Advertisement

Oral contraceptive discontinuation: do side effects matter?

      Objective

      The purpose of this study was to assess self-reported side effects in women after they received the oral contraceptive (OC) and to compare discontinuation rates, according to presence or absence of side effects.

      Study Design

      The study comprised 1716 women aged <25 years who initiated the OC at 3 publicly funded family planning clinics and completed structured interviews after 3 and 6 months.

      Results

      Nearly 60% of subjects discontinued the OC by 6 months. Most subjects reported no changes in headaches, weight, moodiness, and sexual satisfaction during the first 3 months of OC use. Subjects with any complaints, especially women with increased headaches or moodiness, were more likely to discontinue the OC prematurely. Nonetheless, most discontinuation occurred for reasons that were unrelated to side effects.

      Conclusion

      Side effects are absent or mild among most OC users, but women with complaints are more likely to discontinue. Side effects are less important reasons for discontinuation than widely believed.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Abma J.
        • Chandra A.
        • Mosher W.
        • Peterson L.
        • Piccinino L.
        Fertility, family planning, and women’s health: New data from the 1995 National Survey of Family Growth: National Center for Health Statistics.
        Vital Health Stat. 1997; : 23
        • Osterberg L.
        • Blaschke T.
        Adherence to medication.
        N Engl J Med. 2005; 353: 487-497
        • Berenson A.B.
        • Wiemann C.M.
        Contraceptive use among adolescent mothers at six months postpartum.
        Obstet Gynecol. 1997; 89: 999-1000
        • Emans S.J.
        • Grace E.
        • Woods E.R.
        • Smith D.E.
        • Klein K.
        • Merola J.
        Adolescents’ compliance with the use of oral contraceptives.
        JAMA. 1987; 257: 3377-3381
        • Oakley D.
        • Sereika S.
        • Bogue E.
        Oral contraceptive pill use after an initial visit to a family planning clinic.
        Fam Plann Perspect. 1991; 23: 150-154
        • Rosenberg M.J.
        • Meehan T.E.
        • Waugh M.S.
        Use and misuse of oral contraceptives: risk indicators for poor pill taking and discontinuation.
        Contraception. 1995; 51: 286-288
        • Rosenberg M.J.
        • Waugh M.S.
        Oral contraceptive discontinuation: a prospective evaluation of frequency and reasons.
        Am J Obstet Gynecol. 1998; 179: 577-582
        • Westhoff C.
        • Kerns J.
        • Morroni C.
        • Cushman L.
        • Tiezzi L.
        • Murphy P.A.
        Quick start: a novel oral contraceptive initiation method.
        Contraception. 2002; 66: 141-145
      1. Westhoff C, Heartwell S, Edwards S, Zieman M, Cushman L, Kalmuss D. Oral contraceptives: quick start versus conventional start: Association of Reproductive Health Professionals’ (ARHP) 43rd Annual Conference. Reprod Health [In press].

        • Sneed R.
        • Hutchko M.
        • Robilotto T.
        • Johnson S.
        • Westhoff C.
        Using a health behavior model to predict oral contraceptive continuation.
        Contraception. 2003; 68 ([abstract]): 139-155
        • Westhoff C.
        • Morroni C.
        • Kerns J.
        • Murphy P.A.
        Bleeding patterns after immediate versus conventional oral contraceptive initiation: a randomized controlled trial.
        Fertil Steril. 2003; 79: 322-329
        • Westhoff C.
        • Truman C.
        • Kalmuss D.
        • et al.
        Depressive symptoms and Depo-Provera.
        Contraception. 1998; 57: 237-240
      2. Davis A, O’Connell K. Oral contraceptives, side effects, and depression in adolescent girls. Contraception [In press].

        • Davis A.
        • Schnare S.
        Hormonal contraceptives and libido.
        Dialogues in Contraception. 2005; 9: 5-8