Comparing Sexual Function and Mental Health in Women Using Different Contraceptive Methods
Women often use contraceptives (birth control) during their reproductive years, with options including hormonal (e.g., birth control pills) and non-hormonal methods (e.g., condoms or copper IUDs). While hormonal contraceptives can help reduce the fear of unwanted pregnancy and control menstrual bleeding, they may also negatively affect sexual function and mental health. For example, hormonal contraceptives may lower sexual desire, cause pain during intercourse, and lead to mood changes.
A recent study explored these issues by comparing sexual function, satisfaction, anxiety, and depression among women using hormonal contraceptives, non-hormonal methods, or no contraceptives at all. Understanding these effects can help women choose the most suitable contraceptive method for their needs.
The study involved 315 sexually active women aged 18-45, mostly in committed relationships and with higher education. Participants were recruited through social media and were divided into three groups based on the type of contraceptive they used: hormonal, non-hormonal, or none.
Participants answered a series of questionnaires assessing their sexual function, satisfaction, quality of life, anxiety, and depression. These questionnaires included the Female Sexual Function Index (FSFI), Sexual Quotient–Feminine version, and others that measured mental health and overall well-being. The researchers then compared the effects of different contraceptive methods on sexual health and mental well-being.
Of the 315 women who completed the questionnaires, 51% used hormonal contraceptives, 31% used non-hormonal methods, and 18% used no contraceptives. The study found that women using hormonal contraceptives reported worse sexual function (according to their FSFI scores), lower satisfaction, poorer general health (as shown by lower scores on a 12-item Medical Outcomes Short Form Health Survey), and higher levels of anxiety and depression compared to those using non-hormonal methods or no contraceptives. Non-hormonal contraceptive users experienced better arousal and less pain.
Notably, women who took oral contraceptives were generally younger and experienced worse sexual function and higher anxiety than those using copper IUDs, who reported better outcomes in both arousal and anxiety. The researchers offered a few theories to explain why this might be the case. First of all, they explained that synthetic hormones in most hormonal contraceptives lower testosterone levels, which can reduce arousal and vaginal lubrication, possibly leading to decreased sexual function and satisfaction.
Another potential explanation is the impact of hormonal contraceptives on neurochemistry. Estrogens and progestogens in hormonal methods affect neurotransmitters like serotonin and dopamine, which regulate mood, anxiety, and depression. Therefore, hormonal contraceptive methods, especially those containing progestogens, can alter the activity of enzymes like monoamine oxidase, lowering serotonin levels and increasing mood-related issues, such as anxiety and depression.
While the prevalence of painful sex (dyspareunia) did not differ significantly between the groups, women using hormonal contraceptive methods were more likely to report sexual dysfunction overall.
Despite these findings, the authors of the study emphasized that sexual function is complex and influenced by many factors. Future research is needed to better understand the long-term effects of contraceptives on sexual health and well-being.
For more information on this topic, please read these publications from the ISSM Journals: The Journal of Sexual Medicine, Sexual Medicine Reviews, and Sexual Medicine Open Access:
Oral Contraception and Female Sexual Dysfunction in Reproductive Women
References:
Déa, C. A., Moreira, E. C. H., & Zamboti, C. L. (2024). Sexual function, quality of life, anxiety, and depression in women of reproductive age using hormonal, nonhormonal, and no contraceptive methods. The Journal of Sexual Medicine, 21(8), 683–690. https://doi.org/10.1093/jsxmed/qdae060
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