Abstract
Context
Adolescents are frequent users of hormonal contraception (HC), yet their adherence
to these methods is often poor. Concerns about side effects, especially those affecting
the menstrual system, are often given as reasons for contraceptive nonadherence or
discontinuation. We sought to identify teens' concerns and misperceptions about the
menstrual-related side effects of HC.
Methods
Open focus groups were conducted with both sexually active and virgin adolescent women
aged 12���18 years who were recruited from the Philadelphia area. The adolescents
did not have to be contraceptive users in order to participate. The question put to
each group was, ���What are the things you have heard about the birth control pill,
Depo-Provera and Norplant?��� Groups were audio-recorded, transcribed and analyzed
using qualitative software.
Results
We conducted 13 female-only groups. Participants raised frequent concerns about menstrual-related
side effects, believing that these side effects were evidence of possible negative
effects of HC on their reproductive health. Four themes related to hormonal contraceptive-induced
menstrual irregularity emerged from the groups. Theme 1: Menstruation is natural and
should not be altered in any way. Theme 2: The menstrual period is necessary for cleansing
of the body. Theme 3: ���Spotting,��� intermenstrual bleeding and amenorrhea cause
doubts about the method's effectiveness and worries about pregnancy. Theme 4: All
menstrual irregularity, from intermenstrual bleeding to amenorrhea, causes worry about
the effects on fertility and on physical health.
Conclusions
Teens have concerns about the menstrual irregularity caused by HC. Providers understand
that these side effects are minor and of little medical consequence. Yet, adolescent
patients may be ascribing great significance to these effects and may be declining
these methods because of fear and misperceptions.
Keywords
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Article info
Publication history
Published online: May 24, 2006
Accepted:
March 17,
2006
Received in revised form:
February 8,
2006
Received:
May 20,
2005
Identification
Copyright
© 2006 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
