Contraceptive Side Effects Research Articles

Acceptability and continuation of use of the subdermal contraceptive implant among adolescents and young women in Argentina: a retrospective cohort study

A new public policy was instituted in Argentina for free distribution of subdermal contraceptive implants to women aged 15–24 years old in the public healthcare system. The objective of this study is to determine the extent to which this population adhered to the implant, as well as predictors of continuation. The retrospective cohort study was based on a telephone survey of a random sample of 1101 Ministry of Health-registered implant users concerning the continuation of use, satisfaction with the method and side-effects, and reasons for removal. Descriptive statistics and multivariate regression analysis were used to explore the association between adherence and having received contraceptive counselling, satisfaction, and side effects. We found high levels of adherence (87%) and satisfaction (94%). Common reported side effects were amenorrhoea or infrequent bleeding, perceived weight gain, increased menstrual bleeding and headaches. Multivariate regression analysis indicates that, among adolescents, having received contraceptive counselling increased comfort, while frequent bleeding at six months hindered trust. Participants who had a history of a prior delivery or who had themselves primarily chosen the method were less likely to request the removal of the implant. Our results support the public policy of free implant distribution in the public health sector. This is a sustainable public policy that contributes to equity and access to effective contraception. It is appropriate for adolescents and young women and will also reduce unintended pregnancies. Our results suggest that counselling patients is key prior to insertion of the implant, as it improves acceptability and continuation.

‘In fact, that’s when I stopped using contraception’: a qualitative study exploring women’s experiences of using contraceptive methods in KwaZulu-Natal, South Africa

ObjectivesThis study explored women’s experiences of using contraceptive methods in KwaZulu-Natal, South Africa.SettingIn October 2021, we conducted a qualitative study at Umlazi Township in KwaZulu-Natal province, South Africa, through face-to-face...

‘Here, the girl has to obey the family's decision’: A qualitative exploration of the tactics, perceived perpetrator motivations, and coping strategies for reproductive coercion in Bangladesh

Reproductive coercion (RC) undermines women's decision-making in reproductive health and negatively impacts women's health and well-being. This qualitative study explored RC in Bangladesh using in-depth interviews (IDIs) and focus group discussions (FGDs) with violence support centre clients, menstrual regulation (MR) and postabortion care (PAC) clients, and MR/PAC providers and pre- and post-procedure counsellors. All IDIs and FGDs were audio recorded, transcribed verbatim, and translated from Bangla to English for thematic analysis. RC was perpetrated primarily by male partners and in-laws and included both pregnancy-promoting tactics (such as contraceptive sabotage and forced continuation of an unwanted pregnancy) and pregnancy-preventing tactics (such as forced contraceptive use and forced MR). Threats and violence were tactics used for pregnancy-promoting and pregnancy-preventing RC. Perceived motivations for RC perpetration included family formation or dissolution, son preference, and a desire to maintain power or control over a woman. The primary motivator for contraceptive sabotage was concern about the safety and side effects of contraception, rather than pregnancy promotion. We classify this as contraceptive-related coercive control rather than RC due to the lack of pregnancy promoting intent. Women's responses to RC and contraceptive-related coercive control ranged from capitulation to active coping strategies such as covert use of contraception and MR, and enlisting providers' help to avoid forced MR. Differences in motivation for perpetration of RC and contraceptive-related coercive control call for distinct intervention strategies to support women's reproductive autonomy.

Male partner influence on Women's choices and utilisation of family planning services in Mufulira district, Zambia

