Hormonal contraceptive use in Denmark 2010-2019

INTRODUCTION: Hormonal contraception (HC) celebrates its 60th anniversary this year. Thanks to thousands of scientific studies on these products, we now have solid knowledge about the short- and long-term effects and also the adverse effects of different contraceptive types. The aim of this study was to analyse trends in the use of different types of HC through the latest decade in different age groups of Danish women and to study reasons for any changes.

METHODS: Individual-level HC sale statistics were provided from the National Registry of Medicinal Products. All statistics were stated as defined daily doses per 1,000 women per day. Absolute numbers and distributions among users were calculated.

RESULTS: The overall use of HC was stable in women from 15 to 25 years, decreased among women aged 25-34 years and increased among women aged 35 years or more. On average, an increase from 35% to 39% was recorded. Across all age groups, the use of second-generation combined oral contraceptives (COC) has almost completely replaced the use of third- and fourth-generation pills, and from the age of 20 years of age, the use of COC has decreased contrasting a steep increase in use of the hormone-intrauterine device (IUD). The magnitude of this shift increased with increasing age.

CONCLUSIONS: Whereas the overall use of hormonal contraception has increased over the latest decade from 35% to 39% among all women aged 15-49 years, hormone-IUDs have increasingly replaced COCs so that they are now dominating among women aged 30 years or more. These changes are expected to have decreased venous thrombosis and menorrhagic complaints in young women substantially.

FUNDING: Expenses were covered by Department of Gynaecology, Rigshospitalet.

TRIAL REGISTRATION: The Danish Data Protection Agency (R. no. 2015-41-4481).