Contraceptive Side Effects Research Articles

Experiences and impacts of side effects among contraceptive users in the UK: exploring individual narratives of contraceptive side effects

Purpose While many women worldwide use contraception, there is a paucity of research on individual experiences of side effects. To address this gap, we investigated individual’s contraception experiences. Methods Women aged 18 to 35, living in the UK were invited to participate in an online survey on contraception. Free text responses were collected. Through a directed content analysis approach, we developed a coding framework (based on existing literature and initial response review) including six themes; method(s) of contraception, side effect(s) experienced, impact of side effect(s), timing of side effect(s), interactions with healthcare practitioners, and trial-and-error. Results Overall, 337 participants provided free-text responses. Side effect experiences and impacts varied greatly between individuals and contraceptives. Most participants described negative effects, including mental health issues and bleeding problems. However, some shared positive experiences mainly related to bleeding management or the absence of side effects. Participants described how side effects often varied or appeared over time. Some participants felt unheard by healthcare practitioners. Conclusions This study highlights how specific contraceptive experience is to the individual. We advocate for a patient-centred approach to contraceptive counselling. Practitioners should play an active role in improving contraception prescription, acknowledging the diverse experiences and preferences of patients.

'They will be like a person with a disease': a qualitative investigation of variation in contraceptive side-effect experiences in Central Oromia, Ethiopia.

Contraceptive side effects are consistently given as the main reason why women are dissatisfied with contraception or choose not to use it. However, why some women suffer more from side effects remains unknown. Through inductive analysis of in-depth interviews and focus group discussions with 40 contraceptive users and 3 key informants in Central Oromia, Ethiopia, we explored women's rationales for variation in side-effect experiences. The data first reveal the wide diversity in type and severity of side-effect experiences reported by users of contraception. Second, we found that women's rationales for why some individuals suffer more side effects from contraception invoke economic and physical hardship (food insecurity and heavy workloads), as well as interindividual differences in biology (one's blood must 'fit' with contraception). Finally, the analysis revealed the tension many women face in trying to negotiate the trade-off between the consequences of these side effects and those of an unwanted pregnancy. The results show the value of using a biosocial approach, which centres women's voices and experiences, for informing the measurement of contraceptive side effects within population health surveys and clinical trials. Additionally, the findings helpgain an understanding of how an individual's social, biological, and cultural contexts drive variation in when and why different side effects manifest.

From data to decisions: Exploring family planning services utilization in Karnataka and India through the prism of NFHS-4 and NFHS-5.

Family planning (FP) services are pivotal in assessing a country's healthcare efficacy. Despite India's strides in FP promotion, disparities persist in its utilization rates. This study analyzes Karnataka's FP trends by using National Family Health Survey (NFHS) rounds 4 and 5, comparing its indicators with national averages. A retrospective record review-based descriptive study design was employed. Data from NFHS-4 (2015-16) and NFHS-5 (2019-21) were analyzed using MS Excel 365. Key variables included age at marriage, total fertility rate (TFR), and various contraceptive methods. Karnataka exhibited a stable rate of early marriages for women and a decline among men aged 25-29 years. TFR in Karnataka slightly decreased, with increased contraceptive usage and significant growth in modern contraceptive methods. However, male sterilization rates remained low. There was an improvement in health workers' engagement with female non-users and in providing information on contraceptive side effects. While Karnataka has progressed in FP, challenges such as early marriages persist. Enhancing integration, leveraging technology, and empowering women are essential for comprehensive FP services in India.

