The experiences and preferences of contraceptive users span a wide range globally and, at times, represent unexpected views and attitudes. A recent scoping review authored by Chelsea Polis and colleagues (2018) found that (1) preferences related to nonstandard bleeding frequencies like amenorrhea range widely across countries and are viewed negatively in some studies and positively in others; (2) CIMCs are a major reason for contraceptive nonuse, dissatisfaction, or discontinuation; and (3) users often link CIMCs with health risks and categorize them as side effects.
Since this review was conducted, additional data have been collected on user experiences in a variety of settings, including during or as add-on studies to contraceptive clinical trials and during large national/cross-national surveys. For example, Amelia Mackenzie shared results from research FHI 360 conducted recently: (1) bleeding profiles vary widely and depend on the method and the user; (2) consistent, complete, and clear counseling is one avenue to increase knowledge of menstrual changes but it is not being provided widely; and (3) users perceive different types of CIMCs differently depending on a variety of factors including context. Additionally, Simon Kibira reported that researchers in Uganda combined a variety of data types (national/cross-national, clinical, and qualitative) to examine user preferences and attitudes regarding CIMCs and found that (1) bleeding changes are a challenge for many women and have consequences, including psychological and financial implications as well as contraceptive discontinuation, and (2) it is important to consider specific side effects individually and in varied social, economic, and cultural settings. Overall, more research on user experiences is needed, but thus far has shown that CIMCs have consequences and preferences depend greatly on context.