Background Women’s physical and mental health are strongly inter-related and may influence patterns of contraceptive use. We examined the longitudinal associations between young women’s physical and mental health and method of contraceptive use over a 5-year period.
Methods Data from 4952 young women (≤27 years) participating in the Australian Longitudinal Study on Women’s Health who completed four self-reported surveys between 2013 and 2017 were analysed. Women’s contraceptive use was categorised as: contraceptive pill/oral contraceptives, long-acting reversible contraception (LARC), condom, other methods and none. Multinomial logistic regression was used to determine the longitudinal associations between women’s physical and mental health and method of contraception.
Results Over the 5-year period the percentage of pill users decreased from 60% (95% CI 58% to 61%) to 41% (95% CI 39% to 42%) and LARC users increased from 13% (95% CI 12% to 14%) to 21% (95% CI 20% to 22%) as did non-users from 9% (95% CI 8% to 9%) to 17% (95% CI 16% to 18%). Compared with women using the pill, women who used LARCs were more likely to be overweight (OR 1.34; 95% CI 1.17 to 1.53) and obese (OR 1.84; 95% CI 1.55 to 2.19), current smokers (OR 1.45; 95% CI 1.23 to 1.71) and reported fair or poor general health (OR 1.50; 95% CI 1.28 to 1.76) and very high levels of psychological distress (OR 1.47; 95% CI 1.24 to 1.76). Similar results were also found among women who used condoms or no contraception.
Conclusions Findings suggest that obesity, smoking and poor physical and mental health play an important role in young women’s contraceptive use.
- hormonal contraception
- long-acting reversible contraception
- oral contraceptives
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Contributors IJR made substantial contributions to the conception and design of the study and conducted the statistical analyses and drafted the manuscript. GDM made substantial contributions to the acquisition of the data, the interpretation of the results and critical revision of the manuscript for intellectual content. JCL made substantial contributions to the conception and design of the study, the interpretation of the results and critical revision of the manuscript for intellectual content. All authors read and approved the final manuscript.
Funding GDM is supported by an Australian National Health and Medical Research Council Principal Research Fellowship (GNT1121844). The ALSWH is funded by the Australian Government Department of Health.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Patient consent for publication Not required.
Ethics approval The study has ethics approval from The University of Queensland (UQ) and The University of Newcastle (UoN) Human Research Ethics Committees (HREC).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. The data underlying this study are owned by the Australian Government Department of Health. The process for data access is documented on the Australian Longitudinal Study on Women’s Health (ALSWH) website (http://www.alswh.org.au) which includes all the survey questionnaires, data books of frequency tables for all surveys, metadata, conditions of data access and request form. Data may be made available to collaborating researchers where there is a formal request to make use of the material. Permission to use the data must be obtained from the Data Access Committee of ALSWH.
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