title: Contraceptive use in the Nordic countries.
abstract: BACKGROUND
  The aim was to compare contraceptive use in the Nordic countries and to assess compliance with recommendations from the European Medicines Agency regarding the use of combined oral contraception containing low-dose estrogen and levonorgestrel, norethisterone or norgestimate.
  
  
  METHODS
  Data on hormonal contraceptive prescriptions and sales figures for copper intrauterine devices were obtained from national databases and manufacturers in Denmark, Finland, Iceland, Norway and Sweden in 2010-2013.
  
  
  RESULTS
  Contraceptive use was highest in Denmark (42%) and Sweden (41%), followed by Finland (40%). Combined oral contraception was the most used method in all countries, with the highest use in Denmark (26%). The second most used method was the levonorgestrel-releasing intrauterine system, with the highest use in Finland (15%) and ≈10% in the other countries. Copper intrauterine devices (7%) and the progestin-only pill (7%) were most often used in Sweden. Combined oral contraception use decreased with increasing age and levonorgestrel-releasing intrauterine system and progestin-only pills use increased. The use of long-acting reversible methods of contraception (=levonorgestrel-releasing intrauterine system, copper intrauterine devices, and implants) increased with time and was highest in Sweden (20%) and Finland (18%). The highest use of European Medicines Agency recommended combined oral contraception was in Denmark, increasing from 13 to 50% between 2010 and 2013. In Finland, recommended combined oral contraception remained below 1%.
  
  
  CONCLUSIONS
  Contraceptive use was highest in Denmark and Sweden, levonorgestrel-releasing intrauterine system use was highest in Finland and all long-acting methods were most common in Sweden. The use of combined oral contraception recommended by the European Medicines Agency was highest in Denmark.
authors.affiliation: Department of Obstetrics and Gynecology, Sahlgrenska Academy at Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Ingela
authors.initials: I
authors.lastname: Lindh
authors.affiliation: Research Group Epidemiology of Chronic Diseases, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Finn E
authors.initials: FE
authors.lastname: Skjeldestad
authors.affiliation: Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Insitute and Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Kristina
authors.identifier: http://orcid.org/0000-0001-6516-1444
authors.initials: K
authors.lastname: Gemzell-Danielsson
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Oskari
authors.identifier: http://orcid.org/0000-0002-8671-130X
authors.initials: O
authors.lastname: Heikinheimo
authors.affiliation: Department of Obstetrics and Gynecology, Sahlgrenska Academy at Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Helena
authors.identifier: http://orcid.org/0000-0003-2405-0662
authors.initials: H
authors.lastname: Hognert
authors.affiliation: Department of Obstetrics and Gynecology, Sahlgrenska Academy at Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Ian
authors.identifier: http://orcid.org/0000-0002-0400-5509
authors.initials: I
authors.lastname: Milsom
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Rigshospitalet University Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Øjvind
authors.identifier: http://orcid.org/0000-0002-9157-4004
authors.initials: Ø
authors.lastname: Lidegaard
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017280:Condoms / Q000706:statistics & numerical data; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use; D003280:Contraceptives, Oral, Synthetic / Q000627:therapeutic use; D003281:Contraceptives, Postcoital / Q000627:therapeutic use; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000706:statistics & numerical data; D016912:Levonorgestrel / Q000627:therapeutic use; D008875:Middle Aged; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D055815:Young Adult
chemical_list: D003278:Contraceptives, Oral, Hormonal; D003280:Contraceptives, Oral, Synthetic; D003281:Contraceptives, Postcoital; D016912:Levonorgestrel
keywords: Contraceptive use; hormonal contraception; intrauterine devices; long-acting reversible contraception; oral contraceptives