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Association between young women’s physical and mental health and their method of contraception in a longitudinal, population-based study

Background Women’s physical and mental health are strongly inter-related and may influence patterns of contraceptive use. We examined the longitudinal associations between young women’s physical and mental health and method of contraceptive use over a 5-year period. Methods Data from 4952 young women (≤27 years) participating in the Australian Longitudinal Study on Women’s Health who completed four self-reported surveys between 2013 and 2017 were analysed. Women’s contraceptive use was categorised as: contraceptive pill/oral contraceptives, long-acting reversible contraception (LARC), condom, other methods and none. Multinomial logistic regression was used to determine the longitudinal associations between women’s physical and mental health and method of contraception. Results Over the 5-year period the percentage of pill users decreased from 60% (95% CI 58% to 61%) to 41% (95% CI 39% to 42%) and LARC users increased from 13% (95% CI 12% to 14%) to 21% (95% CI 20% to 22%) as did non-users from 9% (95% CI 8% to 9%) to 17% (95% CI 16% to 18%). Compared with women using the pill, women who used LARCs were more likely to be overweight (OR 1.34; 95% CI 1.17 to 1.53) and obese (OR 1.84; 95% CI 1.55 to 2.19), current smokers (OR 1.45; 95% CI 1.23 to 1.71) and reported fair or poor general health (OR 1.50; 95% CI 1.28 to 1.76) and very high levels of psychological distress (OR 1.47; 95% CI 1.24 to 1.76). Similar results were also found among women who used condoms or no contraception. Conclusions Findings suggest that obesity, smoking and poor physical and mental health play an important role in young women’s contraceptive use.