Discontinuation of modern hormonal contraceptives: an Italian survey

Abstract

Objectives: The aim of the study was to examine, in a sample of Italian women, the rate of discontinuation of use of hormonal contraception.

Methods: In a retrospective cross-sectional study, data were collected from a chart review of 1809 women using or stopping the hormonal contraceptive prescribed by their physician. The name of the contraceptive and the reason for discontinuation were taken from the charts. The differences between the methods regarding reasons for discontinuation were analysed.

Results: Of the 1809 women examined, 34.9% had discontinued their hormonal contraception: 6.9% did so for non-method-related reasons, 20.5% due to minor side effects, 4.4% due to major side effects and 3.8% due to difficulties with compliance. Irregular bleeding, weight gain and headache were the main reasons reported for discontinuation. Pills containing 30 μg or 20 μg ethinylestradiol (EE) and the vaginal ring were the most used contraceptive methods. Women using the vaginal ring discontinued less frequently compared with pill users (p < .005). Pills containing 20 μg and 30 μg EE had the same discontinuation rate. Venous thrombosis was the most frequently reported major side effect leading to discontinuation.

Conclusion: About one-third of women who used modern hormonal contraceptives discontinued the method. Although the percentage of women who gave up as a result of minor side effects was lower than it used to be, and the use of low doses of EE by the vaginal route has decreased the rate of discontinuation, physicians should counsel women about the possibility of side effects and encourage them to seek advice before stopping.

Chinese abstract

目的: 本研究的目的是调查意大利女性使用激素避孕的停药率。

方法: 采用回顾性横断面研究, 数据收集来自1809名女性的病历回顾, 她们使用或停止医生处方开具的激素避孕药。

结果: 在调查的1809名女性中, 34.0%停止使用激素避孕: 6.9%无任何方法相关性原因, 20.5%由于较小的副作用, 4.4%由于较重副的作用, 3.8%由于难以依从。不规则出血、体重增加以及头痛是中断的主要原因。服用含有20μg和30μg炔雌醇 (EE) 的药片和阴道环是最常用的避孕方法。与服用药片者相比, 使用阴道环的女性中断频率较少 (p<.005) 。含有20μg和30μg EE的药片中断率相同。静脉血栓是导致药物中断的主要副作用。

结论: 采用现代激素避孕的女性中约1/3中断停药。尽管因次要副作用放弃使用的女性所占百分比低于往常, 且经阴道使用低剂量EE降低了停药率, 医生应告知女性发生副作用的可能性, 并鼓励她们在停药前咨询医生。

Keywords:

• Discontinuation
• ethinylestradiol dose
• hormonal contraceptives
• irregular bleeding
• low-dose pills
• side effects
• vaginal ring

Acknowledgements

With thank P. Lai for her valuable assistance.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.