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January 3, 1986, Vol 255, No. 1 >
ARTICLE | January 3, 1986

Reversible Contraception for the 1980s FREE

David A. Grimes, MD
[+] Author Affiliations

Use of brand names is for identification only and does not imply endorsement by the Department of Health and Human Services or any of its agencies.

Reprints not available.


JAMA. 1986;255(1):69-75. doi:10.1001/jama.1986.03370010075028
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Article
References

EACH DAY, tens of millions of Americans swallow a pill, slide in a diaphragm, or slip on a condom to prevent unwanted pregnancies. These strategies are working, although not as well as they could. While rates of unwanted pregnancies have declined dramatically in recent years,1 nonuse or inconsistent use of contraception, especially among sexually active teenagers,2 persists. In general, fear of complications, not the complications themselves, is the most powerful deterrent to contraception.3 Much of this fear is unwarranted, fueled in part by inaccurate or incomplete media coverage.4 Although no new contraceptive chemical has been introduced in the United States since 1968,5 the safety and acceptability of existing contraceptive methods have improved greatly. In this review, I will provide a brief clinical update on reversible contraception, including current use of contraception, the efficacy of various methods, the safety of these methods, and a brief overview

REFERENCES

1 +
Pratt WF, Mosher WD, Bachrach CA, et al:  Understanding U.S. fertility: Findings from the National Survey of Family Growth, Cycle III . Pop Bull 1984;;39:1-40.
2 +
Jones EF, Forrest JD, Goldman N, et al:  Teenage pregnancy in developed countries: Determinants and policy implications . Fam Plann Perspect 1985;;17:53-63.
3 +
Forrest JD, Henshaw SK:  What U.S. women think and do about contraception . Fam Plann Perspect 1983;;15:157-166.
4 +
Jones EF, Beniger JR, Westoff CF:  Pill and IUD discontinuation in the United States, 1970-1975: The influence of the media . Fam Plann Perspect 1980;;12:293-300.
5 +
Potts M, Wheeler R:  The quest for a magic bullet . Fam Plann Perspect 1981;;13:269-271.
6 +
Bachrach CA:  Contraceptive practice among American women: 1973-1982 . Fam Plann Perspect 1984;;16:253-259.
7 +
Schirm AL, Trussell J, Menken J, et al:  Contraceptive failure in the United States: The impact of social, economic and demographic factors . Fam Plann Perspect 1982;;14:68-75.
8 +
Ory HW:  Mortality associated with fertility and fertility control: 1983 . Fam Plann Perspect 1983;;15:57-63.
9 +
Ory HW, Forrest JD, Lincoln R: Making Choices . New York, The Alan Guttmacher Institute, 1983;.
10 +
Hatcher RA, Guest F, Stewart F, et al: Contraceptive Technology 1984-1985 . New York, Irvington Publishers Inc, 1984;.
11 +
Meade TW, Greenberg G, Thompson SG:  Progestogens and cardiovascular reactions associated with oral contraceptives and a comparison of the safety of the 50 and 30 mcg estrogen preparations . Br Med J 1980;;280:1157-1161.
12 +
Kay C:  Progestogens and arterial disease: Evidence from the Royal College of General Practitioners' Study . Am J Obstet Gynecol 1982;; 142:762-765.
13 +
 Tri-Norinyl and Ortho-Novum 7/7/7: Two triphasic oral contraceptives . Met Lett Drug Ther 1984;;26:93-94.
14 +
Triphasil:  A new triphasic oral contraceptive . Med Lett Drug Ther 1985;;27:48.
15 +
Cohen J:  Clinical use of biphasic and triphasic pills . IPPF Med Bull 1985;, vol 19, No. (4) .
16 +
Kols A, Rinehart W, Piotrow P, et al:  Oral contraceptives in the 1980's . Popul Rep A , 1982;, No. (6) .
17 +
Roy S, Wilkins J, Mishell DR, et al:  The effect of a contraceptive vaginal ring and oral contraceptives on the vaginal flora . Contraception 1981;;24:481-491.
