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Prior pill experiences and current continuation among pill restarters.
Debra Kalmuss1, Shelly Koenemann, Carolyn Westhoff
1Mailman School of Public Health, Columbia University, New York, USA. dk6@columbia.edu
Perspectives on Sexual and Reproductive Health
|September 23, 2008
Summary
Women restarting oral contraceptives after discontinuing due to side effects are more likely to stop again. Understanding past reasons for discontinuation is key for effective counseling and preventing unintended pregnancies.
Area of Science:
- Reproductive Health
- Contraception
- Women's Health
Background:
- Discontinuation of oral contraceptives increases the risk of unintended pregnancies.
- Understanding reasons for past pill discontinuation is crucial for predicting future adherence.
Purpose of the Study:
- To assess the relationship between prior reasons for stopping oral contraceptive use and method continuation upon restarting.
- To identify factors influencing oral contraceptive adherence in young women.
Main Methods:
- Recruitment of women younger than 25 using oral contraceptives at university health centers.
- Randomized trial involving interviews with 628 former users about past experiences and follow-up after restarting use.
- Bivariate and multinomial logistic regression analyses to determine the association between prior discontinuation reasons and method continuation.
Main Results:
- Women who discontinued oral contraceptives due to side effects were less certain about restarting and less satisfied with the method compared to those who stopped for logistical or fertility reasons.
- These women were also more likely to report a shorter duration of use after restarting.
- Lower baseline certainty and satisfaction predict higher risk of early discontinuation.
Conclusions:
- Healthcare providers should inquire about past oral contraceptive experiences and discontinuation reasons when counseling women restarting the pill.
- Counseling for women who previously discontinued due to side effects should address their specific risk factors for early re-discontinuation.
- Informing women about alternative contraceptive choices is essential for those at high risk of early discontinuation.
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