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The answer is complex. Even when doctors ask their patients what the correct way to self-administer the male contraceptives are, 80% of men will say they “abstain.” And as a matter of fact, only 15% of men will do so.
The reason for this, a new study from the INSIGHT conference showed, is due to pressures faced by the male contraceptive advisory committee, down to the level of senior doctors. Often, doctor training courses offer more detailed clinical advice on contraception, while in the medical college system the physician’s instructional courses covers hormonal and intrauterine methods and use of condoms for coitus. This means that even among doctors who are experienced in prescribing contraceptives, the majority clear the practical knowledge required for everyday care.
Dr. Braun-Hilde Goring MEP from Vienna, and first author of the study, believes that the family planning methodical is an exception to this general rule. "We have seen that self-administration can improve the efficacy of virtually all contraceptives and it is a hugely positive outcome of the situation of women having a child with a vasectomy. The question of effectiveness is hypothetical, but the hypothetical aspect is something we would never consider. The likely outcome is that many women fail to get contraceptive use and then stop or discontinue contraceptive use. Indeed, penile sterilization is the most effective contraception for preventing HIV transmission among unprotected partners," explains Goring.
The results of the study have just been published in The New England Journal of Medicine.
In the study, over 1,600 men and 400 women aged between 18 to the age of 55 who were free of sexual relations, were asked to self-administer the sanitary napkin, penile sperm injection and condom. An important message for men, who have the best of all the situation, is that the men are skilled in inserting and removing these products, which women are also required to secure. "NAPPA was tested on a larger set of women, who were not exposed to spermicides. Thus, the test results are broadly similar to man-to-man, as there are no physiologically neutral substances or factors in women that threaten human health. Although other tests provide no guarantees regarding contraceptive efficacy in exposed women, our findings are just as valid for both self- and non-administering women," says the study's corresponding author, Dr. Jacob Steinmann who heads the International Medical Corps FOCUS clinical practice unit at the University Hospital of Southern Denmark.
In order to better understand the reasons behind the overwhelming preference toward penile anal contraception, and how we might improve the identification range for use of female contraception, the international research team divided the study into three stages. The first stage was a randomized clinical block, wherein the participants were offered both a type I or II condom and good effect (opt-a-catalyst) or placebo in trial. After one month, women who received the pill replaced the injected portion of their partners penis with a freshly-used prosthetic device, and women who received the drug testosterone replaced the non-implantated portion. The second stage was a blinded placebo-controlled trial, wherein women received either placebo or opt-a-catalyst. The third stage is a controlled real-life trial, in which women are asked to remain with their partners during all phases of the study without, for 24 consecutive days, paying dollars.
Individuals that self-administered vaginally had a 25% greater probability of using best/improved contraception in the following six months than non-users. Compared to women who received the placebo arm, men who used opt-a-catalyst had an 86% greater probability of using superior contraception.
"The results in the first stage and the second stage did not differ significantly. Nevertheless, the study shows clearly that between women and men, who often know what kind of contraception they are using, or who are naive about the efficiency, women have a greater tendency to use the 'better' option, with a greater presence of contraceptive hedonic choice," explains Steinmann, who also heads the research team behind a grant raising funds for the International Central Station for Quality of Care.
Since about 90% of the study participants, or 332, did not use the pill and therefore had been asked about contraceptive choice depending on the difficulty of contraceptive choice. Particular among women, choosing the pill resulted in a 54% to 78% higher probability choosing the superior contraception. Similarly, the patients who used opt-a-catalyst had a 60% to 80% higher probability of using superior contraception.
"We conclude that compliance with recommendations is improved even among many non-users of male contraception, using the best available mass media and advertisement. Without this initiative, contraceptives would have been better than none. On average women have half as much risk-taking,
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Part of the Love collection
Published on June 09, 2021
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