18 +
Ratech H, Stewart ME:  Uterine leiomyomas, serum cholesterol and oral contraceptives: A preliminary study of epidemiologic differences in Los Angeles, California and Albany, New York . Diagn Gynecol Obstet 1982;;4:21-24.
19 +
Grounds M:  Anovulants: Thrombosis and other associated changes . Med J Aust 1974;; 2:440-446.
20 +
Mishell DR Jr:  Noncontraceptive health benefits of oral steroidal contraceptives . Am J Obstet Gynecol 1982;;142:809-816.
21 +
Ory HW:  The noncontraceptive health benefits from oral contraceptive use . Fam Plann Perspect 1982;;14:182-184.
22 +
Linos A, Worthington JW, O'Fallon WM, et al:  Case-control study of rheumatoid arthritis and prior use of oral contraceptives . Lancet 1983;;1:1299-1300.
23 +
Del Junco DJ, Annegers JF, Luthra HS, et al:  Do oral contraceptives prevent rheumatoid arthritis? JAMA 1985;;254:1938-1941.
24 +
Wolner-Hanssen P, Svensson L, Mardh P-A, et al:  Laparoscopic findings and contraceptive use in women with signs and symptoms suggestive of acute salpingitis . Obstet Gynecol 1985;;66:233-238.
25 +
Realini JP, Goldzieher JW:  Oral contraceptives and cardiovascular disease: A critique of the epidemiologic studies . Am J Obstet Gynecol 1985;;152:729-798.
26 +
Ory HW.  The pill at 20: An assessment . Fam Plann Perspect 1980;;12:278-283.
27 +
Porter JB, Hunter JR, Jick H, et al:  Oral contraceptives and nonfatal vascular disease . Obstet Gynecol 1985;;66:1-4.
28 +
Connell EB:  Oral contraceptives: The current risk-benefit ratio . J Reprod Med 1984;; 29:513-523.
29 +
Blumenstein BA, Douglas MB, Hall WD:  Blood pressure changes and oral contraceptive use: A study of 2,676 black women in the southeastern United States . Am J Epidemiol 1980;;112:539-552.
30 +
Pike MC, Henderson BE, Krailo MD, et al:  Breast cancer in young women and use of oral contraceptives: Possible modifying effect of formulation and age at use . Lancet 1983;;2:926-930.
31 +
Hennekens CH, Speizer FE, Lipnick RJ, et al:  A case-control study of oral contraceptive use and breast cancer . JNCI 1984;;72:39-42.
32 +
Rosenberg L, Miller DR, Kaufman DW, et al:  Breast cancer and oral contraceptive use . Am J Epidemiol 1984;;119:167-176.
33 +
Stadel BV, Rubin GL, Webster LA, et al:  Oral contraceptives and breast cancer in young women . Lancet 1985;;2:970-973.
34 +
Washington AE, Gove S, Schachter J, et al:  Oral contraceptives, Chlamydia trachomatis infection, and pelvic inflammatory disease . JAMA 1985;;253:2246-2250.
35 +
Royal College of General Practitioners' Oral Contraception Study:  Oral contraceptives and gallbladder disease . Lancet 1982;;2:957-959.
36 +
Layde PM, Vessey MP, Yeates D:  Risk factors for gall-bladder disease: A cohort study of young women attending family planning clinics . J Epidemiol Comm Health 1982;;36:274-278.
37 +
Pardthaisong T, Gray RH:  The return of fertility following discontinuation of oral contraceptives in Thailand . Fertil Steril 1981;;35:532-534.
38 +
Rothman KJ, Louik C:  Oral contraceptives and birth defects . N Engl J Med 1978;;299:522-524.
39 +
Wilson JG, Brent RL:  Are female sex hormones teratogenic? Am J Obstet Gynecol 1981;;141:567-580.
40 +
Liskin L, Fox G: IUDs:  An appropriate contraceptive for many women . Popul Rep /B/ , 1982;, No. (4) .
41 +
Tatum HJ:  Milestones in intrauterine device development . Fertil Steril 1983;;39:141-143.
42 +
Mishell DR Jr:  Current status of intrauterine devices . N Engl J Med 1985;;312:984-985.
