Contraceptive Preferences and Practices Among Perimenopausal Females in Mahaoya MOH Area

Introduction: Perimenopause marks the transition phase from normal ovulation to anovulation and, ultimately to permanent loss of follicle maturation and ovulation causing menopausal changes in females. Fertility and probability of conception decline by half as early as the mid-forties; however, women during perimenopause still need effective contraception. Many studies and multiple reports worldwide have shown perimenopausal contraception to be an important but rather neglected issue.  
Methodology: An audit was conducted among the medical clinic attendees at the rural base hospital of Mahaoya. Knowledge of contraception, usage patterns, basic sociodemographic details and medical conditions were evaluated.  
Results: The study cohort had a mean age of 46.9 years with poor education levels and low-income backgrounds. Approximately half of the women (45.9%) have had an unexpected pregnancy. Even though a considerable proportion of women were sexually active (82.4%), the usage of contraception was only seen among (54.1%) of the participants. Permanent sterilization with LRT (30%) was the most common method employed, followed by DMPA (25%), IUCD (22%), Jadella (13%), COCP (5%) and condom (5%) usage.  
The knowledge of contraception (knowledge, attitudes, side effects, emergency contraception etc.) was adequate only among a minority (28.4%) and only 14.8% had adequate knowledge on when to stop contraceptive usage. The main source of knowledge had been through well-women clinics.
Discussion & Conclusions: Comprehension of the importance, appropriate time of stoppage and usage of contraception is quite low in this cohort of women selected from a rural population of Sri Lanka. Some women have given up on usage based on side effects, but the majority have a clear deficiency of knowledge, thus resulting in a higher incidence of unexpected pregnancies.  
Suggestions: A series of educational programs are essential to uplift the knowledge among these women. A re-audit done later can assess the improvement in practices.