Title: PERSPECTIVES ON THE SIDE EFFECTS OF HORMONAL CONTRACEPTIVES
AMONG WOMEN OF REPRODUCTIVE AGE IN KITWE DISTRICT OF ZAMBIA: A
QUALITATIVE EXPLORATIVE STUDY
Version: 1 Date: 21 Mar 2023
Reviewer's report:
BMC manuscript review  reviewed 3/13/2023
There are no major conceptual errors in the text. However, there are some minor issues that can
be improved:
In the first sentence, it says "chemical agents" as a form of contraception, which is quite broad.
This may not be easily understood by a few  readers. Perhaps it is better to provide examples of
chemical agents used as contraceptive. Such as  spermicides or hormonal contraceptives. The
text mentions that "inconsistent use of contraceptives among women often results in unintended
pregnancies.". Suggest that the sentence be modified. It is misleading even with consistent
use, contraceptives may not always be 100% effective. It would be more accurate to say
that consistent use of contraceptives greatly reduces the risk of unintended pregnancies.In the
paragraph discussing the side effects of hormonal contraceptives, it says that they are "unable to
offer protection against sexually transmitted infections (STIs)." This is true for most hormonal
contraceptives, but not for condoms.  It is better to say ‘ that hormonal contraceptives other
than condoms do not offer protection against STIs’.In the last paragraph, it says that the study
employed "convenient sampling" to select participants. We cannot make generalization based
on this sampling method. While this is a valid sampling method, it may be seen as   rigorous
than other methods such as random sampling. It would be helpful to explain why convenient
sampling was chosen and how it was carried out.
The text suggests that participants in the study linked the side effects of contraceptives to
infertility. This link between infertility and side effects may be very tenuous . You should
mention that infertility is a medical condition that requires a diagnosis and cannot be attributed
solely to contraceptive use. Participants may have experienced difficulties conceiving after
discontinuing contraceptive use, but this does not necessarily indicate infertility. The text uses
the term "secondary infertility" which is not an accurate medical term. Infertility is defined as the
inability to conceive after 12 months of regular unprotected intercourse, regardless of whether
the individual has had a previous pregnancy or not. The term "secondary infertility" is sometimes
used to refer to difficulty conceiving after having a previous successful pregnancy, but it is not
a medical diagnosis.
I also wonder if the  side effects of hormonal contraceptives are generally infrequent, which is not
entirely accurate. While serious side effects are rare, they can occur and can be life-threatening.
For example, hormonal contraceptives have been associated with an increased risk of blood
clots, stroke, and heart attack, particularly in women who smoke or have other risk factors. The
text suggests that contraceptives are broadly considered safe, but it is important to note that all
medications have potential risks and side effects. While the benefits of contraception generally
outweigh the risks, it is important for individuals to be aware of the potential risks and to discuss
them with their healthcare provider.The text suggests that menstrual bleeding prevented women
from participating in religious activities in Bangladesh, but it is important to note that this may
not be a universal experience and may be specific to certain cultural or religious contexts.