BackgroundFamily planning services are essential in reducing maternal deaths as well as improving the reproductive and sexual health of women. Although family planning services are frequently focused on women, men are often the primary decision-makers. We conducted a study to explore male partner influence on women's choices and utilisation of family planning services in Mufulira district, Zambia. MethodsA qualitative explorative study design that utilised two focus group discussions (n = 20) and in-depth interviews (n = 30) involving women of reproductive age was conducted. Convenient sampling was employed to select participants. In-depth interviews and focus group discussions were recorded, translated, and transcribed verbatim. Content analysis was utilised through code classification and theme identification. Data were imported into NVivo.×64 for coding and node generation. FindingsThe study revealed key themes on male partner influence on contraception use such as fear of infidelity, fear of physical abuse, preference for a large family size , disruption of sexual pleasure, and perceived side effects of contraceptives. These themes highlight the influence of culturally driven gender and power dynamics on male partner attitudes towards contraception. Participants described how their male partners exhibited prenatal attitudes and control over them thereby limiting their decision-making power on contraception use. Undesirable contraception side effects such as reduced vaginal lubrication contributed to sexual pleasure disruption among men. Concerns that women's use of contraception can lead to infidelity also contributed to male partner disapproval of contraception use. ConclusionsUnderstanding barriers to contraception utilisation presented by male partners is essential in preventing contraception discontinuation and can increase contraception uptake among women. Our findings highlight the influence of culturally driven gender and power dynamics on male partner attitudes towards contraception. Therefore, male partner education on family planning services is key. Also, men need to be incorporated as key stakeholders when planning and implementing family planning programmes.

Multiple induced abortions – implications for counselling and contraceptive services from a multi-centre cross-sectional study in Sweden

Objectives To investigate factors associated with multiple induced abortions. Materials and methods A multi-centre cross-sectional survey among abortion-seeking women (n = 623;14-47y) in Sweden, 2021. ‘Multiple abortions’ was defined as having had ≥2 induced abortions. This group was compared to women with a previous experience of 0-1 induced abortion. Regression analysis was conducted to determine independent factors associated with multiple abortions. Results 67.4% (n = 420) reported previous experience of 0-1 abortion, and 25.8% (n = 161) ≥2 abortions (42 women chose to not respond). Several factors were associated with multiple abortions, but when adjusted in the regression model, the following factors remained; parity ≥1 (OR = 2.96, 95%CI [1.63, 5.39]), low education (OR = 2.40, 95%CI [1.40, 4.09]), tobacco use (OR = 2.50, 95%CI [1.54, 4.07]) and exposure to violence over the last year (OR = 2.37, 95%CI [1.06, 5.29]). More women in the group who had 0-1 abortion (n = 109/420) believed they could not become pregnant at the time of conception, compared to women who had ≥2 abortions (n = 27/161), p=.038. Mood swings, as a contraceptive side-effect, were more often reported among women with ≥2 abortions (n = 65/161), compared to those with 0-1 abortion (n = 131/420), p=.034. Conclusion Multiple abortions is associated with vulnerability. Sweden provides high quality and accessible comprehensive abortion care; however, counselling must be improved both to achieve contraceptive adherence and identify and address domestic violence.

A 5-year comparative study of efficacy and acceptability of three different sizes of TCu380Ag and TCu380A intrauterine devices.

The intrauterine contraceptive device TCu380Ag when compared with TCu380A at 1 year of use had better acceptability and continuation rates. To study the continuation rate, efficacy, and acceptability of TCu380Ag in three sizes versus TCu380A at 5 years of use. A total of 600 women opting for intrauterine contraceptive devices were randomized equally into two groups. Group 1 received the TCu380Ag device (Normal, Maxi, and Mini for uterocervical length 7-8.5cm, 8-9cm, and 6-7.5cm, respectively) and Group 2 received the TCu380A device. Follow-up was performed at 5 years to assess efficacy, acceptability, and continuation. Frequency data comparisons was performed across categories using χ2 /Fisher exact test. At 5 years of use, Kaplan-Meier survival analysis showed that TCu380Ag compared with TCu380A had a higher continuation rate (45% vs. 35%, P= 0.010) with 100% efficacy each. TCu380Ag had fewer side effects, including heavy menstrual bleeding (16.6% vs. 34.1%, P< 0.001), abdomen pain (12.1% vs. 23.0%, P= 0.001), and expulsions (4.4% vs. 8.7%, P< 0.050), and fewer discontinuations attributable to contraceptive side effects (42.7% vs. 56.9%, P= 0.012). The mini TCu380Ag had the highest continuation rates and least menstrual irregularity (P< 0.050). The TCu380Ag device in three sizes is an alternative to TCu380A for women desiring 5 years of contraception with equal efficacy, better continuation, and acceptability. The mini size is preferred for women with a uterocervical length of 6 to 7.5cm.

