Early symptoms and discontinuation among users of oral contraceptives in Sri Lanka.

The relationship between symptoms reported during the first two cycles of oral contraceptive use and subsequent discontinuation was studied using data from a comparative clinical trial of two oral contraceptives (standard dose and low dose) in Sri Lanka. Among 24 symptoms considered, the most commonly reported were headache, nausea, irritability, dizziness, tiredness, intermenstrual spotting/bleeding, backache, abdominal pain, vomiting, and hair loss. Headache, nausea, vomiting, and dizziness were closely associated with each other and strongly predictive of discontinuation for both drugs. No other symptoms were consistently associated with each other or with subsequent discontinuation. Intermenstrual spotting/bleeding was associated with later discontinuation of the standard dose preparation, but not the lower dose preparation.