Abstract
BackgroundWomen in the US have access to various hormonal contraceptive methods that can regulate menstruation. This study examined the attitudes and perceptions of reproductive-aged women toward contraceptive methods, including how menstrual regulation and suppression preferences influenced contraceptive choice.MethodsData collection used a mixed-methods approach, including 6 focus groups (n = 61), individual interviews (n = 18), and a web-based survey (n = 547).ResultsParticipants described contraceptive method preferences that allowed monthly bleeding and daily control, expressing concerns about long-acting reversible contraception (LARC) because of decreased user involvement. Some participants noted LARC improved their menstrual control. Many participants felt menstruation was healthy, whereas suppression was abnormal and resulted in negative health outcomes. Though participants indicated LARC as beneficial (M = 4.99 ± 1.66), convenient (M = 5.43 ± 1.68), and healthy (M = 4.62 ± 1.69), they chose combined oral contraceptives due to convenience.ConclusionsFindings suggest women need more information about menstrual regulation and suppression before selecting a contraceptive method, specifically in relation to LARC versus combined oral contraception. Framing menstrual suppression as healthy and natural may improve perceptions of long-term health consequences related to LARC. Providers should discuss menstrual suppression safety to ensure selection of contraceptive options aligning with women’s preferences and needs.
Highlights
Women in the US have access to various hormonal contraceptive methods that can regulate menstruation
Some COCs allow for monthly bleeding, while long-acting reversible contraception (LARC) methods can cease menstruation completely [18]
Qualitative results: focus group and interview findings Qualitative analysis revealed three themes related to perceptions of menstrual suppression when choosing a contraceptive method
Summary
Women in the US have access to various hormonal contraceptive methods that can regulate menstruation. This study examined the attitudes and perceptions of reproductive-aged women toward contraceptive methods, including how menstrual regulation and suppression preferences influenced contraceptive choice. Frequent menstruation may increase ovarian, endometrial, and breast cancer risk [7] and menstruation-related symptoms, such as DeMaria et al BMC Women's Health (2019) 19:125. Contraceptive choice may relate to factors including cost, knowledge, access, and side effects, like menstrual suppression [15, 16]. Some COCs allow for monthly bleeding, while LARC methods can cease menstruation completely [18]. COCs are primarily discussed as an option for menstrual regulation and suppression; the hormonal IUD and implant may reduce or cease monthly menstruation [7, 8, 18]. The COC 21/7 regimen was designed for women and providers who believe monthly bleeding is natural and healthy [2, 5]; yet, this bleeding results from hormonal withdrawal, not from the biological cycle, and offers no medical benefits [7, 19]
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