Who does what? Reproductive responsibilities between heterosexual partners

Managing fertility and sexual and reproductive health across the life course is associated with numerous responsibilities disproportionately experienced by women. This extends beyond dealing with the physical side effects of contraception and can include the emotional burden of planning conception and the financial cost of accessing health services. This scoping review aimed to map how reproductive responsibilities were defined and negotiated (if at all) between heterosexual casual and long-term partners during any reproductive life event. Original research in high-income countries published from 2015 onwards was sourced from Medline (Ovid), CINAHL and Scopus. In studies that focused on pregnancy prevention and abortion decision making, men felt conflict in their desire to be actively engaged while not wanting to impede their partner’s agency and bodily autonomy. Studies identified multiple barriers to engaging in reproductive work including the lack of acceptable male-controlled contraception, poor sexual health knowledge, financial constraints, and the feminisation of family planning services. Traditional gender roles further shaped men’s involvement in both pregnancy prevention and conception work. Despite this, studies reveal nuanced ways of sharing responsibilities – such as companionship during birth and abortion, ensuring contraception is used correctly during intercourse, and sharing the costs of reproductive health care.

Psychological side effects of hormonal contraception: a disconnect between patients and providers

BackgroundExisting literature about the psychological side effects of hormonal contraception (HC) is limited. The goal of this study is to better characterize patients’ subjective experiences with HC, its side effects, and contraception counseling.MethodsThis is a cross-sectional, survey-based study using a convenience sample of patients who had used HC at some point in their lives. Recruitment occurred from June 2021-February 2022.ResultsOf the 188 responses included in the analysis, 43.6% reported experiencing mood changes as a side effect of HC at some point in their lives. The most common reason participants cited for discontinuing or switching contraception methods was side effects (48.3%). Participants with a history of psychiatric illness were significantly more likely to report mood changes as a side effect of their HC (61.2%) compared to participants with no history of psychiatric illness (29.5%). Among patients with a history of psychiatric illness, 38.8% responded that their psychiatric symptoms worsened with HC while only 11.2% responded that their symptoms improved with HC. The majority (83%) of participants responded that their provider never mentioned the possibility of psychological side effects during contraception counseling. If/when they experienced side effects associated with their HC, 22.7% of participants disagreed that their provider adequately addressed their concerns.ConclusionThese findings suggest that mood changes may be among the most common perceived side effects of HC and speak to a disconnect between patients and providers when it comes to discussing the possibility of psychological side effects with HC.

To Assess the Impact of IEC Activities on Knowledge of Family Planning among Adolescent Girls of 13-17 yrs in Rural Area of Amritsar

Back Ground: The major health issues among adolescent girls are early pregnancy, child birth, anemia. Lack of knowledge related to family planning among adolescent girls can adversely affect their and their children lives. Sexual activity in adolescent period is associated with ignorance about sex and sexuality and also predisposed by family traditions of early marriage that can lead to teenage pregnancies leading to illegal abortion, increased IMR and MMR. Adolescents should have knowledge of the health concerns and side effects of contraceptives so that they can make choices to prevent unwanted pregnancies. Aims and Objectives: Assessing the impact of IEC activities on knowledge of family planning among adolescent girls of rural area of Amritsar. Material and Methods: An interventional study was carried out among 13-17 years adolescent girls studying in the Government Senior Secondary Schools at Nagkalan and Sohian Kalan and out of school adolescent girls of the same age group residents of these two villages were also included in the study. IEC activities were done and after three months the effect of intervention was assessed. Among the enlisted 250 eligible adolescent girls, 230 were analyzed and valid conclusions were drawn. Results: out of total 230 respondents, 73 (31.73%) respondents had correct knowledge about legal age of girl at marriage. Out of total 230 respondents, before intervention only 60 (26.0.8%) of the respondents heard about contraceptive methods, after intervention this percentage increased to 68.69%.Conclusion: After intervention more number of adolescent girls had correct knowledge related to family planning

