Sexual function changes attributed to hormonal contraception use – a qualitative study of women experiencing negative effects

Malmborg, Agota; Brynte, Louise; Falk, Gabriella; Brynhildsen, Jan; Hammar, Mats; Berterö, Carina

doi:10.1080/13625187.2020.1736545

Cited by 9 publications

(14 citation statements)

References 43 publications

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“…The women in our study expressed the wish for more information, in particular about side-effects. This is in agreement with other studies reporting that side-effects were under-communicated 1,11 . As side-effects are the primary reason for discontinuing contraception it seems of vital importance to prepare women 9,31,32 .…”

Section: Discussionsupporting

confidence: 93%

“…Unacceptable side-effects are the most common reason for discontinuing a specific contraceptive method 9,10 . The literature suggests that women do suffer considerable sideeffects, which are possibly under-communicated during the contraceptive consultation 1,11 . Non-hormonal contraceptive methods have a high Pearl Index (more women conceive) but less side-effects than hormonal contraceptives 12 .…”

Section: Introductionmentioning

confidence: 99%

“…Research shows that women find it hard to discuss intimate aspects of their life with health professionals and that some women may find it easier to discuss sexually related issues with a female health professional 1,21,22 . A good counsellor-patient relationship facilitates the decision-making process 10,11 .…”

Section: Introductionmentioning

confidence: 99%

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Norwegian women’s experiences and opinions on contraceptive counselling: A systematic textcondensation study

Lukasse¹,

Baglo²,

Engdal³

et al. 2021

Eur J Midwifery

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INTRODUCTION Contraception plays a pivotal role in most women’s lives, from teenage years to the menopause. Contraception and sexual wellbeing are closely related. Ideally, women should be able to access contraception and discuss issues concerning their sexual life during a contraceptive counselling session. Previously, only doctors conducted contraceptive consultations. Increasingly, other healthcare workers are providing contraceptive care. The aim of this study is to explore women’s experiences and opinions related to contraceptive counselling. METHODS An electronic questionnaire was distributed in 2017–2018. The texts of 308 women’s written responses to open-ended questions were analyzed using systematic text-condensation. RESULTS The analysis resulted in four themes: 1) Women-centered care, 2) Side-effects of hormonal contraceptives, 3) Non-hormonal methods and male involvement, and 4) Counsellors’ professional background. Women wished for a consultation that would lead to the best choice of contraception for them, taking into account their medical history, personal preference and living circumstances. Side-effects of hormonal products were under-communicated, as were non-hormonal methods. Respondents had contradicting opinions about midwives as contraceptive counsellors and were unfamiliar with them in this role. CONCLUSIONS The quality of contraceptive counselling in Norway needs to be improved. Women require individualized follow-up, sufficient information and a choice of methods to find the most suitable alternative for them. A good relationship with a health provider they trust could improve contraceptive consultation. Midwives’ knowledge and competence in this area need to be made more widely known.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Norwegian women’s experiences and opinions on contraceptive counselling: A systematic textcondensation study

Lukasse¹,

Baglo²,

Engdal³

et al. 2021

Eur J Midwifery

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“…Contraceptive use has complex effects on sexual behaviour [ 1 ] and mood, including those related to reduced concerns about unintended pregnancy, direct hormonal effects and effects on endogenous sex hormones. Hormonal contraceptive use has been associated with reduced sexual function [ 2 ]. Method switching and discontinuation has been attributed to reduced desire experienced during hormonal contraception [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Sexual behaviour among women using intramuscular depot medroxyprogesterone acetate, a copper intrauterine device, or a levonorgestrel implant for contraception: Data from the ECHO randomized trial

