Perceived Contraceptive Attributes and Method Choice1

Young Women's Contraceptive Decision Making: Do Preferences for Contraceptive Attributes Align with Method Choice?

CONTEXT

Understanding how women's preferences for certain attributes of contraceptive methods relate to their method choice can inform the content of contraceptive counseling.

METHODS

Data from 715 women aged 18-29 who had ever used contraceptives were drawn from the 2009 National Survey of Reproductive and Contraceptive Knowledge. Chi-square tests and multivariable logistic regression analyses were used to examine how women's preferences for specific contraceptive attributes were related to their social and demographic characteristics and their current contraceptive choice.

RESULTS

The majority of women considered it extremely important for a method to be very effective at preventing pregnancy (79%) and to be effective at preventing HIV and STDs (67%); fewer than one-quarter felt similarly about a method's being hormone-free (22%). Women who felt it was quite or extremely important for a method to be very effective at preventing pregnancy were not more likely to use the most effective methods than were women who considered this attribute not at all or only slightly important. Women who considered it quite or extremely important for a method to be hormone-free were less likely than others to use hormonal methods (odds ratio, 0.4), and women who considered STD protection quite or extremely important had elevated odds of relying on condoms alone, rather than on an effective contraceptive method alone (3.6).

CONCLUSIONS

Most women desire a very effective method for pregnancy prevention, but it is unclear how this translates to their contraceptive use. The associations between women's preferred contraceptive attributes and method choice warrant further attention.

A prospective study of the effects of oral contraceptives on sexuality and well-being and their relationship to discontinuation

The purpose of the study was to explore predictors of discontinuation of oral contraceptives (OC) including pre-OC use characteristics and adverse physical, emotional, and sexual effects of OCs. Women aged 18+ years in committed, sexually active relationships were assessed before starting OC and reassessed at 3, 6, and 12 months or shortly after discontinuation. Assessment included pre-OC use attitudes and expectations about the pill; self-reported side effects and perimenstrual symptoms including premenstrual syndrome (PMS); physical and emotional well-being; and sexual interest, enjoyment, and frequency of sexual activity. Seventy-nine women completed the study, 38% continued OCs, 47% discontinued, and 14% switched to another OC. Emotional side effects, worsening of PMS, decreased frequency of sexual thoughts, and decreased psychosexual arousability correctly categorized 87% of cases by using logistic regression. Emotional and sexual side effects were the best predictors of discontinuation/switching, yet such OC effects have been largely ignored in the research literature.