43 +
IPPF International Medical Advisory Panel.  Statement on intrauterine devices . IPPF Med Bull , 1981;, vol 15, No. (6) .
44 +
White MK, Ory HW, Rooks JB, et al:  Intrauterine device termination rates and the menstrual cycle day of insertion . Obstet Gynecol 1980;;55:220-224.
45 +
Heartwell SF, Schlesselman S:  Risk of uterine perforation among users of intrauterine devices . Obstet Gynecol 1983;;61:31-36.
46 +
Ory HW:  A review of the association between intrauterine devices and acute pelvic inflammatory disease . J Reprod Med 1978;; 20:200-204.
47 +
Lee NC, Rubin GL, Ory HW, et al:  Type of intrauterine device and the risk of pelvic inflammatory disease . Obstet Gynecol 1983;;62:1-6.
48 +
Kaufman DW, Watson J, Rosenberg L, et al:  The effect of different types of intrauterine devices on the risk of pelvic inflammatory disease . JAMA 1983;;250:759-762.
49 +
Stadel BV, Schlesselman S:  Extent of surgery for pelvic inflammatory disease in relation to duration of intrauterine device use . Obstet Gynecol 1984;;63:171-178.
50 +
Daling JR, Weiss NS, Metch BJ, et al:  Primary tubal infertility in relation to the use of an intrauterine device . N Engl J Med 1985;; 312:937-941.
51 +
Cramer DW, Schiff I, Schoenbaum SC, et al:  Tubal infertility and the intrauterine device . N Engl J Med 1985;;312:941-947.
52 +
Duguid HL, Parratt D, Traynor R:  Actinomyces-like organisms in cervical smears from women using intrauterine contraceptive devices . Br Med J 1980;;281:534-537.
53 +
Petitti DB, Yamamoto D, Morgenstern N:  Factors associated with actinomyces-like organisms on Papanicolaou smear in users of intrauterine contraceptive devices . Am J Obstet Gynecol 1983;;145:338-341.
54 +
Pine L, Malcolm GB, Curtis EM, et al:  Demonstration of Actinomyces and Arachnia species in cervicovaginal smears by direct staining with species-specific fluorescent antibody conjugate . J Clin Microbiol 1981;;13:15-21.
55 +
Duguid HL:  Actinomycosis and IUDs . IPPF Med Bull , 1983;, vol 17, No. (3) .
56 +
Guillebaud J:  The safety of intrauterine devices . Stud Fam Plann 1979;;10:174-177.
57 +
Cates W Jr, Ory HW, Rochat RW, et al:  The intrauterine device and deaths from spontaneous abortion . N Engl J Med 1976;;295:1155-1159.
58 +
Ory HW,  The Women's Health Study: Ectopic pregnancy and intrauterine contraceptive devices: New perspectives . Obstet Gynecol 1981;;57:137-144.
59 +
Guillebaud J, Bonnar J, Morehead J, et al:  Menstrual blood-loss with intrauterine devices . Lancet 1976;;2:387-390.
60 +
Huggins G:  IUD use and unexplained vaginal bleeding . Obstet Gynecol 1981;;58:409-416.
61 +
Jackson M, Berger GS, Keith LG: Vaginal Contraception . Boston, GK Hall Medical Publishers, 1981;, pp 63-97.
62 +
Sherris JD, Moore SH, Fox G:  New developments in vaginal contraception . Pop Rep H , 1984;, No. (7) .
63 +
Sherris JD, Lewison D, Fox G:  Update on condoms: Products, protection, promotion . Pop Rep H , 1982;, No. (6) .
64 +
Kelaghan J, Rubin GL, Ory HW, et al:  Barrier-method contraceptives and pelvic inflammatory disease . JAMA 1982;;248:184-187.
65 +
Austin H, Louv WC, Alexander WJ:  A case-control study of spermicides and gonorrhea . JAMA 1984;;251:2822-2824.
66 +
Wright NH, Vessey MP, Kenward B, et al:  Neoplasia and dysplasia of the cervix uteri and contraception: A possible protective effect of the diaphragm . Br J Cancer 1978;;38:273-279.
