Women's attitudes about combined hormonal contraception (CHC) - induced menstrual bleeding changes - influence of personality traits in an Italian clinical sample.

OBJECTIVES We investigated the attitudes to change the frequency of menstrual bleeding by using combined hormonal contraception (CHC). Personality characteristics were also explored. METHODS We conducted a cross-sectional study in two university hospitals in northern Italy. Current, past and never CHC users (n = 545; age 18-44 years) completed a self-administered semi-structured questionnaire and the Ten-Item Personality Inventory (TIPI). RESULTS Forty-five percent of responders (n = 301) would prefer to change their bleeding frequency by using CHC. A flexible regimen was the preferred choice (n = 80; 33%) followed by extended regimens to bleed every 3 months (n = 54; 22%) or to never bleed (n = 43; 18%). The main positive reasons were to avoid dysmenorrhea (43%) and have more freedom in sexual (36%) and active (35%) life, whereas the main reason for a negative attitude was 'menstrual rhythm is natural' (59%). Age had a significant influence on women's willingness to change menstrual frequency by using CHC [>39 years (57%), 30-39 years (31%) and <30 years (46%)] (χ2: 9.1; p = 0.01). Never users significantly reported a more negative attitude (71%) in comparison with past (51%) and current users (49%) (χ2: 18.7; p = 0.001). Personality traits played a role, with higher scores of openness (p = 0.005) and extraversion (p = 0.001) in women with a positive attitude. CONCLUSIONS Almost half of our study sample reported a preference for changing their menstrual pattern by using CHC. Flexibility was the preferred choice across age and use of CHC. Personality characteristics (openness and extroversion) might influence attitudes toward CHC-induced menstrual bleeding changes.

[1]  B. Derntl,et al.  Weak associations between personality and contraceptive choice , 2022, Frontiers in Neuroscience.

[2]  C. Kennedy,et al.  Values and preferences for contraception: A global systematic review , 2022, Contraception.

[3]  S. Kaplan,et al.  Long-term safety of extended levonorgestrel-containing oral contraceptives in the United States. , 2021, Contraception.

[4]  Dominic P. Kelly,et al.  No personality differences between oral contraceptive users and naturally cycling women: Implications for research on sex hormones , 2019, Psychoneuroendocrinology.

[5]  Beth Sundstrom,et al.  The myth of menstruation: how menstrual regulation and suppression impact contraceptive choice , 2019, BMC Women's Health.

[6]  R. Sánchez-Borrego,et al.  Cross-sectional evaluation of the impact of information on flexible extended regimens of oral contraceptives in the choices made by women seeking contraceptive counselling: the FLEXO study , 2018, The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception.

[7]  E. MacGregor,et al.  The 7-day contraceptive hormone-free interval should be consigned to history , 2018, BMJ Sexual & Reproductive Health.

[8]  A. Berry,et al.  There might be blood: a scoping review on women’s responses to contraceptive-induced menstrual bleeding changes , 2018, Reproductive Health.

[9]  N. Flores,et al.  Real-world experience of women using extended-cycle vs monthly-cycle combined oral contraception in the United States: the National Health and Wellness Survey , 2018, BMC Women's Health.

[10]  J. Bitzer,et al.  Contraceptive counselling and care: a personalized interactive approach , 2017, The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception.

[11]  C. Fiala,et al.  Women’s preferences for menstrual bleeding frequency in 12 European countries: the Inconvenience Due to Women’s Monthly Bleeding (ISY) survey , 2017, The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception.

[12]  R. Ballester-Arnal,et al.  Personality as a mediating variable in condom use among Spanish youth , 2017, Journal of health psychology.

[13]  C. Fiala,et al.  Women’s preferences for menstrual bleeding frequency: results of the Inconvenience Due to Women’s Monthly Bleeding (ISY) survey , 2016, The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception.

[14]  R. Nappi,et al.  Extended regimen combined oral contraception: A review of evolving concepts and acceptance by women and clinicians , 2015, The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception.

[15]  E. Micks,et al.  Why Stop Now? Extended and Continuous Regimens of Combined Hormonal Contraceptive Methods. , 2015, Obstetrics and gynecology clinics of North America.

[16]  C. Benedetto,et al.  Effects of combined hormonal contraception on health and wellbeing: Women's knowledge in northern Italy , 2015, The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception.

[17]  V. Newton,et al.  Hormonal contraception and regulation of menstruation: a study of young women's attitudes towards ‘having a period’ , 2014, Journal of Family Planning and Reproductive Health Care.

[18]  R. Sánchez-Borrego,et al.  Extended regimens of combined hormonal contraception to reduce symptoms related to withdrawal bleeding and the hormone-free interval: A systematic review of randomised and observational studies , 2014, The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception.

[19]  B. Seifert,et al.  A survey on Swiss women's preferred menstrual/withdrawal bleeding pattern over different phases of reproductive life and with use of hormonal contraception , 2014, The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception.

[20]  J. Stephenson,et al.  Evolution of extended use of the combined oral contraceptive pill , 2014, Journal of Family Planning and Reproductive Health Care.

[21]  Laura A Percy,et al.  Tailoring oral contraceptive pills to meet the needs of women , 2013, Journal of Family Planning and Reproductive Health Care.

[22]  C. Minson,et al.  Characteristics of scheduled bleeding manipulation with combined hormonal contraception in university students. , 2013, Contraception.

[23]  A. Szarewski,et al.  Women's attitudes towards monthly bleeding: Results of a global population-based survey , 2012, The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception.

[24]  J. Bitzer,et al.  The CHOICE study: Effect of counselling on the selection of combined hormonal contraceptive methods in 11 countries , 2012, The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception.

[25]  I. Wiegratz,et al.  Long-Cycle Treatment with Oral Contraceptives , 2012, Drugs.

[26]  T. Kuehl,et al.  Attitudes and prescribing patterns of extended-cycle oral contraceptives. , 2011, Contraception.

[27]  P. Jordan,et al.  Military women's attitudes toward menstruation and menstrual suppression in relation to the deployed environment: development and testing of the MWATMS-9 (short form). , 2010, Women's health issues : official publication of the Jacobs Institute of Women's Health.

[28]  R. Snow,et al.  Association between characteristics of current menses and preference for induced amenorrhea. , 2009, Contraception.

[29]  A. Paoletti,et al.  Attitudes of Italian women concerning suppression of menstruation with oral contraceptives , 2008, The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception.

[30]  J. Steinauer,et al.  Extended cycle combined hormonal contraception. , 2007, Obstetrics and gynecology clinics of North America.

[31]  N. Ragni,et al.  What is the desired menstrual frequency of women without menstruation-related symptoms? , 2006, Contraception.

[32]  A. Faúndes,et al.  Menstruation and amenorrhea: opinion of Brazilian women. , 2005, Contraception.

[33]  I. Wiegratz,et al.  Attitude of German women and gynecologists towards long-cycle treatment with oral contraceptives. , 2004, Contraception.