Hormonal Contraception and Female Pain, Orgasm and Sexual Pleasure

Abstract

Introduction Almost half of all pregnancies in the United States are unintentional, unplanned, or mistimed. Most unplanned pregnancies result from inconsistent, incorrect, or nonuse of a contraceptive method. Diminished sexual function and pleasure may be a barrier to using hormonal contraception. Aim This study explores sexual function and behaviors of women in relation to the use of hormonal vs. nonhormonal methods of contraception. Methods Data were collected as part of an online health and sexuality study of women. Main Outcome Measures Main outcomes variables assess frequencies in two domains: (i) sexual function (proportion of sexual events with experiences of pain or discomfort, arousal, contentment and satisfaction, pleasure and enjoyment, lubrication difficulty, and orgasm) and (ii) sexual behavior (number of times engaged in sexual activity, proportion of sexual events initiated by the woman, and proportion of sexual events for which a lubricant was used). Sociodemographic variables and contraceptive use were used as sample descriptors and correlates. The recall period was the past 4 weeks. Results The sample included 1,101 women with approximately half (n = 535) using a hormonal contraceptive method exclusively or a combination of a hormonal and nonhormonal method, and about half (n = 566) using a nonhormonal method of contraception exclusively. Hierarchical regression analyses were conducted to examine the relation of hormonal contraceptive use to each of the dependent variables. Women using a hormonal contraceptive method experienced less frequent sexual activity, arousal, pleasure, and orgasm and more difficulty with lubrication even when controlling for sociodemographic variables. Conclusions This study adds to the literature on the potential negative sexual side effects experienced by many women using hormonal contraception. Prospective research with diverse women is needed to enhance the understanding of potential negative sexual side effects of hormonal contraceptives, their prevalence, and possible mechanisms. Clinical and counseling implications are discussed.

Sexual Functioning in Adolescents With Major Depressive Disorder

“…This finding differs from an adult study in which those using a hormonal contraceptive experienced less frequent sexual activity, arousal, pleasure, and orgasm 33 . It may be that our findings merely reflect the fact that, even prior to MDE onset, adolescents and young adults using hormonal contraception derive more pleasure from their sexual encounters, which prompts them to both be more sexually active and use contraception.…”

The Intimate Link

“…Some of these limitations include combining various contraceptive methods into hormonal versus nonhormonal methods which potentially fails to capture how individual methods and hormonal components may affect a woman's sexual experiences very differently 41,63 ; exclusion of certain methods because of small numbers 64 ; small samples sizes in general 59 ; and cross-sectional study designs, which may result in bias created by not including women who had previously discontinued use of HERC. Some of these limitations include combining various contraceptive methods into hormonal versus nonhormonal methods which potentially fails to capture how individual methods and hormonal components may affect a woman's sexual experiences very differently 41,63 ; exclusion of certain methods because of small numbers 64 ; small samples sizes in general 59 ; and cross-sectional study designs, which may result in bias created by not including women who had previously discontinued use of HERC.…”

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

“…Condoms and other barrier methods have direct effects on sensation and lubrication, whereas hormonal contraception could directly affect factors such as libido and orgasm as well. In a 2013 study comparing approximately 500 women using hormonal methods to a similarly-sized group using non-hormonal methods of contraception exclusively, researchers found that women using hormonal methods experienced lower levels of arousal, decreased sexual pleasure, fewer orgasms and more difficulties with vaginal lubrication, even when controlling for sociodemographic characteristics such as age, relationship status, sexual exclusivity status and children in the home [11]. Any method which inhibits ovulation and the mid-cycle increase in cervical fluid might impact some sexual experiences in as yet unknown ways [12].…”