JBM  Vol.5 No.6 , June 2017
Combined Oral Contraceptive Use at the University of Port Harcourt Teaching Hospital, Port Harcourt, Southern Nigeria: A-20 Year Review
Abstract: Background: While the combined oral contraceptive pill (COCP) is one of the most commonly used methods of birth control especially in the developed countries, robust and current information on the pill use in developing countries including Nigeria is at best lacking. Objectives: The study was conducted to determine the prevalence rate, efficacy and side effects of COCP at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Southern Nigeria. Methods: It was a retrospective analysis of all clients who used the COCP between 1st January 1997 and 31st December, 2016, at the family planning clinic of UPTH Port Harcourt. Data on sociodemographic profile, side effects and source of information were extracted from the clients’ case notes coded and fed into Excel spread sheet and analysed. Results: Of the 8310 new acceptors of modern contraceptive methods in UPTH, 399 clients used the COCP, giving a prevalence rate of 4.8%. The mean age of the acceptors was 26.42 ± 4.27 years while the mean parity was 1.90 ± 0.36. Menstrual disruption was the most common complications with 78 episodes constituting 47.0% of all the complications. One unintended pregnancy occurred during the period of observation, giving a Pearl index of 0.01. Conclusion: The study showed that although COCP is very effective, readily available, safe and reliable method of fertility control, the acceptance rate is very low and the patronage rapidly declining and may therefore go into extinction as a family planning method in Port Harcourt, Southern, Nigeria.
Cite this paper: Ojule, J. and Oranu, E. (2017) Combined Oral Contraceptive Use at the University of Port Harcourt Teaching Hospital, Port Harcourt, Southern Nigeria: A-20 Year Review. Journal of Biosciences and Medicines, 5, 7-17. doi: 10.4236/jbm.2017.56002.

[1]   Gallo, M.F., Grimmes, D.A., Schulz, K.F. and Helmershorst, F.M. (2004) Combination Estrogen-Progestin Contraceptives and Body Weight: Systematic Review of Randomised Control Trials. Obstetrics & Gynecology, 103, 359-373.

[2]   Fraser, I.S. (2000) Forty Years of Combined Oral Contraception: The Evolution of a Revolution. The Medical Journal of Australia, 173, 541-544.

[3]   Finger, W.R. (1996) Oral Contraceptives Are Very Safe, Very Effective. Network, 16, 4-5.

[4]   Russell, R. and Kingsland, C. (2008) The Risks and Benefits of Combined Oral Contraceptive Pill. The Journal of the Royal College of Physicians of Edinburgh, 38, 224-227.

[5]   Emuveyan, E.E. (2005) Advances in Contraception. In: Kwawukume, E.Y. and Emuveyan, E.E., Eds., Comprehensive Gynaecology in the Tropics, Graphic packaging Ltd., Accra, 233-246.

[6]   Kripke, C. (2006) Cyclic vs Continuous or Extended Cycle Combined Contraceptives. American Family Physician, 73, 804.

[7]   Edmonds, K. and Gebbie, A.E. (2006) Fertility Control. In: Monga, A., Ed., Gynaecology by Ten Teachers, 18th Edition, Book Power Publishing Company, London, 59-75.

[8]   Stewart, M. and Black, K. (2015) Choosing a Combined Oral Contraceptive Pill. Australian Prescriber, 38, 6-11.

[9]   Fraser, I.S., Jensen, J., Schaefers, M., Mellinger, U., Parke, S. and Serrani, M. (2012) Normalisation of Blood Loss in Women with Heavy Menstrual Bleeding Treated with Oral Containing Estradiol Valerate/Dienogest. Contraception, 86, 96-101.

[10]   Fruzzetti, F., Tremollieres, F. and Bitzer, J. (2012) An Overview of the Development of Combined Oral Contraceptives Containing Estradiol: Focus on Estradiol Valerate/Dienogest. Gynecological Endocrinology, 28, 400-408.

[11]   Iklaki, C.U., Inaku, J.E., Ekabua, J.E., Odusolu, P.O. and Njoku, C.O. (2012) Use of Combined Oral Contraceptive Pill among Teenage Girls in Calabar, Nigeria. Open Access Journal of Contraception, 3, 31-35.

[12]   Michelle, M.D., Roland, T. and Burkman, M.D. (2003) Contraception and Family Planning. In: Decherny, A.H. and Laurent, N., Eds., Current Obstetrics and Gynaecologic Diagnosis and Treatment, Lang Medical Books/McGraw-Hill Companies, Inc., New York, 631-650.

[13]   Mansour, D., Inki, P. and Gemzell-Danielsson, K. (2010) Efficacy of Contraceptive Methods. A Review of the Literature. The European Journal of Contraception and Reproductive Health Care, 15, 4-16.