67 +
Fihn SD, Latham RH, Roberts P, et al:  Association between diaphragm use and urinary tract infection . JAMA 1985;;254:240-245.
68 +
Gillespie L:  The diaphragm: An accomplice in recurrent urinary tract infections . Urology 1984;;24:25-30.
69 +
Baehler EA, Dillon WP, Dryja DM, et al:  The effects of prolonged retention of diaphragms on colonization by Staphylococcus aureus of the lower genital tract . Fertil Steril 1983;;39:162-166.
70 +
Jick H, Hannan MT, Stergachis A, et al:  Vaginal spermicides and gonorrhea . JAMA 1982;; 248:1619-1621.
71 +
Singh B, Cutler JC, Utidjian HMD:  Studies on the development of a vaginal preparation providing both prophylaxis against venereal disease and other genital infections and contraception . Br J Ven Dis 1972;;48:57-64.
72 +
Bracken MB:  Spermicidal contraceptives and poor reproductive outcomes: The epidemiologic evidence against an association . Am J Obstet Gynecol 1985;;151:552-556.
73 +
Edelman DA:  Vaginal contraception: An overview . Int J Gynaecol Obstet 1984;;22:11-17.
74 +
Edelman DA, McIntyre SL, Harper J:  A comparative trial of the Today contraceptive sponge and diaphragm . Am J Obstet Gynecol 1984;;150:869-876.
75 +
Borko E, McIntyre SL, Feldblum PJ:  A comparative clinical trial of the contraceptive sponge and Neo-Sampoon tablets . Obstet Gynecol 1985;;65:511-515.
76 +
North BB, Vorhauer BW:  Use of the Today contraceptive sponge in the United States . Int J Fertil 1985;;30:81-84.
77 +
IPPF International Medical Advisory Panel:  Statement on periodic abstinence for family planning . IPPF Med Bull 1982;;18:2-3.
78 +
Liskin LS, Fox G:  Periodic abstinence: How well do new approaches work? Pop Rep I, 1981;, No. (3) .
79 +
Klaus H:  Natural family planning: A review. Obstet Gynecol Surv 1982;;37:128-150.
80 +
Medina JE, Cinfuentes A, Abernathy JE, et al:  Comparative evaluation of two methods of natural family planning in Colombia . Am J Obstet Gynecol 1980;;138:1142-1147.
81 +
Wade ME, McCarthy P, Braunstein GD, et al:  A randomized prospective study of the useeffectiveness of two methods of natural family planning . Am J Obstet Gynecol 1981;;141:368-376.
82 +
 Postcoital contraception . Lancet 1983;; 1:855-856.
83 +
Johnson JH:  Contraception: The morning after . Fam Plann Perspect 1984;;16:266-270.
84 +
Dixon GW, Schlesselman JJ, Ory HW, et al:  Ethinyl estradiol and conjugated estrogens as postcoital contraceptives . JAMA 1980;;244:1336-1339.
85 +
Yuzpe AA, Lancee WJ:  Ethinylestradiol and Di.-norgestrel as a postcoital contraceptive . Fertil Steril 1977;;28:932-936.
86 +
Adashi EY:  The morning after: Novel hormonal approaches to postcoital interception . Fertil Steril 1983;;39:267-269.
87 +
Lippes J, Malik T, Tatum HJ:  The postcoital copper T . Adv Plann Parenthood 1976;; 11:24-29.
88 +
Grimes DA:  Unplanned pregnancies in the United States . Obstet Gynecol , in press.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Pratt WF, Mosher WD, Bachrach CA, et al:  Understanding U.S. fertility: Findings from the National Survey of Family Growth, Cycle III . Pop Bull 1984;;39:1-40.
2 +
Jones EF, Forrest JD, Goldman N, et al:  Teenage pregnancy in developed countries: Determinants and policy implications . Fam Plann Perspect 1985;;17:53-63.
3 +
Forrest JD, Henshaw SK:  What U.S. women think and do about contraception . Fam Plann Perspect 1983;;15:157-166.
4 +
Jones EF, Beniger JR, Westoff CF:  Pill and IUD discontinuation in the United States, 1970-1975: The influence of the media . Fam Plann Perspect 1980;;12:293-300.
