Contraceptive Pill Side Effects and Their Prevalence Among Women Attending Maternal and Child Health Centers in the Kurdistan Region
DOI:
https://doi.org/10.64048/hir.v1n2.003Keywords:
Contraceptive pills, Side effects, Prevalence, Women’s health, Family planning, Reproductive health, Kurdistan RegionAbstract
Background and Aim: In the Kurdistan Region of Iraq, contraceptive pills are widely used for family planning, but their side effects can significantly influence women’s health and healthcare-seeking behavior. This study aimed to assess the prevalence of side effects associated with contraceptive pills among women attending maternal and child health centers.
Method: This cross-sectional descriptive study was conducted from January to April 2023 in maternal and child health centers across Erbil, Sulaimani, and Duhok, using a convenience sampling method. Data were collected through structured face-to-face interviews using a questionnaire that included sociodemographic information, clinical history, and side effects of contraceptive pills. Statistical analysis was performed using SPSS version 26. Descriptive statistics were used to summarize the data, and Chi-square tests were applied to examine associations between major side effects and demographic or clinical characteristics.
Results: Among 671 participants, the most frequently reported side effects were painful or missed periods (44.7%), headache (44.4%), fatigue (38.0%), and vision problems (35.3%). Rare but notable complications included blood clots (1.8%), breast lumps (3.3%), stroke (0.3%), and heart attack (0.4%). Younger women (20–29 years) reported higher rates of painful or missed periods (50.0%), while combined pill users experienced significantly higher frequencies of all major side effects compared to progesterone-only users (p < 0.001). Duration of use and higher education level were also significantly associated with increased prevalence of side effects (p < 0.05). Healthcare-seeking behavior showed 57.7% of women with side effects consulted providers, with gynecologists most frequently approached.
Conclusions: The study demonstrated that side effects of contraceptive pills are common among women in the Kurdistan Region, with significant variations by age, education, type, and duration of use. Strengthening counseling services and providing accurate information on potential side effects are essential for improving contraceptive adherence and safeguarding women’s reproductive health.
Downloads
References
AKHAGBAKER, J. M., KAREEM, M. S., RASOOL, A. A., SABER, A. F., AZIZ, K. F. & KAREEM SR, M. S. 2024. Assessment of knowledge and practice regarding psychological first aid among secondary school students in Erbil City. Cureus, 16. https://doi.org/10.7759/cureus.64671
ALSPAUGH, A., BARROSO, J., REIBEL, M. & PHILLIPS, S. 2020. Women's contraceptive perceptions, beliefs, and attitudes: an integrative review of qualitative research. Journal of midwifery & women's health, 65, 64-84. https://doi.org/10.1111/jmwh.12992
AZZOLINO, D., AROSIO, B., MARZETTI, E., CALVANI, R. & CESARI, M. 2020. Nutritional status as a mediator of fatigue and its underlying mechanisms in older people. Nutrients, 12, 444. https://doi.org/10.3390/nu12020444
BELLIZZI, S., MANNAVA, P., NAGAI, M. & SOBEL, H. L. 2020. Reasons for discontinuation of contraception among women with a current unintended pregnancy in 36 low and middle-income countries. Contraception, 101, 26-33. https://doi.org/10.1016/j.contraception.2019.09.006