Joint decision on contraceptive use and determinant factors among married women of reproductive ages (15–49) in Ethiopia: a multilevel analysis using Ethiopian Demographic and Health Survey; 2016 data

BackgroundContraceptive usage in Ethiopia is significantly influenced by the decision-maker at the household level. Joint decision-making involving both women and their husbands/partners is considered ideal for improving contraceptive uptake among women and for managing health outcomes related to contraceptive side effects. However, there is a lack of substantial evidence regarding the prevalence and impact of joint decision-making on contraceptive use in Ethiopia. Therefore, the current study aimed to assess the magnitude of joint decision-making on contraceptive use and its determinant factors among married, contraceptive-using, reproductive-age women in Ethiopia.MethodsThis study was conducted based on the Ethiopian Demographic and Health Survey (EDHS) 2016 data. A total weighted sample of 3,669 married, contraceptive-using, reproductive-age women were included in the study. Multilevel logistic regression was employed due to the hierarchical nature of the data. Variables with a p-value of ≤ 0.2 in the bivariate multilevel analysis were included in the multivariable multilevel analysis. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to determine the direction and strength of associations. Variables with a p-value of < 0.05 in the multivariable multilevel analysis were considered statistically significant for joint decision-making on contraceptive use.ResultsThe prevalence of joint decision-making on contraceptive use in Ethiopia was 78.81% [95% CI: 71.35-74.23%]. Several factors were found to be statistically significant in relation to joint decision-making on contraceptive use: Women educational level primary, secondary, and higher (Adjusted odds’ ratio (AOR = 1.5; CI 1.2–1.9), (AOR = 1.9; CI 1.3–2.9), and (AOR = 2.1; CI 1.2–3.5) respectively, protestant in religion (AOR = 1.7; CI 1.7–2.5), wealth status rich (AOR = 1.4; CI 1.1–1.9), media exposure (AOR = 1.4; CI 1.1–1.9), and community poverty high (AOR = 0.6; CI 0.6–0.9).ConclusionsIn Ethiopia, the majority of contraceptive users are married, reproductive-age women, and their decision to use contraceptives is typically made jointly with their husbands or partners. Factors positively associated with joint decision-making on contraceptive use include women’s educational level (primary, secondary, and higher), being Protestant, having a higher wealth status, and media exposure. Conversely, women living in communities with high poverty levels are less likely to make joint decisions about contraceptive use. Health care providers, health care programmers and policy makers should be focused on these determinant factors to enhance joint decision-making in women’s contraceptive use in Ethiopia.

Understanding factors affecting the acceptance of post-abortion contraception: A comprehensive analysis

To assess the proportion of post-abortion contraceptive acceptance and the determinant factors in the utilization of contraception. It is a prospective observational study done on 468 women who presented for abortion care in a tertiary care centre. Data were collected using a pre-structured questionnaire, counselled for contraceptive usage. The family planning method accepted was noted and followed up after one month. Data were analysed using descriptive statistics and expressed in the form of frequency and percentages. In the present study, the magnitude of acceptance of post-abortion contraception was 73.08%. Most women were in the age group 21-30 years (62.82%), the majority belonged to lower socioeconomic status (43.16%), 78.62% were homemakers. Age of the women, education status, and history of the previous usage of contraception showed a positive association with acceptance of post-abortion contraception. The most accepted method was tubectomy (24.35%) followed by barrier contraception (20.51%). During follow-up after 1 month, 69.24% were willing to continue the same method and 5.1% opted for a change in the contraceptive method. The common determinant factors for not opting for post-abortion contraception were due to religious belief, partner opposition, fear of side effects of contraceptive methods and willingness to concieve again shortly. The proportion of post-abortion family planning utilization is good but could be improved. Education before and especially at the time of abortion strongly influenced the usage of family planning services especially in rural areas where the accessibility is comparatively low. Family planning counseling during the time of abortion plays an important role in accepting post-abortion family planning services. At all levels of health care, family planning counseling and services should be provided to those who come for abortion to reduce maternal morbidity and mortality.

