J Fam Plann Reprod Health Care [JOURNAL]

Migraine is a common headache disorder, particularly in women. It usually starts during the teens and twenties, a time when many women are seeking contraception advice. Migraine without aura is the most prevalent type of... Migraine is a common headache disorder, particularly in women. It usually starts during the teens and twenties, a time when many women are seeking contraception advice. Migraine without aura is the most prevalent type of migraine, affecting up to 70% of people with migraine, while the remainder experience attacks with and/or without aura. Aura is a phase of focal neurological symptoms, typically visual. An increasing body of evidence identifies aura as a marker of increased risk of ischaemic stroke and its presence is a contraindication to the use of combined hormonal contraception (CHC). However, aura is often confused with more generalised premonitory visual symptoms of migraine that may precede attacks of migraine with and without aura, which are not associated with stroke risk. Diagnostic confidence is needed so that CHC is not withheld unnecessarily.

Get PDF PubMed ↗

Commentary on 'A qualitative analysis of women's explanations for changing contraception: the importance of non-contraceptive effects'.

Inoue K

J Fam Plann Reprod Health Care · 2016 Oct · PMID 29175842 · Publisher ↗

Abstract loading — click title to view on PubMed.

Get PDF PubMed ↗

A randomised trial comparing pain and ease of use of two different stabilising forceps for insertion of intrauterine contraception.

Speedie JMM, Mansour D, Landy R … +1 more , Clement KM

J Fam Plann Reprod Health Care · 2016 Oct · PMID 29175841 · Publisher ↗

BACKGROUND: Pain at intrauterine contraception (IUC) fitting may be a deterrent for women and any reduction in discomfort would be likely to be beneficial to both women and clinicians. AIM: This study investigated the as... BACKGROUND: Pain at intrauterine contraception (IUC) fitting may be a deterrent for women and any reduction in discomfort would be likely to be beneficial to both women and clinicians. AIM: This study investigated the associated pain and the ease of use of two different stabilising forceps at the time of IUC placement. DESIGN: Single-blinded randomised controlled trial. One hundred parous women aged 18-50 years who had undergone at least one vaginal delivery were recruited. SETTING: An integrated sexual health service in the North of England. METHODS: Women were randomised to the use of either a Littlewoods forceps or a single-toothed tenaculum forceps to stabilise the cervix at the time of IUC placement. Pain levels were measured at forceps application, IUC insertion, and 5 and 10 minutes post-procedure using a visual analogue scale (VAS). A clinician graded ease of use of the forceps and any associated bleeding. Wilcoxon rank-sum tests were used to compare pain levels between the two forceps groups. Linear regression was used when adjusting for potential confounders. RESULTS: Mean VAS scores were similar at forceps application (=0.52), IUC fitting (=0.10) and at 5 minutes (=0.32). There was a statistical difference in the degree of pain experienced at 10 minutes in the tenaculum group (=0.01). Physicians found both forceps easy to use and there was no difference in bleeding (=0.49). CONCLUSIONS: Parous women who have had a vaginal delivery can be reassured that IUC fitting is well tolerated. Pain scores were not affected by the type of forceps used to stabilise the cervix at IUC placement. Both forceps investigated were easy to use.

Get PDF PubMed ↗