Side Effects as Determinants of Contraceptive Non-Compliance and Failure among Fertile Age Couples in Makassar, Indonesia
Keywords:
Contraception, family planning, side effects, compliance, contraceptive failure
Abstract
Contraceptive side effects are a key determinant of contraceptive choice and continuation and often lead to discontinuation or method switching. This poses a public health concern as it reduces contraceptive adherence and effectiveness, thereby increasing the risk of unintended pregnancy, unintended birth, and abortion. This study aimed to examine the association between contraceptive side effects, non-compliance, and contraceptive failure among fertile-age couples in the working area of the Kassi Community Health Center, Makassar City. An observational analytical study with a cross-sectional design was conducted among 76 active family planning acceptors, selected using purposive sampling. Data were collected through structured interviews using questionnaires. The results showed that menstrual disorders (p = 0.004), vaginal discharge (p = 0.002), weight changes (p = 0.041), mood changes (p = 0.012), and decreased libido (p = 0.002) were significantly associated with non-compliance. Menstrual disorders (p = 0.006), vaginal discharge (p = 0.003), and decreased libido (p = 0.015) were also significantly associated with contraceptive failure. In addition, non-compliance was strongly associated with contraceptive failure (p = 0.000). Contraceptive side effects contribute both directly and indirectly to contraceptive failure, primarily through non-compliance, particularly among users of hormonal contraception. Strengthening family planning counseling and providing comprehensive information on contraceptive effectiveness and side effects are essential to reduce non-compliance and failure rates.
References
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Page, NM, Karuniawati, N., et al. (2025) 'Determinants of Unmet Need for Hormonal Contraception in Couples of Fertilizing Age (PUS) at the Faculty of Public Health, Muslim University of Indonesia', 5(2), pp. 223–230. Available at: https://doi.org/10.47650/pjphsr.v5i2.1870.
Page, NM, Masnilawati, A., et al. (2025) 'Side Effects and Return of Fertility of Hormonal and Non-Hormonal Contraceptive Acceptors in the Kassi-Kassi Health Center Work Area, Makassar City', 5(2), pp. 285–295. Available at: https://doi.org/10.47650/pjphsr.v5i2.1846.
Rothschild, C.W. et al. (2022) 'Contributions of side effects to contraceptive discontinuation and method switch among Kenyan women: a prospective cohort study', BJOG: An International Journal of Obstetrics and Gynecology , 129(6), pp. 926–937. Available at: https://doi.org/10.1111/1471-0528.17032.
Schrumpf, L.A. et al. (2020) 'Side effect concerns and their impact on women's uptake of modern family planning methods in rural Ghana: A mixed methods study', BMC Women's Health , 20(1), pp. 1–8. Available at: https://doi.org/10.1186/s12905-020-0885-0.
Sultan, S. et al. (2024) 'Association of Hormonal Contraceptives with Depression among Women in Reproductive Age Groups : A Cross-Sectional Analytic Study', 2024. Available at: https://doi.org/10.1155/2024/7309041.
Sumiyati, Uki Retno Budihastuti, BM (2022) 'Meta-Analysis of the Effect of Hormonal Contraception on Sexual Dysfunction in Injection and Oral Contraceptive Acceptors', JMCH , 07(07), pp. 729–741.
Vuaghan, ASB (2017) 'Contraceptive Failure in the United States : Estimates from the 2006 – 2010', Perspectives on Sexual and Reproductive Health , 49(1), pp. 7–16. Available at: https://doi.org/10.1363/psrh.12017.
Wondie, AG (2021) 'The association between unmet need for contraception and unintended pregnancy among reproductive-aged women in Ethiopia', Medicine Access @ Point of Care , 5, p. 239920262110334. Available at: https://doi.org/10.1177/23992026211033436.
Wood, S.N. et al. (2020) 'Women's sexual experiences as a side effect of contraception in low- and middle-income countries : evidence from a systematic scoping review', 0397. Available at: https://doi.org/10.1080/26410397.2020.1763652.
