Abstract
Abstract
Background: Oral contraceptives are the most widely used hormonal contraceptive among young Norwegian women, yet the younger age groups demonstrate high rates of unplanned pregnancies and induced abortions. The aim of this investigation was to increase the understanding of how frequent users of oral contraceptives experience side effects, if side effects are more common among certain types of oral contraceptives and whether side effects are associated with reduced compliance or discontinuation of oral contraceptives.
Method: We wanted to investigate how the topics presented themselves among users of SUSS, a health information service for young adults. Web inquiries in the SUSS database from 2005-2009 were searched for brands of oral contraceptives, side effects and reduced compliance. Results were descriptively presented. For the literature presentation the following search words were used: oral contraceptives, side effects, adverse effects, dissatisfaction, compliance and discontinuation.
Findings: Among 2420 SUSS requests about oral contraceptives 46 % mentioned side effects. Among those bleeding was the most frequently reported side effect, in 18 % of the inquiries, and the rate varied from 37 % to 63 % for different brands. Estrogen related side effects were reported by 7 % and progesterone related side effects by 10 %. In comparing high dose and low dose oral contraceptives, users of low dose oral contraceptives reported a higher rate of bleeding (20 %) than the high dose users (16 %). Estrogen related side effects were not found to be more common among users of high dose oral contraceptives (7 %) compared to low dose oral contraceptives (6 %), nor were progesterone related side effects or other side effects shown to be of different occurrence between the groups. 22 % of the inquiries concerned reduced compliance or discontinuation of oral contraceptives. The rate varied from 5 % to 28 % for different brands. Brands with a high rate of reported side effects were not found among those with the highest rates of reduced compliance or discontinuation. Among users of high dose oral contraceptives 24 % reported bleeding as a side effect, and 16 % of the requests concerned reduced compliance or discontinuation, among users of low dose oral contraceptives the corresponding values were 20 % and 20 %.
Conclusion: The results from the SUSS database show that bleeding is the most commonly reported side effect among users of oral contraceptives, and that there is a higher incidence of bleeding among users of low dose oral contraceptives. The results did not display a clear association between side effects and reduced compliance or discontinuation. Doctors, midwifes and nurses have an important function in caring for young users of oral contraceptives through careful counseling about side effects to increase compliance and reduce the incidence of unplanned pregnancies.