A comprehensive analysis of contraceptive safety: Implications for gynecological health and education levels

The use of contraceptives is essential for lowering the net reproduction rate and stabilizing population growth. Developing countries are characterized by high birth rates and rapid population growth. With lower contraceptive usage rates among eligible couples and resistance towards family planning methods, achieving population stabilization seems challenging. Therefore, this study aims to study the effects of various contraceptive methods on gynecological health and their safety profiles, The present observational study, was conducted in Department Obstetrics and Gynaecology at tertiary health care centre, Panjab, India. A total of 450 women were evaluated with the help of a pre-designed and pre-tested questionnaire to address knowledge, awareness, and perception of contraception among the rural and urban population in Punjab. The data were collected and analysed.All the participants were known to the traditional contraception and only few were aware about the modern contraception. Participants preferred tubal ligation (43.78%) over vasectomy (75.78%) and rarely considered hysterectomy (1.11%). Most knew about male condoms (99.56%) but fewer about female condoms (0.44%). Among the participants, 59.78% were aware of contraception side effects. Regarding condom use, opinions were divided, with 48.67% in favor and 51.33% against. Educated individuals were aware of contraception but not its major side effects. Therefore, we suggest investigating social, cultural, and knowledge aspects to improve understanding.

Patient-Centered Care in Action: How Clinicians Respond to Patient Dissatisfaction with Contraceptive Side Effects.

Patient-centered care is widely cited as a component of quality contraceptive health care, but its operationalization in clinical interaction is contested. This article examines patient-centered care as an interactional phenomenon using the case of patient dissatisfaction with side effects of hormonal contraceptive medications. Drawing on transcript data from 109 tape-recorded reproductive health visits, I find that provider responses to treatment dissatisfaction range from patient-centered to relatively authoritarian. Providers typically offer patient-centered responses that validate patient experiences and integrate them into contraceptive counseling and method selection. At the same time, explicit communication about patients' contraceptive priorities is rare. In its absence, providers use patient-centered communication to smooth the interactional path toward uptake of highly effective hormonal methods, mostly ignoring the possibility that some patients may prefer less effective methods. Patient-centered contraceptive care was circumscribed by the clinical goal of pregnancy prevention.

The Relationship Between the Use of Injectable Contraceptives and Changes in Body Weight

Background: Injectable contraception is a contraceptive method made into a liquid and injected into the body. Some contain estrogen and progesterone once a month, but some only contain progesterone every three months. The most frequent side effect of contraception is weight gain. Depo Medroxy Progesterone Acetate (DMPA) stimulates the appetite control center in the hypothalamus, which causes acceptors to overeat. Excessive weight gain causes a number of diseases, such as obesity, hypertension, diabetes, and heart disease.Objective. Purpose : this study aims to analyze the relationship between the provision of injectable contraception and weight changes in PMB "X" Cilincing District, North Jakarta. Method : this type of research is quantitative with a cross-sectional design. The population is all KB acceptors at PMB NY "X" Cilincing District, North Jakarta, in 2022, totaling 110 respondents, and the sample is total sampling. Data processing with SPSS using the chi-square test. Results : The highest age is 20-35 years old, 78 (70.9%) people; most respondents have a college education, 49 (44.5%) people; more than half of respondents are homemakers, 61 (55.5%) people; the highest parity is one person, 63 (57.3%) people, and the longest time as a KB acceptor, the most respondents are more than one year, 65 (59.1%) people. In this study, it was also reported that respondents who experienced weight gain were 89 (90.9%) people, and 87 (79.1%) used a 3-month injection KB. The results of the statistical test obtained a value of p = 0.000 (p &lt;0.05), which indicates a relationship between injection contraception and weight changes. Conclusion : There is a relationship between injection contraception and weight changes with a value of p = 0.000 (p &lt;0.05).

