Doctor contraceptive-prescribing behaviour and women's attitudes towards contraception: two European surveys

J Eval Clin Pract. 2011 Jun;17(3):493-502. doi: 10.1111/j.1365-2753.2010.01465.x. Epub 2010 Jun 10.


Rationale, aims and objectives: Many women are prescribed oestrogen-containing contraceptives for whom oestrogen-containing methods may be less suitable.

Methods: Two surveys examining contraceptive prescription practices among doctors (n = 419) and attitudes towards contraception among women (n = 1623) in France, Germany, Spain, Italy and Russia were evaluated.

Results: Progestin-only pills and hormone-free intrauterine devices were the most commonly prescribed contraceptives for women with medical conditions for which oestrogen-containing methods are not preferred (40% and 20%, respectively), those suffering from oestrogen-related side effects (32% and 21%) and those with concerns about the safety of oestrogen-containing methods (28% and 24%). Combined oral contraceptives (COC) were prescribed to ≥ 10% in these two groups. One-quarter of contraceptive users had asked to be switched from one COC to another because of oestrogen-related side effects; a similar proportion had been switched by their doctor for this reason. Half of the women surveyed did not want or had concerns about foreign/additional oestrogen, and about 80% said that they would consider switching to a different hormonal contraceptive to minimize oestrogen exposure. Although most doctors were aware of the World Health Organization medical eligibility criteria for contraceptive use, they still prescribed COCs or other oestrogen-containing contraceptives to women with medical conditions for which oestrogen-containing options are not favoured, suggesting a need for additional education.

Conclusion: By complying with guidelines and heeding women's concerns, doctors can individualize their contraceptive recommendation to improve safety, acceptance and compliance and, ultimately, reduce the risk of an unintended pregnancy.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Contraceptive Agents, Female / administration & dosage
  • Contraceptive Agents, Female / adverse effects
  • Contraceptive Agents, Female / therapeutic use*
  • Contraceptive Devices, Female / adverse effects
  • Contraceptive Devices, Female / statistics & numerical data*
  • Cross-Sectional Studies
  • Estrogens / administration & dosage
  • Estrogens / adverse effects
  • Estrogens / therapeutic use*
  • Europe
  • Female
  • Guideline Adherence / statistics & numerical data
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Women's Health
  • World Health Organization
  • Young Adult


  • Contraceptive Agents, Female
  • Estrogens