Factors influencing women's satisfaction with birth control methods
den Tonkelaar D,Oddens BJ
Published January 5, 2002The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception, 6(3), 153-158
den Tonkelaar, D., & Oddens, B. J. (2001). Factors influencing women's satisfaction with birth control methods. The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 6(3), 153-158. https://doi.org/10.1080/713604231
den Tonkelaar D, Oddens BJ. Factors influencing women's satisfaction with birth control methods. Eur J Contracept Reprod Health Care. 2001;6(3):153-158. doi:10.1080/713604231
den Tonkelaar, D., and Björn J. Oddens. "Factors influencing women's satisfaction with birth control methods." The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, vol. 6, no. 3, 2001, pp. 153-158.
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International Health Foundation, Geneva, Switzerland. info@ihf.nl
International Health Foundation, Geneva, Switzerland.
Abstract
Objectives
To study the extent to which variation in satisfaction with a birth control method is explained by variation in perceived physical and psychological effects.
Methods
A population survey among 1466 German women was carried out. Within the overall sample, 1303 women had ever used oral contraceptives, 996 had relied on condoms, 342 had ever used intrauterine devices (IUD), 428 had used natural family planning and 139 women were sterilized. For each method a woman had ever used, she answered questions about satisfaction with the method, concerns about getting pregnant or suffering health risks during use, ease of use, changes in sexual relationship, relationship with the partner and mood. Past and current users of oral contraceptives and IUDs and sterilized women additionally reported changes in menstrual bleeding.
Results
Variation in satisfaction was, for a large part, explained by variation in health concerns among oral contraceptive users, by variation in perceived changes in the quality of the sexual relationship among condom users, by perceived ease of use among IUD users and sterilized women, and by variation in pregnancy concern among natural family planning users.
Conclusion
Counselling about these perceived experiences is most likely to result in greater satisfaction and therefore improved compliance.
User satisfaction and the physical and psychological effects of five commonly used contraceptive methods were investigated in a population survey among 1466 West German women. The focus was on effects attributed by current and past users to these methods, rather than objectively assessed effects, to shed further light on personal experiences that are highly relevant to the user but often remain unknown to prescribers and unreported in the medical literature. Within the overall sample, 1303 women were surveyed concerning their current or past use of oral contraceptives (OC), 996 regarding condoms, 342 with respect to intrauterine devices (IUD), 428 in regard to natural family planning (NFP), and 139 in relation to sterilization (respondents completed questions about each method used). It emerged that satisfaction was greatest with sterilization (92% of users), followed by OC (68% of ever users), IUD (59%), NFP (43%), and condoms (30%). Almost one in three NFP users had experienced an unwanted pregnancy during use of this method, as compared with one in 20 OC and condom users. The majority of users reported no mood changes during use of the methods studied. The percentages reporting negative mood changes (various items were scored) were up to 16% among OC users, 23% among condom users, and 30% among NFP users. The latter observations suggested that subjective side effects of a contraceptive agent on mood generally reflected, at least in part, the user's sense of confidence in the method concerned (notably, with regard to efficacy and safety). Oral contraceptives, IUD, and sterilization had a broadly positive impact on sex life, whereas that of condoms was often negative. Whereas OC users often reported less heavy and painful menstruation (in up to 56% of cases), IUD were associated with heavier, prolonged, and more painful menstruation (in up to 65% of cases), as also was sterilization, although to a lesser extent (in up to 32% of cases). Overall, the study findings indicated that OC and sterilization had less negative impact on physical and psychological functioning than the other methods studied, in contrast to what the general public often believes.
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Unseld M et al., 2017·Front Public Health·Free full text on PubMed Central
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Comparative Studies · Contraception Versus Fertility Awareness
Summary In 1968, a prospective study was started in collaboration with the Family Planning Association to try to provide a balanced view of the beneficial and harmful effects of different methods of contraception. This investigation is now in progress at seventeen clinics and over 17,000 women are under observation. At the time of recruitment, all these women were married white British subjects, aged 25–39 years, who voluntarily agreed to participate. Fifty-six per cent were using oral contraceptives, 25% were using a diaphragm and 19% were using an intrauterine device (IUD). During follow-up each woman is questioned at return visits to the clinic and a record of pregnancies and their outcome, hospital referrals (inpatient or outpatient), changes in contraceptive methods and the results of cervical smears, is accumulated. Women who default are sent a postal questionnaire and, if this is not returned, are telephoned or visited in their homes to collect the necessary information. So far, data obtained during 56,000 woman-years of observation are available for analysis. Follow-up has been maintained with an annual lapse rate of about 0.3%due to withdrawal of co-operation or loss of contact; adherence to the method of contraception in use at recruitment has been reasonably good, and the reporting of pregnancies and hospital admissions appears to have been both reliable and unbiased. The present data include only 24 deaths, so the mortality associated with different contraceptive methods cannot yet be estimated. With regard to morbidity, however, our preliminary results closely resemble those obtained in the prospective study carried out by the Royal College of General Practitioners (1974) and in the principal retrospective studies carried out in Britain and the United States. Women who used oral contraceptives at the start of the study experienced a deficiency of hospital referrals for cancer, benign lesions of the breast, menstrual disorders other than amenorrhoea, duodenal ulcer, and retention cysts of the ovary; they showed an excess of referrals for cerebrovascular disease, cervical erosion, skin disorders, self-poisoning, migraine, venous thrombosis and embolism, hayfever, gallbladder disease, amenorrhoea, and sterility. Women who used a diaphragm showed a deficiency of hospital referrals for carcinoma-in-situ and dysplastic lesions of the cervix uteri and accidental injury; and an excess of referrals for haemorrhoids and cystitis. Women who used an IUD experienced an excess of hospital referrals for anaemia, varicose veins and salpingitis. About half of these differences (12 out of 23) were predicted from other studies while some suggestive evidence already existed for a further five. Of the remaining six, some probably reflect the influence of selective factors or chance. Multiple pregnancies, stillbirths, malformations, the sex ratio and birthweight showed no consistent relationship to method of contraception. The outcome of unplanned pregnancies occurring in women using an IUD, however, was remarkably unfavourable both in terms of ectopic gestation and miscarriage. Clear evidence was found of impairment of fertility after discontinuation of oral contraceptives. Whether this is likely to lead to permanent sterility in some women is uncertain. The study has provided data on the efficacy of a wide variety of contraceptive methods. In general the failure rates are in keeping with those obtained in other large-scale studies, save that those for the diaphragm and the sheath are much lower than those usually quoted. The available evidence does not yet allow a final balance to be struck between the benefits and risks associated with the new methods of contraception that have become widely used during the last two decades. It seems clear, however, that there are no material risks associated with the use of the diaphragm apart from the risk of pregnancy and that there may be some unintended benefits.
Contraception › Family Planning Use and Attitudes › Attitudes and Acceptability
D den Tonkelaar
PMID 11763979 11763979 DOI 10.1080/713604231 10.1080/713604231 den Tonkelaar et al. 2002, den Tonkelaar 2002
Cite this article
den Tonkelaar, D., & Oddens, B. J. (2001). Factors influencing women's satisfaction with birth control methods. The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 6(3), 153-158. https://doi.org/10.1080/713604231
den Tonkelaar D, Oddens BJ. Factors influencing women's satisfaction with birth control methods. Eur J Contracept Reprod Health Care. 2001;6(3):153-158. doi:10.1080/713604231
den Tonkelaar, D., and Björn J. Oddens. "Factors influencing women's satisfaction with birth control methods." The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, vol. 6, no. 3, 2001, pp. 153-158.