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Contraceptive method switching in Peninsular Malaysia: ethnic differences, 1940s-1970s

Davanzo J, Starbird E, Reboussin D, Tan Boon Ann, Abdullah SH

Malays J Reprod Health, 1988 Jun;6(1):1-21.
PMID: 12281591
Matched MeSH terms: Contraceptive Agents, Female
Management of bleeding irregularities among etonogestrel implant users: Is combined oral contraceptives pills or nonsteroidal anti-inflammatory drugs the better option?

Upawi SN, Ahmad MF, Abu MA, Ahmad S

J Obstet Gynaecol Res, 2020 Mar;46(3):479-484.
PMID: 31958877 DOI: 10.1111/jog.14195

AIM: This study is to evaluate whether unacceptable bleeding among the etonogestrel implant user could be better alleviated using combined oral contraceptive pills (COCP) or nonsteroidal anti-inflammation drugs (NSAID).
METHODS: This is a prospective randomized study for evaluation of 84 etonogestrel implant (Implanon) users with prolonged or frequent bleeding. They were assigned to either receiving a COCP containing 20 mcg ethinyl estradiol/150 mg desogestrel for two continuous cycle or NSAID; mefenamic acid 500 mg TDS for 5 days, 21 days apart for two cycles. Bleeding pattern during the treatment was recorded and analyzed.
RESULTS: A total of 32 women (76.2%) in COCP group and 15 women (35.7%) in NSAID group stop bleeding within 7 days after the initiation of treatment which was statistically significant (P

Matched MeSH terms: Contraceptive Agents, Female/therapeutic use*
Fibrinolytic response in women on low-dose oral contraceptive

Ishak R, Ahmad R, Gudum HR, Hassan K, Ang ES

Malays J Reprod Health, 1992 Jun;10(1):7-11.
PMID: 12345026

PIP: Long term use of low doses of combination oral contraceptives appears to increase plasminogen level, thereby increasing fibrinolytic activity and reducing the risk of thromboembolism. Blood levels of plasminogen, tissue plasminogen activator (tPA), and plasminogen activator inhibitor (PAI), were measured before and after stress (5 minutes of stair climbing) in a group of 30 women, 23-40 years old, who had taken 30 mcg of ethinyl estradiol with 150 mcg of desogestrel or levonorgestrel for at least 1 year. Similar measurements were taken from a control group of 30 women matched for age, height, and weight. Plasminogen and tPA levels in both groups increased significantly after exercise. The level of PAI did not change significantly with stress in either group. The level of plasminogen was significantly higher in the group taking contraceptives, whether before or after exercise, when compared to the control group. Levels of tPA and PAI, although slightly increased in the oral contraceptive group, were not significantly different between the two groups. The increase in plasminogen may be due to the estrogen component of the contraceptives. Stress seems to increase fibrinolytic response.

Matched MeSH terms: Contraceptive Agents; Contraceptive Agents, Female
A comparative study of Loestrin versus Nordette in Kelantan, West Malaysia

Arshat H

Malays J Reprod Health, 1984 Jun;2(1):25-31.
PMID: 12267518
Matched MeSH terms: Contraceptive Agents; Contraceptive Agents, Female*
Pregnancy after contraceptive use

Ang Eng Suan, Arshat H

Malays J Reprod Health, 1986 Jun;4(1):6-11.
PMID: 12268570

PIP: The initial results of a study conducted to develop guidelines for the clinical management of family planning acceptors with regard to return of fertility following contraceptive use, are presented. 193 parous women attending an urban family planning clinic were interviewed regarding their last pregnancy conceived after stopping a method of contraception. The average interval to pregnancy was 3.9, 2.8 and 1.8 months for ex-users of oral pills, intrauterine devices and conventional methods of contraception, respectively, with median delays to conception of 1.9, 1 and within the 1st month for the 3 categories. In comparison, 149 women who had not used any method at all took 7.3 months before becoming pregnant. Selected variables including age and parity, duration of use and problems encountered, and outcome of pregnancy are further analysed. Follow-up investigations and treatment are recommended 12 months after stopping oral pills and 6 months after removal of intrauterine device for those who have not yet conceived.

