Assessment of contraceptive use and side effects among women in five countries across the Middle East: a cross-sectional study

Purpose: Contraceptive use and associated adverse effects are underreported in the Middle East. This study aimed to investigate contraceptive use and reported side effects in five Middle Eastern countries. Methods: This study, conducted over eight weeks in the UAE, Egypt, Jordan, Syria, and Iraq, utilized an online closed-ended structured questionnaire to extract the study information. Reproductive-age women were surveyed about hormonal and non-hormonal contraceptive usage practices, frequency, types, and severity of contraceptive-associated side effects. Logistic regression analysis was utilized to determine the predictors of the occurrence of side effects associated with contraceptive use. Results: The prevalence of contraceptive use was 81.2% (1069/1317). The most common contraceptive methods were combined oral contraceptive pills (46.6%, 511/1069), mini pills (15.4%, 169/1069), and hormonal loops (13.8%, 151/1069). The prevalence of contraceptive-associated side effects was 41.9% (448/1069). The commonly reported mild-to-moderate side effects were irregular menstrual bleeding (87.9%), headaches (88.2%), and mood changes (93.5%). Interestingly, the participants living in Egypt (AOR: 14.58, 95% CI: 4.67–45.53, p = 0.012) and Iraq (AOR: 25.71, 95% CI: 9.93–66.60, p = 0.001) had greater odds of developing contraceptive-related side effects than did their counterparts. Breastfeeding (AOR: 0.43, 95% CI: 0.20–0.92, p = 0.03), hypertension (AOR: 0.50, 95% CI: 0.26–0.99, p = 0.047), and smoking (AOR: 0.43, 95% CI: 0.20–0.90, p = 0.027) status reduced the risk of side effects. Surprisingly, healthcare follow-ups significantly increased the risk of side effects among contraceptive users (AOR: 3.48, 95% CI: 2.03–5.97; p = 0.001). Conclusion: Many contraceptive users reported experiencing side effects, which are predominantly mild to moderate. This underscores the need for improved patient education and follow-up, especially in Egypt and Iraq.