Nelson Anita L, Cohen Stephen, Galitsky Alex, Hathaway Mark, Kappus Dale, Kerolous Majid, Patel Kiren, Dominguez Linda
Western University of Health Sciences, Pomona, CA, USA.
SUNY Upstate Medical University & Women's Wellness Place, Syracuse, NY, USA.
Contraception. 2018 Mar;97(3):256-273. doi: 10.1016/j.contraception.2017.09.010. Epub 2017 Sep 25.
The aim of this survey was to understand US women's contraception journey from her first prescribed method to her current one including reasons for choosing and stopping/switching methods, healthcare provider relationships, and bleeding preferences.
We administered a nationally-representative, web-based survey of US women aged 16 to 50 years currently using (N=1656) or had previously used (N=1448) prescription contraception, or who had never used it but would consider using it in the future (N=103). Statistical analyses were based on overlap formulae with sample weights adjusted to 2010 US census demographic benchmarks.
The survey was sent to 11,906 women, and 5957 responded (50% response rate). Among qualified respondents, 3104 had experience with prescription contraception. Oral contraceptives (OC) remain the most frequently prescribed method as first or subsequent contraception. However, as women switch to their current prescription method, more chose IUD contraception. As reported by respondents, only 48% of current users received counseling on how to use specific methods, and 58% were counseled on bleeding patterns to expect, while 67% were offered counseling on potential side effects. Many of the side effects reported in this study for first and current prescription contraception were nonspecific and may be related to a nocebo effect, lack of understanding about normal bodily fluctuations, or poor compliance. Many women (34%) reported 'making their periods lighter' as a reason for using their current prescription method, and 53% would prefer to skip their monthly period altogether.
Misperceptions about contraception are common, and prescription contraception choice can be quite complex. Clinicians can enhance patient satisfaction by providing adequate information and matching methods to women's lifestyles, reproductive choices, and pregnancy risk.
This study provides insight into modern women's attitudes and views toward prescription contraception that may be important to clinicians and women themselves.
本次调查旨在了解美国女性从首次处方避孕方法到当前使用的避孕方法的历程，包括选择和停止/更换方法的原因、与医疗保健提供者的关系以及对出血情况的偏好。
我们对16至50岁的美国女性进行了一项具有全国代表性的基于网络的调查，这些女性目前正在使用（N = 1656）或曾经使用过（N = 1448）处方避孕方法，或者从未使用过但未来会考虑使用（N = 103）。统计分析基于重叠公式，样本权重根据2010年美国人口普查的人口统计基准进行调整。
该调查共发送给11906名女性，5957人回复（回复率50%）。在合格受访者中，3104人有过处方避孕经历。口服避孕药（OC）仍然是首次或后续避孕时最常开具的方法。然而，随着女性更换为当前的处方避孕方法，更多人选择了宫内节育器避孕。据受访者报告，只有48%的当前使用者接受了关于如何使用特定方法的咨询，58%的人接受了关于预期出血模式的咨询，而67%的人接受了关于潜在副作用的咨询。本研究中首次和当前处方避孕报告的许多副作用都不具有特异性，可能与反安慰剂效应、对正常身体波动缺乏了解或依从性差有关。许多女性（34%）报告称“使月经量减少”是使用当前处方避孕方法的原因，53%的女性更希望完全跳过每月的月经。
对避孕的误解很常见，处方避孕方法的选择可能相当复杂。临床医生可以通过提供充分信息并使方法与女性的生活方式、生殖选择和怀孕风险相匹配来提高患者满意度。
本研究深入了解了现代女性对处方避孕的态度和看法，这对临床医生和女性自身可能都很重要。
