Contraceptive counselling and self-prescription of contraceptives of German gynaecologists: Results of a nationwide survey

Abstract

Objective To evaluate the attitude toward contraceptive methods of gynaecologists who, in Germany, are the sole prescribers of contraceptives.Methods An anonymous questionnaire was sent to 9545 gynaecologists inquiring about factors involved in their prescription of contraceptives, the contraceptives they preferred, and those they would recommend to their daughter, if they had one.Results The response rate of this survey was 21% (N = 2016). The combined oral contraceptive (COC) was the most commonly prescribed method followed by the levonorgestrel-releasing intrauterine system (LNG-IUS), the vaginal ring, the progestin-only pill (POP), the patch, and the progestin-only injectables. Of the respondents 51% would never prescribe the patch and 45% would never prescribe the hormonal implant at all; 61% would choose the LNG-IUS for themselves/for their partner; 18% would opt for a COC and 8% for the vaginal ring. Concerning their imaginary daughter, 71% would prefer a COC, 26% the ring, and 9% the LNG-IUS. The first counselling session lasted 13.8 ± 4.9 min, and the provision of information on the occasion of following visits 6.6 ± 3.2 min.Conclusion The contraceptives most prescribed by German gynaecologists were COCs, followed by the LNG-IUS, the vaginal ring, and POPs. The spectrum of contraceptives preferred for personal use differed in some ways from those prescribed to patients. Reasons for this discrepancy should be investigated.Chinese 摘要 目的 评估德国妇科医生对避孕方法的态度，在德国这些医生具有独自处方权。方法 共计9545名妇科医生参与了匿名问卷调查，问题包括避孕药具处方的相关因素、他们更愿意选择的避孕药具、他们会推荐给自己女儿（如果有）的避孕药具。结果 调查的有效反馈率为21%（N = 2016）。复方口服避孕药（COC）在处方中应用最普遍，其次为左炔诺孕酮宫内缓释系统（LNG-IUS）、阴道环、单孕激素片剂（POP）、贴片以及单孕激素注射。数据显示，有51%的医生不会处方激素贴片，45%不会处方激素埋植；61%倾向于为自己或伴侣选择LNG-IUS；18%选择COC，8%选择阴道环。若有女儿，71%的妇科医生会为其选择COC，26%选择避孕环，9%选择LNG-IUS。第一次咨询会平均时长13.8±4.9分钟，随后的信息补充访问时长6.6±3.2分钟。结论 德国妇科医生处方中最常选用的避孕方式为COCs，之后依次为LNG-IUS、阴道环和POPs。但医生在个人选择避孕药时与给患者的处方建议有所不同，这一差异的原因需要进一步研究。