Effects of combined hormonal contraception on health and wellbeing: Women's knowledge in northern Italy

Abstract

Objectives We investigated levels of knowledge of the effects of combined hormonal contraceptives (CHCs) on general/reproductive health and physical/psychosexual wellbeing.

Methods A cross-sectional study was conducted in two university hospitals in northern Italy. Healthy current-, past- and never CHC users (n = 545; age 18–44 years) completed a self-administered questionnaire.

Results Ninety-three percent of current-, 74% of past-, and 56% of never users believed they were sufficiently informed (χ²: 67.1; p = 0.001) about the benefits and risks of CHCs. Respondents mentioned: (i) a reduced risk of ovarian (67%) and endometrial (53%) cancer; (ii) an increased risk of thrombosis (82%); (iii) an increased risk of breast cancer (45%); (iv) a decreased fertility (19%) and no influence on risk of sexually transmitted infections (48%); (v) a reduced risk of menstrual abnormalities (77%) and acne (79%); (vi) less dysmenorrhoea (83%) and more headache (56%), weight gain (74%), increased appetite (51%), leg cramps (77%), mood swings (45%), vaginal dryness (47%), and low sex drive (48%). Beliefs about diseases/conditions and symptoms were influenced by CHC use.

Conclusions CHC use is linked to good knowledge of risks and benefits. Our data suggest HCPs must be proactive in providing relevant information so that women can choose their contraception with a balanced insight of side effects.

Chinese Abstract

摘要：

目的我们调查复方激素避孕药（CHCs）对全身/生殖健康以及身体/心理健康影响的知识水平。

方法一项横断面研究在意大利北部的两所大学医院进行。目前使用、过去使用和从没使用CHC的受访者（N =545；年龄18–44岁）完成自填问卷。

结果93%目前使用CHC、74%过去使用CHC和56%从没使用CHC的受访者认为他们被充分告知了CHC的好处和风险（χ²: 67.1；p =0.001）。受访者提到：（i）卵巢癌的风险降低（67%）和子宫内膜癌的风险降低（53%）；（ii）血栓形成的风险增加（82%）；（iii）乳腺癌的风险增加（45%）；（iv）生育率降低（19%），对性传播疾病的风险没有影响（48%）；（v）月经异常的风险降低（77%）、痤疮的风险降低（79%）；（vi）痛经减少（83%）、头痛增加（56%），体重增加（74%），食欲增加（51%），小腿抽筋（77%），情绪波动（45%），阴道干涩（47%），和性欲降低（48%）。使用CHC使其对疾病/健康状况和症状的观念受到了影响。

结论CHC使用与良好的风险和受益的知识相关。我们的数据表明，医疗专业人员必须主动提供相关信息，从而使女性能平衡各种副作用后选择他们的避孕方法。

Keywords:

• Combined hormonal contraceptives
• Knowledge
• Risk
• Women
• Northern Italy

ACKNOWLEDGEMENTS

The authors are indebted to Bayer Pharma, Italy, for an unrestricted university grant to support this project (costs related to the printing of the questionnaires). They are also grateful to the Office for linguistic services at the University of Pavia for editorial assistance and language revision.

Declaration of interest: Dr Nappi has financial relationships (lecturer, member of advisory boards, and/or consultant) with Bayer Pharma, Eli Lilly, Gedeon Richter, HRA Pharma, MSD, Novo Nordisk, Pfizer Inc., Shionogi and Teva/Theramex. Dr Chiara Benedetto has received lecture fees, is a member of advisory boards and/or is a consultant for Bayer, MSD, Pfizer Inc. and Teva/Theramex. None of the other authors report any conflict of interest.