Zimmerman, L.A. et al. (2021) 'Association between experience of specific side-effects and contraceptive switching and discontinuation in Uganda: results from a longitudinal study', Reproductive Health , 18(1), pp. 1–12. Available at: https://doi.org/10.1186/s12978-021-01287-5.
A yaga .A. et al. (2021) 'Contraceptive method use, discontinuation and failure rates among women aged 15 – 49 years : evidence from selected low income settings in Kumasi, Ghana', pp. 1–10.
Egwim, J. et al. (2024) 'Predictors of Abnormal Vaginal Discharge among Women of Reproductive Age in Southeast Nigeria', pp. 240–256. Available at: https://doi.org/10.4236/ijcm.2024.157018.
Elsalam, K. (2022) Green Synthesis of Silver Nanomaterials. In Green Synthesis of Silver Nanomaterials (1 ed.) . Elsevier. Available at: https://doi.org/10.1016/C2020-0-00288-4.
Esme Marie-Laure Essis, Amalaman, DM et al. (2023) 'Libido–sexual disorders and abandonment of injectable contraceptives among users of the Ivorian Association for Family Well-Being in Korhogo, Côte d'Ivoire', Frontiers in Global Women's Health [Preprint], (May). Available at: https://doi.org/10.3389/fgwh.2023.1026253.
Gaidha Khusnul Pangestu, Eugenius Phyowai Ganap, EPG (2023) 'the Effect of 3-Month Injection Contraception Method (DMPA) On Sexual Function and Body Weight Scooping Review', SENTRI: Scientific Research Journal Vol.2, No.12 December 2023 ejournal.nusantaraglobal.ac.id/index.php/sentri PENGARUH , 2(12).
Gayatri, M. and Irawaty, DK (2021) 'Side Effects of Injectable and Oral Contraceptives and Unintended Pregnancy Among Reproductive Women in Indonesia', Jurnal Biometrika dan Kependudukan , 10(2), pp. 162–170. Available at: https://doi.org/10.20473/jbk.v10i2.2021.162-170.
Gebeyehu, N.A. et al. (2022) 'Discontinuation of long-acting reversible contraceptive use and its determinants among women in Ethiopia: Systematic review and meta-analysis', Frontiers in Public Health , 10. Available at: https://doi.org/10.3389/fpubh.2022.979231.
Haddad, L.B., Townsend, J.W. and Sitruk-Ware, R. (2021) 'Contraceptive Technologies: Looking Ahead to New Approaches to Increase Options for Family Planning', Clinical Obstetrics and Gynecology , 64(3), pp. 435–448. Available at: https://doi.org/10.1097/GRF.0000000000000628.
Hamang, SH, Masnilawati, A., Karuniawati, N., & Nurhayati, N. (2022) 'Women's Empowerment through Understanding Contraceptive Methods in Improving the Quality of Family Life in Tellumpoccoe Village, Marusu District, Maros Regency', Cahaya Mandalika Community Service Journal , 3(2), pp. 10–15.
Hayati (2022) 'Compliance with the Use of 3-Month Injectable Contraceptives During the Covid-19 Pandemic', BSI Nursing Journal , 10(1).
Joyce, S. et al. (2022) 'Factors Associated with Failed Contraception in Women Attending Level One Hospitals in Lusaka, Zambia', 49(2), pp. 170–175.
Martell, S. et al. (2023) 'Psychological side effects of hormonal contraception : a disconnect between patients and providers', Contraception and Reproductive Medicine , pp. 1–11. Available at: https://doi.org/10.1186/s40834-022-00204-w.
Masnilawati, Andi. Asfar, A. (2023) 'Effectiveness of Counseling for Husbands in Family Planning Decision Making and Long-Term Contraceptive Method Selection in the Kassi-Kassi Community Health Center Work Area, Makassar', Suara Forikes Health Journal , 14(3).
Masnilawati, A. and Karuniawati, N. (2022) 'Factors Associated with the Choice of Contraceptives in Fertile Age Couples in the Kassi-Kassi Community Health Center Working Area, Makassar', Suara Forikes Health Research , 13(Special), pp. 177–182. Available at: http://forikes-ejournal.com/index.php/SF.
