What causes contraceptive side-effects? Testing the hormonal mismatch hypothesis in Ethiopia.

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This project aims to investigate the hypothesis that side-effects from hormonal contraception experienced by women living in rural poor environments result from a mismatch between women's levels of endogenous hormones and the dosage of hormonal contraception. Studies have shown that there is wide interpopulation variation between women living in different ecologies, yet most contraceptives are still trialled predominantly in Western populations. The research will investigate whether women living in environments with high nutritional/physical stress have lower levels of endogenous hormones (e.g. progesterone) and experience more severe side-effects from hormonal contraception (e.g. injectables). It will analyse hormonal, side-effects and sociodemographic data that will be collected across two socioecological settings in Ethiopia (urban rich/rural poor). Funding for fieldwork costs and laboratory analysis is already secured through a larger interdisciplinary project bringing together the University of Oxford, the London School of Hygiene and Tropical Medicine (LSHTM) and Addis Ababa University. This project has the potential to stimulate innovations in contraceptive design and service delivery and transform the conceptualisation of contraceptive side-effects as more tham merely ""myths"" in reproductive health policy.