November 11, 2011

Hormonal Birth Control & Sexual Functioning–What’s The Deal?

Recent research suggests that using a hormonal method of birth control is associated with decreased sexual functioning...what's the deal?

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Since it’s widespread legalization, the pill has been somewhat controversial, despite the fact that it is highly effective in preventing unintended pregnancies. Family planning, through the use of hormonal methods of birth control (e.g. the pill, NuvaRing, patch), has been a right enjoyed by many American women (and technically men, although men rarely get mentioned in regard to birth control and family planning) for several decades. With a wide variety of pill formulas (estrogen and progestin combination; progestin-only) and many modes of hormonal intake (e.g. orally, absorption through the skin, implant, shot, intrauterine device), hormonal birth control methods can be a great way for women and men to control the timing and frequency with which they wish to grow families. However, like all other forms of synthetic medication, hormonal birth control methods are not without side effects.

Does hormonal birth control impact women’s sexual functioning?

I have yet to use this forum to discuss my own research, however, my colleagues and I have been working on a study in which we examined the relationship between hormonal birth control methods and various aspects of women’s sexual functioning such as women’s frequency in engaging in and initiating sexual activity, and frequency experiencing pain, lubrication, ease and intensity of orgasm, satisfaction, pleasure, and arousal. We recently presented our findings at the national meetings for the American Public Health Association and the Society for the Scientific Study of Sexuality. Many of the women we spoke with at the conference were not surprised by our findings as they mentioned suspecting the relationship based on their anecdotal experience. Women also noted feeling as though something was wrong with them, feeling anxious and feeling distressed over their lack of interest in sex and diminished sexual functioning after beginning a hormonal birth control method. Yet, after hearing our findings, they indicated feeling relief that they were not alone in experiencing these distressing symptoms.

My co-authors and I find this extremely frustrating–the very substance meant to liberate women sexually (by alleviating the risk of unintended pregnancy) may be contributing to impairments in their sexual functioning. Although we don’t claim that these findings are causal, my colleagues and I are pleased to help shed some light on this issue.

The Survey Says…

Among our sample of 1101 women (535 using hormonal contraceptive methods and 566 using non-hormonal methods), when controlling for age, relationship status, sexual relationship status, and having children living at home (this means taking the effect of all these factors into account), using a hormonal method was associated with less frequent sex, less frequent feelings of arousal, pleasure, orgasm, and vaginal lubrication.

We are grateful that some media outs such as: Jezebel and The Daily Beast have been publicizing our findings. It is our hope that greater awareness about the potential relationship between hormonal contraceptive methods and sexual functioning will help ease anxiety for women who feel as though something is wrong with them and perhaps spur other researchers (particularly clinical researchers) to further examine this potential relationship.

But, we still endorse hormonal methods of birth control as highly effective!

Although my colleagues and I are pleased to see the findings publicized in some main stream media outlets, we want to make sure that our underlying message does not get distorted. Although we found a less than ideal relationship between hormonal methods and certain aspects of sexual functioning, including pleasure and orgasm, we highly endorse hormonal methods as highly effective in reducing the risk of unintended pregnancy and highly successful in regards to family planning. Unfortunately, some have interpreted our findings to imply that women should avoid using hormonal methods—this is not our intention in conducting or publicizing our research.

Rather than view these findings as a recommendation to cease hormonal method use, it is our hope that women (and men) may instead interpret these findings as a reason to demand innovations in women’s contraceptive methods. It is important to take a woman’s sexual experience into consideration when developing these methods in the same way that a man’s sexual pleasure and experience weighs heavily on the development of the male condom. We believe that the take-home message should not be, “Stop taking your hormonal method because it may impact your sexual functioning in a negative way,” but rather, “Let’s try to find better hormonal methods for women!”  In the meantime, we suggest that if you are distressed by similar effects from your current method, consult your healthcare provider to discuss the MANY highly effective methods available.  By simply switching from one method like the pill to another method such as the NuvaRing or Mirena, with different combinations of hormones and different modes of delivery, women may experience a drastic reduction in some or all of these negative side effects.

Bio-medical science has made several advances in regard to hormonal birth control since its advent in 1960. For example, the amount of synthetic hormone women using the pill ingest has been substantially decreased. Additionally, there are numerous hormonal methods with a wide variety of hormone intake currently available (i.e. NuvaRing and patch–absorption, Implanton–implant, Depo-Provera–shot) as well as numerous formulas of the birth control pill (ingestion). But research assessing hormonal methods still has room to grow, especially research related to the potential relationship between hormonal methods and sexual functioning.

Another Fight for Equality

When conceptualizing male-oriented forms of birth control (i.e. the male condom; the theoretical male pill), pleasure is at the forefront of the discussion. We believe that at the very least, pleasure should enter into the dialogue surrounding women’s birth control options, including hormonal methods. We believe that, rather than shy away from the discussion and accept the status quo (or worse yet, reject current hormonal methods in exchange for increasing women’s risk for experiencing unintended pregnancy), women (and men) should request increased research efforts to develop better hormonal methods.