Associated factors with discontinuation use of combined oral contraceptives

PURPOSE: Due to the scarce information available in Brazil in relation to the number of women who initiated the use of combined oral contraceptives and prematurely discontinued, the objective was to assess the reasons for discontinuation of the use of several combined oral contraceptives among Brazilian women living in urban areas. METHODS: A cross-sectional study with 400 gynecologists registered withy the Brazilian Federation of Obstetricians and Gynecologists. Each physician interviewed 10 non-pregnant, not breastfeeding, not amenorrheic women aged 18 to 39 years who consulted requesting combined oral contraceptive (COC) with a questionnaire at the beginning of use and at six months later. The questionnaire included sociodemographic data, type of COC chosen or prescribed and reasons for discontinuation when it occurred during follow-up. The strategy of selection allowed the inclusion of women from different socioeconomic strata, however, only those attended at private or insurance offices. The sample size was estimated at 1,427 women. RESULTS: A total of 3,465 interviews were conducted at the first visit and 1,699 six months later. The women were 20 to 29 years old, 57.3 percent were single and an equal proportion of 45.0 percent attended high school or college. Most (60.7 percent) were nulligravidas and among those who had used some contraceptive before, 71.8 percent had used a COC. Among the more prescribed or chosen COC the most prevalent were monophasic with ethynil estradiol (20 µg) and regarding progestin the most prevalent was with gestodene (36.5 percent) followed by a COC with drosperinone (22.0 percent). At six months 63.5 percent still used COC. Among those who discontinued the main reasons were wishing to become pregnant (36.5 percent) and side effects (57.3 percent) and the most prevalent were headache (37.6 percent), weight gain (16.6 percent) and irregular bleeding (23.6 percent)...