Difficulties in access to the use of contraceptive methods, acceptability of changes in the menstrual pattern induced by the use of contraceptives and influence on their discontinuation.

• Grant number: 24/23375-4
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: February 01, 2025
• End date: January 31, 2026
• Field of knowledge: Health Sciences - Medicine - Maternal and Child Health
• Principal Investigator: Luis Guillermo Bahamondes
• Grantee: João Vinícius Marcondes Rosa
• Host Institution: Centro de Atenção Integral à Saúde da Mulher (CAISM). Hospital da Mulher Professor Doutor José Aristodemo Pinotti. Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil
• Associated research grant: 23/13279-5 - Clinical aspects of new and current users of long-acting reversible contraceptives (intrauterine devices and implants) and once-a-month injectable contraceptives, AP.TEM

Abstract

Contraceptives are essential in reducing unplanned pregnancies, due to their effectiveness and benefits not only in preventing pregnancy, but also other gynecological conditions such as menstrual irregularity. However, access to contraceptives is still limited in many cases due to multiple barriers linked to services, professionals and patients. In addition to the barriers, there are factors such as changes in menstrual patterns and their influence on discontinuing the method, which contribute negatively to the use of contraceptive methods. Objective: To analyze the difficulties in accessing contraceptive methods, the acceptability of any changes in the menstrual pattern induced by the use of contraceptives and their influence on discontinuation. Subjects and Methods: This is a prospective cross-sectional study that will evaluate contraceptive users at two points in time, the first occurring at the first contact and the second after 6 months of using the contraceptive method. The study will include women aged between 18 and 49 who attend the family planning clinic, women who use contraception, women who are looking for the method, who agree to take part in the study and sign a free and informed consent form. A structured, pre-tested questionnaire will be used to explore sociodemographic issues, access to contraceptive methods, acceptability of any changes in the menstrual pattern induced by the use of contraceptives, satisfaction with the use of the method and the pattern that leads to early discontinuation of the method. The same questionnaire will be administered to the same group of patients after 6 months of using contraceptive methods. For this study and to allow all the variables to be representative, the calculation based on the estimated proportion in a descriptive study with a categorical qualitative variable will be used, in this case the estimated proportion of acceptance of long-term methods (LARC) of 23. 3%, according to Diaz et al. (2000), and setting the alpha significance level or type I error at 5% (alpha=0.05) (or 95% confidence interval) and the sampling error at 5% (d=0.05), setting the sample at n= 275 women, which predicting a 20% loss rate, the sample calculation was set at around n=330 women. For data analysis: the Statistical Analysis System (SAS) will be used, and the following tests will be used: Chi square test, Student's test, bivariate and multivariate analysis.