Contraceptive sex acceptability: a commentary, synopsis and agenda for future research

Higgins, Jenny A.; Davis, Anne R.

doi:10.1016/j.contraception.2014.02.029

Cited by 20 publications

(18 citation statements)

References 82 publications

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“…15 However, sexual acceptability includes other key domains, including psychological factors such as sexual disinhibition, sexual aspects of side effects such as bleeding and cramping, and women’s perceptions of whether their methods affect sexuality. 7, 9, 16, 17 …”

Section: Introductionmentioning

confidence: 99%

Women's Sexual Function, Satisfaction, and Perceptions After Starting Long-Acting Reversible Contraceptives

Higgins

Sanders

Palta

et al. 2016

Obstetrics &Amp; Gynecology

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Objective To document how long-acting reversible contraception (LARC) affects women’s sexual outcomes. Methods In this prospective, observational cohort study, we enrolled new-start intrauterine device (IUD) and contraceptive implant users attending four family planning clinics. Data collection occurred at baseline, one month, and three months. Primary outcomes were the Female Sexual Function Index, New Sexual Satisfaction Scale, and perceived sexual effects of method (positive, negative, or none). Secondary outcomes included other factors associated with LARC’s sexual acceptability, including the ability to “let go” in sex, sense of control over pregnancy, and bleeding changes. Chi-square and F-tests assessed differences between method groups at baseline, and mixed effects models, robust Wald chi-square tests, and conditional logistic regression documented differences from baseline and trends over time. Results In December 2014-April 2015, 200 patients consented and enrolled in the study. Among 159 women who completed three survey rounds, 20% selected copper IUDs, 46% levonorgestrel IUDs, and 34% implants. Sexual functioning and satisfaction scores did not change over time. However, across methods, participants were more likely to report improvements to their sexual lives compared to baseline (χ2 p<0.001). By 3 months, 40% (n=64) reported positive changes and 17% (n=27) negative changes. Positive sexual changes were associated with one’s sense of control over pregnancy and one’s ability to “let go” in sex. Negative sexual changes were largely attributable to increased vaginal bleeding. Conclusion Although new LARC users reported no measurable objective change in sexual function or satisfaction, a sizable minority reported perceived positive, method-related sexual changes. Clinical Trial Registration ClinicalTrials.gov, www.clinicaltrials.gov, NCT02734199.

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Section: Introductionmentioning

confidence: 99%

Women's Sexual Function, Satisfaction, and Perceptions After Starting Long-Acting Reversible Contraceptives

Higgins

Sanders

Palta

et al. 2016

Obstetrics &Amp; Gynecology

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“…Statistical analysis was performed in accordance with the Cochrane Handbook for Statistical Review of Interventions. 27,28 The DerSimonian and Laird random effect 29 was chosen, because variation between studies' populations and high heterogeneity in BP analysis was observed. A P value <0.05 was considered statistically significant.…”

Section: Data Synthesis and Analysismentioning

confidence: 99%

Effect of Probiotics on Blood Pressure

et al. 2014

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Abstract-Previous human clinical trials have shown that probiotic consumption may improve blood pressure (BP) control.The aim of the present systematic review was to clarify the effects of probiotics on BP using a meta-analysis of randomized, controlled trials. PubMed, Scopus, Cochrane Library (Central), Physiotherapy Evidence Database, and Clinicaltrial.gov databases were searched until January 2014 to identify eligible articles. Meta-analysis using a random-effects model was chosen to analyze the impact of combined trials. Nine trials were included. Probiotic consumption significantly changed systolic BP by −3.56 mm Hg (95% confidence interval, −6.46 to −0.66) and diastolic BP by −2.38 mm Hg (95% confidence interval, −2.38 to −0.93) compared with control groups. A greater reduction was found with multiple as compared with single species of probiotics, for both systolic and diastolic BP. Subgroup analysis of trials with baseline BP ≥130/85 mm Hg compared with <130/85 mm Hg found a more significant improvement in diastolic BP. Duration of intervention <8 weeks did not result in a significant reduction in systolic or diastolic BP. Furthermore, subgroup analysis of trials with daily dose of probiotics <10 11 colony-forming units did not result in a significant meta-analysis effect. The present meta-analysis suggests that consuming probiotics may improve BP by a modest degree, with a potentially greater effect when baseline BP is elevated, multiple species of probiotics are consumed, the duration of intervention is ≥8 weeks, or daily consumption dose is ≥10 The online-only Data Supplement is available with this article at http://hyper.ahajournals.org/lookup/suppl

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“…In 2005, Severy and Newcomer argued that sexuality is a “critical” but understudied issue in contraceptive acceptability research . Two years later, a commentary in this journal similarly noted a pleasure deficit in the field: Even though contraceptives are designed for sexual activity, few studies have explored methods’ effects on women's sexual satisfaction or functioning, let alone how such effects shape contraceptive uptake, adherence and continuation . Nonetheless, in recent years, reproductive health researchers have shown increasing interest in how contraception affects women's sexual well‐being and how sexuality may influence contraceptive choices and practices .…”

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confidence: 99%

The Sexual Acceptability of Intrauterine Contraception: A Qualitative Study of Young Adult Women

Higgins

Ryder

Skarda

et al. 2015

Perspect Sexual Reproductive

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CONTEXT The IUD is extremely effective but infrequently used by young adult women, who disproportionately experience unintended pregnancies. Research has not examined how IUD use may affect sexuality, which could in turn affect method acceptability, continuation and marketing efforts. METHODS Focus group discussions and interviews were conducted in 2014 with 50 women between the ages of 18 and 29—either University of Wisconsin students or women from the surrounding community who received public assistance—to explore their thoughts about whether and how IUD use can affect sexual experiences. A modified grounded theory approach was used to identify common themes in terms of both experienced and anticipated sexual acceptability of the IUD. RESULTS Six themes emerged: Security (IUD’s efficacy can reduce sexual inhibition), spontaneity (IUD can allow for free-flowing sex), sexual aspects of bleeding and cramping (IUD’s side effects can affect sex), scarcity of hormones (IUD has little or no hormones, and reduces libido less than hormonal methods such as the pill), string (IUD’s string can detract from a partner’s sexual experience) and stasis (IUD use can have no impact on sex). Some reported sexual aspects of IUD use were negative, but most were positive and described ever-users’ method satisfaction and never-users’ openness to use the method. DISCUSSION Future research and interventions should attend to issues of sexual acceptability: Positive sexual aspects of the IUD could be used promotionally, and counseling about sexual concerns could increase women’s willingness to try the method.

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Contraceptive sex acceptability: a commentary, synopsis and agenda for future research

Cited by 20 publications

References 82 publications

Women's Sexual Function, Satisfaction, and Perceptions After Starting Long-Acting Reversible Contraceptives

Women's Sexual Function, Satisfaction, and Perceptions After Starting Long-Acting Reversible Contraceptives

Effect of Probiotics on Blood Pressure

The Sexual Acceptability of Intrauterine Contraception: A Qualitative Study of Young Adult Women

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