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How would you rate your use of combined hormonal contraceptives - are you the perfect ’student’, using them exactly as you have been instructed by your health care professional or do you regularly rely on emergency contraception (Plan B or the ‘morning after pill’) for ‘damage control’? If you are not at the ‘top of the class’ for your contraceptive behavior, you may also be playing swings and roundabouts with your emotions. The outcome of a study of 26,250 women, aged 18 to 49 has just been published and confirms that being inconsistent with your contraceptive regime can adversely affect your health, your schooling, your job and your relationship with your partner.

The study was carried out over a three month period in Spain where women completed a questionnaire at outpatient clinics of the departments of gynecology and family planning centers of public and private institutions throughout across the country in 2006. The lead investigator of the study, Dr Inaki Lete, Hospital Santiago Apostol, Vitoria-Gasteiz, Spain, collated information about attitudes and the psychological impact of imperfect use of hormonal contraceptives from women who used three different hormonal contraceptive methods, being the combined pill, (65%) the skin patch (12%) and NUVARING(R) (23%) (etonogestrel/ethinyl estradiol vaginal ring). Non-compliant behavior (inconsistent use of a hormonal contraceptive) was defined as missing or delays in the taking/ application/insertion or removal of the pill, patch or ring. Dr. Lete is confidant that the findings from the study will help health care professionals to “empower women to increase compliance with the prescribed contraceptive regimens.”

The study found that:

71% of pill users, 32% of patch users and 21.6 % of ring users reported that they did not use their hormonal contraceptives properly . The emotional stress the women suffered when they ‘defaulted’ was described as being ‘worried’ and scared’
Between 58.3% and 68.8% were ‘worried’ and between 16.4% and 22.6 % were ’scared’ when they ‘defaulted’ during use
10 -20% of women reported that imperfect use of their current contraceptive negatively affected their work activities and their relationship with their partner and about 3% had missed days of work or school
40% of the pill and patch users had experienced the additional stress (and extra cost) of performing a home pregnancy test compared with 29% of those using the vaginal ring
in ALL groups approximately 40% of women called or visited a physician, incurring further costs over and above their contraceptive prescription
14% of pill users, 11% of patch users and 6.3% of ring users requested emergency contraception- yet another extra cost added to the stress and inconvenience, not to mention the increased side effects

The study also showed that even though most women had used their contraceptives imperfectly and had been ‘worried’ or ’scared’ at times, they continued to use the same contraceptive method. If you are having difficulty keeping to a consistent regime with your type of contraceptive and you still have an active sex life, it may be time to consider changing to another method of birth control or using an additional contraceptive method - if only to reduce your anxiety level.

Not using your combined hormonal contraceptives correctly not only increases your risk of getting pregnant but can give you ‘pregnancy panic’ attacks. Who wants to fork out extra cash for pregnancy test kits, visits to the doctor and emergency contraception (Plan B) when a little more vigilance or added protection would leave you a few dollars more for that sexy lingerie he’d love and send you to the top of a far more enjoyable class!

By: Carole Pemberton

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