5 +
Potts M, Wheeler R:  The quest for a magic bullet . Fam Plann Perspect 1981;;13:269-271.
6 +
Bachrach CA:  Contraceptive practice among American women: 1973-1982 . Fam Plann Perspect 1984;;16:253-259.
7 +
Schirm AL, Trussell J, Menken J, et al:  Contraceptive failure in the United States: The impact of social, economic and demographic factors . Fam Plann Perspect 1982;;14:68-75.
8 +
Ory HW:  Mortality associated with fertility and fertility control: 1983 . Fam Plann Perspect 1983;;15:57-63.
9 +
Ory HW, Forrest JD, Lincoln R: Making Choices . New York, The Alan Guttmacher Institute, 1983;.
10 +
Hatcher RA, Guest F, Stewart F, et al: Contraceptive Technology 1984-1985 . New York, Irvington Publishers Inc, 1984;.
11 +
Meade TW, Greenberg G, Thompson SG:  Progestogens and cardiovascular reactions associated with oral contraceptives and a comparison of the safety of the 50 and 30 mcg estrogen preparations . Br Med J 1980;;280:1157-1161.
12 +
Kay C:  Progestogens and arterial disease: Evidence from the Royal College of General Practitioners' Study . Am J Obstet Gynecol 1982;; 142:762-765.
13 +
 Tri-Norinyl and Ortho-Novum 7/7/7: Two triphasic oral contraceptives . Met Lett Drug Ther 1984;;26:93-94.
14 +
Triphasil:  A new triphasic oral contraceptive . Med Lett Drug Ther 1985;;27:48.
15 +
Cohen J:  Clinical use of biphasic and triphasic pills . IPPF Med Bull 1985;, vol 19, No. (4) .
16 +
Kols A, Rinehart W, Piotrow P, et al:  Oral contraceptives in the 1980's . Popul Rep A , 1982;, No. (6) .
17 +
Roy S, Wilkins J, Mishell DR, et al:  The effect of a contraceptive vaginal ring and oral contraceptives on the vaginal flora . Contraception 1981;;24:481-491.
18 +
Ratech H, Stewart ME:  Uterine leiomyomas, serum cholesterol and oral contraceptives: A preliminary study of epidemiologic differences in Los Angeles, California and Albany, New York . Diagn Gynecol Obstet 1982;;4:21-24.
19 +
Grounds M:  Anovulants: Thrombosis and other associated changes . Med J Aust 1974;; 2:440-446.
20 +
Mishell DR Jr:  Noncontraceptive health benefits of oral steroidal contraceptives . Am J Obstet Gynecol 1982;;142:809-816.
21 +
Ory HW:  The noncontraceptive health benefits from oral contraceptive use . Fam Plann Perspect 1982;;14:182-184.
22 +
Linos A, Worthington JW, O'Fallon WM, et al:  Case-control study of rheumatoid arthritis and prior use of oral contraceptives . Lancet 1983;;1:1299-1300.
23 +
Del Junco DJ, Annegers JF, Luthra HS, et al:  Do oral contraceptives prevent rheumatoid arthritis? JAMA 1985;;254:1938-1941.
24 +
Wolner-Hanssen P, Svensson L, Mardh P-A, et al:  Laparoscopic findings and contraceptive use in women with signs and symptoms suggestive of acute salpingitis . Obstet Gynecol 1985;;66:233-238.
25 +
Realini JP, Goldzieher JW:  Oral contraceptives and cardiovascular disease: A critique of the epidemiologic studies . Am J Obstet Gynecol 1985;;152:729-798.
26 +
Ory HW.  The pill at 20: An assessment . Fam Plann Perspect 1980;;12:278-283.
27 +
Porter JB, Hunter JR, Jick H, et al:  Oral contraceptives and nonfatal vascular disease . Obstet Gynecol 1985;;66:1-4.
28 +
Connell EB:  Oral contraceptives: The current risk-benefit ratio . J Reprod Med 1984;; 29:513-523.
29 +
Blumenstein BA, Douglas MB, Hall WD:  Blood pressure changes and oral contraceptive use: A study of 2,676 black women in the southeastern United States . Am J Epidemiol 1980;;112:539-552.
