A survey on Swiss women's preferred menstrual/withdrawal bleeding pattern over different phases of reproductive life and with use of hormonal contraception

Abstract

Background Today, options for bleeding-free lifestyle are actively promoted by the media, the pharmaceutical industry and health specialists. With regard to contraceptive counselling it is important to find out what women really want.

Methods In the present study we collected information on women's attitudes towards monthly bleeding and preferences, if they could have the option to modify their individual bleeding pattern. Furthermore we evaluated the preferences with use of combined hormonal contraceptives (CHCs). Switzerland has never been surveyed before with regard to these issues. Questionnaires were distributed in our family planning clinic and two outdoor offices to clients aged 15 to 19 years, 25 to 34 years, and 45 to 49 years.

Results Of 530 questionnaires, 292 were eligible for analysis. Around 50 of the participants would appreciate having fewer menstrual period-related symptoms. Some 37% preferred experiencing a monthly bleeding; 32% opted for every 2 to 6 months; and 29%, for no bleeding at all. This heterogeneous distribution did not differ between clients with and without menstrual symptoms. With regard to CHC use, predictable bleeding was rated as very positive and breakthrough bleeding as negative.

Conclusion Contraceptive counsellors should be aware that women's wishes differ widely. Predictability of bleeding seems to be more important to them than postponing it.

Chinese Abstract

摘 要 背景 如今媒体、药厂以及健康专家都在积极地倡导选择一种没有月经的生活方式。但是，在做避孕药咨询的时候，了解什么是妇女真正需要的才是至关重要的。

方法 在这项研究中，我们收集关于妇女对月经的态度，以及如果妇女有机会改变她们的月经模式，她们的选择信息。另外，我们评估了使用复方激素避孕药（CHCs）的妇女对月经模式的选择。以往在瑞士还未曾有人做过这方面的调查。在研究中，我们通过我们的计划生育门诊以及两个离苏黎世较近的妇科诊所向15-19岁，25-34岁，45-49岁这三个年龄段的妇女发放调查问卷。

结果 在发出的530份问卷中，有292份是有效的。50%的参加者希望月经期的相关症状是较轻的。37%的妇女希望每月有月经，32%的妇女倾向2-6个月一次，29%的妇女愿意没有月经。是否有月经期的症状并不会影响这种选择差异的分布。在使用避孕药的妇女中，可预测的出血被看做是避孕药最好的作用，而突破性的出血则被认为是最大的副作用。

结论 避孕药的咨询者需要意识到妇女对月经的要求是有很大差异的。对于避孕药的使用，可预测的出血模式比推迟月经更为重要。

Keywords:

• Monthly bleeding
• Irregular bleeding
• Extended cycle
• Hormonal contraceptives
• Women's preferences

ACKNOWLEDGEMENTS

The authors thank all patients who agreed to complete the questionnaire.

Declaration of interest: G.M. serves on advisory boards and has received financial support to undertake research and to speak at conferences, from Bayer HealthCare and Merck/MSD. The other authors report no conflicts of interest. No funding was received for this survey. The authors alone are responsible for the content and the writing of the paper.