Sexual Patterns, Menstrual Health Status and Prevalence of Modern Contraceptive Use Among Reproductive Aged Females in Bosnia and Herzegovina During the Covid-19 Pandemic.

Background: Nowadays, most women of reproductive age utilize various methods of contraception to avoid undesired pregnancy and regulate menstrual cycles.

Objective: The aim of this study is to evaluate current sexual patterns, menstrual health status and use of contraceptive methods in reproductive aged females in Bosnia and Herzegovina during the COVID-19 pandemic.

Methods: This cross-sectional study was conducted in the period between February 21^st and March 5^th 2022 via an online anonymous questionnaire which was distributed using social media platforms.

Results: Menstrual periods were normally regular in 269 (85.7 %) of the females, whereas 45 (14.3 %) experienced irregular menstrual cycles. Females report having either one sexual partner 149 (47.5%) or no sexual partners 76 (24.2%) and typically no 92 (29.3%) or frequent (more than 8 sexual intercourses) sexual intercourses per month. The usage of contraceptive methods was reported among the majority 212 (67.5%) and mostly by using of male condom 104 (33.1%), followed by the withdrawal method 64 (20.4%), oral contraceptive pills 35 (11.1%), emergency contraceptive pills "after 24h" 2 (0.6%) and intrauterine device 7 (2.2%). The usage of contraceptive methods was higher among younger females (X²=18.07, p<0.001) and among those who were employed (X²=10.86, p<0.001). Those who used oral contraceptive pills used mostly pills that are combination of progesterone and oestrogen 32 (91.4%) and for the purpose of regulation of menstrual cycles 26 (74.2%) and to prevent unwanted pregnancies 9 (25.8%). Females who had no sexual intercourses per month (OR+0.27, 95% CI 0.09-0.79, p=0.018) were less likely, while those who had irregular menstrual cycles (OR=2.44, 95% CI 1.04-5.71, p=0.039) were more prone to use oral contraceptive pills.

Conclusion: Bosnia and Herzegovina reproductive aged female had relatively regular menstrual cycles, the majority used modern contraceptive methods to prevent unwanted pregnancies or for the regulation of menstrual cycles during the COVID-19 pandemic.