Impact of Coronavirus disease 2019 (COVID-19) on contraception use in 2020 and up until the end of April 2021 in France

Abstract

Objectives : To assess the impact of the COVID-19 pandemic on the use of reimbursed contraceptives in France after 15 months of the pandemic, according to age-group and updating previous data only pertaining to the first lockdown (two months). Study design : We conducted a national register-based study by extracting all reimbursements of oral contraceptives (OC), emergency contraception (EC), intra-uterine devices (IUD) and implants from the French National Health Insurance database (SNDS), which includes and covers 99.5% of the French population, in 2018, 2019, 2020 and from 01/01/2021 to 04/30/2021. We calculated the expected use of contraceptives in 2020 and 2021 in the absence of the pandemic, based on 2018 and 2019 usage and taking annual trends into account. We assessed the difference between observed and expected dispensing rates by contraceptive type and by age-group (≤18 years old, 18<age≤25, 25<age≤35, >35). Results : Dispensing of all contraceptives decreased compared to expected dispensing numbers: -2.0% for OC, -5.3% for EC, -9.5% for LNG-IUS, -8.6% for C-IUD, and -16.4% for implant. This decrease in the dispensing of contraceptives was observed in all age-groups, but mainly concerned women under the age of 18 years (-22% for OC, -10% for EC, -37.2% for LNG-IUS, -36.4% for C-IUD, -26.4% for implant) and those aged 18-25 (-5.1% for OC, -11.9% for EC, -18.1% for LNG-IUS, -15.9% for C-IUD, -17.6% for implants). Conclusions : Our study showed that the dispensing of contraceptives in France was markedly impacted by the COVID-19 pandemic. Prescriptions for long-acting contraceptive use and women under the age of 25 years were the most substantially impacted. Ensuring access to contraceptive methods during health emergencies must be a public health policy priority.

Women’s Access to Sexual and Reproductive Health Services during Confinement Due to the COVID-19 Pandemic in Spain

“…Dispensation of emergency oral contraception products is free in pharmacies; therefore, their use and access by women should not have been compromised in Spain. However, these data are in line with what happened in other European countries where consumption was also reduced [28].…”

Impact of COVID-19 on the prescription of contraceptives in a city in São Paulo

“…This fact may be associated with the reduction in offers of face-to-face consultations in gynecology, due to the social isolation necessary at the time of the pandemic. Other international studies also showed these same trends, such as a French study that showed a 2% reduction in the dispensing of oral contraceptives during the lockdown period, with prescriptions for the use of long-term contraceptives and women under 25 years of age being the most impacted 16 . This behavior was also observed in a South African study that reported reduced use of LARCs during the first 5 weeks of social isolation 17 .…”

“…The impact of these restrictions on unwanted pregnancy at a population level remains undetermined 16 . However, the negative effects seem to be more evident in low-and middle-income countries and among low-income people 17,20,21 .…”

Use of progestogens and the risk of intracranial meningioma: national case-control study

“…Further study to assess a dose-response association in the event of prolonged use would be needed. The progestogen implants (etonogestrel) are also rarely used in France, and concern young women, for whom the risk of meningioma is probably very low 6061. We have also not studied the risk associated with the use of hormonal intrauterine systems containing 19.5 mg levonorgestrel because its marketing in France was too recent (2018).…”