Neuropsychological side effects of combined hormonal contraceptives for the treatment of mild symptoms. Bioethical assessment of its adequacy

Since the beginning of the commercialization, in 1960, of combined estrogen-progestin hormonal contraceptives (CHCs), their use has become widespread for other non-contraceptive indications: dysmenorrhea, irregular cycle length, hypermenorrhea and acne, among others (Lete, 2009; Barranco, 2016). In all cases, these are mild pathologies or minor symptoms for which there are effective therapeutic alternatives. Millions of women in the world receive this treatment, which acts by inhibiting the hypothalamic-pituitary-ovarian hormonal axis (HHO Axis), the central axis and regulator of the entire sexual and reproductive physiology of women. Despite the existence of an enormous number of women subjected to this inhibition (ACHs are currently used by some 214 million women around the world, with an annual market of close to 18 billion dollars), very little research has been done on the consequences of suppressing the HHO axis. Only in recent years, and in parallel to the demonstration of the existence of functional receptors for gonadotropins at different levels in the central and peripheral nervous systems, have publications on the neuropsychological effects of HCAs begun to appear. It is also striking that, despite being the most widely used drugs and for the longest time for the treatment of functional gynecological disorders, their use is outside the technical data sheet (i.e., they are used for purposes other than those listed in the official indication approved in their technical data sheet and which appear in the package insert). Although the use of these hormonal products causes a wide variety of side effects, which have been widely studied in the medical literature, the present study proposes, after an exposition of the different aspects of the use of HCAs, a detailed review of the available literature on the neuropsychological effects due to the annulment of the HHO axis. This in order to, after a biological analysis, subsequently establish whether there is an ethical appropriateness in the use that concerns us.

Men's involvement in family planning programs and associated factors from the perspective of women in Afghanistan; a case study

ObjectivesFamily planning is a cornerstone to the achievement of Sustainable Development Goals. However, men's involvement in family planning has been a challenge in many countries. This study aimed to investigate the participation of men in the family planning programs and related factors from the perspective of women referring to family planning organizations in Herat, Afghanistan 2021. MethodsThe study had a cross-sectional design. The participants of the study consisted of 544 married women aged 15-49 years selected by simple random sampling. The data collection tool was a valid and reliable questionnaire to assess the participation of men in family planning programs. To analyze the data, descriptive statistics and analytical methods including Mann-Whitney and Pearson Chi-Square tests were applied in SPSS 21. The answers to the open-end questions were analyzed, coded and classified in two main categories. ResultsThe average age of study participants was 28(±10) years and a significant proportion of them were illiterate (48.5%). Most of the participants were housewives (83.6%) and their husbands were non-professional workers (39.9%). The husbands participated in family planning programs by choosing the type of contraception (29.2%), provision of contraceptives (29.6%) and supporting their wives using them (49.3%). There were statistically significant relationships between women's and their husband's education level, and husband's employment status with the type of participation in family planning. The main incentives for Afghan men to participate family planning were the increased attention of families to the education and needs of children and the health and welfare of the wives. However, cultural norms supporting larger families, the desire for having boy children, the fear of contraception's side effects and religious prohibitions discourage them in using family planning methods. ConclusionA large number of the respondents stated that their spouse participated in family planning programs. It shows the importance and success of family planning centers in promoting sexual and reproductive health and family planning. Study showed that various factors affected men's participation in family planning programs. Recognition of these factors can help policy makers in designing behavioral interventions based on social marketing, and enhancing the effectiveness of these programs.

Identifying and addressing barriers to contraception uptake among adolescent girls in urban Burkina Faso: Evidence from a qualitative study.

