Long Term Follow Up of Women Using Reversible Contraceptive Methods-Conclusions from Combining Data of 3 Different Audits

Abstract

Objective: The matter of the choice of the available contraceptive methods has increased in the last few years. Physicians have a wide range of contraceptive methods to choose but in the same time are in a big concern about the appropriate type of contraception they should select for their patient and the effects in woman’s health and couple’s wellbeing. We present the outcome of 3 different audits in a large population of Northern Greece and we discuss the outcome of their results. Method: Three different audits studied medical data from 14.880 women, of different ages, which presented to the outpatient family planning clinic of our hospital. They were all interviewed using a standardized questionnaire, from which we got important information about behavior, the use, effects and reactions of contraceptive methods. The only exclusion criterion from the study was the use of the pill for less than three months, removal of IUD in less than three months, failure to attend for follow up and women who had moved away from the geographical area. The data of our analysis were retrospectively selected from the case files of 11.129 women between 15 to 40 years old, who used reversible contraception between the years 1984-2011. Results: In the first audit, 2120 women participated, users of any type of oral contraceptive pills? They gave information about the satisfaction, the side-effects and the main reasons of discontinuing the use of the pill. In the second audit 9009 women chose different types of Intrauterine Devices (IUD) as a contraceptive method. All of them have been examined in outpatient department and they have been checked for the safety of their IUD in correlation with unexpected pregnancy. Data about outcome, side effects and unexpected pregnancies were recorded. The third audit refers to the concerns about the use of oral sex steroids in relationship with cervical cancer and pathology in smear test. In the IUD group, we had more often results of inflammatory changes, negative for malignancy, in comparison with the contraceptive pill group. There was not statistically significant difference between the two groups regarding low and high grade squamous intraepithelial lesions (LGSIL/HGSIL). Conclusions: By studying the results of all these audits, we can get some important information about the behavior, the side-effects and ways of improving the usage of all types of reversible contraception. These results can be used as a baseline from which to monitor trends in the use of contraception in correlation to similar studies.