3rd and 4th generation estroprogestatives French controversy: What ă effect on women's behavior?

Objective > The primary objective of this study was to determine the ă reasons given by women who have changed or suspended their contraceptive ă method in 2013. What influence had the 3rd and 4th generation ă estroprogestatives (EP) French controversy and advices from doctors? Did ă they notice any consequences of the controversy on their lifestyle? Did ă they feel an impact on their behavior to health professionals? ă Methods > A study was conducted on women of childbearing age. Data ă collection took place between November 4 and December 16, 2013. The ă included subjects were between 18 and 55 years old females. Subjects ă were surveyed through an anonymous self-administered questionnaire ă distributed through pharmacies. The protocol called for the construction ă of clusters of subjects by having heard about, or not, of the ă controversy. Patients reporting having heard about the controversy have ă formed the ``exposed'' group while the others have formed the ă ``unexposed'' group. We compared two parameters between these two ă groups: the rate of subjects who reported having modified or suspended ă their contraceptive method in 2013 on one hand, and the rate of subjects ă who reported having made a change in their contraceptive method without ă or against advices from a doctor on the other hand. ă Results > The sample included 988 subjects. The average age was 34 ă years. The level of exposure to media debates was 86.5%. Of the ă respondents, 19.8% were under 3rd or 4th generation EP in 2012, thus ă directly involved in the discussions and affected by health ă recommendations. Of the patients, 38.5% reported having changed their ă contraception in 2013. In these women, when they confirmed having heard ă about the controversy, 40.1% of them claimed to have conducted this ă process without or against advices from a doctor. This number dropped to ă 18.2% for those who had not heard of it. Media coverage of the 3rd and ă 4th generation EP vascular risk was not mentioned more by patients who ă suspended all medical contraceptive method than it was by patients who ă simply changed their method. In all, 52.1% of women who completely ă stopped their contraception indicated that this choice was at least ă partly due to a change in their sexuality or reproductive life. This ă reason was evoked only in 19.0% of women who have simply made a change ă of contraceptive method. Among the views of women, the EP controversy ă was one of the reasons for a change of contraception method in 41.8% of ă cases, while advices from a doctor did play a role in 19.9% of cases. ă One has seen a decline of 11.0% of oral contraception between 2012 and ă 2013, almost superimposed on that of oral 3rd and 4th generation EP ă (10.6%). However, the use of 1st and 2nd generation EP stagnated: their ă increase was 0.4%. Beyond any change of contraceptive method, 66.9% of ă women expressed the absence of any impact of the controversy on their ă behavior. Of the women, 6.1% showed a loss of confidence in health ă professionals. ă Conclusion > We have shown how patients who stopped or modified their ă contraception method during 2013 placed the controversy influence in the ă forefront of the reasons for their decision. Although a medical reason ă has been widely quoted, only one in five felt that the advice of her ă doctor had clearly contributed to her choice. The influence of the media ă seemed to encroach on the doctor-patient relationship, which is ă fundamental to the quality of healthcare in the long term.