Depot medroxyprogesterone acetate (DMPA) is a highly-effective, injectable contraceptive method that requires injections every 12 to 15 weeks. The need for return visits to a healthcare provider may present barriers to access, use, and continuation of DMPA. Studies demonstrate that self-administration of subcutaneous DMPA (DMPA-SC) outside clinical settings is safe, effective, feasible, acceptable, and can improve continuation. Based on existing evidence and potential to improve contraceptive access and autonomy, the Society of Family Planning recommends that DMPA-SC self-administration be made widely available as an additional option for patients. Provider-administered DMPA must also remain available to meet patients\' individual needs and preferences.

The World Health Organization (WHO) published guidelines for hormonal contraceptive eligibility for women at high risk of HIV in March 2017. This guidance followed from a technical consultative meeting convened by the WHO in December 2016, where all the available evidence on hormonal contraceptives and risk of HIV acquisition was reviewed. This was an expert meeting with representation from global experts in family planning and HIV management, including clinicians, epidemiologists, researchers and civil society. The guideline development group, through a consensus, made recommendations to change the medical eligibility criteria for contraceptive use from category 1 to category 2 for progestogen-only injectable contraceptives among women at high risk of HIV. There was no change in the recommendation for all other methods of hormonal contraception. The data that informed this decision are from observational studies, which have limitations; therefore, causality or association of hormonal contraception and risk of HIV acquisition have not been proven. This guidance will have an impact on countries that have a high HIV disease burden and where progestogen-only injectable contraceptives are the highest used, as in South Africa (SA). The information has to be communicated in line with the WHO\'s sexual and reproductive health rights principles of ensuring that all women should receive evidence-based recommendations. This will empower them to make informed choices about their reproductive needs. This article seeks to clarify the decision-making process of the WHO and how the new recommendations were formulated. It also gives SA\'s response to the guidance and a perspective of what informed the National Department of Health\'s position, taking into account the effect this will have on SA\'s contraceptive guidelines.

暂无摘要。

暂无摘要。

暂无摘要。

This past July, the community of physicians practicing obstetrics/gynecology and women\'s medicine was startled by a paper in the Journal of the American Medical Association, which reported data from one arm of the Women\'s Health Initiative (WHI). The major finding was that the group of subjects undergoing treatment with combined HRT in the form of Prempro (0.625 mg/day conjugated equine estrogens (CEE) + 2.5 mg/day medroxyprogesterone acetate) was found to have increased risk of breast cancer and no apparent cardiac benefit. Although several benefits were considered, the likely result to be realized by 8 years, interim findings by the study\'s safety committee at 5 years were deemed sufficiently troubling to stop this arm of the trial at 5.2 years. Reaction was mixed. This paper places findings into a clinical perspective and considers their effect on the practice guidelines of relevant professional organizations.

暂无摘要。

暂无摘要。

Paraphilic syndromes, of which there are at least 40, are known legally as perversions and on the street as kinky and bizarre sex. Paraphilia accounts for a very high proportion of sex-offending that is prosecuted as criminal. A new treatment which combines a hormonal antiandrogen with sexological counseling therapy is becoming widely adopted in America and Europe. The treatment is available also to noncriminal paraphiliacs whose syndrome is a source of interpersonal suffering and crisis.