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von Stockum S, Bauerfeind A, Becker K, Franke C, Fruzzetti F, Calaf J, Keck C, Heinemann K. NOMAC-E2 shows a better contraceptive effectiveness than LNG combined oral contraceptives in women under 25: real-world PRO-E2 study. Gynecol Endocrinol 2023; 39:2162036. [PMID: 36617423 DOI: 10.1080/09513590.2022.2162036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Objective: To investigate unintended pregnancy and changes in mood, acne, and weight in NOMAC-E2 vs levonorgestrel-containing COC (COCLNG) users under 25 years.Methods: In this large, observational study, new users (first-ever users of an eligible COC or restarting with the same or a new eligible COC after a break of at least 2 months) of NOMAC-E2 and COCLNG were recruited in 12 countries in Europe, Australia, and Latin America and followed up via questionnaires for up to 2 years. Unintended pregnancy was expressed by the Pearl Index (PI; contraceptive failures/100 women-years). Crude (HRcrude) and adjusted hazard ratios (HRadj) were calculated. Mood and acne changes were defined as change of score from baseline. Weight change was defined as percent change of body weight.Results: Overall, 12,829 NOMAC-E2 users and 17,095 COCLNG users under 25 were followed-up. The risk of unintended pregnancy was statistically significantly lower in the NOMAC-E2 cohort; confirmed events: 30 NOMAC-E2 (PI 0.24; 95% CI, 0.16-0.35) vs 94 COCLNG (PI 0.51; 95% CI, 0.41-0.62). The HRcrude for unintended pregnancy comparing NOMAC-E2 to COCLNG was 0.47 (95% CI, 0.31-0.71) and the HRadj was 0.52 (95% CI, 0.34-0.78). No differential effect on acne, mood, and weight was observed between cohorts.Conclusions: NOMAC-E2 shows a significantly better contraceptive effectiveness in young women and has no differential effect on acne, mood, and weight compared to COCLNG.
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Affiliation(s)
- Sophia von Stockum
- Berlin Center for Epidemiology and Health Research (ZEG), Berlin, Germany
| | - Anja Bauerfeind
- Berlin Center for Epidemiology and Health Research (ZEG), Berlin, Germany
| | - Kerstin Becker
- Berlin Center for Epidemiology and Health Research (ZEG), Berlin, Germany
| | - Christian Franke
- Berlin Center for Epidemiology and Health Research (ZEG), Berlin, Germany
| | - Franca Fruzzetti
- Department of Obstetrics and Gynecology, Pisa University Hospital, Pisa, Italy
| | - Joaquim Calaf
- Department of Obstetrics and Gynaecology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | | | - Klaas Heinemann
- Berlin Center for Epidemiology and Health Research (ZEG), Berlin, Germany
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Creinin MD, Jensen JT, Chen MJ, Black A, Costescu D, Foidart JM. Combined Oral Contraceptive Adherence and Pregnancy Rates. Obstet Gynecol 2023; 141:989-994. [PMID: 37023457 DOI: 10.1097/aog.0000000000005155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/09/2023] [Indexed: 04/08/2023]
Abstract
OBJECTIVE To assess the relationship of adherence and pregnancy in participants using an estetrol and drospirenone combined oral contraceptive. METHODS We performed a secondary analysis for which we pooled data from two parallel, multicenter, phase 3 trials (United States and Canada, Europe and Russia) that enrolled participants 16-50 years of age to receive estetrol 15 mg and drospirenone 3 mg in a 24 hormone and four placebo pills regimen for up to 13 cycles. Participants reported pill intake, sexual intercourse, and other contraceptive use on paper diaries. We limited this efficacy analysis to at-risk cycles (one or more reported acts of intercourse and no other contraceptive use) in participants 16-35 years of age at screening. We excluded cycles with other contraceptive use unless pregnancy occurred in that cycle. We assessed primarily the relationship between number of pills not taken per cycle and pregnancies and, secondarily, when pregnancies occurred during product use with a test for trend and χ2 analyses