International survey to assess women's attitudes regarding choice of daily versus nondaily female hormonal contraception

Abstract

Background: The availability of reliable contraception tailored to suit women's needs and lifestyles is an essential step in addressing unintended pregnancy and its substantial human and financial costs. The daily combined oral contraceptive pill has been the short-acting hormonal contraceptive of choice for the last 50 years. However, for some women, this may be neither suitable nor optimal.

Methods: Here we report the findings of a large, online, questionnaire-based study conducted in Brazil, France, Germany, Italy, and the USA. The study was designed to assess women's attitudes, beliefs, and unmet needs regarding current hormonal contraceptive options via an anonymous online survey. Women eligible for contraception were required to respond to questions using either a binary (yes/no) or seven-point scale (1, complete disagreement; 7, complete agreement). Women were also asked about other relevant issues, such as lifestyle, perception of menstruation and pregnancy, level of education, and relationship with their health care professional.

Results: In total, 12,094 women were questioned, of whom 68% required contraception. Overall, 28% of women expressed an interest in novel contraceptive products, and 49% stated that they would prefer a nondaily method. Although many women expressed satisfaction with the pill, daily intake was thought to be burdensome, resulting in irregular and ineffective usage. However, many women continued to choose the pill due to lack of consideration of and education about other options. Approximately half of the women wished to conceive in the near future.

Conclusion: The findings indicate that nearly half of respondents would prefer a nondaily form of contraception. Furthermore, approximately half of respondents wished to conceive in the near future, suggesting that they are unlikely to favor long-acting options. Effective education on contraceptive choices may help women to find the method that best suits their needs, thus improving contraceptive compliance.

Keywords: contraceptive options; female contraception; hormonal contraceptives; survey; women’s attitudes.

Figure 1

Current contraception usage^a (excludes women who were postmenopausal, infertile, or who had been sterilized by tubal ligation, had a sterilization implant at the time of questionnaire completion, those in a monogamous relationship whose partner had been sterilized by vasectomy, and those opposed to use of contraception). Because respondents were able to choose multiple options, percentages may not add up to 100% in each category. Responses to the questions were binary (yes/no). Notes: ^aThe current contraceptive method reflects the contraceptive that the survey population were using at the time when the study was conducted; ^bnatural methods include the basal temperature method and the rhythm and calendar methods. Abbreviation: IUD/IUS, intrauterine device/system.

Figure 2

Responses to the survey question on what is wanted from a contraceptive method from the perspective of the user’s needs. Responses to the questions were given on a seven-point scale (1, complete disagreement; 7, complete agreement).

Figure 3

Responses to the survey question on the preferred dosing regimen for a contraceptive method. Responses to the questions were binary (yes/no).

Figure 4

Factors that would prompt women to change their contraceptive. Responses to the questions were given on a seven-point scale (1, complete disagreement; 7, complete agreement).

Figure 5

(A) Missed doses of oral contraceptive per year; (B) discontinuation of oral contraceptives per year; and (C) reasons for discontinuation of oral contraceptive. Responses to the questions were binary (yes/no).