Does structured counselling influence combined hormonal contraceptive choice?

Eur J Contracept Reprod Health Care. 2011 Dec;16(6):418-29. doi: 10.3109/13625187.2011.625882.


Objective: To assess the effect of structured counselling on women's contraceptive decisions and to evaluate gynaecologists' perceptions of comprehensive contraceptive counselling.

Methods: Belgian women (18-40 years old) who were considering using a combined hormonal contraceptive (CHC) were counselled by their gynaecologists about available CHCs (combined oral contraceptive [COC], transdermal patch, vaginal ring), using a comprehensive leaflet. Patients and gynaecologists completed questionnaires that gathered information on the woman's pre- and post-counselling contraceptive choice, her perceptions, and the reasons behind her post-counselling decision.

Results: The gynaecologists (N=121) enrolled 1801 eligible women. Nearly all women (94%) were able to choose a method after counselling (53%, 5%, and 27% chose the COC, the patch, and the ring, respectively). Counselling made many women (39%) select a different method: patch use increased from 3% to 5% (p<0.0001); ring use tripled (from 9% to 27%, p<0.0001). Women who were undecided before counselling most often opted for the method their gynaecologist recommended, irrespective of counselling.

Conclusion: Counselling allows most women to select a contraceptive method; a sizeable proportion of them decide on a method different from the one they initially had in mind. Gynaecologists? preferences influenced the contraceptive choices of women who were initially undecided regarding the method to use.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Attitude of Health Personnel*
  • Belgium
  • Confidence Intervals
  • Contraceptive Agents, Female / administration & dosage*
  • Contraceptive Devices, Female
  • Contraceptives, Oral, Combined
  • Contraceptives, Oral, Hormonal
  • Counseling*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Education as Topic*
  • Patient Preference*
  • Portugal
  • Surveys and Questionnaires
  • Transdermal Patch
  • Young Adult


  • Contraceptive Agents, Female
  • Contraceptives, Oral, Combined
  • Contraceptives, Oral, Hormonal