as appropriate. RESULTS Among 2,837 participants in this analysis, 31 on-treatment pregnancies occurred during 26,455 at-risk cycles. Pregnancies occurred in 0.09%, 0.25%, 0.83%, and 1.6% of cycles in which participants reported they took all hormone pills (n=25,613 cycles) or did not take one (n=405 cycles), two (n=121 cycles), and more than two (n=314 cycles) hormone-containing pills, respectively (P<.001). No pregnancies occurred in 2,216 cycles when one or more pills were missed and missed-pill instructions were followed. All pregnancies related to not taking pills occurred in the first three cycles. Pregnancy rates ranged from 0% to 0.21% per cycle with no significant trend by cycle (P=.45). CONCLUSION Pregnancy occurs more frequently when combined oral contraceptive users report not taking all hormone-containing pills per 28-day cycle and exceeds 1% only when more than two pills are not taken. Pregnancies in participants who reported missed pills occurred only when missed-pill instructions were not followed. A 0.09% pregnancy risk per cycle among users of a 24 hormone and four placebo pills formulation who report taking all pills likely approximates a true method-failure rate. FUNDING SOURCE Estetra SRL, an affiliate company of Mithra Pharmaceuticals. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, NCT02817828 and NCT02817841.
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Affiliation(s)
- Mitchell D Creinin
- Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, California; the Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon; the Department of Obstetrics and Gynecology, University of Ottawa, and Ottawa Hospital Research Institute, Ottawa, and the Department of Obstetrics and Gynaecology, McMaster University, Hamilton, Ontario, Canada; and Estetra SRL, an affiliate company of Mithra Pharmaceuticals, and the Department of Obstetrics and Gynecology, University of Liège, Liège, Belgium
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Zheng A, Nelson HN, McCall-Hosenfeld JS, Lehman EB, Chuang CH. Recent Intimate Partner Violence and Oral Contraceptive Pill Adherence in a Cohort of Reproductive-Aged Women. J Womens Health (Larchmt) 2022; 31:1703-1709. [PMID: 36126298 PMCID: PMC9805850 DOI: 10.1089/jwh.2021.0622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Objective: Intimate partner violence (IPV) is an important public health problem that impacts reproductive decision-making. Although previous literature has reported a negative impact on contraceptive adherence overall, this study specifically aims to investigate the association between IPV and oral contraceptive pill (OCP) adherence. Methods: We analyzed baseline survey data from 373 OCP users participating in the MyNewOptions study. Recent IPV was defined as any positive response to HARK, a 4-question tool assessing emotional, sexual, and physical abuse in the past year, or self-report of sexual coercion in the past 6 months. High OCP adherence was defined by self-report of missing ≤1 pill per month, which was then corroborated by pharmacy claims data. Multivariable regression analyses were performed to assess the influence of recent IPV history and patient-level variables on OCP adherence. Results: Just over half of our participants were highly adherent to OCPs (53.6%), and approximately one-quarter reported recent IPV exposure (25.2%). Women with recent IPV were significantly less likely to be OCP adherent than those without IPV (adjusted odds ratio (AOR) 0.54, 95% confidence interval (CI): 0.32-0.92). Protestant religion was also associated with high OCP adherence (AOR 2.41, 95% CI: 1.24-4.65, compared with no religious affiliation), while younger age groups (18-25 and 26-33 years) were less likely to have high OCP adherence compared with the 34-40 age group (AOR 0.45, 95% CI: 0.20-1.00 and AOR 0.40, 95% CI: 0.18-0.91, respectively). Conclusion: Recent IPV exposure is associated with low OCP adherence among women of reproductive age. ClinicalTrials.gov identifier: NCT02100124.