Several barriers drive low uptake of contseraception among adolescents. This study investigates the effectiveness of (re)solve, a school-based program in Burka Faso, to overcome barriers to contraception uptake and facilitate the development of intention to use it. This paper presents qualitative endline findings from a mixed-methods longitudinal study conducted between 2019 and 2020 in two urban sites using in-depth interviews with girl participants and implementers, and key informant interviews with local stakeholders. We found that adolescent girls in the target group are likely to soon become sexually active but may be underestimating this risk. We also identified three key barriers to access to contraception in the study sites: misinformation and fear of side effects of contraception, stigma and negative attitudes, and a lack of youth-friendly sexual and reproductive health services. We conclude that the school-based (re)solve program was able to address barriers and spark contraceptive interest among participant girls.

The Importance of Developing Online Counseling Services for Family Planning Programs in Indonesia

One of the reasons for the high of contraceptive acceptors drop out is the low number of contraceptive information received by clients. Indonesian Population Demographic Survey in 2017 stated that only 29% of women in Indonesia received contraceptive information including contraceptive side effects, how to deal with side effects, and alternative contraception that can be used. This is due to a limited number of family planning instructors, and a large number of tasks that health workers must carry out, especially midwives as the largest source of contraceptive services in Indonesia. The solution to overcome the low level of contraceptive information services is to build an online counseling service for family planning programs. Online counseling services based on digital technology are flexible and can be accessed by anyone who needs information. For this reason, this technology must be built on an evidence-based basis and a good reputation, so it is hoped that in addition to meeting the need for family planning information, it is also able to change behavior for the use of appropriate contraception.

The Relationship of the use of Injected Hormonal Contraception with the Event of White about KB Accepters in The Working Area of the Singosari Inpatient Health Center, Pematang Siantar City, In 2022

A Family Planning (KB) is an effort to regulate the birth of children, distance, and the ideal age of childbirth, regulate pregnancy, through promotion, protection, and assistance in accordance with reproductive rights to realize a quality family This research was carried out in the work area of the inpatient health center Singosari Pematang Siantar in 2022 The reason for choosing this location is because the use of contraceptives in men in this region is still lacking. The type of research used in this study is observational analytics with a cross-sectional research design . The data collection technique used in this study was to provide a list of questions (questionnaires) to the research targets related to or related to the use of injectable-type contraceptives and the incidence of vaginal discharge in respondents. . The population in this study were acceptors of injectable birth control for 1 month and 3 months who experienced vaginal discharge in the Working Area of the Singosari Pematang Siantar Inpatient Health Center in 2022'. A total of 41 people. The sampling technique used in this study is purvosive sampling or the sample that is used as the object of research is what has been determined as a sample, namely respondents who experienced vaginal discharge because they used 1 month of injectable birth control and 3 months of injectable birth control, which was 41 people. Chi-Square test results state Ho is rejected if the probability of &lt;0.05. The results of the chi-square test analysis were obtained df = 1, and nulai p value (p = 0.005&lt;0.05) then Ho was rejected and Ha was accepted, then there was a significant relationship between the use of injectable hormonal birth control and the incidence of vaginal discharge in the acceptor of birth control in the work area of the Singosari Pematang Siantar Inpatient Health Center in 2022. It is hoped that midwives will further improve counseling regarding the use and side effects of hormonal contraceptives, and encourage acceptors to maintain the cleanliness of reproductive devices so as to avoid the occurrence of vaginal discharge.

Offered Support and Knowledge about the Menstrual Cycle in the Athletic Community: A Cross-Sectional Study of 1086 Female Athletes.

