Discontinuation of modern hormonal contraceptives: an Italian survey

Fruzzetti, Franca; Perini, Daria; Fornaciari, Lara; Russo, Marinella; Bucci, Fiorella; Gadducci, Angiolo

doi:10.1080/13625187.2016.1234598

Cited by 29 publications

(29 citation statements)

References 15 publications

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“…Our data are higher than the above, but quite similar to those of a large clinical study performed in a real-life setting (27.7%) 14. The discontinuation rate for irregular bleedings that we observed with E2-COCs was higher than that (5.3%) observed in a previous study performed on women who took pills with 20 mcg of EE,12 possibly due to the higher stability of the endometrium when synthetic estrogens were used 15. This may be considered an expected finding since the progestin-induced stimulation of endometrial 17 beta-hydroxysteroid dehydrogenase causes a rapid local inactivation of E2 7,9,15.…”

Section: Discussionsupporting

confidence: 85%

“…Our study shows that the percentage of women discontinuing E2-COCs is still high, but most of the patients were still taking the pill after 1 year (65%), suggesting the clinical acceptability of the compound in young and adult women. In a previous study, we reported that one-third of users may discontinue pills containing 30 mcg or 20 mcg of EE, mainly due to minor side effects, with irregular bleedings, weight gain and headache being the main reasons reported for discontinuation 12. The unacceptable bleeding pattern is the principal cause for discontinuation also for E2-COCs, whereas the incidence of other minor side effects (weight gain, headache, etc.)…”

Section: Discussionmentioning

confidence: 96%

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<p>Contraception with estradiol valerate and dienogest: adherence to the method</p>

Fruzzetti

Paoletti

Fidecicchi

et al. 2019

OAJC

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Purpose: The aim of the study was to examine the discontinuation rate of hormonal contraception with estradiol valerate (E2V) and dienogest (DNG). Patients and methods: We collected data at the Family Planning Clinics of the Departments of Obstetrics and Gynecology of Pisa and Cagliari. We included in the analysis 354 consecutive women using oral contraceptive pills containing E2V and DNG. We analyzed the rate and the reason for discontinuation, classifying the reasons in 5 categories: 1) minor side effects, 2) adverse events, 3) other events not directly caused by the drug or conditions for which the pill could represent a risk factor, 4) no compliance with the method and 5) no further need. Results: Of the 354 women examined, 50.8% had discontinued E2V/DNG pill. Excluding women who stopped the pill because of no further need (10.5%), 27.4% discontinued because of minor side effects, 1.7% discontinued for adverse events, 9.9% because of other events not directly caused by the drug or conditions for which the pill could represent a risk factor and 1.4% because of difficulties with compliance. Irregular bleedings were the main reasons reported for discontinuation. The time to discontinuation for irregular bleedings was significantly ( p <0.02) longer in adults than in adolescents and slightly but not significantly longer in women who received information about this possible effect. Conclusion: Unacceptable cycle control was the principal cause of discontinuation of pill with E2V and DNG. An appropriate information about this possible effect may improve adherence to this combined oral contraceptive.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 96%

<p>Contraception with estradiol valerate and dienogest: adherence to the method</p>

Fruzzetti

Paoletti

Fidecicchi

et al. 2019

OAJC

Self Cite

View full text Add to dashboard Cite

show abstract

“…Women may stop using hormonal contraception if they consider it unnecessary. Although short-acting reversible contraception (SARC), such as oral, transdermal or vaginal ring contraceptives, may be discontinued [5], long-acting reversible contraception (LARC), such as subdermal implants or intrauterine contraceptive devices, require removal by a health care professional. The aim of this study was to investigate whether women were continuing to use their contraceptive method during social distancing due to the pandemic (primary endpoint) and whether there were any unintended pregnancies after discontinuation (secondary endpoint).…”

Section: Introductionmentioning

confidence: 99%

Sexual activity and contraceptive use during social distancing and self-isolation in the COVID-19 pandemic