[14]   Klippin, C., Duijkens, T., Trummer, D. and Marr, J. (2008) Suppression of Ovarian Activity with Drospirenone Containing Oral Contraceptive in a 24/4 Regime. Contraception, 78, 16-25.

[15]   Curtis, K.M., Chrisman, C.E. and Peterson, A.B. (2002) WHO Programme for Mapping Best Practices in Reproductive Health. Contraception for Women in Selected Circumstances. Obstetrics & Gynecology, 99, 1100-1112.

[16]   Hatcher, R.A., Trussel, J., Stewart, F., et al. (2004) Contraceptive Technology. 18th Edition, Adent Media, New York, 236, 374, 327.

[17]   Enyindah, C.E. and Nonye-Enyindah, E. (2011) Contraception with Combined Oral Contraceptive in Port Harcourt, Nigeria. PMJ, 6, 81-88.

[18]   World Health Organisation (2011) Department of Reproductive Health and Research. Family Planning: A Global Handbook for Providers: Evidence-Based Guidance Developed through Worldwide Collaboration, Geneva Switzerland. WHO centre for Communications Program, 1-10.

[19]   Havrilesky, L.J., Moorman, P.G., et al. (2013) Oral Contraceptive Pills as Primary Prevention for Ovarian Cancer: A Systematic Review and Meta-Analysis. Obstetrics & Gynecology, 122, 30-142.

[20]   Shulman, L.P. (2011) The State of Hormonal Contraception Today: Benefits and Risks of Hormonal Contraceptives: Combined Estrogen and Progestin Contraceptives. American Journal of Obstetrics & Gynecology, 205, S9-S13.

[21]   Taylor, T., Keyse, L. and Bryant, A. (2005/2006) Contraception and Sexual Health. Office for National Statistics, London.

[22]   Mosher, W.D., Martinez, A.M., et al. (2004) Use of Contraception and Use of Family Planning Services in the United States: 1982-2002. Advanced Data, 350, 1-36.

[23]   Ojule, J.D. and Oranu, E.O. (2017) Birth Control Pills Profile of Acceptors at the University of Port Harcourt Teaching Hospital, Port Harcourt Nigeria. British Journal of Medicine and Medical Research, 20, 1-7.

[24]   Grubb, G.S. (1987) Women Perception of the Safety of the Pill: A Survey of Eight Countries. Journal of Biosocial Science, 19, 313-321.

[25]   Khan, M.A. (2001) Side Effects and Oral Contraceptive Discontinuation in Rural Bangladesh. Contraception, 64, 161-167.

[26]   Peru, C.M.D. (1991) Demographic and Health Survey 1991-1992. Macro International Inc., Demographic and Health Survey, Dominican Republic.

[27]   Ojule, J.D., Oranu, E.O. and Enyindah, C.E. (2012) Experience with Implanon in Southern Nigeria. JMMS, 3, 710-714.

[28]   Adewole, I.F., Oye-Adeniran, B.A., Iwere, N., et al. (2002) Contraceptive Usage among Abortion Seekers in Nigeria. West African Journal of Medicine, 21, 112-114.

[29]   Wu, J., Wang, L., Rauyajin, O. and Good, S. (2002) Contraceptive Use Behaviour among Never Married Young Women Who Are Seeking Pregnancy Termination in Beijing. Chinese Medical Journal, 115, 851-855.

[30]   Savabi-Esfahany, M., Fadaei, S. and Yousefy, A. (2006) Use of Combined Oral Contraceptives in Isfahan, Islamic Republic of Iran. Eastern Mediterranean Health Journal, 12, 417-422.

[31]   Oye-Adeniran, B.A., Adewole, I.F., Odeyemi, K.A., Ekanem, E.E. and Umoh, A.V. (2005) Contraceptive Prevalence among Young Women in Nigeria. Journal of Obstetrics and Gynaecology, 25, 182-185.

[32]   Datey, S., Gaur, L.N. and Saxena, B.N. (1995) Vaginal Bleeding Patterns of Women Using Different Contraceptive Methods (Implants, Injectables, IUDs, Oral Pills): An Indian Experience. An ICMR Task Force Study. Contraception, 51, 155-165.

[33]   Chigbu, B., Onwere, S., Aluka, C., Kamanu, C., Okoro, O. and Feyi-Waboso, P. (2010) Contraceptive Choices of Women in Rural South-Eastern Nigeria. Nigerian Journal of Clinical Practice, 13, 195-199.

[34]   Rosenberg, M. (1998) Weight Change with Oral Contraceptive Use and during the Menstrual Cycle. Results of Daily Measurements. Contraception, 58, 345-349.

[35]   Ojule, J.D. and Oranu, E.O. (2017) Experience with Combined Injectable Contraceptive (Norigynon) in Port Harcourt. British Journal of Medicine and Medical Research, 19, 1-6.