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Affiliation(s)
- Amy Zheng
- Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Hallie N. Nelson
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York, USA
| | - Jennifer S. McCall-Hosenfeld
- Division of General Internal Medicine and Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Erik B. Lehman
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Cynthia H. Chuang
- Division of General Internal Medicine and Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
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Swan LE, Vu H, Higgins JA, Bui LM, Malecki K, Green TL. Exploring financial stress and resource deprivation as barriers to preferred contraceptive use in Wisconsin in 2021. Contraception 2022; 115:22-26. [DOI: https:/doi.org/10.1016/j.contraception.2022.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
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Swan LE, Vu H, Higgins JA, Bui LM, Malecki K, Green TL. Exploring financial stress and resource deprivation as barriers to preferred contraceptive use in Wisconsin in 2021. Contraception 2022; 115:22-26. [DOI: 10.1016/j.contraception.2022.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 11/03/2022]
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da Cunha Pereira P, Monteiro I, Bahamondes L. Natural contraception apps knowledge among Brazilian women and Obstetrics and Gynaecology residents. EUR J CONTRACEP REPR 2022; 27:289-293. [PMID: 35583156 DOI: 10.1080/13625187.2022.2075844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Our objectives were to determine the knowledge and interest in apps for natural contraception among women and Obstetrics and Gynaecology (OBGYN) residents. STUDY DESIGN An online survey was sent to Brazilian women to gather sociodemographic data, knowledge and interest towards fertility-awareness contraceptive methods and smartphone apps for this purpose. Also, we sent an online survey to OBGYN residents to evaluate the reproductive physiology knowledge of natural contraception and interest in improving it and knowledge and smartphone apps for this purpose. RESULTS A total of 730 women answered the survey, and 638 were included in the study and 94 OBGYN residents answered the survey. Among the respondent women 386 (60.5%) were interested in more information about natural contraception, 226 (35.5%) showed interest in use natural contraception, 85 (13.3%) indicated that they were users of natural contraception, 15 (16.8%) of this group currently uses an app for this purpose and 485 (76%) considers a practical option to have an app for natural contraception. Regarding the respondent residents all answers were included in the study; 62 (65.9%) knew the right definition of 'Natural Contraception', 52 (55.3%) showed interest in information about this topic and 78 (82.9%) considers a practical option to have an app for natural contraception. CONCLUSIONS Less than 15% of the respondent women use natural contraception although about 60% expressed some interest in learning more, and that among OBGYN residents, half showed interest.
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Affiliation(s)
- Paula da Cunha Pereira
- Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Campinas, Brazil
| | - Ilza Monteiro
- Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Campinas, Brazil
| | - Luis Bahamondes
- Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Campinas, Brazil
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Reyes-Martí L, Rubio-Rico L, Ortega-Sanz L, Raigal-Aran L, de la Flor-López M, Roca-Biosca A, Valls-Fonayet F, Moharra-Francés M, Escuriet-Peiro R, de Molina-Fernández MI. Contraceptive counselling experiences in Spain in the process of creating a web-based contraceptive decision support tool: a qualitative study. Reprod Health 2021; 18:237. [PMID: 34838040 PMCID: PMC8626746 DOI: 10.1186/s12978-021-01254-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/04/2021] [Indexed: 11/15/2022] Open
Abstract
Background The choice of contraceptive method is a complex decision, and professionals should offer counselling based on the preferences, values and personal situation of the user(s). Some users are unsatisfied with the counselling received, which may, among other consequences, adversely affect method use adherence. In view of this situation, we propose exploring the experiences and needs of users and professionals for contraceptive counselling, in the context of creating a web-based contraceptive decision support tool. Methods/design Qualitative research was conducted through focus group discussions (64 users split into eight groups, and 19 professionals in two groups, in Tarragona, Spain) to explore the subjects’ experiences and needs. The data were categorized and the categories were defined and classified based on the three-step protocol or framework for Quality on Contraceptive Counseling (QCC), created by experts, which reviews the quality of interactions between user and professional during the counselling process. Results In counselling, users demand more information about the different methods, in an environment of erroneous knowledge and misinformation, which lead to false beliefs and myths in the population that are not contrasted by the professional in counselling. They complain that the method is imposed on them and that their views regarding the decision are not considered. Professionals are concerned that their lack of training leads to counselling directed towards