Situation of Adolescent Contraceptive Use in Germany

Abstract

Introduction Would adolescent girls in Germany choose a different method of contraception to the combined oral contraceptive if provided with the appropriate information? Is there a need for long-acting contraception among our adolescent girls? How satisfied are female patients with the information they receive at their respective gynaecology practices, and how much do the girls know about different methods of contraception? Materials and Methods In the study “Thinking About Needs in COntraception” (TANCO), not only female patients, but also their respective gynaecologists were surveyed online about current methods of contraception, their satisfaction with these methods, and also their level of knowledge concerning the individual methods of contraception, the situation related to advice about different contraceptive options and their general satisfaction with gynaecological care. This article presents the data from the subset of adolescent girls aged 14 to 19 years (n = 2699) out of the total of 18 521 women surveyed. Results The girls surveyed were familiar with at least the name of more than five different methods of contraception (average 5.3). The doctors assumed that the respondents would know only 4.2 different methods. When asked explicitly about how the individual methods of contraception work, clear deficits became evident. This applies not only to the entire population of respondents, but also the users of the respective contraceptive method. In addition, a strong interest in long-acting contraception emerged from the survey, particularly among young women. Discussion The data from the TANCO study reveal a clear discrepancy between the existing contraception almost exclusively in the form of the contraceptive pill and the contraceptive options considered by adolescent girls if they are thoroughly informed. The need for education into alternatives to the pill is high, as is the willingness to use such alternatives after receiving information – much higher than the figures suggested by the gynaecologists.

Evaluation of a patient-centred, needs-based approach to support shared decision making in contraceptive counselling: the COCO study

“…(questionnaire approach) (Table 1). The questionnaire content was based on insights gathered from the TANCO [5,8] and CHOICE [12] studies and the professional counselling experience of the authors (PGO and JB).…”

“…A key step in achieving a shared decision-making approach is understanding what is important to women seeking contraception. Although there is a high prevalence of contraceptive use among women in Germany, there is a lack of valid data regarding their contraceptive needs and preferences [4,5]. Surveys of contraceptive use in Germany show that combined oral contraceptives (COCs) remain the most commonly used method, with little use of methods such as the contraceptive ring, the levonorgestrel-releasing intrauterine system (LNG-IUS), copper intrauterine device (IUD) or hormonal implant [4,5].…”

“…Although there is a high prevalence of contraceptive use among women in Germany, there is a lack of valid data regarding their contraceptive needs and preferences [4,5]. Surveys of contraceptive use in Germany show that combined oral contraceptives (COCs) remain the most commonly used method, with little use of methods such as the contraceptive ring, the levonorgestrel-releasing intrauterine system (LNG-IUS), copper intrauterine device (IUD) or hormonal implant [4,5]. These surveys also show a lack of knowledge regarding how different methods work [5] and their effectiveness [6,7].…”

“…Surveys of contraceptive use in Germany show that combined oral contraceptives (COCs) remain the most commonly used method, with little use of methods such as the contraceptive ring, the levonorgestrel-releasing intrauterine system (LNG-IUS), copper intrauterine device (IUD) or hormonal implant [4,5]. These surveys also show a lack of knowledge regarding how different methods work [5] and their effectiveness [6,7]. For example, studies show that women consistently overestimate the effectiveness of COCs and underestimate the effectiveness of long-acting reversible contraceptive (LARC) methods [6][7][8].…”

“…The Thinking about Needs in Contraception (TANCO) studies, conducted initially in Germany [5] and then expanded across 10 EU countries [8], showed that HCPs consistently underestimate women's interest in hearing about different methods. This mismatch in understanding the need for knowledge and information may contribute to dissatisfaction with contraceptive methods [9].…”