Many female athletes perceive that symptoms related to the menstrual cycle such as dysmenorrhea, premenstrual symptoms, amenorrhea or side-effects of hormonal contraceptives negatively impact their training, performance, and general well-being. Knowledge and communication about female athletes’ health is therefore important in the sport community. The aims of this study were to explore the level of knowledge and communication about menstrual cycle issues and use of hormonal contraceptives in the athletic community and to describe the kinds of medical support offered to female athletes. A total of 1086 Swedish and Norwegian athletes from 57 different sports responded to a web-based questionnaire. Of these, 58% (n = 627) practiced team sports and 42% (n = 459) individual sports. Twenty-six percent (n = 278) of the athletes perceived their knowledge about female athlete health to be poor/very poor and the knowledge was most often acquired from medical staff. Fifty-three percent (n = 572) of the athletes perceived the knowledge acquired of their coaches as poor/very poor, even though a significantly (p < 0.001) higher proportion of athletes with a female coach (30%, n = 31) rated their coach’s knowledge as very good/good, compared to athletes with a male coach (5%, n = 31). Only 11% (n = 116) of the athletes discussed female health issues with their coach. The majority (81%, n = 842) of the athletes partly to strongly agreed that female athlete health is considered a taboo topic in the athletic community. Forty-seven percent (n = 510) of the athletes had access to a physiotherapist, while only three percent (n = 29) had access to a gynecologist. Low perceived knowledge, lack of communication and support demonstrate the need for a multi-professional medical team and enhanced educational efforts focused on female athlete health in the athletic community.

A STUDY ON FACTORS INFLUENCING CONTRACEPTIVE PRACTICES AMONG ELIGIBLE COUPLES OF URBAN FIELD PRACTICE AREA, DEPARTMENT OF COMMUNITY MEDICINE, FACULTY OF MEDICAL SCIENCES KHAJA BANDA NAWAZ UNIVERSITY, KALABURAGI

Background: According to Census 2011, India's population stood at 1,21,01,93,422, and the last decade has seen India's population growth by 17.64%. This high growth rate in India is a threat to its developmental and the unlimited utilization has caused various problems like unemployment, overcrowding and environmental pollution. The contraceptive methods have not been widely accepted by a large number of the eligible couples and the extent of acceptance of contraceptive methods still varies within societies and also among different religious groups. This study was done to nd out inuencing factors for the acceptance of contraceptives among the eligible couples of the urban eld practice area, Department of Community Medicine, Faculty of Medical Sciences, KBNU, Kalaburagi. To Objective: nd out the proportion of eligible couples using contraceptive methods and factors inuencing its acceptance among the eligible couples of the urban eld practice area, Department of Community Medicine, Faculty of Medical Sciences, KBNU, Kalaburagi. A Cross- Methodology: sectional study was conducted in urban eld practice area of Department of Community Medicine, Faculty of Medical Sciences, KBNU, Kalaburagi. Socio-demographic details, contraceptive methods used and factors inuencing its usage were collected using pre-tested, semistructured questionnaire. Data was analyzed using Epi-Info 7 software and appropriate statistical tests were applied. Level of signicance was set at a P value of&lt;0.05. Out of 357 populations, 95 belonged to the age group 26-30 years. 121(33.8 Results: 9%) opted for tubectomy, 38(10.64%) were taking OCP'S, 25(7%) using condoms, 11(3.08%) have IUCD'S, 3(0.84%) were using injectable contraceptives, and only 1 opted for vasectomy. Statistically signicant association of contraceptive acceptance was found with type of family, early years of marriage, education of the husband, more number of living children and presence of male child. In order Conclusions: to make family planning effective, counseling and education should be provided to eligible couples to dismiss false facts regarding side effects of contraceptive methods.

Selected effects of combined oral contraceptives use

Introduction and objective:: Combined oral contraceptives (COCs) are one of the most popular methods of contraception worldwide. The universality of this method leads to the constant analysis of its influence on the female body. The purpose of this study is to discuss selected side effects of COC use.&#x0D; Review methods: In July 2022, articles found in the Medline (Pubmed) and Google Scholar databases were selected by using the following keywords: oral contraceptive use; risk of cancer; depression; side effects of hormonal contraception; venous thrombosis.&#x0D; Brief description of the state of knowledge: COC use has been shown to be associated with a 2-6 fold increase in the risk of developing venous thromboembolism (VTE). The component responsible for this side effect was initially thought to be synthetic estrogen - ethinylestradiol. It is now recognized as having the greatest influence on mood disorders. An increased risk of cancer has been reported in women taking COCs in case of breast cancer and liver cancer. Inverse relationship was observed in colorectal cancer, ovarian cancer and endometrial cancer.&#x0D; Summary: COC use can have side effects, but it also has many health benefits. Therefore, it is important to constantly learn about this topic and minimize the risk of adverse side effects.