Low Usage of Modern Contraceptives Among Women of Reproductive Age in Tanzania: Analysis Beyond Availability and Awareness Factors

Most studies on contraceptives have linked low use with awareness and problems of availability. However, these studies have not considered low or discontinuation of use of contraceptives to be a positive phenomenon where women exercise their reproductive rights or autonomy. Hence, this article has adopted a Marxist-Feminist theory of contraceptives to examine the association between socio-demographic factors and low usage of contraceptives among women of reproductive age. It also evaluates the influence of the availability and awareness on the use or non-use of contraceptives among such a group of women. The article is based on a cross- sectional case study conducted in Kigoma Rural District, Tanzania. The data were collected through questionnaires modified from TDHS, interviews with nurses, and an in-charge of a health facility. Secondary data were collected from TDHS (2016, 2022), Tanzania Service Delivery Point report, Stock Inventory Charts and Our World data sets. Quantitative analysis was performed through STATA 14, and secondary data was processed through content analysis. The study found that though the majority of the reproductive age are aware of contraceptives, most (80%) have not used them. We do not treat this as a problem, but an exercise of reproductive rights and autonomy by women. In addition, there is no significant evidence to prove any influence of socio-demographic factors on low use of contraceptives. Low use and discontinuation of contraceptives are associated with the need for more children by women, and the side effects of contraceptives. Therefore, we conclude that women should be left to decide when and how to use contraceptives: they should not be forced through direct or indirect health services.

Contraceptive Utilization and Perceived Spousal Involvement among Female Employees of Child-bearing Age in a Private University in Ogun State, Nigeria

Objective: This study assessed the utilization and perceived spousal involvement in contraceptive use among female employees of child-bearing age in a private university in Nigeria. Methods: This was a descriptive cross-sectional study of 270 women who were selected using a purposive sampling method. A structured interviewer-administered questionnaire was used to elicit data. Contraceptive utilization was assessed as ever or never utilized. Perception of male involvement was graded as good or poor using items on the questionnaire. Data analysis was done using IBM SPSS version 22 and presented as tables. P&lt; 0.05 was taken as statistically significant. Results: Participants' mean age was 35.3± 5.9 years. Most 236 (87.4%) of them had tertiary education. Four-fifths- 219 (81.1%) had ever been counselled on family planning or utilized contraceptives 216 (80.0%). The majority 232 (85.9%) of the women had good perceived spousal involvement scores, while 38 (14.1%) of the women had poor perceived spousal involvement scores. There were statistically significant associations between receiving family planning counselling, spouse involvement in contraceptive choices, fear of side effects, and spousal refusal with the utilization of contraceptives and perception of spousal involvement (p&lt;0.001 in all instances) Conclusion: Receiving family planning counselling and spousal support positively influenced the utilization of contraceptives and the perception of male involvement, while the fear of contraceptive side effects had negative effects on both outcomes. There is a need to improve male engagement and female counselling in contraceptive use. Health education should also focus on debunking exaggerations of contraceptive side effects.

Feasibility of adolescent contraceptive care in the pediatric emergency department: A pilot randomized controlled trial.

This study assessed feasibility constructs of adolescent contraceptive care in the pediatric emergency department (PED), including contraception initiation. We conducted a randomized trial in two PEDs with pregnancy-capable adolescents aged 15-18 years who were assigned to enhanced usual care (usual) or same-day initiation (same day). All received counseling and clinic referral, but same-day participants could also receive contraception in the PED. We trained PED clinicians in counseling and prescribing. Adolescents and clinicians rated feasibility using five Likert-type items (1 = strongly disagree to 5 = strongly agree) after the session. We assessed PED medication initiation and appropriateness via medical record review and contraception use and side effects at 30 days via adolescent survey. To further explore feasibility, we conducted clinician interviews at study completion; these were audio-recorded, transcribed, and analyzed. We hypothesized contraceptive care would be feasible (defined as average score ≥ 4 across five survey items). We enrolled 37 adolescents (12 in usual and 25 in same-day), mean age was 16.6 years, 73% were Black, and 19% were Hispanic. We trained 27 clinicians. Average feasibility scores were 4.6 ± 0.4 (adolescents) and 4.1 ± 0.8 (clinicians). Eleven (44%) same-day participants initiated contraception in the PED. One adolescent with migraines initially received estrogen-containing pills; this was corrected after discharge. At 30 days, same-day participants were more likely to report contraception use (78% vs. 13%; p = 0.007). One adolescent reported bloating as a side effect. Clinicians enjoyed delivering contraceptive care, found study resource materials useful, and identified staffing shortages as a barrier to care delivery. We are among the first to report on PED-based adolescent contraception initiation to prevent unintended pregnancy. Adolescents and clinicians reported that contraceptive care was feasible. Initiation was common and medications were largely appropriate and tolerated. Future efforts should explore integrating contraceptive care into routine PED care.

