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  • Title: [Use of the pill by adolescents for contraception or as therapy].
    Author: van Hooff MH, Hirasing RA, Kaptein M, Koppenaal C, Voorhorst FJ, Schoemaker J.
    Journal: Ned Tijdschr Geneeskd; 1995 Jan 28; 139(4):178-82. PubMed ID: 7845497.
    Abstract:
    OBJECTIVE: To describe frequency of oral contraceptive (OAC) use, indications for OAC use and influence of calender age, gynaecological age (age minus age at menarche) and level of education on OAC use among ninth grade secondary school girls. SETTING: Secondary schools in Amstelland-de Meerlanden, a combined urban and rural region to the south of Amsterdam. METHOD: By questionnaire and individual interview on menstrual cycle pattern and OAC use, school girls were asked about duration and reasons for OAC use and what preparation they used. RESULTS: The response to the questionnaire was 92%, that to the interview 83%. Of the 2248 responders 248 (11%; mean age 15.3 years (SD: 0.6)) used OAC: 74% used low dose 'sub 50' preparations, 3% pills with 50 micrograms oestrogen, 3% 3-phase preparations and 17% pills with antiandrogens. Of girls aged 14, 15 and 16 years 4%, 12% and 28%, respectively, used OAC. Of the 15-year-olds 36% mentioned contraception as most important reason, 20% menstrual cycle irregularity, 28% dysmenorrhoea, 12% acne and 5% other reasons. With multiple logistic regression analysis age, gynaecological age and level of education were independent variables for OAC use in general and for OAC use for contraception or dysmenorrhoea, but less so for OAC use for menstrual cycle irregularity or acne. CONCLUSION: During adolescence low dose OACs are frequently used. Of adolescent OAC users 36% mentioned contraception as most important reason. OAC use in the Netherlands among girls aged 15 and 16 years doubled in comparison with 1982. Gynaecological age and calender age (determinants of biological maturation), and level of education (a determinant of life style) were associated with OAC use. The objective was to describe frequency of oral contraceptive (OC) use, indications for OC use and influence of calendar age, gynecological age (age minus age at menarche), and level of education on OC use among 9th grade secondary school girls. Secondary schools of 4 different types in Amstelland-de Meerlanden, a combined urban and rural region to the south of Amsterdam, were surveyed during the 1990-91 school year by questionnaire and individual interview on menstrual cycle pattern and OC use, and school girls were asked about the duration and reasons for OC use and what preparation they used. The response rate was 92% to the questionnaire and 83% to the interview. Of the 2248 respondents, 248 (11%; mean age 15.3 years) used OCs: 74% used low-dose sub-50 mcg preparations, 3% used pills with 50 mcg of estrogen, 3% used 3-phase preparations, and 17% used pills with antiandrogens. 4%, 12%, 28%, and 42%, respectively, of girls 14, 15, 16, and 17 years old used OCs. 36% of the 15-year-old girls mentioned contraception as the most important reason, 20% menstrual cycle irregularity, 28% dysmenorrhea, 12% acne, and 5% other reasons. Among 14-, 15-, and 16-year old girls, contraception was cited as the most important reason for OC use by 4%, 31%, and 36%, respectively. 39 girls used OCs for acne, of whom 34 used a preparation containing cyproterone acetate. Multiple logistic regression analysis indicated age, gynecological age, and level of education as independent variables for OC use in general and for OC use for contraception or dysmenorrhea, but less so for OC use for menstrual cycle irregularity or acne. In the model of OC use for contraception, age was the most important determinant, while in the model of OC use for dysmenorrhea it was the gynecological age. OC use for menstrual cycle control was associated significantly with age and gynecological age, but not with school type (p=0.07). In the first year after menarche not a single girl used OCs for menstrual cycle regulation.
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