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Most (61%) women were continuing a method used in the previous month. During the 24\u2010week follow up, incidence of contraceptive switch was 61.3 per 100 person\u2010years (95% confidence interval [CI] 52.4\u201371.8) and incidence of discontinuation was 38.5 per 100 person\u2010years (95% CI 31.6\u201347.0). On average, one\u2010quarter (prevalence [Pr] 0.24, 95% CI 0.22\u20130.26) of participants reported side effects or method problems weekly, with sexual side effects the most prevalent symptom (Pr 0.15, 95% CI 0.13\u20130.16). Lack of expected bleeding was associated with higher risk of method switch (adjusted hazard ratio [aHR] 2.36, 95% CI 1.22\u20134.57). Risk of all\u2010modern method discontinuation was higher among women experiencing irregular bleeding (aHR 2.39, 95% CI 1.20\u20134.77), weight changes (aHR 2.72, 95% CI 1.47\u20134.68) and sexual side effects (aHR 2.42, 95% CI 1.40\u20134.20).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Addressing irregular bleeding, weight changes and sexual side effects through development of new products that minimise these specific side effects and anticipatory counseling may reduce method\u2010related discontinuation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Bleeding, weight changes, sexual problems associated with discontinuation of #contraception, but many continue despite side effects.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17032","type":"journal-article","created":{"date-parts":[[2021,11,28]],"date-time":"2021-11-28T09:29:13Z","timestamp":1638091753000},"page":"926-937","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Contributions of side effects to contraceptive discontinuation and method switch among Kenyan women: a prospective cohort study"],"prefix":"10.1111","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2419-9881","authenticated-orcid":false,"given":"CW","family":"Rothschild","sequence":"first","affiliation":[{"name":"Department of Epidemiology University of Washington  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BA","family":"Richardson","sequence":"additional","affiliation":[{"name":"Departments of Biostatistics and Global Health University of Washington  Seattle WA USA"},{"name":"Division of Vaccine and 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Health Services University of Washington  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EL","family":"Lokken","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"John\u2010Stewart","sequence":"additional","affiliation":[{"name":"Departments of Global Health, Epidemiology, Medicine, and Pediatrics University of Washington  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JA","family":"Unger","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Washington  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Kinuthia","sequence":"additional","affiliation":[{"name":"Department of Research and Programs Kenyatta National Hospital  Nairobi 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