Contraceptive counselling by male or female doctors – is there any
difference?
S. Tschudin, G. Merki
University Women’s Hospital, Basel, Switzerland
Objectives: Contraceptive behaviour is an important determinant of
women’s reproductive health. With regard to problems concerning acceptance and
compliance a highly qualified and individually adapted contraceptive counselling
is crucial. It depends on the counsellor’s knowledge and experience about
contraceptive methods as well as his / her communication skills, background,
personal attitudes and probably his or her gender. We therefore wanted to
investigate how gynaecologists use to counsel and whether there might be any
gender differences in counselling.
Design and methods: On the basis of a questionnaire we interviewed by
telephone 24 female and 24 male practising Swiss gynaecologists between
September and October 2002. We asked them about the content and strategies of
their contraceptive counselling as well as their opinion concerning important
aspects for the choice of a method and the patient’s compliance. The data were
analysed by descriptive statistics.
Results: Half of the gynaecologists were 41–50 years, 8 were 30–40
and 4 over 50 years old. 36 of them were practising in an urban, 12 of them in a
rural area. Their counselling comprised medical aspects such as information
about various contraceptive methods (80%), health risks (75%), side effects
(50%), contraceptives’ efficacy (more often cited by male physician than
female 58 vs. 38%), STD (male doctors 33% vs. 62%), emergency contraception (17
vs. 0%) and personal aspects such as the patients needs, family planning (25%),
partnership (12 vs. 25%) and sexuality (5 vs. 12%). From 7 aspects that had to
be quoted about their importance for the choice of a contraceptive method
efficacy was considered very important by 100%, reversibility by 83%, side
effects by 85% and convenience by 79%. Naturalness and costs were more often
quoted as important by female and health benefits by male gynaecologists. Side
effects are considered the most important factor for patient’s compliance by
male and female gynaecologists (60% each), while counselling and information is
predominantly cited by female and patient’s character and personality by male
doctors.
Conclusions: While reproductive health issues were central topics of
the counselling, sexual health issue are still often neglected. According to our
results gender differences occasionally influence the choice of the topics as
well as the attitude towards the patient.
