Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0041-1741410
Epidemiological Survey on the Perception of Adverse Effects in Women Using Contraceptive Methods in Brazil
Pesquisa epidemiológica sobre a percepção dos efeitos adversos dos métodos contraceptivos por mulheres no Brasil![](https://www.thieme-connect.de/media/10.1055-s-00030576/202201/lookinside/thumbnails/10-1055-s-0041-1741410_200347-1.jpg)
Abstract
Objective The present study aimed to understand patient perception of the adverse effects of contraceptives to improve health care and adherence to treatment.
Methods An online questionnaire was available for women in Brazil to respond to assess their perception of adverse effects and their relationship with contraceptive methods.
Results Of all 536 women who responded, 346 (64.6%) reported current contraceptive use. One hundred and twenty-two (122–34.8%) women reported having already stopped using contraception because of the adverse effects. As for the contraceptive method used, the most frequent was the combined oral contraceptive (212–39.6%). When we calculated the relative risk for headache, there was a relative risk of 2.1282 (1.3425–3.3739; 95% CI), suggesting that the use of pills increases the risk of headache, as well as edema, in which a relative risk of 1.4435 (1.0177–2.0474; 95% CI) was observed. For low libido, the use of oral hormonal contraceptives was also shown to be a risk factor since its relative risk was 1.8805 (1.3527–2.6142; 95% CI). As for acne, the use of hormonal contraceptives proved to be a protective factor, with a relative risk of 0.3015 (0.1789–0.5082; 95% CI).
Conclusion The choice of a contraceptive method must always be individualized, and the patients must be equal participants in the process knowing the expected benefits and harms of each method and hormone, when present.
Resumo
Objetivo Este estudo é destinado a entender a percepção de pacientes sobre os efeitos adversos dos métodos contraceptivos para aprimorar o atendimento médico e a aderência das mulheres ao tratamento.
Métodos Um questionário online foi disponibilizado para que mulheres no Brasil respondessem a fim de avaliar a sua percepção em relação aos efeitos adversos e a associação desses aos métodos contraceptivos.
Resultados Das 536 mulheres que responderam, 346 (64,5%) alegaram uso atual de método contraceptivo. Cento e vinte e duas (122–34,8%) mulheres disseram que já haviam parado o uso de métodos contraceptivos devido aos seus efeitos adversos. Quanto ao método contraceptivo em uso, o mais frequentemente utilizado foi o contraceptivo hormonal oral combinado (212–39,6%). Quando calculamos o risco relativo para cefaleia, foi encontrado um risco relativo de 2,1282 (1,3425–3,3739; 95% intervalo de confiança [IC]), sugerindo que o uso das pílulas aumenta o risco de ocorrência desse efeito adverso, bem como de edema, cujo risco relativo foi de 1,4435 (1,0177–2,0474; 95% IC). Em relação à redução da libido, o uso de contraceptivo hormonal oral combinado foi também considerado um fator de risco, pois seu risco relativo foi 1,8805 (1,3527–2,6142; 95% IC). No que se refere à acne, o uso de contraceptivos hormonais demonstrou ser um fator de proteção, com risco relativo de 0,3015 (0,1789–0,5082; 95% IC).
Conclusão A escolha de um método contraceptivo deve sempre ser individualizada, e as pacientes devem participar igualmente nesse processo sabendo dos benefícios e malefícios esperados de cada método e hormônio, quando presente.
Keywords
contraception - hormonal contraception - drug-related side effects and adverse reactions - gynecology - epidemiologyPalavras-chave
contracepção - contracepção hormonal - efeitos colaterais e reações adversas relacionadas ao uso de medicamentos - ginecologia - epidemiologiaContributors
All authors were involved in the design and interpretation of the analyses, contributed to the writing of the manuscript, as well as read and approved the final manuscript.
Publication History
Received: 16 September 2020
Accepted: 13 October 2021
Article published online:
29 January 2022
© 2022. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
References
- 1 Marcinkow A, Parkhomchik P, Schmode A, Yuksel N. The quality of information on combined oral contraceptives available on the Internet. J Obstet Gynaecol Can 2019; 41 (11) 1599-1607 DOI: 10.1016/j.jogc.2019.01.024.
- 2 United Nations. Department of Economic and Social Affairs. Population Division. Trends in contraceptive use worldwide 2015. New York: UN; 2016
- 3 Abma JC, Martinez GM. Sexual activity and contraceptive use among teenagers in the United States, 2011–2015. Natl Health Stat Rep 2017; 2017 (104) 1-23
- 4 American College Health Association. National College Health Assessment. Spring 2014 Reference Group Executive Summary. Hanover: ACHA; 2014
- 5 Almstedt HC, Cook MM, Bramble LF, Dabir DV, LaBrie JW. Oral contraceptive use, bone mineral density, and bone turnover markers over 12 months in college-aged females. J Bone Miner Metab 2020; 38 (04) 544-554 DOI: 10.1007/s00774-019-01081-1.
- 6 Sitruk-Ware R, Nath A. Characteristics and metabolic effects of estrogen and progestins contained in oral contraceptive pills. Best Pract Res Clin Endocrinol Metab 2013; 27 (01) 13-24 DOI: 10.1016/j.beem.2012.09.004.
- 7 Dinger J, Do Minh T, Heinemann K. Impact of estrogen type on cardiovascular safety of combined oral contraceptives. Contraception 2016; 94 (04) 328-339 DOI: 10.1016/j.contraception.2016.06.010.
- 8 Schindler AE, Campagnoli C, Druckmann R, Huber J, Pasqualini JR, Schweppe KW. et al. Classification and pharmacology of progestins. Maturitas 2003; 46 (Suppl. 01) S7-S16 DOI: 10.1016/j.maturitas.2003.09.014.
