Doctoral candidate, Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA,
Associate professor, Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA.
Int Perspect Sex Reprod Health. 2020 Dec 31;46:247-262. doi: 10.1363/46e1520.
Women's concerns about contraceptive-induced menstrual changes can lead to method discontinuation and nonuse, contributing to unmet need for contraception. Research on women's perceptions of amenorrhea related to longer acting methods and in low-income countries is limited.
Data were from nationally representative household surveys and focus group discussions with women of reproductive age conducted in Burkina Faso and Uganda in 2016-2017. Bivariate cross-tabulations and multivariate logistic regression analyses were used to examine sociodemographic and reproductive characteristics associated with women's attitudes about contraceptive-induced amenorrhea (n=2,673 for Burkina Faso and 2,281 for Uganda); menstrual health determinants were also examined for Burkina Faso. Qualitative data from focus group discussions were analyzed to understand reasons behind women's attitudes and how they influence contraceptive decision making.
Sixty-five percent of women in Burkina Faso and 40% in Uganda reported they would choose a method that caused amenorrhea during use. In Burkina Faso, the predicted probability of accepting amenorrhea was higher for women aged 15-19 (compared with older women), living in rural areas, married and cohabiting (compared with never married), currently using a contraceptive method (compared with never users) and from Mossi households (compared with Gourmantché); menstrual health practices were not associated with amenorrhea acceptability. In Uganda, the least wealthy women had the highest predicted probability of accepting amenorrhea (51%). Qualitative analysis revealed a variety of reasons for women's attitudes about amenorrhea and differences by country, but the relationship between these attitudes and contraceptive decision making was similar across countries.
Addressing misconceptions about contraception and menstruation may result in more informed method decision making.
女性对避孕引起的月经变化的担忧可能导致方法中断和不使用，从而导致避孕需求未得到满足。关于长效方法和低收入国家与闭经相关的女性认知的研究有限。
数据来自布基纳法索和乌干达 2016-2017 年进行的全国代表性家庭调查和育龄妇女焦点小组讨论。使用双变量交叉表和多变量逻辑回归分析来检查与女性对避孕引起的闭经的态度相关的社会人口学和生殖特征（布基纳法索 n=2673，乌干达 n=2281）；还检查了布基纳法索的月经健康决定因素。对焦点小组讨论的定性数据进行了分析，以了解女性态度背后的原因以及它们如何影响避孕决策。
布基纳法索 65%的妇女和乌干达 40%的妇女报告说，她们会选择在使用过程中导致闭经的方法。在布基纳法索，15-19 岁的女性（与年龄较大的女性相比）、居住在农村地区、已婚和同居（与从未结婚的女性相比）、目前使用避孕方法（与从未使用过的女性相比）和莫西家庭（与 Gourmantché 相比）接受闭经的可能性更高；月经健康实践与闭经的可接受性无关。在乌干达，最不富裕的妇女接受闭经的可能性最高（51%）。定性分析揭示了女性对闭经的态度的各种原因，以及国家之间的差异，但这些态度与避孕决策之间的关系在两国之间是相似的。
解决避孕和月经方面的误解可能会导致更明智的方法决策。
