Selected papers from the 25th annual scientific meeting of the American Gynecological and Obstetrical Society
Agos paper
Oral contraceptive discontinuation: do side effects matter?

Presented at the 25th Annual Meeting of the American Gynecological and Obstetrical Society, Sept. 14-16, 2006, Williamsburg, VA.
https://doi.org/10.1016/j.ajog.2006.12.015Get rights and content

Objective

The purpose of this study was to assess self-reported side effects in women after they received the oral contraceptive (OC) and to compare discontinuation rates, according to presence or absence of side effects.

Study Design

The study comprised 1716 women aged <25 years who initiated the OC at 3 publicly funded family planning clinics and completed structured interviews after 3 and 6 months.

Results

Nearly 60% of subjects discontinued the OC by 6 months. Most subjects reported no changes in headaches, weight, moodiness, and sexual satisfaction during the first 3 months of OC use. Subjects with any complaints, especially women with increased headaches or moodiness, were more likely to discontinue the OC prematurely. Nonetheless, most discontinuation occurred for reasons that were unrelated to side effects.

Conclusion

Side effects are absent or mild among most OC users, but women with complaints are more likely to discontinue. Side effects are less important reasons for discontinuation than widely believed.

Section snippets

Methods

This multicenter randomized trial was conducted between March 2003 and February 2005 at 3 University centers: Emory University, Atlanta, GA; Mt. Sinai Medical Center, New York, NY; and the University of Texas Southwestern Medical Center, Dallas, TX. Recruitment took place in their Family Planning and Teen Clinics. These clinics serve predominantly Latina and African American populations; they are funded in part by Title X and by other federal and state grants.

Clinical Center Institutional

Results

We enrolled 1720 women in the study. Four women enrolled twice, and we excluded their second enrollment, which left 1716 women. Subjects were mainly Hispanic, young, and poor; approximately 40% of the women had previous episodes of OC use (Table 1). Overall, 89% of eligible subjects completed the 3-month interview (n = 1498). Subsequently, 84% percent of eligible subjects completed the 6-month interview (n = 1369). Ten percent of the subjects (n = 171) were pregnant during the follow-up period.

Comment

This is a large community-based study that prospectively assessed side effects in women who were starting OCs. The 6-month discontinuation rate of 57% is comparable with smaller studies in similar patient populations.3, 4, 5 Our study is unusual because it used a structured questionnaire to assess symptoms in all OC users. We chose 4 possible side effects to assess in detail: weight change, headaches, moodiness, and sexual satisfaction. These symptoms emerged as those symptoms that were most

Discussion

Jeffrey Peipert, MD. OCs are highly effective when used consistently and correctly. However, OC users have a high rate of discontinuation that ranges from 18%-50%. Side effects are the most commonly reported reason to discontinue OCs.

Dr Westhoff et al evaluated perceived side effects among OC users and attempted to correlate these side effects with OC discontinuation. The study is a cohort analysis of a large multicenter randomized trial. The study population is mostly minority women seen at

References (14)

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This work was supported by National Institutes of Health grant 1RO1-HD42413.

Cite this article as: Westhoff CL, Heartwell S, Edwards S, et al. Oral contraceptive discontinuation: Do side effects matter? Am J Obstet Gynecol 2007;196:412.e1-412.e7.

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