Hormonal contraceptive use among teenage girls in Germany – results of the German National Health Interview and Examination Survey (KiGGS)

Background: Hormonal contraceptive (HC) use plays an important role in preventing teenage pregnancy. Putative adverse health effects of HC use are discussed controversially depending on the type of HC preparations, and the combination of HC use and other health-related behavior. We report here on the prevalence of HC users among teenage girls in Germany and describe sociodemographic and cardiometabolic user profiles. Methods: Detailed HC use was recorded within the past 7 days among 1840 girls aged 13–17 years, who participated in the KiGGS 2003–2006. HC users and nonusers were compared with respect to cardiometabolic measures. Determinants of HC use were obtained from logistic regression models. Results: The overall prevalence of HC users was 19.6%, rising from 0.2% among 13-year-olds to 41.3% among 17-year-olds. Following contraception (88.8%), dysmenorrhea (9.2%), irregular menstruation (5.8%) and acne (4.3%) were further the most frequently self-reported indications for HC use. HC use was positively associated with main residence in East Germany (odds ratios 1.45, 95% confidence intervals 1.02–2.06) and current smoking (3.21, 2.38–4.33), but inversely related to migration background (0.35, 0.19–0.65), engagement in physical activities (0.62, 0.40–0.97), and presence of siblings in the family (0.55, 0.33–0.94). No association was found with urbanicity, educational level, body mass index, and parental socio-economic status. Compared to HC non-users, HC users had significantly higher blood pressure, and serum levels of total cholesterol, high and low density lipoprotein cholesterol, triglycerides, C-reactive protein, 25(OH)-Vitamin D and iron after adjustment for confounding factors. Conclusions: The prevalence of HC use among teenage girls in Germany is high and comparable with that in other western European countries. HC use was significantly related to several cardiometabolic risk factors and health-related behavior. While most of the associations with metabolic measures appear to be clinically irrelevant, a strong association with cigarette smoking and low physical activity, respectively, is a concern.