CAHILL, N., SONNEVELDT, E., STOVER, J., WEINBERGER, M., WILLIAMSON, J., WEI, C., BROWN, W. & ALKEMA, L. 2018. Modern contraceptive use, unmet need, and demand satisfied among women of reproductive age who are married or in a union in the focus countries of the Family Planning 2020 initiative: a systematic analysis using the Family Planning Estimation Tool. The Lancet, 391, 870-882. https://doi.org/10.1016/S0140-6736(17)33104-5
D’SOUZA, P., BAILEY, J. V., STEPHENSON, J. & OLIVER, S. 2022. Factors influencing contraception choice and use globally: a synthesis of systematic reviews. The European Journal of Contraception & Reproductive Health Care, 27, 364-372. https://doi.org/10.1080/13625187.2022.2096215
DINEEN-GRIFFIN, S., GARCIA-CARDENAS, V., WILLIAMS, K. & BENRIMOJ, S. I. 2019. Helping patients help themselves: a systematic review of self-management support strategies in primary health care practice. PloS one, 14, e0220116. https://doi.org/10.1371/journal.pone.0220116
DOOHAN, M. A., KING, N., WHITE, M. J. & STEWART, I. B. 2023. Trends in menstrual cycle symptoms, physical activity avoidance, and hormonal contraceptive use in a general population of adult women. Sexual & reproductive healthcare, 36, 100853. https://doi.org/10.1016/j.srhc.2023.100853
EL ANSARI, W., EL-ANSARI, K. & ARAFA, M. 2025. Breaking the silence–systematic review of the socio-cultural underpinnings of men’s sexual and reproductive health in Middle East and North Africa (MENA): A handful of taboos? Arab Journal of Urology, 23, 16-32. https://doi.org/10.1080/20905998.2024.2387511
FAREEQ SABER, A., MASIH, S., KARIMIRAD, M. R., SHARIFI, F. & MANOOKIAN, A. 2024. The relationship between internet addiction, sleep quality, and psycho‐social problems among secondary school students in Erbil, 2023–2024. Public Health Nursing, 41, 933-942. https://doi.org/10.1111/phn.13353
GODAT, S., FOURNIER, N., SAFRONEEVA, E., JUILLERAT, P., NYDEGGER, A., STRAUMANN, A., VAVRICKA, S., BIEDERMANN, L., GREUTER, T. & FRAGA, M. 2018. Frequency and type of drug-related side effects necessitating treatment discontinuation in the Swiss Inflammatory Bowel Disease Cohort. European journal of gastroenterology & hepatology, 30, 612-620. https://doi.org/10.1097/MEG.0000000000001078
KARPOWICZ, N., MĄCZKA, K., SKOCZYLAS, A., PACOCHA, N., KUNICKI, M., GRYMOWICZ, M. & SMOLARCZYK, R. 2024. The Most Common Side Effects, Concerns and Discontinuation Patterns of Oral Contraceptive Pills Among Polish Women: A Cross-Sectional Study. Journal of Family & Reproductive Health, 18, 170. https://doi.org/10.18502/jfrh.v18i3.16659
KOTB, M. A. M., RAGAB, H. M., ELWAN, Y. A. & HUSSEIN, Y. H. H. 2022. Oral contraceptive pills use and adverse effects. Egyptian Journal of Hospital Medicine, 86, 286-290. https://doi.org/10.21608/ejhm.2022.211984
LEE, D., KIM, Y. & DEVINE, B. 2022. Spillover effects of mental health disorders on family members’ health-related quality of life: Evidence from a US sample. Medical Decision Making, 42, 80-93. https://doi.org/10.1177/0272989X211027146
LETHABY, A., WISE, M. R., WETERINGS, M. A., RODRIGUEZ, M. B. & BROWN, J. 2019. Combined hormonal contraceptives for heavy menstrual bleeding. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD000154.pub3
MARTELL, S., MARINI, C., KONDAS, C. A. & DEUTCH, A. B. 2023. Psychological side effects of hormonal contraception: a disconnect between patients and providers. Contraception and reproductive medicine, 8, 9. https://doi.org/10.1186/s40834-022-00204-w
MARTIN, D., SALE, C., COOPER, S. B. & ELLIOTT-SALE, K. J. 2018. Period prevalence and perceived side effects of hormonal contraceptive use and the menstrual cycle in elite athletes. International journal of sports physiology and performance, 13, 926-932. https://doi.org/10.1123/ijspp.2017-0330
