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  • Title: Women's satisfaction with birth control: a population survey of physical and psychological effects of oral contraceptives, intrauterine devices, condoms, natural family planning, and sterilization among 1466 women.
    Author: Oddens BJ.
    Journal: Contraception; 1999 May; 59(5):277-86. PubMed ID: 10494480.
    Abstract:
    User satisfaction and the physical and psychological effects of five commonly used contraceptive methods were investigated in a population survey among 1466 West German women. The focus was on effects attributed by current and past users to these methods, rather than objectively assessed effects, to shed further light on personal experiences that are highly relevant to the user but often remain unknown to prescribers and unreported in the medical literature. Within the overall sample, 1303 women were surveyed concerning their current or past use of oral contraceptives (OC), 996 regarding condoms, 342 with respect to intrauterine devices (IUD), 428 in regard to natural family planning (NFP), and 139 in relation to sterilization (respondents completed questions about each method used). It emerged that satisfaction was greatest with sterilization (92% of users), followed by OC (68% of ever users), IUD (59%), NFP (43%), and condoms (30%). Almost one in three NFP users had experienced an unwanted pregnancy during use of this method, as compared with one in 20 OC and condom users. The majority of users reported no mood changes during use of the methods studied. The percentages reporting negative mood changes (various items were scored) were up to 16% among OC users, 23% among condom users, and 30% among NFP users. The latter observations suggested that subjective side effects of a contraceptive agent on mood generally reflected, at least in part, the user's sense of confidence in the method concerned (notably, with regard to efficacy and safety). Oral contraceptives, IUD, and sterilization had a broadly positive impact on sex life, whereas that of condoms was often negative. Whereas OC users often reported less heavy and painful menstruation (in up to 56% of cases), IUD were associated with heavier, prolonged, and more painful menstruation (in up to 65% of cases), as also was sterilization, although to a lesser extent (in up to 32% of cases). Overall, the study findings indicated that OC and sterilization had less negative impact on physical and psychological functioning than the other methods studied, in contrast to what the general public often believes. A survey covering sociodemographic characteristics, contraceptive use, and previous use of oral contraceptives (OCs), condoms, IUDs, and natural family planning (NFP) was conducted among 1466 West German women to evaluate their satisfaction with their birth control method. The focus was on the effects attributed to these methods by current and past users to of them rather than on objectively assessed effects. The aim was to gain insight into personal experiences that are very significant to the user but often remain unknown to prescribers and unreported in the medical literature. Results showed that almost 1 in 3 NFP users had had an unwanted pregnancy during the period of use; the figure was 1 in 20 among OC and condom users. A majority of users for each method claimed no mood changes during the use of that method. Negative mood changes were reported among 16% of OC users, 23% of condom users, and 30% of NFP users. The subjective side effects of a contraceptive agent on mood were observed to reflect the user's sense of confidence in the method concerned. OC, IUD and sterilization had a broadly positive impact on sex life, while that of the condom was always negative. OC users reported less heavy and painful menstruation. IUDs were associated with heavier, prolonged and more painful menstruation, as was sterilization to a lesser extent. The satisfaction rate among OC and sterilization users was generally higher than that among those who used other methods. Overall, OC and sterilization had less of a negative physical and psychological impact than did the other methods.
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