Hofmeyr,

Singata-Madliki,

Batting

et al. 2024

PLoS ONE

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Background Contraceptive use has complex effects on sexual behaviour and mood, including those related to reduced concerns about unintended pregnancy, direct hormonal effects and effects on endogenous sex hormones. We set out to obtain robust evidence on the relative effects of three contraceptive methods on sex behaviours, which is important for guiding contraceptive choice and future contraceptive developments. Methods This is a secondary analysis of data from the Evidence for Contraceptive Options and HIV Outcomes (ECHO) randomized trial in which 7,829 HIV-uninfected women from 12 sites in Eswatini, Kenya, South Africa and Zambia seeking contraception were randomly assigned to intramuscular depot-medroxyprogesterone acetate (DMPA-IM), the copper intrauterine device (Cu-IUD) or the levonorgestrel (LNG) implant. Data collected for 12 to 18 months using 3-monthly behavioural questionnaires that relied on recall from the preceding 3 months, were used to estimate relative risk of post-baseline sex behaviours, as well as sexual desire and menstrual bleeding between randomized groups using modified Poisson regression. Results We observed small but generally consistent effects wherein DMPA-IM users reported lower prevalence of specified high risk sexual behaviours than implant users than Cu-IUD users (the ‘>‘ and ‘<‘ symbols indicate statistically significant differences): multiple sex partners 3.6% < 4.8% < 6.2% respectively; new sex partner 3.0% < 4.0% <5.3%; coital acts 16.45, 16.65, 17.12 (DMPA-IM < Cu-IUD); unprotected sex 65% < 68%, 70%; unprotected sex past 7 days 33% <36%, 37%; sex during vaginal bleeding 7.1%, 7.1% < 8.9%; no sex acts 4.1%, 3.8%, 3.4% (DMPA-IM > Cu-IUD); partner has sex with others 10% < 11%, 11%. The one exception was having any sex partner 96.5%, 96.9% < 97.4% (DMPA-IM < Cu-IUD). Decrease in sexual desire was reported by 1.6% > 1.1% >0.5%; amenorrhoea by 49% > 41% >12% and regular menstrual pattern by 26% <35% < 87% respectively. Conclusions These findings suggest that women assigned to DMPA-IM may have a modest decrease in libido and sexual activity relative to the implant, and the implant relative to the Cu-IUD. We found more menstrual disturbance with DMPA-IM than with the implant (and as expected, both more than the Cu-IUD). These findings are important for informing the contraceptive choices of women and policymakers and highlight the need for robust comparison of the effects of other contraceptive methods as well.

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“…According to studies in both Europe, Africa, Asia and Latin-America, discontinuation of hormonal contraceptives during the first year of use is common [ 4 – 8 ]. Women describe, discontinuation due to experiences of health concerns [ 4 ] such as irregular bleeding patterns [ 4 – 6 ], weight gain, headache [ 4 ], and negative effects on mood and sexual desire [ 7 , 8 ]. Among women who choose LARC, discontinuation within two years also seems common due to experiences of health concerns [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Women’s experiences of dealing with fertility and side effects in contraceptive decision making: a qualitative study based on women’s blog posts

Johansson,

Vesström,

Alehagen

et al. 2023

Reprod Health

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Background Worldwide, there is limited knowledge regarding women’s views of future fertility in relation to contraceptive use. Few studies include material where women share their experiences at peer-written public domain websites, in spite of a larger portion of women discontinuing use of contraceptives. The objective of this study was to explore women’s experiences of contraceptive methods based on data gathered from individual blog posts. Methods Explorative qualitative study including 123 individual blog posts as the data source analysed with inductive thematic analysis. Results Two themes were identified. Theme 1, ‘Seeking control over reproduction and optimise fertility’ including the sub-themes; Having the possibility to decide if, and when, to become pregnant, The value of effective contraceptive methods and the impact of women’s sexuality, A wish to understand the body’s normal fertility function and Limited knowledge—sharing information about the menstrual cycle during counselling and Theme 2, ‘Making the complex decision on their own’ including the sub- themes; Limited or subpar guidance in counselling and need for information from social media, Relational and environmental factors influencing contraceptive decision making and Considering beneficial effects and fears of adverse health effects when using hormonal contraceptive methods. Conclusions During counselling, women desired an extended dialogue regarding effectiveness, health effects of different methods and an increased understanding of their menstrual cycle. Insufficient understanding of contraceptive methods can lead to use of methods not providing the expected level of protection. Hormonal contraceptives, especially Long-acting reversible contraception (LARC) were believed to inhibit fertility long after ending treatment.

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Sexual function changes attributed to hormonal contraception use – a qualitative study of women experiencing negative effects

Cited by 9 publications

References 43 publications

Norwegian women’s experiences and opinions on contraceptive counselling: A systematic textcondensation study

Norwegian women’s experiences and opinions on contraceptive counselling: A systematic textcondensation study

Sexual behaviour among women using intramuscular depot medroxyprogesterone acetate, a copper intrauterine device, or a levonorgestrel implant for contraception: Data from the ECHO randomized trial

Women’s experiences of dealing with fertility and side effects in contraceptive decision making: a qualitative study based on women’s blog posts

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