Contraceptive health risks--women's perceptions

"One Blood Clot Is One Too Many": Affected Vocal Users' Negative Perspectives on Controversial Oral Contraceptives

In this article, I analyze women's negative experiences with the fourth generation of contraceptive pills: controversial drugs Yaz and Yasmin. Drawing on in-depth interviews with 24 contraceptive users residing in Canada, I highlight how women who have experienced deleterious side effects understand the risks of hormonal contraception and advocate for changes in health risk communication and prescription drug regulation. Findings show that interviewees did not feel they received adequate risk information prior to starting their new drug regimen nor did they think that pregnancy risks should be used as a comparison point for placing hormonal contraceptive risk into perspective. Patient views were generally underlined by a critique of professional risk/benefit assessment techniques and procedures. To illustrate how the modern complexities of health risk assessment extend to the realm of hormonal contraceptives, I here provide a detailed examination of women's negative experiences while on the pill.

Race-Ethnic Differences in Sexual Health Knowledge

Despite extensive research examining the correlates of unintended fertility, it remains a puzzle as to why racial and ethnic minorities are more likely to experience an unintended birth than non-Hispanic whites. This paper focuses on sexual literacy, a potential precursor of unintended fertility. Analyses use a unique dataset of unmarried young adults aged 18-29, the 2009 Survey of Unmarried Young Adults' Contraceptive Knowledge and Practices, to examine beliefs regarding pregnancy risks, pregnancy fatalism, and contraceptive side effects. At the bivariate level, foreign-born Hispanics hold more erroneous beliefs about the risk of pregnancy than other groups, and non-Hispanic blacks are more likely to believe in contraceptive side effects than non-Hispanic whites. Both foreign-born Hispanics and non-Hispanic blacks are more likely than non-Hispanic whites to hold a fatalistic view towards pregnancy. Race-ethnic differences are attenuated for pregnancy misperceptions and fatalism in multivariate models controlling for sources of health information, sexual and fertility experiences, and sociodemographic characteristics. However, non-Hispanic blacks remain more likely than non-Hispanic whites to believe there is a high chance of reduced sexual desire and serious health consequences when using hormonal contraceptives. These differences may contribute to race-ethnic variation in contraceptive use and, ultimately, unintended fertility.

The benefits and risks of using a levonorgestrel-releasing intrauterine system for contraception

The contraceptive profile of the levonorgestrel-releasing intrauterine system (LNG-IUS; Mirena®) is well established, with efficacy similar to that achieved with sterilization and rapid return to fertility after discontinuation of use. The LNG-IUS is typically associated with transient menstrual disturbance during the first few months of use, but this usually settles with continued use, with a concomitant decrease in menstrual blood loss. Overall, the safety profile of the LNG-IUS has been well established across a wide population of women, and the available data do not suggest that the LNG-IUS adversely affects bone health or increase the risk of adverse cardiovascular events or breast and uterine cancers. This article reviews the literature to provide updated information on the risks and benefits associated with the LNG-IUS, particularly focusing on its use in contraception.

What is it about intrauterine devices that women find unacceptable? Factors that make women non-users: a qualitative study

INTRODUCTION

There is a lack of published research into the perceptions of 'non-users' of copper intrauterine contraceptive devices (IUDs). Despite this being one of the most commonly used methods of contraception in other countries, only 5% of contraceptive users in Great Britain aged 16-49 years currently use an IUD. This study explores how women's lay beliefs and perceptions about IUDs lead to rejection of this contraceptive choice.

METHODS

One-to-one semi-structured interviews were conducted with 10 women of varying ages and parity recruited from an urban general practice. None of the women had ever used IUDs but all had used contraception in the previous 6 months. Data were subjected to qualitative analysis.

RESULTS

Five analytical themes were identified: lack of objective information about IUDs, reported side effects of IUDs, anxieties about the process of fitting an IUD, IUDs as an infection risk and lack of personal control of an IUD, once fitted.

CONCLUSIONS

Some of the themes identified mirrored those found in studies of user attitudes to and experiences of IUDs. Others, particularly the prominent worries about mess and embarrassment during fitting and the association between the hidden nature of the fitted device and unreliability, are new and need wider exploration.

Attitudes of married individuals towards oral contraceptives: a qualitative study in Istanbul, Turkey

OBJECTIVE

To determine positive and negative attitudes of married Turkish women and men regarding the use of oral contraceptives (OCs).

METHODS

Twenty focus group discussions were conducted during the period October 1998-March 1999 in Umraniye, which is one of the densely populated districts of Istanbul.

RESULTS

Most of the negative attitudes relating to OCs stemmed from concerns over side effects, particularly in the male focus groups. Health care professionals' behaviour, lack of concern or bias, and their reluctance to prescribe also limited the uptake of OCs. The female groups had very positive attitudes towards OCs compared to those of the male groups. It was identified that although OCs are largely provided free of charge in Turkey, beliefs and attitudes towards them are the important factors which affect the uptake of the method.

CONCLUSION

Special efforts may be needed to educate these groups and also to teach the health professionals about family planning counselling.

Knowledge and practice of contraception in United Arab Emirates women

OBJECTIVE

To determine the knowledge and practice of contraception among United Arab Emirates (UAE) women.

METHOD

Four hundred and fifty UAE women at risk of pregnancy were randomly selected from the community and primary health care centres and interviewed about knowledge and practice of contraception using a structured questionnaire.

RESULTS

Four hundred women (89%) gave consent to participate in the study. One hundred and sixty-six participants (41.5%) were using contraception. All used natural methods backed with other methods. There were significant associations between using contraception and each of age, high level of education and low family income (p < 0.0001 for the three variables). Religious beliefs and low expectation of success of birth control were the reasons given for non-use. Eighty-five percent of subjects did not accept sterilisation without medical indications, nor using contraception before the first pregnancy. Of the women, 42.5% believed that contraceptive methods should not be used after the age of 40, and 78% were unaware that they could be used for treatment of gynaecological diseases. Disturbed bleeding patterns occurred in 48.7% of users, and these were most bothered by the inability to pray (100%) and to have sexual intercourse (97.5%).

CONCLUSION

Contraception is not commonly used by UAE women because of sociocultural traditions, religious beliefs and poor knowledge.