Long-acting contraception.

Goldsmith A; Toppozada M
Chicago, Illinois, Northwestern University, Program for Applied Research on Fertility Regulation [PARFR], 1983. ii, 235 p.

This collection of articles begins with an overview of contraception in the Arab World, describing a situation of high parity and population growth, and underlining the need for family planning (EP) for demographic, health, and socioeconomic purposes. Constraints on programs are many, including factors such as the desire for large families, and the inconsistency and hesitation of religious leaders in supporting FP. The state of contraceptive development is discussed in terms of effectiveness and the variety of approaches. The pharmacological aspects of slow-releasing steroidal systems (injectable, medicated intrauterine and intravaginal, and biodegradable) are reviewed, as are the chemistry, pharmacokinetic and pharmacodynamic properties, efficacy, metabolic effects, and possible serious side effects of low-level progestogens. The probable lack of fetal effect of injectable and implantable progestins is stressed. Bleeding pattern effects of long-acting steroidal contraceptives, and prospects for improvement are reviewed. The formulations and mechanisms for action of injectable contraceptives are reviewed. Specific reference is made to norethisterone enanthate injectable contraceptive. The Poly NET contraceptive system for the programmed delivery of conraceptive drugs from implants, is reviewed from in vitro and in vivo studies. Clinical studies of the contraceptive NORPLANT implant hormone release system are also discussed. IUDs are examined in 3 chapters on new developments in IUD technology, uterine geometry and IUD performance, and intrauterine release of levonorgestrel. Finally sterilization is discussed in terms of anatomical and physiological fallopian tube factors, technics, long-term sequelae of female sterilization, and female sterilization using chemical agents.

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