The attitude of Swiss women regarding menstruation and their view of contraceptive methods suppressing menstruation 

J. Bitzer, S. Tschudin, B. Frey 

Department of Obstetrics and Gynecology University of Basel, Basel, Switzerland 

Introduction Menstruation is in many women experienced in a highly ambivalent manner. Physical and emotional symptoms may impair the quality of life and at the same time menstruation is an unique expression of the female body. Various contraceptive methods may modify or even suppress menstruation . 

Methods A representative sample of 234 Swiss women were interviewed by telephone using a semistructured interview. 

Results Forty-one percent had a negative, 41% a neutral and 17% a positive attitude towards menstruation. 30% considered themselves not at all, 34% a little, 32% rather and 4% severely bothered by menstruation. 68% of women report premenstrual mood swings, irritability, more than half report physical symptoms. During menstruation 66% complain about mental and physical symptoms. Regarding the coping with menstrual complaints, 30% of the women use analgesics intermittently. Seventy percent take behavioral measures. Despite these negative experiences almost half of the women (45%) were reluctant using contraceptives to modify menstruation. The main reasons given were: it is unnatural, against nature (33%); unspecified fear of hormones in general (27%); fear of specific risks especially cancer (27%). 

Conclusion Contraception with regular bleeding is well accepted by Swiss women but changes in the menstrual pattern cause ambivalent feelings.The advantages regarding life quality are seen but on the other hand there is anxiety regarding undefined risks of interfering with nature. Contraceptive counselling needs to be sensitive to individual and cultural concepts about menstruation and enhance shared decision making regarding the possibilities of hormonal contraception to modify menstruation according to the individual's priorities.