eng Oriental Scientific Publishing Company Biomedical and Pharmacology Journal 0974-6242 2025-12-30 18 4 3049 3056 10.13005/bpj/3317 69217 article Fitim Alidema 1 Migena Tasholli 2 Department of Pharmacology, Faculty of Pharmacy, UBT College, Prishtina, Kosovo Department of Nursing, Faculty of Medical Sciences, UBT College, Prishtina, Kosovo Abstract Hormonal contraceptives, including combined oral contraceptives (COCs), progestin-only pills (POPs), injectables, vaginal rings, patches, implants, and LNG-IUDs, are key tools in reproductive health, with varying effectiveness, safety profiles, and clinically relevant endocrine effects. However, local evidence on usage patterns and determinants of choice in Kosovo remains limited. This cross-sectional quantitative study, conducted from January to December 2024, involved 400 current users aged 15–49 years. A structured questionnaire covered demographic and clinical history, reproductive background, current method, reasons for choice, counseling and access, side effects, and adherence. Analyses included descriptive statistics, bivariate comparisons (χ²/ANOVA), multinomial logistic regression (reference = COCs, compared with POPs and LARC), and binary logistic regression for continuation (non-discontinuation within 12 months). The distribution of methods was as follows: COCs 46.8%, POPs 17.5%, LARC 24.3% (implants 9.8%, LNG-IUD 14.5%), and other methods 11.5%. Selection of LARC was associated with age ≥30 years, multiparity, frequent pill omissions (OR 1.72–2.39; p<0.05), and structured counseling by physicians or pharmacists (OR 1.81; p=0.012). POPs were preferred among smokers aged ≥35 years and women with migraine with aura or hypertension (OR 1.94; p=0.021). Twelve-month continuation was higher with LARC (84.1%) compared to COCs/POPs (66.7%; p=0.003) and decreased in the presence of moderate or severe side effects (OR 0.62; p=0.018) or higher monthly cost (OR 0.71; p=0.029). Therapeutic indications such as PCOS, dysmenorrhea, and menorrhagia were significantly associated with COCs and LNG-IUD use (p<0.05). Among current users in Kosovo, COCs remain the dominant method, but LARC demonstrates significantly higher continuation rates and is favored in specific clinical profiles. Structured counseling and affordability are crucial determinants of rational choice and sustained use. Expanding access to LARC, standardizing counseling, and addressing myths and side effects are essential strategies to optimize endocrine and reproductive outcomes. https://biomedpharmajournal.org/vol18no4/prevalence-and-determinants-of-hormonal-contraceptive-use-among-women-in-kosovo-a-cross-sectional-study-january-december-2024/ Adherence COCs Hormonal Contraceptives Kosovo LARC POPs Side Effects