30 +
Pike MC, Henderson BE, Krailo MD, et al:  Breast cancer in young women and use of oral contraceptives: Possible modifying effect of formulation and age at use . Lancet 1983;;2:926-930.
31 +
Hennekens CH, Speizer FE, Lipnick RJ, et al:  A case-control study of oral contraceptive use and breast cancer . JNCI 1984;;72:39-42.
32 +
Rosenberg L, Miller DR, Kaufman DW, et al:  Breast cancer and oral contraceptive use . Am J Epidemiol 1984;;119:167-176.
33 +
Stadel BV, Rubin GL, Webster LA, et al:  Oral contraceptives and breast cancer in young women . Lancet 1985;;2:970-973.
34 +
Washington AE, Gove S, Schachter J, et al:  Oral contraceptives, Chlamydia trachomatis infection, and pelvic inflammatory disease . JAMA 1985;;253:2246-2250.
35 +
Royal College of General Practitioners' Oral Contraception Study:  Oral contraceptives and gallbladder disease . Lancet 1982;;2:957-959.
36 +
Layde PM, Vessey MP, Yeates D:  Risk factors for gall-bladder disease: A cohort study of young women attending family planning clinics . J Epidemiol Comm Health 1982;;36:274-278.
37 +
Pardthaisong T, Gray RH:  The return of fertility following discontinuation of oral contraceptives in Thailand . Fertil Steril 1981;;35:532-534.
38 +
Rothman KJ, Louik C:  Oral contraceptives and birth defects . N Engl J Med 1978;;299:522-524.
39 +
Wilson JG, Brent RL:  Are female sex hormones teratogenic? Am J Obstet Gynecol 1981;;141:567-580.
40 +
Liskin L, Fox G: IUDs:  An appropriate contraceptive for many women . Popul Rep /B/ , 1982;, No. (4) .
41 +
Tatum HJ:  Milestones in intrauterine device development . Fertil Steril 1983;;39:141-143.
42 +
Mishell DR Jr:  Current status of intrauterine devices . N Engl J Med 1985;;312:984-985.
43 +
IPPF International Medical Advisory Panel.  Statement on intrauterine devices . IPPF Med Bull , 1981;, vol 15, No. (6) .
44 +
White MK, Ory HW, Rooks JB, et al:  Intrauterine device termination rates and the menstrual cycle day of insertion . Obstet Gynecol 1980;;55:220-224.
45 +
Heartwell SF, Schlesselman S:  Risk of uterine perforation among users of intrauterine devices . Obstet Gynecol 1983;;61:31-36.
46 +
Ory HW:  A review of the association between intrauterine devices and acute pelvic inflammatory disease . J Reprod Med 1978;; 20:200-204.
47 +
Lee NC, Rubin GL, Ory HW, et al:  Type of intrauterine device and the risk of pelvic inflammatory disease . Obstet Gynecol 1983;;62:1-6.
48 +
Kaufman DW, Watson J, Rosenberg L, et al:  The effect of different types of intrauterine devices on the risk of pelvic inflammatory disease . JAMA 1983;;250:759-762.
49 +
Stadel BV, Schlesselman S:  Extent of surgery for pelvic inflammatory disease in relation to duration of intrauterine device use . Obstet Gynecol 1984;;63:171-178.
50 +
Daling JR, Weiss NS, Metch BJ, et al:  Primary tubal infertility in relation to the use of an intrauterine device . N Engl J Med 1985;; 312:937-941.
51 +
Cramer DW, Schiff I, Schoenbaum SC, et al:  Tubal infertility and the intrauterine device . N Engl J Med 1985;;312:941-947.
52 +
Duguid HL, Parratt D, Traynor R:  Actinomyces-like organisms in cervical smears from women using intrauterine contraceptive devices . Br Med J 1980;;281:534-537.
53 +
Petitti DB, Yamamoto D, Morgenstern N:  Factors associated with actinomyces-like organisms on Papanicolaou smear in users of intrauterine contraceptive devices . Am J Obstet Gynecol 1983;;145:338-341.