the methods they know best. They acknowledge that a paternalistic paradigm persists in the healthcare they provide, and decision support tools may help to improve the situation. Conclusions Users feel unsatisfied and/or demand more information and a warmer, more caring approach. Professionals are reluctant to assume a process of shared decision-making. The use of a contraception DST website may solve some shortcomings in counselling detected in our environment. In Spain, individuals can use a variety of contraceptive methods. Professionals involved in contraceptive counselling should help users to choose and properly use the method that best suits their preferences, personal situation and health status. However, there is a high number of unplanned pregnancies and the population feels dissatisfied with the counselling received. In the context of creating a website dealing with contraceptive methods, we wished to find out how counselling was taking place, giving voice those directly concerned. A qualitative study was proposed to explore the experiences and needs of users and professionals during counselling. Ten focus groups were conducted involving 64 users and 19 professionals from Tarragona (Spain). The results were ordered based on the Quality on Contraceptive Counseling (QCC) framework, created by experts, which determines what the relationship between user and professional should be like during the counselling process. Our analysis highlighted users’ little knowledge and false beliefs concerning contraception who, moreover, complained of receiving little information during counselling. They expressed their discontent with methods being imposed on them by the professional without exploring their preferences or needs. Meanwhile, the professionals argued that they often prescribe the method with which they are most familiar due to the lack of time during consultations at their office and/or because they are unfamiliar with other methods. These results, among others, offer the possibility of improving contraceptive counselling in Spain, if solutions to the difficulties and/or barriers detected are posed and implemented.
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Affiliation(s)
- Laura Reyes-Martí
- Nursing Department, Universitat Rovira i Virgili, Av/Catalunya, 35, 43002, Tarragona, Spain
| | - Lourdes Rubio-Rico
- Nursing Department, Universitat Rovira i Virgili, Av/Catalunya, 35, 43002, Tarragona, Spain.
| | - Laura Ortega-Sanz
- Nursing Department, Universitat Rovira i Virgili, Av/Catalunya, 35, 43002, Tarragona, Spain
| | - Laia Raigal-Aran
- Nursing Department, Universitat Rovira i Virgili, Av/Catalunya, 35, 43002, Tarragona, Spain
| | - Miriam de la Flor-López
- Medicine Department, Universitat Rovira i Virgili, C/Dr. Mallafrè Guasch, 4, 43005, Tarragona, Spain
| | - Alba Roca-Biosca
- Nursing Department, Universitat Rovira i Virgili, Av/Catalunya, 35, 43002, Tarragona, Spain
| | - Francesc Valls-Fonayet
- Nursing Department, Universitat Rovira i Virgili, Av/Catalunya, 35, 43002, Tarragona, Spain
| | - Montse Moharra-Francés
- Agency for Health Quality and Assessment of Catalonia (AQuAS) of the Catalan Ministry of Health, Carrer de Roc Boronat, 81, 08005, Barcelona, Spain
| | - Ramon Escuriet-Peiro
- Catalan Health Service of the Catalan Ministry of Health, Travessera de Les Corts, 131-159 - Edifici Olímpia. Població, 08028, Barcelona, Spain
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Fumero A, Marrero RJ, Peñate W, Bethencourt JM, Barreiro P. Adherence to Oral Contraception in Young Women: Beliefs, Locus of Control, and Psychological Reactance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111308. [PMID: 34769824 PMCID: PMC8582819 DOI: 10.3390/ijerph182111308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/21/2021] [Accepted: 10/26/2021] [Indexed: 12/15/2022]
Abstract
Background: There is a high dropout rate of oral contraceptive pills (OCP), mainly due to a lack of adherence to treatment. The aim of this study was to identify the psychological processes and attitudes toward medication involved in adherence to OCP, depending on the prescription, to avoid unintended pregnancies (AUP) or gynecological problems (GP). Methods: This cross-sectional study was conducted by asking 689 young women in the fertile period, mean age 23.41 (SD = 5.90), to complete questionnaires related to attitudes, beliefs, psychological reactance, locus of control, and adherence to contraceptive medication. Descriptive analyses and a binary logistic regression were performed. Results: The results confirmed that different beliefs and psychological processes were involved in adherence to oral contraception, based on women’s reasons for taking contraceptive medication. More psychological processes were involved in non-adherence in the AUP group than in the GP group. Psychological reactance contributed most to explaining non-adherence in women who used the OCP to prevent unintended pregnancies. Conversely, women with gynecological problems reported difficulties in adherence, mainly due to their beliefs about contraceptive pills. Conclusions: These findings indicate that attitudes toward medication and psychological processes can play an important role in adherence to OCP, including reasons for using the pill. Identifying the psychological factors and beliefs linked with contraception could guide health professionals to provide counseling to women, thus increasing their adherence to medication and maximizing their health and well-being.
