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 In Gynaecology

Individuals who use, have used or have considered using contraception as well as healthcare professionals who provide contraceptive care have come together to define the most important research issues in contraception. These are questions which are crucial for patients and healthcare professionals alike, but are only partially or not-at-all answered by science to date.

The top 10 is the outcome of a two-year project led by the Faculty of Sexual & Reproductive Healthcare (FSRH), the Contraception Priority Setting Partnership (Contraception PSP). The aim was to identify what individuals across the sexual and reproductive health community deem to be the most important unaddressed research concerns in contraception in order to inform future research in this area.

This is the first time that FSRH has taken a systematic approach to ask users and healthcare professionals what kind of research they think should be conducted on contraception. It is an invaluable opportunity to set priorities which might have been overlooked by researchers themselves or the pharmaceutical industry.

The Contraception PSP followed a robust methodology entailing surveys and workshops; the surveys have been answered by more than 700 respondents combined.

Top 10 research issues in contraception are:

  1. Which interventions (decision support aids, ease of access, motivational interviewing) increase uptake and continuation of effective contraception including long-acting methods (implants, injections and intrauterine contraceptives)?
  2. What is the risk of side-effects (vaginal bleeding, mood, weigh gain, libido) with hormonal contraception (pills, patches, rings, implants, injections and hormonal intrauterine system)?
  3. What are the long-term effects of using contraception (pills, patches, rings, injections, implants, intrauterine) on fertility, cancer and miscarriage?
  4. What models of care increase access and support decision-making for vulnerable groups (such as young people, people who don’t speak or read English)?
  5. Which interventions are safe and effective for women who have irregular bleeding on long-acting hormonal contraception?
  6. Does pharmacy provision of contraceptive services increase uptake and/or continuation of contraception?
  7. What are the risks or benefits to using combined hormonal contraception (pill, patch or ring) continuously to stop or reduce periods?
  8. What factors (advice from friends, family, professionals, beliefs, experience) influence women making decisions about contraception?
  9. Are there tests or factors such as age that can reliably identify women who no longer require contraception around the menopause (including women using methods which can stop periods such as implants, hormonal coils, pills)?
  10. Are there effective new methods of contraception available for men?

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