ABSTRACT
The continuing increase in teenage pregnancies and abortions calls for more effective sex education on the one hand, including a detailed explication of the (perfectly normal) changes an adolescent body is undergoing, but we also need to understand the way teenagers actually do use contraceptives. Modern contraception for teenagers should not cause any side effects and its efficacy must not be linked to compliance. Gynaecologists must acquaint themselves with the laws covering the prescription of contraceptives to adolescents. Whether hormonal contraceptives for men are also suitable for teenage boys remains to be seen. Advising mentally or physically handicapped teen-agers or those with chronic diseases on their contraceptive options is particularly challenging. Adolescents are more prone to contract HPV infections and thus need to be screened, counselled and told about the association between HPV and cervical dysplasia.
Subject(s)
Contraception Behavior , Contraceptives, Oral/administration & dosage , Pregnancy in Adolescence/prevention & control , Adolescent , Contraceptive Agents, Male/administration & dosage , Contraceptive Agents, Male/adverse effects , Drug Administration Routes , Female , Humans , Male , Pregnancy , Sex EducationABSTRACT
In Germany we observe an increasing number of unwanted teenage pregnancies associated with a consecutively escalating rate of abortions. The education at school, through parents and public media does not show sufficient prevention efficacy. One of the key issues in this context seems to be the discrepancy between time of education and premature sexual activity. Suitable contraceptives are required to meet individual needs and parameters of the adolescent. There are various suitable options as low dose oral contraception of the new generation, long-term depot contraceptives, the Nuva-Ring and future transdermal and subcutaneous contraceptives currently under evaluation. The interests and demands of the teenage patient are the focus of attention but the legal ground has to be taken into consideration, too: Contraception for adolescents provides potential conflict of interest for the physician and thus makes knowledge of recent laws essential.
Subject(s)
Adolescent , Contraception/methods , Pregnancy in Adolescence , Pregnancy, Unwanted , Female , Germany , Humans , PregnancyABSTRACT
OBJECTIVE: To investigate the manometrical and clinical long-term results following a tear III. PATIENTS: 27 Primiparae with a tear III following a spontaneous vaginal delivery were retrospectively compared with 22 Primiparae without sphincter injury (follow-up: 27 months). METHODS: Water-Perfusion-Manometry and clinical assessment (modified Kelly-Score). Manometric parameter (at rest and during contraction): sphinctertone and - length, vectorvolume, radial asymmetry. Wilcoxon-Text (p < 0.05). RESULTS: Tear III patients showed a significant decrease in sphincter length and vector volume both at rest and during contraction. On clinical assessment there was no difference. CONCLUSION: A tear III weakens the anal sphincter by decreasing sphincter length and vector volume. This weakness can be demonstrated only manometrically but not clinically.