Contraceptive counselling and self-prescription of contraceptives of German gynaecologists: results of a nationwide survey.

OBJECTIVE: To evaluate the attitude toward contraceptive methods of gynaecologists who, in Germany, are the sole prescribers of contraceptives. METHODS: An anonymous questionnaire was sent to 9545 gynaecologists inquiring about factors involved in their prescription of contraceptives, the contraceptives they preferred, and those they would recommend to their daughter, if they had one. RESULTS: The response rate of this survey was 21% (N = 2016). The combined oral contraceptive (COC) was the most commonly prescribed method followed by the levonorgestrel-releasing intrauterine system (LNG-IUS), the vaginal ring, the progestin-only pill (POP), the patch, and the progestin-only injectables. Of the respondents 51% would never prescribe the patch and 45% would never prescribe the hormonal implant at all; 61% would choose the LNG-IUS for themselves/for their partner; 18% would opt for a COC and 8% for the vaginal ring. Concerning their imaginary daughter, 71% would prefer a COC, 26% the ring, and 9% the LNG-IUS. The first counselling session lasted 13.8 ± 4.9 min, and the provision of information on the occasion of following visits 6.6 ± 3.2 min. CONCLUSION: The contraceptives most prescribed by German gynaecologists were COCs, followed by the LNG-IUS, the vaginal ring, and POPs. The spectrum of contraceptives preferred for personal use differed in some ways from those prescribed to patients. Reasons for this discrepancy should be investigated.

The value of complementary and alternative medicine in the treatment of climacteric symptoms: results of a survey among German gynecologists.

OBJECTIVES: The present study aims to detect the attitude and experience towards complementary and alternative medicine (CAM) in the treatment of climacteric disorders among gynecologists in Germany. STUDY DESIGN: A self-administered questionnaire, containing 15 questions, was sent to all gynecologists in private practice in Germany (n=9589). MAIN OUTCOME MEASURES: Gynecologists were asked about their experience with several forms of CAM. They were asked to rate different procedures as "effective", "sometimes effective" or "unimportant". RESULTS: The response rate was 33.7% (n=3227). We report on 2549 (26.6%) eligible questionnaires. Well-known therapies were black cohosh (Cimicifuga racemosa), chaste tree (Vitex agnus castus) and St. John's wort. More than 98% had had experiences with these therapies. Fewer experiences were stated with hormone-yoga (42.9%), acupuncture (29.1%) and homeopathy (21.6%). The most effective alternative therapy rated was an alteration of lifestyle with 54.4% (n=1325) stating it was effective and 35.7% (n=871) stating it was sometimes effective. Only 3.9% (n=96) prescribed no efficacy to a change of lifestyle. Other treatments rated as effective were St. John's wort (25.0%, n=606) and Black cohosh (21.1%, n=527). Agents regarded most ineffective were hormone-yoga (4.7%, n=109), acupuncture (10.3%, n=243) and homeopathy (10.6%, n=250). Female gynecologists were more likely to vote for a therapy to be effective compared to their male colleagues. CONCLUSIONS: German gynecologists seem to have made positive experiences with CAM when observing their patients, in general. An alteration of lifestyle is seen as the most effective alternative therapy in menopause. Due to their widespread use, possible side effect of natural agents should be excluded.

Use of hormone therapy by female gynecologists and female partners of male gynecologists in Germany 8 years after the Women's Health Initiative study: results of a survey.

OBJECTIVE: The publication of the results of the Women's Health Initiative randomized controlled trial in 2002 resulted in a critical discussion on the risks and benefits of hormone therapy (HT), including estrogen plus progestogen therapy and estrogen therapy. The aim of the present study was to evaluate German gynecologists' self-prescription habits regarding HT compared with their habits of prescribing HT to their patients, as an expression of their attitude toward HT. METHODS: A self-administered, anonymous questionnaire was sent to all 9,589 German gynecologists in private practice in November 2010. RESULTS: The response rate was 3,227 (33.7%). This article reports the results for 2,549 eligible questionnaires. A total of 2,459 (97.0%) respondents favored HT for themselves or their female partner. CONCLUSIONS: This report describes the first study in Germany showing an underuse of HT among patients in comparison with the self-administration behavior of gynecologists. For various indications, most German gynecologists favored HT for themselves or their female partner (female gynecologists, n = 1,538, 96%; male gynecologists, n = 917, 98.5%, respectively). This study demonstrates that although the great majority of German gynecologists have a favorable attitude regarding personal use of HT, various discrepancies between physician and patient care exist, especially for the indications of cognitive disorders, achievement of overall well-being, and antiaging. This finding calls for a more unified treatment of perimenopausal and postmenopausal disorders.