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Affiliation(s)
- Ascensión Fumero
- Departmento de Psicología Clínica, Psicobiología y Metodología, Facultad de Psicología, Campus de Guajara, Universidad de La Laguna, 38200 San Cristóbal de Tenerife, Spain; (R.J.M.); (W.P.); (J.M.B.)
- Correspondence:
| | - Rosario J. Marrero
- Departmento de Psicología Clínica, Psicobiología y Metodología, Facultad de Psicología, Campus de Guajara, Universidad de La Laguna, 38200 San Cristóbal de Tenerife, Spain; (R.J.M.); (W.P.); (J.M.B.)
| | - Wenceslao Peñate
- Departmento de Psicología Clínica, Psicobiología y Metodología, Facultad de Psicología, Campus de Guajara, Universidad de La Laguna, 38200 San Cristóbal de Tenerife, Spain; (R.J.M.); (W.P.); (J.M.B.)
| | - Juan M. Bethencourt
- Departmento de Psicología Clínica, Psicobiología y Metodología, Facultad de Psicología, Campus de Guajara, Universidad de La Laguna, 38200 San Cristóbal de Tenerife, Spain; (R.J.M.); (W.P.); (J.M.B.)
| | - Pedro Barreiro
- Servicio Canario de la Salud, 38071 San Cristóbal de Tenerife, Spain;
- Gabinete Mente y Salud, 38003 San Cristóbal de Tenerife, Spain
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Pedro CB, Casacio GDDM, Zilly A, Ferreira H, Ferrari RAP, Silva RMMD. Fatores relacionados ao planejamento familiar em região de fronteira. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo identificar fatores que potencializam ou interferem no planejamento familiar em região de fronteira. Método pesquisa descritiva, de coorte, transversal e quantitativa, realizada com 280 puérperas, Paraná, Brasil. Para a coleta de dados, aplicou-se um instrumento estruturado com variáveis socioeconômicas, antecedentes obstétricos e planejamento familiar. Para análise, utilizou-se o teste de associação Qui-Quadrado ou o teste G complementado pela análise de resíduos ajustados, com nível de significância de 5% (p<0,05). Resultados idade inferior a 19 anos (66%), baixa renda (65,3%), escolaridade (62,6%), ausência de companheiro (95,6%) e multiparidade (74,4%) foram as características que interferiram no planejamento familiar. Maior escolaridade e acesso a métodos contraceptivos apresentaram-se favoráveis ao planejamento familiar. Mulheres que não planejaram a gravidez aderiram mais aos métodos contraceptivos após seis meses do nascimento do filho. Conclusão e implicações para a prática as baixas condições sociodemográficas interferem na adesão ao planejamento familiar em região de fronteira, o que remete para ajustes no serviço de atenção primária.