54 +
Pine L, Malcolm GB, Curtis EM, et al:  Demonstration of Actinomyces and Arachnia species in cervicovaginal smears by direct staining with species-specific fluorescent antibody conjugate . J Clin Microbiol 1981;;13:15-21.
55 +
Duguid HL:  Actinomycosis and IUDs . IPPF Med Bull , 1983;, vol 17, No. (3) .
56 +
Guillebaud J:  The safety of intrauterine devices . Stud Fam Plann 1979;;10:174-177.
57 +
Cates W Jr, Ory HW, Rochat RW, et al:  The intrauterine device and deaths from spontaneous abortion . N Engl J Med 1976;;295:1155-1159.
58 +
Ory HW,  The Women's Health Study: Ectopic pregnancy and intrauterine contraceptive devices: New perspectives . Obstet Gynecol 1981;;57:137-144.
59 +
Guillebaud J, Bonnar J, Morehead J, et al:  Menstrual blood-loss with intrauterine devices . Lancet 1976;;2:387-390.
60 +
Huggins G:  IUD use and unexplained vaginal bleeding . Obstet Gynecol 1981;;58:409-416.
61 +
Jackson M, Berger GS, Keith LG: Vaginal Contraception . Boston, GK Hall Medical Publishers, 1981;, pp 63-97.
62 +
Sherris JD, Moore SH, Fox G:  New developments in vaginal contraception . Pop Rep H , 1984;, No. (7) .
63 +
Sherris JD, Lewison D, Fox G:  Update on condoms: Products, protection, promotion . Pop Rep H , 1982;, No. (6) .
64 +
Kelaghan J, Rubin GL, Ory HW, et al:  Barrier-method contraceptives and pelvic inflammatory disease . JAMA 1982;;248:184-187.
65 +
Austin H, Louv WC, Alexander WJ:  A case-control study of spermicides and gonorrhea . JAMA 1984;;251:2822-2824.
66 +
Wright NH, Vessey MP, Kenward B, et al:  Neoplasia and dysplasia of the cervix uteri and contraception: A possible protective effect of the diaphragm . Br J Cancer 1978;;38:273-279.
67 +
Fihn SD, Latham RH, Roberts P, et al:  Association between diaphragm use and urinary tract infection . JAMA 1985;;254:240-245.
68 +
Gillespie L:  The diaphragm: An accomplice in recurrent urinary tract infections . Urology 1984;;24:25-30.
69 +
Baehler EA, Dillon WP, Dryja DM, et al:  The effects of prolonged retention of diaphragms on colonization by Staphylococcus aureus of the lower genital tract . Fertil Steril 1983;;39:162-166.
70 +
Jick H, Hannan MT, Stergachis A, et al:  Vaginal spermicides and gonorrhea . JAMA 1982;; 248:1619-1621.
71 +
Singh B, Cutler JC, Utidjian HMD:  Studies on the development of a vaginal preparation providing both prophylaxis against venereal disease and other genital infections and contraception . Br J Ven Dis 1972;;48:57-64.
72 +
Bracken MB:  Spermicidal contraceptives and poor reproductive outcomes: The epidemiologic evidence against an association . Am J Obstet Gynecol 1985;;151:552-556.
73 +
Edelman DA:  Vaginal contraception: An overview . Int J Gynaecol Obstet 1984;;22:11-17.
74 +
Edelman DA, McIntyre SL, Harper J:  A comparative trial of the Today contraceptive sponge and diaphragm . Am J Obstet Gynecol 1984;;150:869-876.
75 +
Borko E, McIntyre SL, Feldblum PJ:  A comparative clinical trial of the contraceptive sponge and Neo-Sampoon tablets . Obstet Gynecol 1985;;65:511-515.
76 +
North BB, Vorhauer BW:  Use of the Today contraceptive sponge in the United States . Int J Fertil 1985;;30:81-84.
77 +
IPPF International Medical Advisory Panel:  Statement on periodic abstinence for family planning . IPPF Med Bull 1982;;18:2-3.
78 +
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To understand the clinical management of acute heart failure syndromes.
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Compression-Only CPR: Pushing the Science Forward
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AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
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