Survey of young women's state of knowledge and perceptions about oral contraceptives in Germany

Abstract

Background: In Germany, we see a decline in the use of the oral contraceptive pill. Although there have been studies showing a lack of knowledge about the mode of action of the pill and alternative methods, the number of German women who feel well informed about the pill increased over recent years. At the same time, a trend to increasingly cover negative aspects of oral contraception has emerged in German journalism and social media.

Objective: This study aimed to consider the relationship between the source of information about the pill, subjective and objective knowledge, and how their interaction influences perceptions of the pill.

Study design: An online survey was conducted of 18- to 29-year-old women to test their objective and subjective knowledge, their perception of oral contraceptives, and their trust in gynecologists. The recruitment took place online and in gynecologic practices. The survey opened in September 2020 and closed in April 2021.

Results: A total of 2470 women completed the survey. The most common sources of information were the internet (80%), the gynecologist (47%), and friends and family (47%). Women reporting the internet as a source of information were more likely to have lower perception and trust rates, and less likely to overestimate their own knowledge. The findings suggest that school or university as a source of information has a positive effect on decision-making and general attitude toward information received by gynecologists about oral contraceptives. Those with higher confidence in their knowledge are likely to have a more positive attitude and higher levels of trust.

Conclusion: A feeling of uncertainty, instead of fixed assumptions gathered from unsophisticated sources, affects perception regarding oral contraceptives and trust toward gynecologists negatively. Gynecologists and educators should hence increase efforts to meet potential needs for discussing uncertainties to prevent further loss of confidence.

Keywords: doctor-patient relationship; gynecology; health education; oral contraceptives; transparency in healthcare.

Figure 1

Subjective knowledge by source of information Odds ratio with 95% confidence interval. Reference category: “Not so good.” The subjective state of knowledge in women seems to depend on their source of information. Participants receiving their information from their gynecologist or in school or university were more likely to feel very well or well informed compared with those not using the respective sources.

Figure 2

Diagram of final score of knowledge test, frequency The mean knowledge test score was 17.75 points, with a standard deviation of 3.37. The participant with the lowest number of points achieved 6.5 points, and the highest score achieved was the maximum score with 29.5 points.

Figure 3

Knowledge test score by source of information Average score with 95% confidence interval. Four of the 5 different sources of information led to an increase in average knowledge test score. These findings were significant for gynecologists (B=0.6; SE, 0.16), school and university (B=2.05; SE, 0.19), internet and social media (B=0.81; SE, 0.17), and books and papers (B=0.5; SE, 0.16) as sources of information when compared with not using these sources of information. SE, standard error.

Figure 4

Diagram of comparison of subjective and objective knowledge, frequency The differences in frequency for each group show that 237 women estimated their knowledge to be very high, whereas only 100 reached this category. There were 32 women more than subjectively estimated achieving high knowledge scores, and 237 more in the center group. Less women than subjectively estimated had a low or very low level of knowledge (n=65; 18).

Figure 5

Trust in information received by gynecologist by source of information OR with 95% CI. Reference category: “Not in all matters.” Women who reported receiving their information from their gynecologist or at school/university were the only 2 groups that were more likely to “completely” trust their gynecologist when compared with women using other sources of information (OR, 3.16; 95% CI, 1.95–5.12; and OR, 1.78; 95% CI, 1.20–2.64). All other groups were statistically significantly less likely to completely trust their gynecologist than to trust them “not in all matters” at the 5% significance level. CI, confidence interval; OR, odds ratio.