and another study which found no difference when compared to the birth control pill. The regulatory agency could not definitively conclude that the patch caused more blood clots, but felt that notification of the public about the possible risk was the best course of action.
Health Canada has recently decided that labeling for the Canadian Evra patch should also be altered, even though the patch available in Canada contains less estrogen than the patch available in the United States (60 mcg vs. 75 mcg). The Canadian patch has the equivalent amount of estrogen when compared to 35 mcg pills, whereas the US patch contains about 60% more estrogen. Recent studies have found the peak dose of estrogen with an equivalent birth control pill is two times higher than with the Canadian Evra patch, and the total amount of estrogen is the same. Estrogen is felt to be the component of the pill responsible for the increased blood clot risk.
The new recommendations ask health care providers to consider the overall clot risk for their patients before prescribing Evra. For example, obesity may be an independent risk for blood clots even in non-pill users. Further studies are underway to better understand the venous thrombosis risk of Evra compared to birth control pills. All risks associated with contraception need to be considered in the context of other day-to-day risks and the risk of thrombosis in pregnancy.
www.cbc.ca/health/story/2006/09/20/birth-control.html (URL obtained October 29, 2006)
http://www.hc-sc.gc.ca/dhp-mps/medeff/advisories-avis/prof/2006/evra_hpc-cps_e.html (URL obtained December 3, 2006)
sexualityandu.ca wins international award for public education
Two Canadian health websites produced by the Society of Obstetricians and Gynaecologists of Canada (SOGC) were presented with Aesculapius Awards of Excellence in November, in recognition of excellence in communicating health information to the public.
The awards, presented by the Maryland-based Health Improvement Institute, were awarded to www.sogc.org and www.sexualityandu.ca for their contributions to health education on sexual and reproductive health.
“It is a great honour for our society to be recognized in this way,” said SOGC President Dr. Don Davis. “There is a lot of misinformation when it comes to sexuality and women’s reproductive health. These sites are excellent sources of credible information – information people know they can trust because it’s produced by medical experts.”
The Aesculapius award marks the second major international recognition in the past year for sexualityandu.ca, which was developed as part of the SOGC’s Contraception Awareness Project. Last November, the Canadian sexual health and wellness site was selected as one of the world’s top five e-health projects at the United Nations’ Summit on the Information Society held in Tunisia.
For both sites, the awards come following recent upgrades. In November 2005, the SOGC relaunched its website www.sogc.org, adding additional features such as a new public education section offering health information on subjects such as pregnancy, menopause, and gynaecologic health. The SOGC also revamped its sexualityandu site in July of this year, adding a modern new look and a host of new features. These features include: interactive contraceptive comparison charts; a new section for members of the media featuring Canadian statistics on sexual health; and one of the largest collections of Frequently Asked Questions on sexual health that the Internet has to offer.
Named after the ancient god of medicine and healing, the Aesculapius awards are presented annually to websites and radio and television public service announcements that offer exceptional public health information. The two SOGC sites were evaluated on criteria such as health-objective, content and credibility, user-friendliness, readability, visual design, and effectiveness of reaching its target audience.
For more information on the Aesculapius awards, please visit the Health Improvement Institute’s website at http://www.hii.org.
Participants wanted for study on birth control use
An academic historian is seeking women to fill out online survey or participate in an interview regarding female university students who took the birth control pill between 1960-1980, or dispensed the Pill as a medical practitioner during this time frame, especially at U of T, UBC and McGill. Confidentiality respected. This study deals with the evolution of women's contraceptive practices in Canada and is particularly relevant given recent renewed political interest in the issue of women's reproductive choice. If you are interested in participating in this research – the first of its kind in Canada – please contact Prof. C. Sethna by email at thepillresearch@gmail.com, or by mail at
The University of Ottawa, Institute of Women's Studies,
143 rue Séraphin-Marion,
Ottawa, Ont.,
K1N 6N5,
Tel: 613-562-5800 x2356.