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Hochberg I, Orshalimy S, Yom-Tov E. Real-World Evidence on the Effect of Missing an Oral Contraceptive Dose: Analysis of Internet Search Engine Queries. J Med Internet Res 2020; 22:e20632. [PMID: 32930672 PMCID: PMC7525397 DOI: 10.2196/20632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/30/2020] [Accepted: 07/26/2020] [Indexed: 01/16/2023] Open
Abstract
Background Oral contraceptives (OCs) are a unique chronic medication with which a memory slip may result in a threat that could change a person’s life course. Subjective concerns of missed OC doses among women have been addressed infrequently. Anonymized queries to internet search engines provide unique access to concerns and information gaps faced by a large number of internet users. Objective We aimed to quantitate the frequency of queries by women seeking information in an internet search engine, after missing one or more doses of an OC; their further queries on emergency contraception, abortion, and miscarriage; and their rate of reporting a pregnancy timed to the cycle of missing an OC. Methods We extracted all English-language queries submitted to Bing in the United States during 2018, which mentioned a missed OC and subsequent queries of the same users on miscarriage, abortion, emergency contraceptives, and week of pregnancy. Results We identified 26,395 Bing users in the United States who queried about missing OC pills and the fraction that further queried about miscarriage, abortion, emergency contraceptive, and week of pregnancy. Users under the age of 30 years who asked about forgetting an OC dose were more likely to ask about abortion (1.5 times) and emergency contraception (1.7 times) (P<.001 for both), while users at ages of 30-34 years were more likely to query about pregnancy (2.1 times) and miscarriage (5.4 times) (P<.001 for both). Conclusions Our data indicate that many women missing a dose of OC might not have received sufficient information from their health care providers or chose to obtain it online. Queries about abortion and miscarriage peaking in the subsequent days indicate a common worry of possible pregnancy. These results reinforce the importance of providing comprehensive written information on missed pills when prescribing an OC.
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Affiliation(s)
- Irit Hochberg
- Institute of Endocrinology, Diabetes and Metabolism, Rambam Health Care Campus, Haifa, Israel.,Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Sharon Orshalimy
- School of Public Health, Ben Gurion University, Beer Sheva, Israel
| | - Elad Yom-Tov
- Microsoft Research, Herzeliya, Israel.,Faculty of Industrial Engineering and Management, Technion - Israel Institute of Technology, Haifa, Israel
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Nowosielski K, Kurpisz J, Kowalczyk R. Sexual self-schema: a cognitive schema and its relationship to choice of contraceptive method among Polish women. EUR J CONTRACEP REPR 2019; 24:280-287. [PMID: 31094585 DOI: 10.1080/13625187.2019.1615617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objectives: The aim of the study was to examine sexual self-schema in women using different methods of contraception. Methods: Women (N = 560) aged 18-55 years were divided into two groups: those who used hormonal contraception (n = 285) and those who used non-hormonal contraception (n = 275). Participants were assessed using the Sexual Self-Schema Scale (SSSS), the Well-Matched Marriage Questionnaire and the Hospital Anxiety and Depression Scale and were also asked to fill in a structured questionnaire, giving information on their socioeconomic status, reproductive and medical history, sexual behaviours, psychosexual orientation, sexual experience and type of contraception used. Results: Women in the hormonal group scored lower on romantic, passionate and direct subscales of the SSSS, compared with women in the non-hormonal group. Of the total sample, 35% were classified as positive schematic. Women in the hormonal group were found to be more negative schematic and aschematic as well as less co-schematic compared with women in the non-hormonal group. Furthermore, women in the hormonal group were significantly less religious and perceived their self-evaluated weight to be higher compared with women in the non-hormonal group. Logistic regression revealed that negative schematic (odds ratio [OR] 6.6) and aschematic women (OR 3.7), as well as women with more deliveries (OR 1.6), were more likely to choose hormonal contraception. Conclusion: A sexual self-schema might be a relevant factor affecting the choice of contraceptive method. All women seeking hormonal contraception who are aschematic or negative schematic should consult with a sexual medicine specialist, because those individuals may have more profound reasons underlying their need for this type of contraception.
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Affiliation(s)
| | - Jacek Kurpisz
- b Department and Clinic of Psychiatry , Pomeranian Medical University , Szczecin , Poland
| | - Robert Kowalczyk
- c Department of Sexology , Andrzej Frycz Modrzewski Kraków University , Cracow , Poland
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