Evaluating community pharmacists awareness, perception and roles in providing emergency contraceptives in Jordan

ObjectiveThis cross-sectional study aimed to assess Jordanian community pharmacists' awareness, perception, and roles concerning emergency contraceptives provision. Study designWe administered a structured questionnaire to community pharmacists in Jordan using convenience sampling. The questionnaire included sections on demographic information, knowledge about emergency contraceptives, perception towards emergency contraceptive, and prior experience in emergency contraceptives provision. ResultsA total of 299 community pharmacists responded to the study. Most pharmacists had a Pharm D/BPharm degree (94.6%) and worked in independent community pharmacies (75.6%). While pharmacists demonstrated relatively high knowledge scores regarding emergency contraception, with a median score of 10 out of 14, misconceptions persisted, particularly regarding the mechanism of action and side effects of emergency contraception. Pharmacists expressed mixed perceptions regarding emergency contraception, with a significant proportion advocating for prescription-only access (76.6%) and expressing ethical reservations (48.2%). Only 38.1% reported prior experience in emergency contraceptives provision. Regression analyses revealed that attendance at emergency contraceptives-focused workshops significantly increased the likelihood of pharmacists providing emergency contraceptives (Adjusted Odds Ratio=2.569, p = 0.001). ConclusionsJordanian community pharmacists exhibit readiness to provide emergency contraceptives, but persistent misconceptions and regulatory barriers hinder optimal provision. Targeted educational interventions, particularly through workshops, are crucial in enhancing pharmacists' knowledge and promoting emergency contraceptives provision. ImplicationsResponding pharmacists often reported the misconception that emergency contraceptives can cause abortion. Also, some pharmacists expressed religious or moral objections to prescribing oral emergency contraceptives. Thus, this study underscores the importance of receiving comprehensive training on ethical and religious considerations in healthcare practice.

The biomedicalization of pregnancy prevention, neoliberal feminism, and college women's experiences of the contraceptive paradox

Research examining the “contraceptive paradox” has illuminated how contraception can be a source of empowerment for some and oppression for others. This study advances theorizing of the contraceptive paradox by illustrating how 45 young women experience contraception as both liberating and constraining due to a confluence of biomedicalization processes, gender inequality, and neoliberal feminism. Drawing on focus group data, we find that the biomedicalization of pregnancy prevention and neoliberal feminist discourse, in combination with experiences of social and economic privilege and gender inequality in fertility work, shape participants’ interpretation of contraceptive technology as a key resource for individually liberating themselves from undesired pregnancy. At the same time, their experiences indicate prescription contraception plays an oppressive role in their lives. In addition to blaming themselves and their bodies for negative contraceptive side effects, participants take for granted that assuming sole responsibility for contraceptive use in their relationships with men is the price they must pay to feel free. The findings indicate that addressing a social problem using an individualized biomedical solution obscures the power that structural inequalities exert over pregnancy-capable people, including relatively privileged young women. As an expression of biopower, these dynamics prompted participants to emphasize distributive justice over social justice, foreclosing their engagement in collective action.

Combined estrogen-progestin oral contraceptives and female sexuality: an updated review.

