Samples of short reaction papers about contraceptives
This case-control study evaluates if short-term hormone withdrawal of oral contraceptives (pill pause) is associated with changes in mental health symptoms in long-term users of combined oral contraceptives depending on progestin type, estrogen dose, and baseline mental health symptoms.
Key Points
Question
Is short-term hormone withdrawal, or pill pause, associated with changes in mental health symptoms in long-term users of combined oral contraceptives (COCs) in a manner depending on progestin type, estrogen dose, and baseline mental health symptoms?
Findings
This case-control study including 180 women found significant mood deterioration during the pill pause. The effect size was comparable with mood changes across the menstrual cycle and more pronounced in COC users with higher baseline depression.
Meaning
Similar mood worsening is seen after withdrawal from exogenous hormones in oral contraceptives as from endogenous hormones during menses; therefore, whether a pill pause is advantageous from a mental health perspective is questionable.
Abstract
Importance
Hormonal contraception has been linked to mood symptoms and the ability to recognize emotions after short periods of treatment, whereas the mental health of users of long-term hormonal contraceptives has had limited investigation.
Objective
To evaluate whether short-term hormonal withdrawal, which users of combined oral contraceptives (COCs) undergo once a month (pill pause), was associated with altered mood and emotional recognition in long-term users of COCs.
Design, Setting, and Participants
This case-control study included a community sample of individuals assigned female sex at birth who identified as women and used COC for 6 months or longer. The control group included women with natural menstrual cycles who otherwise fulfilled the same inclusion criteria. The study was conducted between April 2021 and June 2022 in Salzburg, Austria.
Exposure
COC users and women with natural menstrual Although oral contraception (OC) misuse is presumed to play an important role in unwanted pregnancy, research findings have often been equivocal, perhaps reflecting unaddressed inconsistencies in methodological approaches. Using established databases, we performed a systematic review of measurement methods for OC use using primary research reports published from January 1965 to December 2009. Terminology used to describe OC use, which included “continuation,” “compliance,” and “adherence,” differed across studies and was rarely defined. The majority of studies (n = 27 of 38, 71%) relied solely on self-report measures of OC use. Only two reports described survey or interview questions, and reliability and validity data were seldom described. More rigorous measurement methods, such as pill counts (electronic or manual), serum and urinary biomarkers, and pharmacy records, were infrequently employed. Nineteen studies simultaneously used more than one method, but only three studies compared direct and indirect methods. The lack of a consistent, well-defined measurement of OC use limits our understanding of contraceptive misuse and related negative outcomes. Future research should clarify terminology, develop standardized measures, incorporate multimethod approaches with innovative methods, and publish details of measurement methods. The oral contraceptive pill (OC) is the most popular form of hormonal contraception in the United States and is highly effective when used perfectly. Perfect use, however, is seldom achieved. As many as 30% of women report missing one or more pills per month, and approximately half of new OC users will discontinue use within the first year. Recent data from the National Survey of Family Growth indicate that typical users report a 9% failure rate, which may be due in part We used the Afghanistan DHS 2015 dataset which is openly available under https://dhsprogram.com/data/available-datasets.cfm. Family Planning Demographic and Health Survey Focus Group Discussion World Health Organization Inner city Fund Community Health Workers Reproductive, maternal, newborn, child, and adolescent health Bongaarts, J. Does family planning reduce infant mortality rates?. Popul. Dev. Rev.13(2), 323–334 (1987). Article Google Scholar Ahmed, S., Li, Q., Liu, L. & Tsui, A. O. Maternal deaths averted by contraceptive use: An analysis of 172 countries. Lancet380(9837), 111–125 (2012). Article Google Scholar Shaw, D. The ABC’s of Family Planning (University of Britis, 2010). Google Scholar Johns Hopkins Bloomberg School of Public Health. Contraceptive Use Averts 272,000 Maternal Deaths Worldwide 2012. https://publichealth.jhu.edu/2012/ahmed-contraception. Bradshaw, C. J. A. et al. Lower infant mortality and access to contraception reduce fertility in low- and middle-income nations. MedRxiv.2021, 1–23 (2021). Google Scholar United Nations. Trends in Contraceptive Use Worldwide (Department of Economic and Social Affairs: Population Division, 2015). Google Scholar World Health Organization. Family Planning/Contraception 2018. https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception. Accessed 2 April 2020. Cleland, J., Conde-Agudelo, A., Peterson, H., Ross, J. & Tsui, A. Contraception and health. The Lancet.380(9837), 149–156 (2012). Article Google Scholar Central Statistics Organization Afghanistan. Ministry of Public Health, ICF a Afghanistan Demographic and Health Survey (ADHS) 2015 (Central Statistics Organization, 2017). Google Scholar World Health Organization. Maternal Mortality in 2000–2 .Studying the Use of Oral Contraception: A Review of Measurement Approaches
Abstract
Background
Methods
Results
Conclusions
Introduction
Factors influencing the uptake of short-term contraceptives among women in Afghanistan
Data availability
Abbreviations
References