Hormonal postcoital contraception with an ethinylestradiol-norgestrel combination and two danazol regimens.

The ethinylestradiol-norgestrel combination (EE-NG) for postcoital contraception, as described by Yuzpe, has been shown to be an effective method but with frequent side effects. To overcome the problem of adverse effects a new approach using danazol was proposed, but the efficacy and acceptability of this treatment have not yet been tested in large studies. In a 5-year period at the AIECS Family Planning Centre in Milan we treated 2448 women requesting postcoital contraception using Yuzpe's regimen and two danazol regimens (800 mg/1200 mg). The patients' acceptability for danazol treatment was higher than for Yuzpe's regimen due to fewer, milder and shorter side effects. Nine pregnancies occurred in the EE-NG group (2.21%), 17 in the 800 mg group (1.71%) and 6 in the 1200 mg group (0.82%). Our study shows a statistically significant efficacy against expected pregnancy rates both with Yuzpe's regimen and with danazol. The 1200 mg danazol treatment seems to be more effective and can be considered a valid alternative to the EE-NG combination for hormonal postcoital contraception.

PIP: The ethinyl estradiol-norgestrel combination (EE-NG) for postcoital contraception as described by Yuzpe has been shown to be an effective method but with frequent side effects. To overcome the problem of adverse effects, a new approach using danazol was proposed, but the efficacy and acceptability of this treatment has not yet been put to the test in larger groups. In a 5-year period at the AIECS Family Planning Center in Milan, the authors treated 2448 women requesting postcoital contraceptives using Yuzpe's regimen and 2 danazol regimens (800 mg/1200 mg). The danazol treatment met with a greater measure of patient acceptability than did Yuzpe's regimen, due mainly to the smaller number of side effects. 9 pregnancies occurred in the EE-NG group (2.21%), 17 in the 800 mg group (1.71%), and 6 in the 1200 mg group (0.82%). This study shows a statistically significant efficacy against expected pregnancy rates, both with Yuzpe's regimen and with danazol. The 1200 mg danazol treatment seems to be more effective and can be considered a valid alternative to the EE-NG combination for hormonal postcoital contraception.

[Statistical surveys on the composition of a group of pregnant adolescents and on the course and outcome of their pregnancies]. / Rilievi statistici sulla composizione di un gruppo di gestanti adolescenti e sull'andamento ed esito delle loro gravidanze.

This retrospective study concerns 537 adolescent pregnant patients followed at the 1st Dep. of Obst. and Gyn. during the time period 1984-87. Preeclampsia, preterm labor and neonatal mortality were more frequent than in the general population.

[Contraception and the desire for pregnancy in the adolescent]. / Contraccezione e desiderio di gravidanza nell'adolescente.

PIP: During a 3 year period, 1982-85, 851 adolescents approached the Voluntary Abortion Service of the L. Mangiagali clinic in Milan. The observations resulting from the clinical and psychological work as well as current international literature on the subject of attitudes towards birth control methods among adolescents are reported. A study by Zelnick and Kantner in 1979 and a study by Furstenberg in 1978 are discussed. Here percentages of nonmarried adolescents between 15-19 with sexual experience are researched concerning their use of contraceptives and frequency of sexual relations according to race and educational level of mother or of tutor. The research by the clinic itself centers on the psychological experiences relative to the possibility of becoming pregnant. In the majority of the pre-voluntary abortion cases, 78% of the adolescents rely on ineffective methods (e.g., coitus interruptus), 14% used the barrier method, 7.7% oral contraceptives and 0.3% IUDs. It is concluded that the adolescent today initiates sexual relations at a much earlier age and confronts the problems of contraceptives without making a decisive and secure choice. One reason is that there does not seem to be suitable institutions where questions relating to sexuality and contraception can be directed. Another reason consists in the conflict between a subconscious desire for pregnancy versus a rational desire to avoid it. During an adolescent's developing years the counsel and support from parents, instructors and institutions of society are important.^ieng