Sexual side effects of combined oral contraceptives (COCs) have not been fully understood, but increasing evidence prompts broader risk/benefit evaluation and merits inclusion in counseling on contraceptive options. The study sought to explore the impact of combined estrogens-progestin oral contraceptives on components of female sexuality, including sexual desire, anatomic genitourinary changes, lubrication, orgasm, provoked vestibulodynia, well-being, body image, partner preference, and relationship stability. A literature review was performed between April 2023 and January 2024 exploring the association between combined oral contraceptive pills and sexual health. Although COCs decrease free testosterone, it is unclear if COCs affect sexual function, including desire. Antiandrogenic COCs do seem to have a negative effect on sexual arousal, lubrication, and orgasm. Provoked vestibulodynia may be related to early onset of COC use, low-estrogen pills, and antiandrogenic progestins. Emotional and sexual side effects are strong predictors of COC discontinuation. Longitudinal data indicate that using COCs when meeting and selecting a partner has implications on sexual satisfaction and relationship length. Analysis of data is complicated by various doses and forms of estrogen and progestin in COCs, which have changed over time. Lack of randomized placebo-controlled studies and heterogenicity in study design hampers generalized statements about the effects of COCs on sexual function. Despite these challenges, consideration of sexual dysfunction when presenting and prescribing hormonal contraception is essential for informed consent, shared decision making, and ensuring reliable contraceptive choices.

Unveiling Barriers to the Modern Contraceptive Uptake in the Urban Slums of Karachi: Perceptions, Attitude, and Accessibility.

Background Modern contraception plays a vital role in family planning and preventing unintended pregnancies. However, its uptake remains limited in many developing countries, including Pakistan. This study aimed to evaluate the barriers to modern contraception and identify strategies to enhance its adoption in the urban slums of Karachi. Methods A multi-site, cross-sectional study was conducted in 38 slum areas of Karachi, Pakistan. Women aged 15-49 years were interviewed using a comprehensive questionnaire. The questionnaire covered socio-ethnic and economic demographics, knowledge and perceptions of modern contraception, accessibility, affordability, attitudes, and usage. Data analysis was performed using the Statistical Package for Social Sciences (SPSS)version 24 (IBM SPSS Statistics, Armonk, NY). Results The majority of the respondents identified as Pathan ethnicity (49%), and the age range was predominantly from 23 to 34 years (45.5%). A high proportion of participants demonstrated satisfactory knowledge of contraceptives (87.6%). However, a significant portion perceived contraception or family planning to be in conflict with religious beliefs (84%). Many women expressed a desire for more children (56%) and had concerns about contraceptive side effects (78%). A notable proportion of women reported that their spouses forbade the use of contraceptives (12%). Among the surveyed population, the most widely used contraceptives were injections among women (15.5%) and condoms among their male partners (12%). Conclusion Despite sufficient knowledge and accessibility, considerable barriers exist in the uptake of modern contraception in the urban slums of Karachi, Pakistan. These barriers include religious conflicts, cultural norms, concerns about side effects, spousal disapproval, and desires for larger families.

Knowledge Attitude and Barriers to the Use of Family Planning Among Married Men and Women at Fort Portal Hospital-Kabarole-Uganda.