Matched MeSH terms: Contraceptive Agents; Contraceptive Agents, Female*
Hemorrheology and fibrinolytic response in women taking oral contraceptive pills

Ishak R, Hassan K, Arshat H

Malays J Reprod Health, 1987 Dec;5(2):57-60.
PMID: 12315184
Matched MeSH terms: Contraceptive Agents; Contraceptive Agents, Female*
A prospective study of the acceptability of Today vaginal contraceptive sponge among Malaysian women

Ismail MT, Halim AJ, Arshat H

Malays J Reprod Health, 1987 Jun;5(1):17-21.
PMID: 12269177
Matched MeSH terms: Contraceptive Agents
Fulltext Sociodemographic profile, contraceptive practice and awareness of HIV infection among unmarried postpartum women in a tertiary centre in Malaysia

Mustafa KB, Ibrahim Nb, Noraziana AW, Ayu AS, Suhaiza A, Awang M

International Medical Journal Malaysia, 2014;13(2):41-47.
MyJurnal

Introduction: To describe the sociodemographic profile, contraceptive practice, and awareness of HIV infection among unmarried post partum women in the biggest government hospital in Pahang.
Methods: A cross sectional questionnaire-proforma-based study was conducted for one year duration from August 2010 until July 2011 by identifying and recruiting all the unmarried women upon admission for delivery. Basic information were obtained from the use of patients’ case notes, and further related and necessary information were obtained from a direct face-to-face interview based on a proforma.
Results: A total of 121 unmarried women were identified and recruited. The age ranged from 13 to 36 years with a mean age of 21.6 years. 31.4% were teenagers. Only 16% of patients have tertiary education, and 2.5% never had any formal education. About one third of the women were smokers or ex-smokers, 7.5% had consumed alcohol, but none denied ever use of any recreational drugs. Almost 9% has prior history of being sexually assaulted. About three quarter of the women never used any contraceptive method. Majority of the patients (85.1%) were aware of HIV transmission risk; 75% never had any antenatal checkup or booked at late gestation (> 20 weeks); and 45.8% were not aware of any support groups for single mothers. Conclusion: Single unmarried women are associated with disadvantaged sociodemographic profile.
Contraceptive practice was also very low despite significant awareness towards risk of HIV infection. Further follow up, support and care should be offered to these women.

Matched MeSH terms: Contraceptive Agents
TRENDS IN EDUCATION IN OBSTETRICS AND GYNAECOLOGY: A FORUM

MACAFEE CH, MCKELVEY JL, CHESTERMAN JN, MEARES SD, BROWNE AD

Med J Malaysia, 1963 Jun;17:244-52.
PMID: 14060501
Matched MeSH terms: Contraceptive Agents*
Fulltext Coagulation profile in women on low-dose oral contraceptive pills

Roshidah I, Khalid H, Baharum Y

Malays J Reprod Health, 1990 Dec;8(2):97-100.
PMID: 12343152

A cross-sectional study looking at the coagulation system was carried out involving 175 women attending the National Population and Family Development Board's Clinic at the Maternity Clinic, General Hospital, Kuala Lumpur. Study subjects comprise of 50 combined low-dose estrogen/progestrogen oral contraceptive (DC) pill users and 75 non-DC users, acting as controls. The subjects were on the pill for a period of one year or more. There were significant shortening of the prothrombin time (PT) and partial thromboplastin time (PIT) in the DC group as compared to the control group. However, the activities of factors II, Vand VIII assayed were not significantly different between the two groups, suggesting that the changes in the PT and PIT were not significant clinically. The effect of long term usage of combined 10w..cJose DC pills does not seem to indicate changes in the coagulation profile of the women in our study.
PIP: The effect of low dose combined oral contraceptives containing 30 mcg ethinyl estradiol and either 150 mcg levonorgestrel or 150 mcg desogestrel on coagulation indices in Malaysian women was examined. 50 women who had been using the pills for 1 year or more, were compared to 75 non-users. All were attending the Maternity Clinic of the General Hospital, Kuala Lumpur. Pill users registered shorter prothrombin time, 11.5 vs. 11.1 seconds (p=0.016), and partial thromboplastin time, 40.1 vs 35.1 seconds (p=0.000). Since there were no significant differences in Factors II, V, VII, or VIII, the overall effects of low-dose pills on coagulation is probably not clinically significant.

Matched MeSH terms: Contraceptive Agents; Contraceptive Agents, Female
Fulltext Knowledge, awareness, and perception of contraception among senior pharmacy students in Malaysia: A pilot study

Elkalmi RM, Khan MU, Ahmad A, Srikanth AB, Abdurhaman NS, Jamshed SQ, et al.

