ABSTRACT

Few large, longitudinal studies document multiple contraceptive methods’ effects on sexual functioning, satisfaction, and well-being. We leveraged data from the HER Salt Lake Contraceptive Initiative, a prospective cohort study with patient surveys at baseline, one month, and three months. Surveys assessed bleeding changes, contraceptive-related side effects, sexual functioning and satisfaction, and perceptions of methods’ impact on sexual well-being. Individuals in the final sample (N = 2,157) initiated either combined oral contraceptives, levonorgestrel intrauterine devices (IUDs), copper IUDs, implants, injectables, or vaginal rings. Across methods, participants exhibited minimal changes in sexual function (Female Sexual Function Index-6 scores) or satisfaction (New Scale of Sexual Satisfaction scores) over three months. However, many perceived contraception-related changes to sexual well-being. Half (51%) reported their new method had made their sex life better; 15% reported it had made their sex life worse. Sexual improvements were associated with decreased vaginal bleeding, fewer side effects, and IUD use. Negative sexual impacts were associated with physical side effects (e.g., bloating and breast tenderness), increased bleeding, and vaginal ring use. In conclusion, contraceptive users did not experience major changes in sexual functioning or satisfaction over three months, but they did report subjective sexual changes, mostly positive, due to their method.

 抽象的

很少有大型纵向研究记录多种避孕方法对性功能、满意度和幸福感的影响。我们利用了 HER 盐湖避孕计划的数据，这是一项前瞻性队列研究，对基线、一个月和三个月的患者进行了调查。调查评估了出血变化、避孕相关副作用、性功能和满意度以及对方法对性健康影响的看法。最终样本中的个体 ( N = 2,157) 开始使用复方口服避孕药、左炔诺孕酮宫内节育器 (IUD)、铜宫内节育器、埋植剂、注射剂或阴道环。在各种方法中，参与者在三个月内表现出性功能（女性性功能指数 6 分数）或满意度（新性满足量表分数）的最小变化。然而，许多人认为避孕相关的性健康变化。一半（51%）表示他们的新方法使他们的性生活变得更好； 15% 的人表示这让他们的性生活变得更糟。性功能的改善与阴道出血减少、副作用减少和宫内节育器的使用有关。负面的性影响与身体副作用（例如腹胀和乳房胀痛）、出血增加和阴道环的使用有关。总之，避孕药使用者在三个月内没有经历性功能或满意度的重大变化，但由于他们的方法，他们确实报告了主观的性变化，大部分是积极的。