According to the Uganda Demographic and Health Survey, most women and men knew some family planning methods but only about 29%of married women were using contraceptives. 20% of women had an unmet need for family planning. We examined knowledge, attitudes and contraceptive practice as well as factors related to contraceptive use in Fort Portal region Uganda. Methods: Data were collected between Sept-Nov 2023 among 160 married couples using a multi-stage sampling design. Quantitative data was based on semi-structured questionnaires and was triangulated with qualitative data collected during focus group discussions. We compared proportions and performed logistic regression analysis. The concept of family planning was well-known in the studied population. Sex-stratified analysis showed pills and injectables were commonly known by both sexes, while long-term contraceptive methods were better known by women, and traditional methods as well as emergency contraception by men. Formal education was the most important factor associated with better knowledge about contraceptive methods (aOR = 2.07, p,0.001), in particular among women (aOR women = 2.77 vs. aOR men = 1.49; p,0.001). In general, only 1 out of 160 men ever used contraception, while 65% and 44% of females ever used and were currently using contraception respectively. The high knowledge of contraceptives did not match with the high contraceptive practice in the study area. The study demonstrated that mere physical access (proximity to clinics for family planning) and awareness of contraceptives are not sufficient to ensure that contraceptive needs are met. Thus, projects aiming at increasing contraceptive use should contemplate and establish better counselling about contraceptive side effects and method switches. Furthermore, in all family planning activities, both wives’ and husbands’ participation should be considered. Keywords: Family planning, Contraceptive use, Women, Men, Married couples.

(190) Digital Contraception: Effectiveness, Data Privacy, Reproductives Rights

Abstract Introduction We are experiencing a new profound societal transformation: the contraceptive crisis, attributed to the side-effects of hormonal contraception (since 2012) meets the rise of digital technologies. People seem to reject even the slightest risk of hormonal contraception, in favor of entrusting their intimitate data to online companies. But is the rejection of hormonal contraception really du to its iatrogenic risks? Hormonal contraception is 60 years old and its risks are not new and already known, and people don't hesitate to take far greater risks in all areas of their lives: sexual practices and encounters with strangers, sports activities, driving motor vehicles, tobacco, alcohol, etc... In view of this paradox, we will attempt to assess the advantages of digital contraception over medical contraception. Objective Drawing up an inventory of scientific research on digital contraception Know the real reliability of digital contraception and menstruations trackers Know the real risks for health and the other risks of these trackers Using the information obtained, be able to communicate and inform users as objectively as possible Methods Literature review on PubMed and Google Scholar for the last 12 months with the keywords: digital contraception, menstruations applications, period tracking applications, menstruations applications and data priv0acy. Results PubMed reports only six relevant studies about digital period trackers: these are concerned solely with the prospect of pregnancy or with the interest of data that might suggest a pathology such as Polycystic ovary syndrome, endometriosis or some other conditions. One study report that further research is needed to assess contents and its use. It is interesting to note that "data privacy" gives here no result, no result for "digital contraception" either. "Digital contraception" is still not a buzzword on Google Scholar" with only one relevant survey, and various research studies on period trackers report a lack of reliability in informations purporting to be scientific. What's most worrying is that the period trackers use external services for data storage with no guarantee of data protection. Literature reports that users are falsely reassured about their privacy by a non-human actor and are not aware that their data can be sold to mercantile companies. Little known consequences are also about ecology with the pollution of the data centers and about reproductive rights by monitoring periods of amenorrhea. Conclusions There are many blinds spots for users when it comes to menstruations trackers, and it is surprising to see people trusting commercial device, about their health, without any independent scientific guarantee. Thus, we observe a loss of trust for health care providers and we have to understand the current situation in sexual and reproductive health: May be we have to ask not why don't people use medical contraception, but why do people use medical contraception? What are the key factors of using a medical contraception? Rejection of medical authority or even gynecological violence, new gender relations, sexual satisfaction, accessibility of medical contraception must be assessed to place users at the center of the care system. Disclosure No.