J Res Pharm Pract, 2015 Apr-Jun;4(2):94-8.
PMID: 25984548 DOI: 10.4103/2279-042X.155760

OBJECTIVE:This study aimed to assess the knowledge, awareness, and perception of contraception among senior pharmacy students of a public sector university in Malaysia.
METHODS: A cross-sectional, questionnaire-based study was conducted among senior pharmacy students. The pretested questionnaire was used to collect data from the participants over the period of 1-month. The questionnaire was divided into four sections, for gathering the information about students' demographic data, and their knowledge, attitudes, and perception toward contraception. Data were statistically analyzed using SPSS version 20.
FINDINGS: The response rate was 68.6%. The results showed that the contraceptive knowledge was comparatively higher in year four students (P < 0.001), married respondents (P < 0.001) and those taking elective courses (P = 0.022) as compared to their respective counterparts. Majority of the students were well aware and had a positive perception about contraception.
CONCLUSION: Overall findings reflect that the majority of the students had good knowledge, perception, and awareness about contraception. The study recommends future studies to be conducted covering different pharmacy schools across the country to further establish the results.
KEYWORDS: Awareness; contraceptive; knowledge; perception; students

Matched MeSH terms: Contraceptive Agents
A field study of Depo-Provera: its use as a contraceptive method by women in a rural town in West Malaysia from February 1968 to December 1969

Hew Wai Sin, Peng JY, Dato Ariffin Marzuki

Med J Malaysia, 1973 Jun;27(4):299-305.
PMID: 4270790

PIP: To determine the acceptability, practicability, and popularity of Depo-Provera as an additional contraceptive method to be offered by the National Family Planning Board NFPB of Malaysia, 550 patients of Sungai Besar, Malaysia, who accepted the Depo-Provera injection method from the start of the injection program, February 23, 1968, until the cutoff date of December 31, 1969, were studied. At the cutoff date, 318 (58%) were still receiving regular injections at 3-month intervals. The remaining 232 women discontinued use of the injection. Of those who discontinued use, 176 (32%) were interviewed, while the other 56 women were lost to follow-up, due mainly to migration. Assuming that 1 injection would protect a woman from getting pregnant for a 3-month period, the retention rates at the end of 12 and 24 months were 63% and 41%. These continuation rates were fairly high and were as good as those for the oral pill, which is the main contraceptive method provided since the beginning of the operational service program of the NFPB in May 1967. Except for a small number of Indian women with a high rate of discontinuation there was not much difference in continuing the method between the Malays (60%) and the Chinese (56%). The younger age group of women seemed to have a higher proportion of discontinuation. The findings showed that amenorrhea (35%)most bothered the women who discontinued the injection method. Irregular bleeding (20%) and other medical side effects (11%) were the other main complaints that caused women to discontinue using the injection as a contraceptive method. It was concluded that Depo-Provera (150 mg) injected once every 3 months appears to be simple, acceptable, popular, and effective as a contraceptive method among women in a rural town in Malaysia.

Matched MeSH terms: Contraceptive Agents/administration & dosage*
Fulltext Patient perception of pre-pregnancy care and family planning among reproductive-age female diabetes mellitus patients in a primary care clinic in Penang, Malaysia

Leow SN, Tang WS, Pararajasingam RP, Ee WS

Malays Fam Physician, 2020;15(3):35-42.
PMID: 33329861

Introduction: Pre-pregnancy care (PPC) is an important part of diabetic care among females in the reproductive age group, as it improves feto-maternal outcomes.

Objective: We aimed to assess female diabetic patients' perception of PPC and family planning prior to PPC care.

Methods: This was an observational, cross-sectional survey performed from June 2019 to September 2019, using universal sampling of registered female diabetic patients who fit the inclusion criteria prior to integrated PPC care. A self-administered questionnaire was used to assess patients' perception of PPC.

Results: A total of 67 patients were recruited for the study. Only 39.4% (n=26) of the patients had heard of PPC. In our study, Code 1 contraception included those methods with a Pearl index of ≤9. Code 2 & 3 contraception included those methods with a Pearl index of >9. Only one-third of patients, 29.9% (n=20), were using Code 1 contraception, although the majority, 79.1% (n=53), felt that they had completed their family. 45 patients (68.2%) felt that they were at risk of developing complications if they were to become pregnant, and 46 patients (69.7%) felt that their health condition was not suitable for another pregnancy. However, only 31.1% (n=14) and 34.8% (n=16) of these patients were using Code 1 contraception, respectively. There were 30 patients (65.2%) who perceived that their health was not suitable for another pregnancy but were only using Code 2 or 3 contraception.

