Background

Contraceptives are used to prevent unwanted pregnancies and treat certain gynecologic conditions, but many women report non-use or inconsistent use because of method dissatisfaction. The sexual acceptability of contraception—how birth control methods affect users’ sexual well-being—is likely an important component of contraceptive satisfaction but has yet to be systematically examined.

Objective

This study aimed to assess contraceptive satisfaction among new-start contraceptive users and examine whether sexual acceptability measures predict contraceptive satisfaction at 3 months while controlling for more commonly measured contraceptive side effects.

Study Design

This analysis used data derived from the baseline, 1-month, and 3-month surveys of the HER Salt Lake Contraceptive Initiative, a prospective cohort study of new contraceptive clients. From March 2016 to March 2017, enrolled participants received their desired contraceptive method at no cost and could switch or discontinue at any time (up to 3 years). This analysis included individuals who continued their new contraceptive method for at least 1 month and completed all relevant survey measures. We used ordered logistic regression modeling to predict contraceptive satisfaction at 3 months. Primary predictor variables included changes in sexual functioning (6-item Female Sexual Function Index), sexual satisfaction (New Sexual Satisfaction Scale), and perceived impact of the contraceptive method on sex life at 1 month. Covariates included vaginal bleeding changes, physical side effects, and mood-related side effects.

Results

Our analytical sample included 1879 individuals. At 3 months, 52.1% of participants were “completely satisfied” with their contraceptive method, 30.7% were “somewhat satisfied,” 4.2% were “neither satisfied nor dissatisfied,” 6.9% were “somewhat dissatisfied,” and 6.2% were “completely dissatisfied.” Compared with patients who said their contraceptive method made their sex life “a lot” worse at 1 month, patients whose method improved their sex life “a lot” had a 7.7 times increased odds of greater satisfaction at 3 months (95% confidence interval, 4.02–14.60; P<.0001) and patients whose method improved their sex life a “little” had a 5.88 times increased odds of greater satisfaction (confidence interval, 3.12–11.11; P<.001). To a much lesser degree, experiencing less or no bleeding was significantly associated with increased satisfaction, whereas worsening of physical side effects was linked to decreased satisfaction. The only other factors significantly associated with satisfaction were changes in bleeding and physical side effects.

Conclusion

Our findings suggest that patients’ sexual experiences of their contraceptive methods are important correlates of satisfaction. Clinicians may wish to underscore that sexual experiences of birth control methods matter and encourage patients to find a contraceptive method that works for them sexually.

中文翻译：

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性可接受性与避孕满意度随时间关系的前瞻性分析

背景

避孕药具用于预防意外怀孕和治疗某些妇科疾病，但许多女性报告由于方法不满意而未使用或不一致使用。避孕的性可接受性（节育方法如何影响使用者的性健康）可能是避孕满意度的重要组成部分，但尚未得到系统检验。

客观的

本研究旨在评估新开始避孕药使用者的避孕满意度，并检查性可接受性测量是否可以预测 3 个月时的避孕满意度，同时控制更常见的避孕副作用。

学习规划

该分析使用的数据来自 HER 盐湖避孕计划的基线、1 个月和 3 个月调查，这是一项针对新避孕药客户的前瞻性队列研究。从2016年3月到2017年3月，登记的参与者免费获得了他们想要的避孕方法，并且可以随时更换或停止（最长3年）。该分析包括持续使用新避孕方法至少 1 个月并完成所有相关调查措施的个体。我们使用有序逻辑回归模型来预测 3 个月时的避孕满意度。主要预测变量包括性功能变化（6项女性性功能指数）、性满意度（新性满意度量表）以及避孕方法对1个月时性生活的影响。协变量包括阴道出血变化、身体副作用和情绪相关副作用。

结果

我们的分析样本包括 1879 人。3个月时，52.1%的参与者对其避孕方法“完全满意”，30.7%的参与者“有些满意”，4.2%的参与者“既不满意也不满意”，6.9%的参与者“有些不满意”，6.2%的参与者“完全满意”。不满意。” 与那些声称避孕方法在 1 个月时使性生活“大幅”恶化的患者相比，采取避孕方法“大幅”改善性生活的患者在 3 个月时获得更高满意度的几率增加了 7.7 倍（95% 置信区间， 4.02–14.60；P <.0001），而其方法“稍微”改善了性生活的患者，满意度更高的几率增加了 5.88 倍（置信区间，3.12–11.11；P <.001）。在较小程度上，出血较少或没有出血与满意度增加显着相关，而身体副作用的恶化则与满意度下降相关。与满意度显着相关的唯一其他因素是出血和身体副作用的变化。

结论

我们的研究结果表明，患者对其避孕方法的性经历是满意度的重要相关因素。临床医生可能希望强调节育方法的性经历很重要，并鼓励患者找到一种对他们的性行为有效的避孕方法。