Use of the pill by adolescents for contraception or as therapy
Van Hooff, M.H.; Hirasing, R.A.; Kaptein, M.; Koppenaal, C.; Voorhorst, F.J.; Schoemaker, J.
Nederlands Tijdschrift Voor Geneeskunde 139(4): 178-182
1995
ISSN/ISBN: 0028-2162 PMID: 7845497 Document Number: 440489
The objective was to describe frequency of oral contraceptive (OC) use, indications for OC use and influence of calendar age, gynecological age (age minus age at menarche), and level of education on OC use among 9th grade secondary school girls. Secondary schools of 4 different types in Amstelland-de Meerlanden, a combined urban and rural region to the south of Amsterdam, were surveyed during the 1990-91 school year by questionnaire and individual interview on menstrual cycle pattern and OC use, and school girls were asked about the duration and reasons for OC use and what preparation they used. The response rate was 92% to the questionnaire and 83% to the interview. Of the 2248 respondents, 248 (11%; mean age 15.3 years) used OCs: 74% used low-dose sub-50 mcg preparations, 3% used pills with 50 mcg of estrogen, 3% used 3-phase preparations, and 17% used pills with antiandrogens. 4%, 12%, 28%, and 42%, respectively, of girls 14, 15, 16, and 17 years old used OCs. 36% of the 15-year-old girls mentioned contraception as the most important reason, 20% menstrual cycle irregularity, 28% dysmenorrhea, 12% acne, and 5% other reasons. Among 14-, 15-, and 16-year old girls, contraception was cited as the most important reason for OC use by 4%, 31%, and 36%, respectively. 39 girls used OCs for acne, of whom 34 used a preparation containing cyproterone acetate. Multiple logistic regression analysis indicated age, gynecological age, and level of education as independent variables for OC use in general and for OC use for contraception or dysmenorrhea, but less so for OC use for menstrual cycle irregularity or acne. In the model of OC use for contraception, age was the most important determinant, while in the model of OC use for dysmenorrhea it was the gynecological age. OC use for menstrual cycle control was associated significantly with age and gynecological age, but not with school type (p=0.07). In the first year after menarche not a single girl used OCs for menstrual cycle regulation.