Health-related quality of life in young women starting hormonal contraception: a pilot study

Abstract

Objectives: Our purpose was to study whether there is a difference in self-rated health-related quality of life (HRQOL) and changes in HRQOL perception after 3 months of hormonal contraceptive use in adolescents. Seasonal variations in symptoms of depression were also studied. Methods: A test group (T1) (n ¼ 193) and a selected control group (n ¼ 238) of women aged 14-20 years who were visiting a young person's clinic completed the 36-item short-form health survey (SF-36) and answered additional questions on menstrual history and pattern, need for menstrual pain relief medication, and other regular medication. The test group was reassessed after 3 months of hormonal contraception (T2). Seasonal variations in reported SF-36 scores were studied for the whole group. Results: The selected control group and test group at T1 were similar with regard to age at menarche and menstrual pattern. The duration of bleeding and use of painkillers were significantly reduced and the impact on everyday life was significantly improved after 3 months of hormonal contraception (p ¼ .000, two-tailed). No changes in HRQOL or symptoms of possible depression were found after 3 months of hormonal contraception. The highest prevalence odds ratio for possible depression (SF-36 mental health scale score 48), adjusted for group, season and age, for spring vs winter, was 2.15 (95% confidence interval 0.95, 4.85). Conclusions: After 3 months of hormonal contraception both the number of days of menstrual bleeding and the use of medication to relieve menstrual pain were reduced, but there were no significant changes in self-rated HRQOL perception. Seasonal effects on HRQOL were reported. ARTICLE HISTORY

Oral Contraceptive Pills use and adverse effects

“…In this study, Majority of the studied group (92.6%) had dysmenorrhea. This coincides with Grandi et al (7) who found that 57.9% of their studied cases had dysmenorrhea Regarding the menstrual pain severity, it was mild to moderate in half of the women (52%), which is near to the results in the study done by Kristjánsdóttir et al (5) who studied 431 female on oral contraceptive pills and found that 35.3% of the studied cases had regular menstrual pain.…”

“…In the study done by Grandi et al (7) , in Italy who studied 40 patients, the mean age at menarche was 12.84 ± 1.95 y. In a study done in Sweden, by Kristjánsdóttir et al (5) , the mean age of menarche was 12.9 ± 1.3 y.…”

“…The oral contraceptive pill is the most commonly used contraceptive method among young women worldwide. An extensive body of evidence has established that oral contraceptives protect women against somatic conditions that may affect their quality of life: dysmenorrhea, menorrhagia, menstrual cycle irregularities, iron deficiency anaemia, ectopic pregnancy, pelvic inflammatory disease, ovarian cysts, benign breast disease, endometrial cancer and ovarian cancer (5) .…”

“…Table (5) showed that most frequent examinations were done by the studied groups were measuring blood pressure, CBC & breast self-examination (62.3%, 48% & 43.1% respectively). Also most frequent complications found among them were depression, breast pain, inflammation, weight gain and abnormal vaginal secretions (63.7%, 57.7%, 56.6% & 56.3% respectively).…”

Quality of life and mental health in adolescent users of oral contraceptives. Results from the nationwide, representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS)

“…Similar results were reported from a small, cross-sectional Norwegian study in adult women showing a decreased likelihood of a current mood disorder in users of combined contraceptive preparations, whereas, in contrast, users of progestin-only agents experienced a deleterious effect [ 9 ]. One small study in women aged 14–20 years found no significant changes in self-rated quality of life perception or depressive symptoms, despite the fact that both the number of days of menstrual bleeding and the use of analgetic medication to relieve menstrual pain were both reduced [ 10 ]. In a double-blind, randomized, placebo-controlled trial in 340 young, healthy Swedish women aged 18–35 years, Zethraeus et al demonstrated that a first-choice levonorgestrel-containing drug administered for the treatment of premenstrual symptoms resulted in a statistically significant reduction in general well-being, when compared to a placebo, but no statistically significant effects on depressive symptoms [ 11 ].…”