MARTINS, F., SOFIYA, L., SYKIOTIS, G. P., LAMINE, F., MAILLARD, M., FRAGA, M., SHABAFROUZ, K., RIBI, C., CAIROLI, A. & GUEX-CROSIER, Y. 2019. Adverse effects of immune-checkpoint inhibitors: epidemiology, management and surveillance. Nature reviews Clinical oncology, 16, 563-580. https://doi.org/10.1038/s41571-019-0218-0
MICHAEL, T. O., OJO, T. F., IJABADENIYI, O. A., IBIKUNLE, M. A., ONI, J. O. & AGBOOLA, A. A. 2024. Prevalence and factors associated with contraceptive use among sexually active adolescent girls in 25 sub-Saharan African countries. Plos one, 19, e0297411. https://doi.org/10.1371/journal.pone.0297411
MOYER, A. M., MATEY, E. T. & MILLER, V. M. 2019. Individualized medicine: Sex, hormones, genetics, and adverse drug reactions. Pharmacology research & perspectives, 7, e00541. https://doi.org/10.1002/prp2.541
MUTTREJA, P. & SINGH, S. 2018. Family planning in India: The way forward. Indian Journal of Medical Research, 148, S1-S9. https://doi.org/10.4103/ijmr.IJMR_2067_17
NAKIRIJJA, D. S., XUILI, X. & KAYISO, M. I. 2018. Socio-economic determinants of access to and utilization of contraception among rural women in Uganda: The case of Wakiso District. Health Science Journal, 12, 1-20. https://doi.org/10.21767/1791-809X.1000608
PANNAIN, G. D., BRUM, V. D. O. R., ABREU, M. M. A. & LIMA, G. B. 2022. Epidemiological survey on the perception of adverse effects in women using contraceptive methods in Brazil. Revista Brasileira de Ginecologia e Obstetrícia/RBGO Gynecology and Obstetrics, 44, 025-031. https://doi.org/10.1055/s-0041-1741410
ROTHSCHILD, C. W., RICHARDSON, B. A., GUTHRIE, B. L., KITHAO, P., OMURWA, T., MUKABI, J., CALLEGARI, L. S., LOKKEN, E. L., JOHN‐STEWART, G. & UNGER, J. A. 2022. Contributions of side effects to contraceptive discontinuation and method switch among Kenyan women: a prospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology, 129, 926-937. https://doi.org/10.1111/1471-0528.17032
SALZMAN, B., COLLINS, E. & HERSH, L. 2019. Common breast problems. American family physician, 99, 505-514.
TABER, K. S. 2018. The use of Cronbach’s alpha when developing and reporting research instruments in science education. Research in science education, 48, 1273-1296. https://doi.org/10.1007/s11165-016-9602-2
TSE, B., LOZA, A., BAKAYSA, S., JOHNSON, A. & SHIELDS, A. 2024. Headache and Women’s Health. Comorbid Conditions in the Treatment of Headache, 279-295. https://doi.org/10.1201/b23330-17
WIRTA, S. B., BALAS, B., PROENCA, C. C., BAILEY, H., PHILLIPS, Z., JACKSON, J. & COTTON, S. 2018. Perceptions of heart failure symptoms, disease severity, treatment decision-making, and side effects by patients and cardiologists: a multinational survey in a cardiology setting. Therapeutics and clinical risk management, 2265-2272. https://doi.org/10.2147/TCRM.S183200
ZIMMERMAN, L. A., SARNAK, D. O., KARP, C., WOOD, S. N., AHMED, S., MAKUMBI, F. & KIBIRA, S. P. 2021. Association between experience of specific side-effects and contraceptive switching and discontinuation in Uganda: results from a longitudinal study. Reproductive Health, 18, 239. https://doi.org/10.1186/s12978-021-01287-5
Downloads
Published
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Issue
Section
License
Copyright (c) 2025 Jawdat Mamand Alhagbaker, Wahida Abdullah Ibrahim, Lana Abdul Hamed Muhamed, Sideeq Sadir Ali, Jihad Haji Saleh, Ammar Yassin Abdullah (Author)

This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles published in Health Innovation Reports are licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This means anyone is free to share and adapt the work, provided proper attribution is given to the original authors and source.
