Association between contraceptive decision-making and perceived fertility decline among perimenopausal women

Abstract

Purpose

The purpose of this study was to determine: 1) the association between contraceptive decision-making and perceptions of fertility decline as well as associated factors, and 2) the relationship between contraceptive decision-making and contraceptive behavior, in perimenopausal women.

Methods

Women between the ages of 40 and 50 who agreed to participate were included in the study. A self-administered, non-rated questionnaire was administered between July and November 2021. Contraceptive decision-making and the perception of fertility decline were measured using Visual Analogue Scales. In addition, contraceptive behavior was assessed in terms of contraceptive types and usage frequency. Logistic regression analysis was used to examine the relationship between contraceptive decision-making and perceived fertility decline, to identify factors associated with perceived fertility decline, and to examine the relationship between contraceptive decision-making and contraceptive behavior.

Results

The questionnaire was sent to 354 women, of whom 123 were eligible for analysis (47.2% response rate, 73.7% valid response rate). Among women without the desire to become pregnant, those with a higher awareness of their declining fertility were less likely to use contraception than those with a lower awareness (odds ratio (OR): 0.30, 95% confidence interval (CI): 0.14-0.66), and a significant associated factor was knowledge of age-related fertility changes (OR: 2.85, 95%CI: 1.16-7.02). Among women without the desire to become pregnant who had sexual intercourse within 1 year, those more willing to use contraception used contraception every time they had sexual intercourse (OR: 21.57, 95%CI: 5.30-87.83) and used more effective methods (OR: 4.20, 95%CI: 1.49-11.82).

Conclusions

Perimenopausal women without the desire to become pregnant were more aware of their own fertility decline and less likely to use contraception when they were aware of age-related fertility changes. In addition, the clear intention to use contraception led to the choices of using contraception and using a highly effective contraceptive method each time. Therefore, in order to avoid unwanted pregnancies, it is necessary to provide fertility knowledge that captures the characteristics of the perimenopausal period, promotes an understanding of the need for contraception, and supports contraceptive decision-making.