Abstract

PIP: The acceptability of 2 and 3 month injectable contraceptives was assessed and compared, and the acceptability of the injectables was further compared with that of oral contraceptives (OCs) and IUDs among a random sample of women, who attended a clinic in Alexandria, Egypt. The study was conducted by the University of Alexandria. The sample included 100 acceptors of the 2-month injectable, norethisterone oenanthate (NET-O EN), 100 acceptors of the 3-month injectable, depo-medroxy pregesterone acetate (DPMA), 60 OC acceptors, and 60 IUD acceptors. The women were interviewed prior to treatment and 2 or 3 times during the 6 months following their initial acceptance of the methods. Women who discontinued at any time during the 6-month period were interviewed concerning their reasons for discontinuing. The data was analyzed by calculating means and % distribution and by testing for significance. The percent lost to follow up was 12% for the NET-O EN group, 12% for DPMA users, and 0% for IUD and OC acceptors. The mean age of the acceptors was 30.4 years for NET-O EN, 30.7 years for DMPA, 28.3 years for OCs, and 25.2 years for IUDs. For these acceptor groups, the respective mean number of years of schooling was 6.1, 5.2, 7.2, and 7.5, and the respective mean number of pregnancies was 5.6, 5.4, 3.8, and 2.9. All 320 of the women were married, and 319 were Muslim. 99.4% lived in urban areas. 10% had no living male children, and 23.7% had no living female children. 2/3 of the injectable acceptors previously used 2 or more fertility control methods. A higher percent of IUD and OC acceptors, compared to injectable acceptors, reported using only 1 or no previous method. More than 1/2 of the injectable acceptors reported disruptions in their normal bleeding patterns. NET-O EN acceptors were more likely to experience heavy or prolonged bleeding while DPMA acceptors were more likely to report amenorrhea or a decreased flow. IUD acceptors were also bothered by bleeding problems. Almost all the women who reported changes in bleeding patterns were unhappy about the changes. Many of the women who reported amenorrhea worried that they might be pregnant. Women who experienced heavy or unpredictable bleeding worried about anemia and complained that bleeding interfered with their daily routines. 47.6% of the women reported weight gains, but this was generally viewed as an advantage. Nausea was the major side effect associated with OC use. 32% of the OC users, 28.0% of the NET-E ON users, 30.0% of the DMPA users, and none of the IUD users reported nausea. For all 4 groups, convenience and effectiveness were the major advantages the women attributed to their chosen method. Continuation rates were 68% for NET-O EN, 70% for DMPA, 75% for OCs, and 75% for IUDs. The major reason for discontinuation of injectables was bleeding problems. Among injectable users, a higher proportion of discontinuers (49%) than of continuers (20%) reported amenorrhea. The findings suggest that continuation for injectables could be improved if patients were given more detailed information about possible side effects and if they were advised to return to the clinic for treatment of any symptoms they experience.