Caruso

Rapisarda

Minona

2020

The European Journal of Contraception & Reproductive Health

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Objectives: The aims of the study were to investigate the effects of social distancing during the COVID-19 pandemic on the use of hormonal contraceptives, their discontinuation and the risk of unplanned pregnancy. Methods: The study enrolled 317 women listed in the database of the Department of General Surgery and Medical-Surgical Specialties, University of Catania, Italy, family planning clinic who were known to be using hormonal contraceptives. The women were contacted by telephone and asked whether they would like to participate in the study. If they agreed, they were then emailed a questionnaire about their social behaviour and sexual activity during the pandemic, according to their cohabiting status, i.e., whether they were continuing to use their hormonal contraception and whether they had had an unplanned pregnancy. Results: The questionnaire was completed by 175 (81.8%) women who were using short-acting reversible contraception (SARC) and by 90 (87.4%) women who were using long-acting reversible contraception (LARC). All married and cohabiting women were continuing to use their contraceptive method. None had had an unplanned pregnancy. On the other hand, 51 (50.5%) non-cohabiting or single women had discontinued their SARC method while social distancing, for nonmethod-related reasons; however, 47 (46.5%) non-cohabiting or single women had continued their sexual activity, infringing social distancing rules, and 14.9% had had an unplanned pregnancy, for which they had sought a termination. Conclusion: Several non-cohabiting women using SARC had discontinued their contraceptive method during the pandemic but had continued to engage in sexual activity and had had an unplanned pregnancy. Clinicians should counsel women about what they should do in regard to contraception in the event of new, future social distancing measures.

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“…Although some research has reported on women’s contraceptive-induced side effects related to sex, including changes in libido or lubrication, many studies focus only on the experiences of women who have discontinued their use of contraception. 23 , 24 Additionally, while there is evidence that contraception can improve women’s sex lives, most notably by separating sex from pregnancy and childbearing, as Higgins and Smith state, “women do not have sex in order to use contraception”. 25 Rather, women use contraception for a variety of reasons, one of the most common being the desire to have sex without worrying about an unintended pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Women’s sexual experiences as a side effect of contraception in low- and middle-income countries: evidence from a systematic scoping review

Wood

Karp

Zimmerman

2020

Sexual and Reproductive Health Matters

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Contraception is essential to preventing unintended pregnancy. While contraceptive use has increased significantly over the past decade, discontinuation and gaps in use remain common. Although women cite side effects as the reason for discontinuing or stopping methods, little is known about the specific ways in which contraception affects women’s sexual experiences. This systematic scoping review aimed to understand how contraceptive-induced side effects relating to women’s sexual experiences have been measured, classified, and explored in the literature, specifically in low- and middle-income countries (LMICs). Studies were eligible for inclusion if they were peer-reviewed, English-language articles published between 2003 and 2018 that examined women’s sexual experiences related to their use of modern contraception, including sexual satisfaction, arousal, sexual dysfunction, discomfort, vaginal dryness, sexual frequency, and relationship or partner dynamics. Study populations were restricted to women of reproductive age in LMICs. Twenty-two studies were deemed eligible for inclusion, comprising a range of methods and geographies. Emergent sexual experience themes included: menstrual issues impacting sexual experience; libido; lubrication; sexual pleasure; dyspareunia; and female sexual function. Results highlight the variability in measures used, lack of a women-centred perspective, and void in research outside of high-income countries to study the influence of contraception on women’s sexual experiences. Very few studies focused on women’s sexual experiences as the primary outcome or predictor. Providers should adopt woman-centred contraceptive counselling that considers women’s relationships. Further research is needed to disentangle the nuanced effects of contraception on women’s sex lives, contraceptive decision-making, and method continuation.

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Discontinuation of modern hormonal contraceptives: an Italian survey

Cited by 29 publications

References 15 publications

<p>Contraception with estradiol valerate and dienogest: adherence to the method</p>

<p>Contraception with estradiol valerate and dienogest: adherence to the method</p>

Sexual activity and contraceptive use during social distancing and self-isolation in the COVID-19 pandemic

Women’s sexual experiences as a side effect of contraception in low- and middle-income countries: evidence from a systematic scoping review

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