Menstrual symptoms, satisfaction, adherence, health-related quality of life, and depression during monthly-cycle oral contraception among women in the European Union (EU) and the United States (US)
Inaki Lete (ES), Lulu Lee (US), Natalia Flores (US), Rossella Nappi (IT), Marie-Christine Micheletti (NL), Boxiong Tang (US)
[Lete] University Hospital Araba, [Lee] Kantar Health, [Flores] Kantar Health, [Nappi] University of Pavia, [Micheletti] Teva Europe Women’s Health, [Tang] Teva Pharmaceuticals
Context: Women in the US demonstrated beneficial outcomes using extended-cycle oral contraception (OC) in the 2013 National Health and Wellness Survey (NHWS). Extended-cycle OC is a new option for EU women seeking OC. Objective: To understand if EU women may benefit from extended-cycle OC, we examined US and EU women side by side. Methods: The NHWS was conducted in the US (N=75,000) and 5 EU countries (EU5 [UK, France, Germany, Italy, Spain], N=62,000). Descriptive data were examined; no statistical tests were performed. Patients: Women 18-50 yrs, premenopausal, without hysterectomy, and reported using monthly-cycle OC. Intervention: The NHWS was given to women in the US and EU5 and examined descriptively. Main Outcome Measure: Outcomes included presence of menstrual cycle pain in the past month, heavy menstrual bleeding, dysmenorrhea, satisfaction with OC, and adherence. Health-related quality of life (HRQOL) was assessed by physical component summary (PCS), mental component summary (MCS), and health utilities index (SF-6D). Depression (Patient Health Questionnaire-9) was assessed. Results: 3616 US and 5905 EU5 women were included. Menstrual cycle pain in the past month was reported in 36.1% vs 47.7% EU5 vs US women, heavy menstrual bleeding 11.2% vs 14.3%, and dysmenorrhea 23.7% vs 15.0%. Duration of OC use was 68.2±64.8 mo in EU5 women vs US 58.9±62.8 mo. Mean satisfaction appeared lower in EU5 women (5.5±1.5 vs US 5.8±1.2), but low to medium adherence was similar between groups. HRQOL was similar for PCS (EU5 54.4±7.3 vs US 54.4±7.0); slightly lower MCS (EU5 44.2±10.5 vs US 46.7±10.2) and SF-6D (EU5 0.7±0.1 vs US 0.8±0.1) in EU5. EU5 women appeared to report slightly higher mean depression (5.4±5.3 vs US 4.8±5.3). Conclusion: Outcomes did not differ greatly among EU5 and US women. Results suggest women in EU5 may also show improved outcomes with extended-cycle OC.