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Overdose of oral contraceptive pills as a means of intentional self-poisoning amongst young women in Sri Lanka: considerations for family planning
  1. Manjula Weerasinghe1,
  2. Flemming Konradsen2,
  3. Michael Eddleston3,
  4. Melissa Pearson4,
  5. Thilini Agampodi5,
  6. Frederikke Storm6,
  7. Suneth Agampodi7
  1. 1PhD Fellow and Research Co-ordinator, Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura, Sri Lanka and South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
  2. 2Professor, Head of section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  3. 3Professor of Clinical Toxicology and Lister Prize Fellow and Director of the National Poison Information Service South Asian Clinical Toxicology Research Collaboration (SACTRC), Pharmacology, Toxicology and Therapeutics, University of Edinburgh, UK, South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka and Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  4. 4Dr, Trial Manager, South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka and Department of Pharmacology, Toxicology and Therapeutics, University of Edinburgh, Edinburgh, UK
  5. 5Dr, Senior Lecturer, Head of the Department, Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura, Sri Lanka
  6. 6Research Assistant, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  7. 7Professor in Community Medicine, Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura, Sri Lanka
  1. Correspondence to Mr Manjula Weerasinghe, Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura 50008, Sri Lanka; manjugaya{at}yahoo.com

Abstract

Objective Oral contraceptive pills (OCPs) are one of the most popular family planning methods in Sri Lanka. As part of two hospital-based studies on self-harm, the use of OCPs was identified, from yet unpublished results, as a means of intentional self-poisoning. To inform future guidelines for better OCP promotion, this article aims to describe the extent, patient characteristics and outcomes of OCP self-poisoning in the North Central Province of Sri Lanka.

Methods A secondary analysis was carried out on two hospital-based self-harm case series, from January 2011 to June 2014.

Results Fifty-four patients (52 women and two men) with an overdose of OCP as a means of intentional self-poisoning were admitted to one of the surveyed hospitals. The median age of the patients was 19 (interquartile range, 5) years. None of the patients were severely sick from their overdose and two-thirds of the patients were discharged within a day of admission. Intentional self-poisoning with OCPs represented less than 5% of all types of intentional medicine self-poisonings recorded at the hospitals. Information available for a subset of female patients indicates that many cases (13/23, 56.5%) were in their first year of marriage.

Conclusions More research is required to understand why young women in rural Sri Lanka overdose with OCPs as a means of intentional self-poisoning. Although the toxicity of OCPs is low and the public health significance of OCP poisoning remains minor, reproductive health service providers should be attentive to OCP overdose, monitor the development of this problem, and ensure appropriate information to OCP users.

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