Women’s Perspectives on Contraceptive-Induced Amenorrhea in Burkina Faso and Uganda

Citation

Mackenzie, Amelia C. L.; Curtis, Siân L.; Callahan, Rebecca L.; Tolley, Elizabeth E.; Speizer, Ilene S.; Martin, Sandra L.; & Brunie, Aurélie (2020). Women's Perspectives on Contraceptive-Induced Amenorrhea in Burkina Faso and Uganda. International Perspectives on Sexual and Reproductive Health, 46, 247-262.

Abstract

CONTEXT: Women's concerns about contraceptive-induced menstrual changes can lead to method discontinuation and nonuse, contributing to unmet need for contraception. Research on women's perceptions of amenorrhea related to longer acting methods and in low-income countries is limited.
METHODS: Data were from nationally representative household surveys and focus group discussions with women of reproductive age conducted in Burkina Faso and Uganda in 2016-2017. Bivariate cross-tabulations and multivariate logistic regression analyses were used to examine sociodemographic and reproductive characteristics associated with women's attitudes about contraceptive-induced amenorrhea (n=2,673 for Burkina Faso and 2,281 for Uganda); menstrual health determinants were also examined for Burkina Faso. Qualitative data from focus group discussions were analyzed to understand reasons behind women's attitudes and how they influence contraceptive decision making.
RESULTS: Sixty-five percent of women in Burkina Faso and 40% in Uganda reported they would choose a method that caused amenorrhea during use. In Burkina Faso, the predicted probability of accepting amenorrhea was higher for women aged 15-19 (compared with older women), living in rural areas, married and cohabiting (compared with never married), currently using a contraceptive method (compared with never users) and from Mossi households (compared with Gourmantché); menstrual health practices were not associated with amenorrhea acceptability. In Uganda, the least wealthy women had the highest predicted probability of accepting amenorrhea (51%). Qualitative analysis revealed a variety of reasons for women's attitudes about amenorrhea and differences by country, but the relationship between these attitudes and contraceptive decision making was similar across countries.
CONCLUSIONS: Addressing misconceptions about contraception and menstruation may result in more informed method decision making.

URL

http://dx.doi.org/10.1363/46e1520

Reference Type

Journal Article

Year Published

2020

Journal Title

International Perspectives on Sexual and Reproductive Health

Author(s)

Mackenzie, Amelia C. L.
Curtis, Siân L.
Callahan, Rebecca L.
Tolley, Elizabeth E.
Speizer, Ilene S.
Martin, Sandra L.
Brunie, Aurélie

Article Type

Regular

Continent/Country

Burkina Faso
Uganda

Sex/Gender

Women

ORCiD

Speizer - 0000-0001-6204-1316
Curtis - 0000-0001-5225-860X