Factors effecting continuation rates in users of monthly contraceptive injections in Turkish women

Factors effecting continuation rates in users of monthly

contraceptive injections in Turkish women 

I. Gönenç, EZ. Tuzcular Vural, G. Köse,

N. Aka 

Haydarpaca Numune Education and Research Hospital, Family Planning Unit,

Istanbul, Turkey 

Objectives In this study we aimed to investigate the factors

effecting continuation rates in users of monthly norethisterone enanthate (NET-EN)

/ estradiol valerate (EV) injections as a contraceptive method. 

Design and methods Two hundred and forty-five NET-EN/EV users who were being followed-up in a family planning

unit setting were evaluated. Inclusion criteria for the study were a minimum of

three injections applied in the same unit, willingness to answer the

questionnaire and to have complete records. A standardized questionnaire which

consisted of 25 closed-ended questions was used to evaluate the 180 women who

fulfilled the criteria. The data collected was analyzed using the chi-square test using

SPSS-9.0 for Windows statistics programme. The relation between continuation

rates and various factors were investigated using the chi-square test for statistical


Results We found the discontinuation rate for NET-EN/EV injections to

be 43.3%.The most frequent reason for preferring the method was reliability

(48.9%).The most frequently encountered bleeding problem was spotting (27.2%).

Spotting was also the most common complaint and side effect (12.2%). The most

common reason for discontinuation was planning to conceive (39.4%), but we also

found worth to mention that 77.5% of the discontinuers had not started a new

method of contraception. Although we couldn’t find a statistically significant

relationship between abandoning the method and age, women over 36 years had a

greater tendency to continue the method (73.2%). Educational status,

occupational status, monthly income, social health security and presence of a

systemic illness did not have statistically significant relationship with

discontinuing the method (p>0.05).The total number of pregnancies, deliveries,

live births, abortions and menstrual patterns did not have a statistically

significant relationship in abandoning the method (p>0.05). However,

continuation rates were higher than average in women with 5 or more pregnancies.

Although continuation rates were higher in women with a first pregnancy age

younger than 20 years of age, the difference between different age groups did

not prove this relationship to be statistically significant (p>0.05).There

was a positive correlation between spotting and discontinuing the method


Conclusions NET-EN/EV has been available in Turkey for over a

decade. Parameters other than side effects are not related to discontinuation of

NET-EN/EV use. Turkish women find this method reliable and effective, but should

be followed closely and counseled about side effects in order to increase

continuation rates.

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