Mbuzeleni Hlongwa, Chipo Mutambo, KH (2023) '“In fact, that's when I stopped using contraception': a qualitative study exploring women's experiences of using contraceptive methods in KwaZulu-', BMJ , pp. 1–8. Available at: https://doi.org/10.1136/bmjopen-2022-063034.
Mukanga, B. et al. (2023) 'Perspectives on the side effects of hormonal contraceptives among women of reproductive age in Kitwe district of Zambia: a qualitative exploratory study', BMC Women's Health , 23(1), pp. 1–8. Available at: https://doi.org/10.1186/s12905-023-02561-3.
Odwe, G. et al. (2020) 'Contraception : X Which contraceptive side effects matter most? Evidence from current and past users of injectables and implants in Western Kenya', Contraception : 100030. Available at: https://doi.org/10.1016/j.conx.2020.100030.
Page, NM, Karuniawati, N., et al. (2025) 'Determinants of Unmet Need for Hormonal Contraception in Couples of Fertilizing Age (PUS) at the Faculty of Public Health, Muslim University of Indonesia', 5(2), pp. 223–230. Available at: https://doi.org/10.47650/pjphsr.v5i2.1870.
Page, NM, Masnilawati, A., et al. (2025) 'Side Effects and Return of Fertility of Hormonal and Non-Hormonal Contraceptive Acceptors in the Kassi-Kassi Health Center Work Area, Makassar City', 5(2), pp. 285–295. Available at: https://doi.org/10.47650/pjphsr.v5i2.1846.
Rothschild, C.W. et al. (2022) 'Contributions of side effects to contraceptive discontinuation and method switch among Kenyan women: a prospective cohort study', BJOG: An International Journal of Obstetrics and Gynecology , 129(6), pp. 926–937. Available at: https://doi.org/10.1111/1471-0528.17032.
Schrumpf, L.A. et al. (2020) 'Side effect concerns and their impact on women's uptake of modern family planning methods in rural Ghana: A mixed methods study', BMC Women's Health , 20(1), pp. 1–8. Available at: https://doi.org/10.1186/s12905-020-0885-0.
Sultan, S. et al. (2024) 'Association of Hormonal Contraceptives with Depression among Women in Reproductive Age Groups : A Cross-Sectional Analytic Study', 2024. Available at: https://doi.org/10.1155/2024/7309041.
Sumiyati, Uki Retno Budihastuti, BM (2022) 'Meta-Analysis of the Effect of Hormonal Contraception on Sexual Dysfunction in Injection and Oral Contraceptive Acceptors', JMCH , 07(07), pp. 729–741.
Vuaghan, ASB (2017) 'Contraceptive Failure in the United States : Estimates from the 2006 – 2010', Perspectives on Sexual and Reproductive Health , 49(1), pp. 7–16. Available at: https://doi.org/10.1363/psrh.12017.
Wondie, AG (2021) 'The association between unmet need for contraception and unintended pregnancy among reproductive-aged women in Ethiopia', Medicine Access @ Point of Care , 5, p. 239920262110334. Available at: https://doi.org/10.1177/23992026211033436.
Wood, S.N. et al. (2020) 'Women's sexual experiences as a side effect of contraception in low- and middle-income countries : evidence from a systematic scoping review', 0397. Available at: https://doi.org/10.1080/26410397.2020.1763652.
Zimmerman, L.A. et al. (2021) 'Association between experience of specific side-effects and contraceptive switching and discontinuation in Uganda: results from a longitudinal study', Reproductive Health , 18(1), pp. 1–12. Available at: https://doi.org/10.1186/s12978-021-01287-5.
Published
2026-01-31
How to Cite
Masnilawati, A., Jama, F., Karuniawati, N., & Ramadani, N. (2026). Side Effects as Determinants of Contraceptive Non-Compliance and Failure among Fertile Age Couples in Makassar, Indonesia. ancasakti ournal f ublic ealth cience nd esearch, 6(1), 10-19. https://doi.org/10.47650/pjphsr.v6i1.2444
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Copyright (c) 2026 Andi Masnilawati, Fatma Jama, Nia Karuniawati, Nurul Ramadani
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