Contraceptive content shared on social media: an analysis of Twitter

BackgroundInformation on social media may affect peoples’ contraceptive decision making. We performed an exploratory analysis of contraceptive content on Twitter (recently renamed X), a popular social media platform.MethodsWe selected a random subset of 1% of publicly available, English-language tweets related to reversible, prescription contraceptive methods posted between January 2014 and December 2019. We oversampled tweets for the contraceptive patch to ensure at least 200 tweets per method. To create the codebook, we identified common themes specific to tweet content topics, tweet sources, and tweets soliciting information or providing advice. All posts were coded by two team members, and differences were adjudicated by a third reviewer. Descriptive analyses were reported with accompanying qualitative findings.ResultsDuring the study period, 457,369 tweets about reversible contraceptive methods were published, with a random sample of 4,434 tweets used for final analysis. Tweets most frequently discussed contraceptive method decision-making (26.7%) and side effects (20.5%), particularly for long-acting reversible contraceptive methods and the depot medroxyprogesterone acetate shot. Tweets about logistics of use or adherence were common for short-acting reversible contraceptives. Tweets were frequently posted by contraceptive consumers (50.6%). A small proportion of tweets explicitly requested information (6.2%) or provided advice (4.2%).ConclusionsClinicians should be aware that individuals are exposed to information through Twitter that may affect contraceptive perceptions and decision making, particularly regarding long-acting reversible contraceptives. Social media is a valuable source for studying contraceptive beliefs missing in traditional health research and may be used by professionals to disseminate accurate contraceptive information.

The effects of dienogest and combined oral contraceptives on protein S-specific activity in endometriosis patients

ObjectiveOne serious side effect of combined oral contraceptives (COCs) is venous thromboembolism. Reduced activity in activated protein C-related coagulation pathways is attributable to low protein S activity in one-third of Japanese patients with deep vein thrombosis. Herer, we quantified the behavior of protein S-specific activity in response to dienogest (DNG) and COCs using the protein S-specific activity assay system to explore its potential utility as a thrombosis marker. Study DesignThis was a prospective cohort study. Female patients aged 20 – 49 years who were starting drug treatment for endometriosis using DNG or COCs were enrolled. Blood samples were taken before treatment and at the first, third, and sixth months of treatment. To analyze the primary endpoints, changes in total protein S antigen levels, total protein S activity, and protein S-specific activity from baseline to each time point were estimated using a linear mixed-effects model. All statistical analyses were performed in the SAS software version 9.4 (SAS Institute, Cary, NC). A two-sided P < 0.05 was considered statistically significant. Results64 patients took DNG and 34 patients took COCs. Protein S-specific activity did not change significantly from baseline in the six months after treatment started in either group. In the DNG group, total protein S activity and total protein S antigen levels increased slightly from baseline levels after the treatment. The means for total protein S activity and total protein S antigen levels in the COC group remained within reference limits, but they both decreased markedly in the first month and stayed low. Protein S-specific activity in four women remaind below the reference limit throughout the whole study period, suggesting they may have potential protein S deficiencies. ConclusionThe effects of DNG on protein S were negligible, though both total protein S activity and antigen levels decreased soon after COC treatment began and remained low. As there was no VTE event during the study, further studies with larger numbers of patients will be needed to confirm that protein S-specific activity can be a surrogate maker of VTE risk.

Hormonal Contraceptive Side Effects and Nonhormonal Alternatives on TikTok: A Content Analysis.

The use of hormonal contraceptives is decreasing in the United States alongside a growing interest in nonhormonal contraceptive options. Social media messaging may be contributing to this trend. TikTok thus offers a novel opportunity to understand how people share information about risks and alternatives for pregnancy prevention. To describe the availability and content of information about hormonal contraceptive side effects and nonhormonal contraceptive options on TikTok, we conducted a content analysis of 100 videos using the hashtags #birthcontrolsideeffects and #nonhormonalcontraception. We found that these videos were popular and often framed hormonal contraceptives and patient-provider interactions negatively, with users frequently discussing discontinuation of hormonal contraception and no plans for uptake of another contraceptive. When uptake of a new contraceptive method is mentioned, creators typically mention a fertility awareness-based method, which requires specialized knowledge to use safely and effectively. The risks and side effects of hormonal options were often overemphasized compared with the possible risks and side effects of nonhormonal options. This framing may suggest opportunities for providers and health educators to reassess how they counsel about contraceptive options. We conclude with recommendations for future research on TikTok and consider the policy implications of these findings.