“She told me no, that you cannot change”: Understanding provider refusal to remove contraceptive implants

Enthusiasm for long-acting reversible contraception (LARC) is growing among donors and NGOs throughout the global reproductive health field. There is an emerging concern, however, that the push to insert these methods has not been accompanied by a commensurate push for access to method removal. We use data from 17 focus group discussions with women of reproductive age in an anonymized African setting to understand how users approach providers to request method removal, and how they understand whether or not such a request will be granted. Focus group participants described how providers took on a gatekeeping role to removal services, adjudicating which requests for LARC removal they deemed legitimate enough to be granted. Participants reported that providers often did not consider a simple desire to discontinue the method to be a good enough reason to remove LARC, nor the experience of painful side-effects. Respondents discussed the deployment of what we call legitimating practices, in which they marshalled social support, medical evidence, and other resources to convince providers that their request for removal was indeed serious enough to be honored. This analysis examines the starkly gendered nature of contraceptive coercion, in which women are expected to bear the brunt of contraceptive side-effects, while men are expected to tolerate no inconvenience at all, even vicarious. This evidence of contraceptive coercion and medical misogyny demonstrates the need to center contraceptive autonomy not only at the time of method provision, but at the time of desired discontinuation as well.

Understanding the contextual and cultural influences on women's modern contraceptive use in East Uganda: A qualitative study.

Unmet need for contraception, defined as the percentage of women who are sexually active and want to avoid, space or limit pregnancies, but are not using a method of contraception, stands at 28.4% of all married women in Uganda. An understanding of women's contraceptive behaviours, and the motivations that drive these, are key to tackling unmet need, by way of designing, implementing and improving family planning programs to effectively meet the needs of different population groups. This qualitative study sought to understand women's contraceptive use and identify strategies to strengthen contraceptive uptake among women in the Busoga region of east Uganda (chosen due to its low contraceptive prevalence of 31.3% and high unmet need of 36.5% among married women of reproductive age). Six focus group discussions were conducted with single and married women across different age groups (18-24, 25-34, and ≥ 35 years), living in three urban and three rural districts. Thematic analyses of the data highlighted three major themes pertaining to the complex, multi-level nature of contributors to unmet need and women's use of contraception in the Busoga region. Within a largely patriarchal society, women had to navigate many obstacles. Some of these included: fears about contraceptive side effects; partner opposition, community beliefs and stigma that dissuaded contraceptive use; traditional gender and socio-cultural norms that dictated women's fertility choices; and service delivery limitations. Changing community narratives about family planning through testimonies from satisfied users, increasing male acceptance of contraception, and encouraging joint-decision making on matters of reproductive health are strategic focal areas for family planning initiatives to effectively tackle the problem of unmet need among women, and make contraceptives more accessible to women in Uganda.

Assessment of Combined Oral Contraceptive Pill Side Effects among Women Attending Maternal Child Health Centers in Erbil

Purpose: Studies exploring the adverse effects of oral contraceptive pill (OCP) use among women living in Erbil/Iraq are lacking. This study aimed to assess the patterns of use and associated side effects among women in Erbil.&#x0D; Patients and methods: A face-to-face questionnaire survey inquiring about demographic information and issues related to the use of OCPs and related side effects was completed by 235 women who had used OCPs at least once in their lifetime.&#x0D; Results: The women exhibited positive attitudes towards OCP efficacy and safety, positively associated with their patterns of use. The following common side effects of OCPs were reported: pain (69.4%), vision problems (60%), headache and fatigue (59%), speech impairment (53%), irregular bleeding and breast tenderness (52%), nausea (51%), chest pains (40%), chloasma (37%), weight gain (33 %), abdominal pain (28%), shortness of breath (26%), swelling (20 %), spotting (12%), and allergy (7%).&#x0D; Conclusion: The study revealed that women who have many side effects toward OCPs nevertheless tend to use them appropriately. However, educational programs are advisable to improve knowledge about OCP use among women in Erbil.