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Oral contraceptive discontinuation: do side effects matter?

Carolyn L Westhoff1, Stephen Heartwell, Sharon Edwards

  • 1Department of Obstetrics and Gynecology, Columbia University Medical Center/New York Presbyterian Hospital, and the Mailman School of Public Health, Columbia University, New York, NY, USA. clw3@columbia.edu

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Summary

Most women using oral contraceptives (OC) report mild or no side effects. However, experiencing side effects like headaches or mood changes increases the likelihood of discontinuing OC use.

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Area of Science:

  • Reproductive Health
  • Pharmacology
  • Women's Health

Background:

  • Oral contraceptives (OC) are widely used for pregnancy prevention.
  • Understanding user-reported side effects is crucial for adherence and continued use.
  • Discontinuation rates for oral contraceptives vary, influenced by multiple factors.

Purpose of the Study:

  • To evaluate self-reported side effects in women using oral contraceptives (OC).
  • To compare the rates of OC discontinuation based on the presence or absence of reported side effects.

Main Methods:

  • A cohort of 1716 women under 25 years old initiating OC use was studied.
  • Participants were recruited from publicly funded family planning clinics.
  • Structured interviews were conducted at 3 and 6 months to collect data on side effects and discontinuation.

Main Results:

  • Approximately 60% of women discontinued OC use within 6 months.
  • Most users reported no significant changes in headaches, weight, mood, or sexual satisfaction in the initial 3 months.
  • Women reporting side effects, particularly headaches or moodiness, showed a higher likelihood of premature discontinuation.
  • However, the majority of discontinuations were attributed to reasons unrelated to side effects.

Conclusions:

  • While most oral contraceptive (OC) users experience mild or no side effects, reported complaints are associated with increased discontinuation.
  • Side effects appear to be a less significant driver of overall OC discontinuation than commonly perceived.
  • Further research may explore non-side effect related factors influencing long-term OC adherence.