Women’s perceptions about reducing the frequency of monthly bleeding: results from a multinational survey

Abstract

Background:Monthly bleeding can have a negative impact on daily life and, given the choice, many women would reduce the frequency of bleeding. While some women choose to occasionally postpone or reduce bleeding frequency with an oral contraceptive (OC), most women have no or limited experience of regularly reducing the frequency of scheduled bleeding with OCs, ie, the extended OC regimen. Study design: An online survey of 4039 women aged 15-49 years who were currently using, had used, or would consider using any form of hormonal contraception was conducted in Brazil, Canada, Czech Republic, France, Germany, Italy, UK, and USA to assess awareness of and the reasons for and against reducing bleeding frequency. Results: Overall, 51.1% and 30.7% of women surveyed were aware that they could occasionally or regularly reduce bleeding frequency with an OC. Moreover, 27.6% and 9.9% of previous/ current OC users had occasionally or regularly reduced bleeding frequency with an OC. The main reasons for reducing bleeding frequency were convenience, physician recommendations, special events, and relief of problems associated with bleeding. Many women mistakenly believed that reducing bleeding frequency would have a negative health impact. Conclusion: Additional efforts are needed to educate women about the possibility and potential health benefits of reducing bleeding frequency and to dispel misconceptions about the use of extended OC regimens.

Unmet Need for Family Planning in Ghana: The Shifting Contributions of Lack of Access and Attitudinal Resistance

“…As also found in Nigeria (Glasier et al 2003), Ghanaian women may prefer to menstruate regularly and any disturbance may cause anxiety. Similar concerns regarding reduced bleeding frequency associated with Studies in Family Planning 45(2) June 2014 pill use were found in a study in Europe, Latin America, and North America (Szarewski and Moeller 2013). Many women were worried about the possible health impact and thought that loss of menses was "unnatural."…”

There might be blood: a scoping review on women’s responses to contraceptive-induced menstrual bleeding changes

“…Thirty-three studies had information pertinent to this topic, including six in Africa [ 43 , 47 , 87 , 104 , 107 , 122 ], nine in the Americas [ 44 , 46 , 57 , 103 , 133 – 137 ], five in Asia [ 45 , 63 , 64 , 83 , 114 ], nine in Europe [ 51 , 52 , 60 , 67 , 88 , 97 , 109 , 110 , 138 ], two in Oceania [ 106 , 139 ], and two in multi-country studies [ 50 , 140 ]. In studies across multiple countries, including Mali, Kenya, South Africa, Brazil, Spain, the Dominican Republic, Canada, the US, and the UK, regular menstruation was viewed by many women as a marker of health and fertility, as well as providing reassurance of not being pregnant [ 47 , 50 , 51 , 57 , 87 , 103 , 133 – 135 , 137 , 138 ].…”

“…Ten studies, primarily from higher-income countries, provided information specifically pertinent to how women perceive use of menstrual suppression in relation to health concerns [ 44 , 52 , 60 , 67 , 109 , 133 , 135 , 136 , 139 , 140 ]. The largest of these was an online survey of over 4000 women across eight countries (Brazil, Canada, the Czech Republic, France, Germany, Italy, the UK, and the US) [ 140 ]. Health concerns were substantial for women with respect to menstrual suppression, with 42% of women believing that postponing monthly bleeding would have negative effects on their health [ 140 ].…”

“…The largest of these was an online survey of over 4000 women across eight countries (Brazil, Canada, the Czech Republic, France, Germany, Italy, the UK, and the US) [ 140 ]. Health concerns were substantial for women with respect to menstrual suppression, with 42% of women believing that postponing monthly bleeding would have negative effects on their health [ 140 ].…”

“…Some studies discuss other hormonal methods [ 66 , 78 , 139 ] or use of hysterectomy to suppress menstruation [ 139 ]. Other considerations related to menstrual suppression included: practicality and convenience of avoiding menstruation [ 52 , 59 , 135 , 139 – 141 ], fertility concerns [ 60 , 61 , 67 , 134 , 136 , 139 ], perceptions of short and long term health effects [ 44 , 51 , 60 , 61 , 64 , 67 , 134 , 136 , 139 , 140 ], cost of menstrual suppression [ 134 ] and feminine hygiene products [ 52 , 135 ], impact of menstruation on activities [ 51 , 59 , 64 , 66 , 70 , 135 ], management of pain, heavy bleeding or other undesirable menstrual symptoms [ 51 , 53 , 59 , 60 , 62 , 135 , 136 , 141 ], concerns about becoming pregnant while suppressing menstruation [ 52 , 60 , 140 ], and information from or recommendation of a medical provider about menstrual suppression [ 57 , 59 , 61 , 138 ].…”