- 9 Bryant KD. Contraceptive use and attitudes among female college students. ABNF J 2009; 20 (01) 12-16
- 10 Huber LR, Ersek JL. Contraceptive use among sexually active university students. J Womens Health (Larchmt) 2009; 18 (07) 1063-1070 DOI: 10.1089/jwh.2008.1131.
- 11 Ponce de Leon RG, Ewerling F, Serruya SJ, Silveira MF, Sanhueza A, Moazzam A. et al. Contraceptive use in Latin America and the Caribbean with a focus on long-acting reversible contraceptives: prevalence and inequalities in 23 countries. Lancet Glob Health 2019; 7 (02) e227-e235 DOI: 10.1016/S2214-109X(18)30481-9.
- 12 Lindh I, Skjeldestad FE, Gemzell-Danielsson K, Heikinheimo O, Hognert H, Milsom I. et al. Contraceptive use in the Nordic countries. Acta Obstet Gynecol Scand 2017; 96 (01) 19-28 DOI: 10.1111/aogs.13055.
- 13 Challa S, DeLong SM, Carter N, Johns N, Shakya H, Boyce SC. et al. Protocol for cluster randomized evaluation of reaching married adolescents - a gender-synchronized intervention to increase modern contraceptive use among married adolescent girls and young women and their husbands in Niger. Reprod Health 2019; 16 (01) 180 DOI: 10.1186/s12978-019-0841-3.
- 14 Pekkurnaz D. Employment status and contraceptive choices of women with young children in Turkey. Fem Econ 2020; 26 (01) 98-120 DOI: 10.1080/13545701.2019.1642505.
- 15 Curtis KM, Tepper NK, Jatlaoui TC, Berry-Bibee E, Horton LG, Zapata LB. et al. U.S. medical eligibility criteria for contraceptive use, 2016. MMWR Recomm Rep 2016; 65 (03) 1-103 DOI: 10.15585/mmwr.rr6503a1.
- 16 Maroo A, Chahine J. Contraceptive strategies in women with heart failure or with cardiac transplantation. Curr Heart Fail Rep 2018; 15 (03) 161-170 DOI: 10.1007/s11897-018-x.
- 17 Cooper DB, Mahdy H. Oral contraceptive pills. In: StatPearls [Internet]. Treasure Island: StatPearls Publishing; 2021. [cited 2021 Jan 20]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430882/
- 18 Gomez AM, Freihart B. Motivations for interest, disinterest and uncertainty in intrauterine device use among young women. Matern Child Health J 2017; 21 (09) 1753-1762 DOI: 10.1007/s10995-017-2297-9.
- 19 Kavanaugh ML, Jerman J. Contraceptive method use in the United States: trends and characteristics between 2008, 2012 and 2014. Contraception 2018; 97 (01) 14-21 DOI: 10.1016/j.contraception.2017.10.003.
- 20 Moreau C, Cleland K, Trussell J. Contraceptive discontinuation attributed to method dissatisfaction in the United States. Contraception 2007; 76 (04) 267-272 DOI: 10.1016/j.contraception.2007.06.008.
- 21 Wassmann K, Wassmann S, Nickenig G. Progesterone antagonizes the vasoprotective effect of estrogen on antioxidant enzyme expression and function. Circ Res 2005; 97 (10) 1046-1054 DOI: 10.1161/01.RES.0000188212.57180.55.
- 22 Pakalnis A. Migraine and Hormones. Semin Pediatr Neurol 2016; 23 (01) 92-94 DOI: 10.1016/j.spen.2016.01.005.
- 23 Delaruelle Z, Ivanova TA, Khan S, Negro A, Ornello R, Raffaelli B. et al. European Headache Federation School of Advanced Studies (EHF-SAS). Male and female sex hormones in primary headaches. J Headache Pain 2018; 19 (01) 117 DOI: 10.1186/s10194-018-0922-7.
- 24 Martin VT, Behbehani M. Ovarian hormones and migraine headache: understanding mechanisms and pathogenesis–part 2. Headache 2006; 46 (03) 365-386 DOI: 10.1111/j.1526-4610.2006.00370.x.
- 25 Ju Q, Tao T, Hu T, Karadağ AS, Al-Khuzaei S, Chen W. Sex hormones and acne. Clin Dermatol 2017; 35 (02) 130-137 DOI: 10.1016/j.clindermatol.2016.10.004.
- 26 Caglayan EK, Seçkin L, Goçmen Y, Okur A, Arslan E, Serin HI. et al. Mastalgia assessment and hormonal correlations in patients with polycystic ovary syndrome. Gynecol Obstet Reprod Med. 2015; 21 (01) 18-21
- 27 Moideen Nafseer TA, Sunil Krishna M, Rajgopal Shenoy K. Clinical profile of cyclical and noncyclical mastalgia. New Indian J Surg. 2018; 9 (06) 764-770 DOI: 10.21088/nijs.0976.4747.9618.14.
- 28 Tanaka Y, Mori T, Ito F, Koshiba A, Kusuki I, Kitawaki J. Effects of low-dose combined drospirenone-ethinylestradiol on perimenstrual symptoms experienced by women with endometriosis. Int J Gynaecol Obstet 2016; 135 (02) 135-139 DOI: 10.1016/j.ijgo.2016.05.004.
- 29 Boozalis A, Tutlam NT, Chrisman Robbins C, Peipert JF. Sexual desire and hormonal contraception. Obstet Gynecol 2016; 127 (03) 563-572 DOI: 10.1097/AOG.0000000000001286.