Conclusion: The patients' perception of PPC was poor. Patients had an inadequate knowledge of the effectiveness of their current contraceptive practice in relation to their intentions for further pregnancy and their self-perceived risk in case of future conception. We suggest that integration of PPC into routine follow-ups for other high-risk medical diseases, such as hypertension, heart disease, and epilepsy, be considered in future practice.

Matched MeSH terms: Contraceptive Agents
Antifertility effect of Jamu (traditional herbal medicine)

Azimahtol Hawariah Lope Pihie, Embun Naim

Malays J Reprod Health, 1983 Dec;1(2):176-80.
PMID: 12313336
Matched MeSH terms: Contraceptive Agents; Contraceptive Agents, Female
Fulltext The effects of subdermal hormonal contraceptive implant on health indices. A preliminary report

Murad, A.Z., Mokhtar, A., Sudesan, R., Lee, S.F., Ghazali, I.

International Medical Journal Malaysia, 2007;6(2):1-16.
MyJurnal

Subdermal etonogestrel implant (Implanon®) is the newest, long term contraceptive implant which has recently been made available to Malaysian women. This prospective study was conducted to determine the effects on selected health indices among 42 women who had consented to Implanon® as their choice of contraception. Health indices were checked prior to Implanon® insertion and six months post insertion. Findings indicate a significant reduction in total cholesterol with a significant increase in total haemoglobin and BMI. However there was no significant change noted in the fasting blood sugar, glycosylated haemoglobin, systolic blood pressure and diastolic blood pressure.

Matched MeSH terms: Contraceptive Agents
Fulltext Factors associated with ever used of modern contraception among married men attending a primary healthcare clinic

Syahnaz MH, Rasina Nilofer JK, Azmawati MW, Harlina Halizah S

Med J Malaysia, 2018 10;73(5):301-306.
PMID: 30350809 MyJurnal

BACKGROUND: The practice of modern contraceptives still remains a sceptical issue in the society and dormant due to increasing objection of husbands who play a significant role in the family planning practice.
OBJECTIVES: This study was done to determine the factors affecting the ever use of modern contraceptive methods among married men visiting a healthcare clinic in Malaysia.
MATERIAL AND METHOD: A cross sectional study of 443 men aged over 18 years was conducted using convenient sampling from January 2016 till March 2016 at a primary care clinic. A self-administered questionnaire assessing sociodemographic characteristic, attitude towards family planning, spousal communication and ever used of modern contraceptive methods was used.
RESULTS: The proportion of ever used modern contraception was 48% (n=192). Multiple logistic regression revealed that spousal communication on family planning (Adjusted OR 15.8; 95% CI 7.0 - 35.6) and attitude towards marital relationship (Adjusted OR 1.1; CI 1.0 - 1.1) were significant predictors for ever used of modern contraception among married men.
CONCLUSION: The proportion of ever used modern contraception is still not high. Men who communicated with their spouse on modern contraception and perceived family planning as means to preserve their marital relationship were more likely to practice modern contraceptive method.
Study site: Klinik Kesihatan, Selangor, Malaysia

Matched MeSH terms: Contraceptive Agents
Fulltext Comparison of body weight among hormonal and non-hormonal users in a Malaysian cohort

Ibrahim H, Tengku Ismail TA, Hashim N

J Taibah Univ Med Sci, 2019 Feb;14(1):25-30.
PMID: 31435386 DOI: 10.1016/j.jtumed.2018.11.012

Objectives: Weight gain remains an issue for contraceptive users due to the high prevalence of obesity. This retrospective study compares the weight gain between hormonal and non-hormonal contraceptive users in government health clinics in Kota Bharu, Kelantan, Malaysia.
Methods: A total of 380 women who had used the same contraceptive method for at least twelve months were recruited in this study. Covariance analysis was done to compare the weight gain between hormonal and non-hormonal contraceptive users, while studying the same confounders [age, household income, number of pregnancies, and baseline body mass index (BMI)].
Results: Hormonal methods were more commonly used. The mean weight gain among hormonal users (adjusted mean 2.85, 95% CI 2.45, 3.24) was significantly higher than non-hormonal users (adjusted mean 0.46, 95% CI -0.73, 1.65; p-value <0.001), after controlling for age, household income, number of pregnancies, and baseline BMI.
Conclusion: The possibility of weight gain following the use of hormonal methods should be investigated and non-hormonal methods should be considered to prevent weight gain.

Matched MeSH terms: Contraceptive Agents
Fulltext Socioeconomic Correlates of Contraceptive Use among the Ethnic Tribal Women of Bangladesh: Does Sex Preference Matter?

