ArticleBJOG : an international journal of obstetrics and gynaecology2022
Contributions of side effects to contraceptive discontinuation and method switch among Kenyan women: a prospective cohort study.
Article in BJOG : an international journal of obstetrics and gynaecology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 29 citations in OpenAlex.
- Article
- A phenotypicHuman reproduction open · 2026Article
- Challenges to informed choice counselling: a qualitative study of contraceptive self-care introduction in the Copperbelt Province of Zambia.BMJ global health · 2025Article
- Exploring Adolescents' Contraceptive Preferences and Trade-Offs: Findings From a Discrete Choice Experiment in Kenya.Studies in family planning · 2025Article
- PrEP Method Switching: Will it Yield Greater Coverage of HIV Protection? Applying Lessons Learned from Family Planning to Guide Future Research in the Context of PrEP Choice.Current HIV/AIDS reports · 2024Review
- Willingness to use novel reversible methods of male birth control: a community-based survey of cisgender men in the United States.Contraception and reproductive medicine · 2023Article
- Task-shifting and family planning continuation: contraceptive trajectories of women who received their method at a community-based event in Kinshasa, DRC.Reproductive health · 2023Article
- Contraceptive use and discontinuation among women aged 15-24 years in Kenya.Frontiers in reproductive health · 2023Article
- Synthesis of end-user research to inform future multipurpose prevention technologies in sub-Saharan Africa: a scoping review.Frontiers in reproductive health · 2023Article
- Reproductive outcomes following contraceptive discontinuation for method-related reasons: An analysis of 49 Demographic and Health Surveys.PLOS global public health · 2023Article
- Prevalence and factors associated with the use of long-acting reversible and permanent contraceptive methods among women who desire no more children in high fertility countries in sub-saharan Africa.BMC public health · 2022Article
- Contributions of side effects to contraceptive discontinuation and method switch among Kenyan women: a prospective cohort study.BJOG : an international journal of obstetrics and gynaecology · 2022Article
- Expectations versus reality: Two cross-sectional studies on expected and experienced discontinuation symptoms in current and former contraceptive pill users.Women's health (London, England)Article
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Authors and funding
12 authors at 5 institutions in 3 countries.
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Abstract
objectiveTo determine the contribution of specific contraceptive side effects to method switch and modern-method discontinuation among Kenyan women.
designA prospective cohort study.
settingFive counties in Western Kenya.
participantsWomen aged ≥18 years old and emancipated female minors ≥14 years old using modern, reversible contraception were recruited while attending 10 public health facilities.
methodsPatient-reported adverse effect symptoms, method switch and discontinuation were reported through weekly text message-based surveys for 24 weeks. MAIN OUTCOME MEASUREMENTS: Prevalence, hazards ratio (HR).
resultsAmong 825 women, 44% were using implants, 43% injectables, 7% an intrauterine device and 6% oral contraceptive pills at enrolment. Most (61%) women were continuing a method used in the previous month. During the 24-week follow up, incidence of contraceptive switch was 61.3 per 100 person-years (95% confidence interval [CI] 52.4-71.8) and incidence of discontinuation was 38.5 per 100 person-years (95% CI 31.6-47.0). On average, one-quarter (prevalence [Pr] 0.24, 95% CI 0.22-0.26) of participants reported side effects or method problems weekly, with sexual side effects the most prevalent symptom (Pr 0.15, 95% CI 0.13-0.16). Lack of expected bleeding was associated with higher risk of method switch (adjusted hazard ratio [aHR] 2.36, 95% CI 1.22-4.57). Risk of all-modern method discontinuation was higher among women experiencing irregular bleeding (aHR 2.39, 95% CI 1.20-4.77), weight changes (aHR 2.72, 95% CI 1.47-4.68) and sexual side effects (aHR 2.42, 95% CI 1.40-4.20).
conclusionsAddressing irregular bleeding, weight changes and sexual side effects through development of new products that minimise these specific side effects and anticipatory counseling may reduce method-related discontinuation. TWEETABLE ABSTRACT: Bleeding, weight changes, sexual problems associated with discontinuation of #contraception, but many continue despite side effects.
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