Contraceptive counselling by male or female doctors – is there any difference?

Contraceptive counselling by male or female doctors – is there any


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


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.

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