Kamal SM, Hassan CH

J Family Reprod Health, 2013 Jun;7(2):73-86.
PMID: 24971107

Objective: To examine the relationship between socioeconomic factors affecting contraceptive use among tribal women of Bangladesh with focusing on son preference over daughter.
Materials and methods: The study used data gathered through a cross sectional survey on four tribal communities resided in the Rangamati Hill District of the Chittagong Hill Tracts, Bangladesh. A multistage random sampling procedure was applied to collect data from 865 currently married women of whom 806 women were currently married, non-pregnant and had at least one living child, which are the basis of this study. The information was recorded in a pre-structured questionnaire. Simple cross tabulation, chi-square tests and logistic regression analyses were performed to analyzing data.
Results: The contraceptive prevalence rate among the study tribal women was 73%. The multivariate analyses yielded quantitatively important and reliable estimates of likelihood of contraceptive use. Findings revealed that after controlling for other variables, the likelihood of contraceptive use was found not to be significant among women with at least one son than those who had only daughters, indicating no preference of son over daughter. Multivariate logistic regression analysis suggests that home visitations by family planning workers, tribal identity, place of residence, husband's education, and type of family, television ownership, electricity connection in the household and number of times married are important determinants of any contraceptive method use among the tribal women.
Conclusion. The contraceptive use rate among the disadvantaged tribal women was more than that of the national level. Door-step delivery services of modern methods should be reached and available targeting the poor and remote zones.
Keywords: Bangladesh, Contraceptive use, Ethnic tribal women, Sex preference, Logistic regression

Matched MeSH terms: Contraceptive Agents
Fulltext Late antenatal booking and its predictors in Lundu district of Sarawak, Malaysia

Jiee SF, Safii R, Hazmi H

Int J Public Health Res, 2018;8(2):956-964.
MyJurnal

INTRODUCTION: Antenatal care is widely acknowledged as an effective tool to prevent adverse outcomes in pregnant women and their children. In Malaysia, early entry to antenatal care refers to a first visit within the 12th week of gestation. Delayed access to antenatal care has not been extensively studied in Malaysia, whereas several studies have reported a high prevalence of late antenatal booking in developing countries. The objective of this study was to determine the factors and barriers associated with late antenatal booking and the level of knowledge about the timing of antenatal booking among women of childbearing age in the Lundu District of Sarawak.
METHODS: This was a cross-sectional study among 284 pregnant women in all five Maternal and Child Health (MCH) Clinics of Lundu.
RESULTS: The prevalence of late antenatal booking in Lundu was 28.2%. Unmarried women were more likely to book their pregnancy late compared to married women. The prevalence of late antenatal booking was also higher among unemployed women than those who were employed. Respondents without their own income also tended to book their pregnancy later than those who had their own income. Significantly, a high percentage of late antenatal booking was also reported among those who never utilize any contraceptive method, did not plan their pregnancy, those without a history of past medical illness or complications in a previous pregnancy and among those who have a problem with their marriage certificate. Those who booked their pregnancy beyond the 12th week of gestation were also reported to have a lower level of knowledge about the need for an antenatal booking, as compared to those who started their antenatal care early.
CONCLUSION: Unplanned pregnancy, marriage certificate issues, an absence of past medical illness and past obstetric complications were significant predictors of late antenatal booking. Correct and appropriate information relating to antenatal care should be delivered to the public. Health education and advocacy are vital to promote the importance of early antenatal booking to achieve the goal of safe motherhood.
Study site: Maternal and Child Health Clinics, Lundu, Sarawak, Malaysia

Matched MeSH terms: Contraceptive Agents
Fulltext Contraception: herbal and modern strategies

Nurul Ain, K.B., Mahanem, M.N., Irfan, Y.

Medicine & Health, 2018;13(2):20-35.
MyJurnal

Population explosion is one of the global issues of concern. The increasing number of individuals could result in negative impact on social and economy. To overcome this problem, convenient and safe modern contraception was introduced. However, recently many researchers have conducted studies on the effectiveness of medicinal plants as contraceptive agents on human and animal models. Therefore, the studies of herbal and modern contraceptives were summarized in this review article. A total of 66 relevant articles were documented having information regarding the modern and herbal contraceptives. All contraceptives are highly effective provided they are used consistently and in the proper way. Contraception is important as it could prevent diseases and infections caused by sexual intercourse and prevent unintended pregnancy. Therefore, this review is an attempt to summarize the potential of medicinal plants as contraceptive agents and the modern contraceptive methods used as birth control in males and females.

Matched MeSH terms: Contraceptive Agents

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