A randomised controlled trial studying the effects of the copper intrauterine device and the injectable progestogen contraceptive on depression and sexual functioning of women in the Eastern Cape

Simple item page
dc.contributor.advisorKhalil, Dorisen_ZA
dc.contributor.advisorHofmeyr, G Jen_ZA
dc.contributor.authorSingata-Madliki, Mandisaen_ZA
dc.date.accessioned2016-04-05T11:38:13Z
dc.date.available2016-04-05T11:38:13Z
dc.date.issued2014en_ZA
dc.description.abstractA lack of contraception use and contraceptive method discontinuation are common causes of unintended pregnancy in the Eastern Cape. The most common reason for method discontinuation among childbearing women is the unacceptable side effects of their contraceptive choices. Both depression and sexual dysfunction are given as side effects of contraceptive use; however, there is little evidence to support these effects. This randomised, single-blind controlled trial conducted in East London, South Africa, Investigated the effects of the initiation of a long-acting injectable contraceptive, Depot Medroxyprogesterone Acetate (DMP A), compared with the initiation of a copper Intrauterine Contraceptive Device (Cu-IUD) after childbirth on depression and sexual functioning. After counselling, 242consenting pregnant women were randomised to receive DMP A or a Cu IUD within 48 hours of childbirth, in a ratio of 1:1. Primary outcome measures were depression and sexual dysfunction evaluated by validated instruments. Questionnaires were administered at baseline, and telephonically at one month and three months after randomisation. The telephonic interviewer was blinded to the participants' group allocation. English and Xhosa versions of the Beck Depression Inventory and the Edinburgh Postnatal Depression Scale were used to assess depression. The Arizona Sexual Functioning Scale was used to assess sexual functioning. For these primary outcomes, median scores between the intervention groups were compared, as well as the number of events (dichotomous data) in each intervention group. There relative effects of these interventions were summarised by calculating risk ratios, with 95% confidence intervals. Statistical tests used included the Shapiro-Wilk test, T-test, and Wilcoxon test. There were not consistently statistically significant differences in the risk of depression or sexual dysfunction between the intervention groups in this study. However, there was a trend towards more depression in the DMPA group which was statistically significant for mean EPDS score at the one month and for the BDI score three month assessments compared with the IUD group. There was also a trend to more sexual dysfunction with DMPA, but the only statistically significant difference was that fewer women in the DMPA group resumed sexual intercourse within the first month of treatment than in the IUD group. The author's recommendations from the study are that, firstly, family planning providers should inform women during contraceptive counselling that there is no certainty that DMPA causes depression and/or sexual dysfunction; however, it may do so in the postpartum period. Secondly, contraceptive users can continue to use DMPA with confidence as a convenient and effective method of preventing unintended pregnancy. Thirdly, the trend towards postpartum depression and sexual dysfunction in the DMPA group of this study justifies further research with a larger sample size, to include women from various social settings, and for a longer period of follow-up. Lastly, the Cu-IUD is a good alternative to DMPA in women who experience intolerable effects with the latter.en_ZA
dc.identifier.apacitationSingata-Madliki, M. (2014). <i>A randomised controlled trial studying the effects of the copper intrauterine device and the injectable progestogen contraceptive on depression and sexual functioning of women in the Eastern Cape</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Division of Nursing and Midwifery. Retrieved from http://hdl.handle.net/11427/18586en_ZA
dc.identifier.chicagocitationSingata-Madliki, Mandisa. <i>"A randomised controlled trial studying the effects of the copper intrauterine device and the injectable progestogen contraceptive on depression and sexual functioning of women in the Eastern Cape."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Division of Nursing and Midwifery, 2014. http://hdl.handle.net/11427/18586en_ZA
dc.identifier.citationSingata-Madliki, M. 2014. A randomised controlled trial studying the effects of the copper intrauterine device and the injectable progestogen contraceptive on depression and sexual functioning of women in the Eastern Cape. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Singata-Madliki, Mandisa AB - A lack of contraception use and contraceptive method discontinuation are common causes of unintended pregnancy in the Eastern Cape. The most common reason for method discontinuation among childbearing women is the unacceptable side effects of their contraceptive choices. Both depression and sexual dysfunction are given as side effects of contraceptive use; however, there is little evidence to support these effects. This randomised, single-blind controlled trial conducted in East London, South Africa, Investigated the effects of the initiation of a long-acting injectable contraceptive, Depot Medroxyprogesterone Acetate (DMP A), compared with the initiation of a copper Intrauterine Contraceptive Device (Cu-IUD) after childbirth on depression and sexual functioning. After counselling, 242consenting pregnant women were randomised to receive DMP A or a Cu IUD within 48 hours of childbirth, in a ratio of 1:1. Primary outcome measures were depression and sexual dysfunction evaluated by validated instruments. Questionnaires were administered at baseline, and telephonically at one month and three months after randomisation. The telephonic interviewer was blinded to the participants' group allocation. English and Xhosa versions of the Beck Depression Inventory and the Edinburgh Postnatal Depression Scale were used to assess depression. The Arizona Sexual Functioning Scale was used to assess sexual functioning. For these primary outcomes, median scores between the intervention groups were compared, as well as the number of events (dichotomous data) in each intervention group. There relative effects of these interventions were summarised by calculating risk ratios, with 95% confidence intervals. Statistical tests used included the Shapiro-Wilk test, T-test, and Wilcoxon test. There were not consistently statistically significant differences in the risk of depression or sexual dysfunction between the intervention groups in this study. However, there was a trend towards more depression in the DMPA group which was statistically significant for mean EPDS score at the one month and for the BDI score three month assessments compared with the IUD group. There was also a trend to more sexual dysfunction with DMPA, but the only statistically significant difference was that fewer women in the DMPA group resumed sexual intercourse within the first month of treatment than in the IUD group. The author's recommendations from the study are that, firstly, family planning providers should inform women during contraceptive counselling that there is no certainty that DMPA causes depression and/or sexual dysfunction; however, it may do so in the postpartum period. Secondly, contraceptive users can continue to use DMPA with confidence as a convenient and effective method of preventing unintended pregnancy. Thirdly, the trend towards postpartum depression and sexual dysfunction in the DMPA group of this study justifies further research with a larger sample size, to include women from various social settings, and for a longer period of follow-up. Lastly, the Cu-IUD is a good alternative to DMPA in women who experience intolerable effects with the latter. DA - 2014 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - A randomised controlled trial studying the effects of the copper intrauterine device and the injectable progestogen contraceptive on depression and sexual functioning of women in the Eastern Cape TI - A randomised controlled trial studying the effects of the copper intrauterine device and the injectable progestogen contraceptive on depression and sexual functioning of women in the Eastern Cape UR - http://hdl.handle.net/11427/18586 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/18586
dc.identifier.vancouvercitationSingata-Madliki M. A randomised controlled trial studying the effects of the copper intrauterine device and the injectable progestogen contraceptive on depression and sexual functioning of women in the Eastern Cape. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Division of Nursing and Midwifery, 2014 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/18586en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDivision of Nursing and Midwiferyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherMaternal healthcareen_ZA
dc.subject.otherReproductive Healthen_ZA
dc.titleA randomised controlled trial studying the effects of the copper intrauterine device and the injectable progestogen contraceptive on depression and sexual functioning of women in the Eastern Capeen_ZA
dc.typeDoctoral Thesis
dc.type.qualificationlevelDoctoral
dc.type.qualificationnamePhDen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
thesis_hsf_2014_singata_madliki_mandisa.pdf
Size:
8.7 MB
Format:
Adobe Portable Document Format
Description:
Download
Collections
PhD / Doctoral