Factors effecting continuation rates in users of monthly
contraceptive injections in Turkish women
I. Gönenç, EZ. Tuzcular Vural, G. Köse,
N. Aka
Haydarpaca Numune Education and Research Hospital, Family Planning Unit,
Istanbul, Turkey
Objectives In this study we aimed to investigate the factors
effecting continuation rates in users of monthly norethisterone enanthate (NET-EN)
/ estradiol valerate (EV) injections as a contraceptive method.
Design and methods Two hundred and forty-five NET-EN/EV users who were being followed-up in a family planning
unit setting were evaluated. Inclusion criteria for the study were a minimum of
three injections applied in the same unit, willingness to answer the
questionnaire and to have complete records. A standardized questionnaire which
consisted of 25 closed-ended questions was used to evaluate the 180 women who
fulfilled the criteria. The data collected was analyzed using the chi-square test using
SPSS-9.0 for Windows statistics programme. The relation between continuation
rates and various factors were investigated using the chi-square test for statistical
analysis.
Results We found the discontinuation rate for NET-EN/EV injections to
be 43.3%.The most frequent reason for preferring the method was reliability
(48.9%).The most frequently encountered bleeding problem was spotting (27.2%).
Spotting was also the most common complaint and side effect (12.2%). The most
common reason for discontinuation was planning to conceive (39.4%), but we also
found worth to mention that 77.5% of the discontinuers had not started a new
method of contraception. Although we couldn’t find a statistically significant
relationship between abandoning the method and age, women over 36 years had a
greater tendency to continue the method (73.2%). Educational status,
occupational status, monthly income, social health security and presence of a
systemic illness did not have statistically significant relationship with
discontinuing the method (p>0.05).The total number of pregnancies, deliveries,
live births, abortions and menstrual patterns did not have a statistically
significant relationship in abandoning the method (p>0.05). However,
continuation rates were higher than average in women with 5 or more pregnancies.
Although continuation rates were higher in women with a first pregnancy age
younger than 20 years of age, the difference between different age groups did
not prove this relationship to be statistically significant (p>0.05).There
was a positive correlation between spotting and discontinuing the method
(p<0.05).
Conclusions NET-EN/EV has been available in Turkey for over a
decade. Parameters other than side effects are not related to discontinuation of
NET-EN/EV use. Turkish women find this method reliable and effective, but should
be followed closely and counseled about side effects in order to increase
continuation rates.