Treatment satisfaction, adherence, and menstrual symptoms among women in five European Union countries using monthly-cycle oral contraception
Rossella Nappi (IT), Iñaki Lete (ES), Natalia Flores (US), Lulu Lee (US), Marie-Christine Micheletti (NL), Boxiong Tang (US)
[Nappi] Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause , [Lete] Araba University Hospital, [Flores] Kantar Health, [Lee] Kantar Health, [Micheletti] Teva Europe Women’s Health, [Tang] Teva Pharmaceuticals
Context: Women in the European Union (EU) seeking oral contraception (OC) have recently been given the option of extended-cycle OC. Beneficial outcomes among women in the United States using extended-cycle OC were demonstrated using data from the 2013 National Health and Wellness Survey (NHWS). Objective: To examine outcomes among EU women receiving monthly-cycle OC to assess whether they may benefit from extended-cycle OC. Methods: The NHWS was conducted in 5 EU countries (N=62,000): the United Kingdom (N=15,000), France (N=15,000), Germany (N=15,000), Italy (N=10,000), and Spain (N=7,000). Analyses were descriptive. Patients: Women included were premenopausal, without hysterectomy, and 18-50 years old, who reported current use of monthly-cycle OC. Intervention: NHWS data were examined. Main Outcome Measure(s): Assessments included satisfaction with monthly-cycle OC, adherence, and presence in the past month of menstrual cycle pain, heavy menstrual bleeding, or dysmenorrhea. Menstrual-related symptoms due to premenstrual syndrome (PMS)/premenstrual dysphoric disorder (PMDD) were examined. Depression (Patient Health Questionnaire [PHQ]-9) was assessed. Results: 5,905 women were enrolled. Low to medium adherence was reported by 64.0%-75.0% of women, and moderate to high satisfaction was reported with monthly-cycle OC. Reports of heavy menstrual bleeding ranged from 7.7%-16.1%, menstrual cycle pain in the past month ranged from 29.9%-46.5%, and presence of dysmenorrhea ranged from 17.0%-38.1%. The most frequently reported PMS/PMDD physical symptom was abdominal pain, ranged from 62.6%-80.4%. Among PMS/PMDD emotional symptoms, irritability was most common, ranged from 55.7%-69.5%. Mean depression scores ranged from 4.9±5.2 to 6.1±5.2. Conclusions: Our findings indicate a need for improvement in OC-related outcomes. Women in the EU may benefit from an extended-cycle OC.