Newton Victoria Louise, Hoggart Lesley
Research Associate, Faculty of Health and Social Care, The Open University, Milton Keynes, UK.
Senior Lecturer, Faculty of Health and Social Care, The Open University, Milton Keynes, UK.
J Fam Plann Reprod Health Care. 2015 Jul;41(3):210-5. doi: 10.1136/jfprhc-2014-100956. Epub 2014 Oct 27.
Irregular bleeding is one of the most common side effects of hormonal contraception and a key reason for the discontinuation of hormonal methods.
A qualitative study in which 12 young women volunteered to be interviewed in depth, along with six focus group discussions (23 participants). The study had two main research objectives: to document and investigate what young women think and feel about menstruation and contraception, and to explore young women's preferences regarding the intersection of contraceptives and bleeding patterns.
Although participants held a broad view that menstruation can be an inconvenience, they did ascribe positive values to having a regular bleed. Bleeding was seen as a signifier of non-pregnancy and also an innate part of being a woman. A preference for a 'natural' menstruating body was a strong theme, and the idea of selecting a hormonal contraceptive that might stop the bleeding was not overly popular, unless the young woman suffered with painful natural menstruation. Contraceptives that mimicked the menstrual cycle were acceptable to most, suggesting that cyclic bleeding still holds a symbolic function for women.
When counselling young women about the effect of different contraceptive modalities on their bleeding, practitioners should explore how the women feel about their bleeding, including how they might feel if their bleeding stopped or if they experienced erratic bleeding patterns. Practitioners also need to recognise the subjective understanding of the 'natural body' as held by some women, and in these cases to support them in their seeking out of non-hormonal methods of contraception.
不规则出血是激素避孕最常见的副作用之一，也是停用激素避孕方法的关键原因。
一项定性研究，12名年轻女性自愿接受深度访谈，同时进行了6次焦点小组讨论（23名参与者）。该研究有两个主要研究目标：记录和调查年轻女性对月经和避孕的看法与感受，以及探索年轻女性在避孕药具与出血模式交叉方面的偏好。
尽管参与者普遍认为月经可能带来不便，但她们确实赋予了规律出血积极的价值。出血被视为未怀孕的标志，也是女性与生俱来的一部分。对“自然”月经身体的偏好是一个强烈的主题，除非年轻女性遭受痛经折磨，否则选择可能会停止出血的激素避孕药的想法并不受欢迎。大多数人接受模拟月经周期的避孕药，这表明周期性出血对女性仍然具有象征功能。
在向年轻女性咨询不同避孕方式对其出血的影响时，从业者应探讨女性对自身出血的感受，包括如果出血停止或出现不规律出血模式她们可能会有怎样的感受。从业者还需要认识到一些女性对“自然身体”的主观理解，并在这些情况下支持她们寻求非激素避孕方法。
