Skip to main content

Contraception and Sexuality

  • Chapter
  • First Online:
Female and Male Contraception

Abstract

Contraception stands as the fulcrum of a delicate balance between the reproductive experience and sexuality/genitality as an end in itself, giving the latter a playful and recreational dimension. Hormonal contraception can act on sexuality through the steroid components, their quantity, formulation, route of administration, and the regimen used; each of these variables is capable of modulating both the somatic-functional system and the psycho-relational and sexual areas.

The relationship between contraception and sexuality depends on complex individual, biological, psychological, and couple motivational variables; such a statement introduces the real tailoring concept, in short, the identification of a contraceptive suitable for “that woman” and “that couple.” Finally, the acceptability of a contraceptive method depends not only on its tolerability and metabolic neutrality, but also on the impact that the method can have on sexuality and quality of life. Contraceptive counseling must necessarily take into account these important elements, since the success of a contraceptive choice is closely connected to the influence that the method will have on sexuality.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Sonfield A, Hasstedt K, Kavanaugh ML, Anderson R. The social and economic benefits of women’s ability to determine whether and when to have children. New York: Guttmacher Institute; 2013.

    Google Scholar 

  2. Elaut E, Buysse A, De Sutter P, Gerris J, De Cuypere G, T’Sjoen G. Cycle-related changes in mood, sexual desire, and sexual activity in oral contraception-using and nonhormonal-contraception-using couples. J Sex Res. 2016;53:125–36.

    Article  PubMed  Google Scholar 

  3. Caruso S, Agnello C, Malandrino C, Lo Presti L, Cicero C, Cianci S. Do hormones influence women’s sex? Sexual activity over the menstrual cycle. J Sex Med. 2014;11:211–21.

    Article  CAS  PubMed  Google Scholar 

  4. Miller GF. The mating mind: how sexual choice shaped the evolution of human nature. New York: Anchor Books; 2000.

    Google Scholar 

  5. Gangestad SW, Thornhill R. Human oestrus. Proc Biol Sci. 2008;275:991–1000.

    PubMed  PubMed Central  Google Scholar 

  6. Roney JR, Simmons ZL. Hormonal predictors of sexual motivation in natural menstrual cycles. Horm Behav. 2013;63:636–45.

    Article  CAS  PubMed  Google Scholar 

  7. Bullivant SB, Sellergren SA, Stern K, Spencer NA, Jacob S, Menella JA, et al. Women’s sexual experience during the menstrual cycle: Identification of the sexual phase by non-invasive measurement of luteinizing hormone. J Sex Res. 2004;41:82–93.

    Article  PubMed  Google Scholar 

  8. Wilcox AJ, Baird DD, Dunson DB, McConnaughey DR, Kesner JS, Weinberg CR. On the frequency of intercourse around ovulation: Evidence for biological influences. Hum Reprod. 2004;19:1539–43.

    Article  CAS  PubMed  Google Scholar 

  9. Gildersleeve K, Haselton MG, Fales MR. Do women’s mate preferences change across the ovulatory cycle? A meta-analytic review. Psychol Bull. 2014;140:1205–59.

    Article  PubMed  Google Scholar 

  10. Brewis A, Meyer M. Demographic evidence that human ovulation is undetectable (at least in pair bonds). Curr Anthropol. 2005;46:465–71.

    Article  Google Scholar 

  11. Dobbins JG. Implication of a time-dependent model of sexual intercourse within the menstrual cycle. J Biosoc Sci. 1980;12:133–40.

    Article  CAS  PubMed  Google Scholar 

  12. Harris AL, Vitzthum VJ. Darwin’s legacy: an evolutionary view of women’s reproductive and sexual functioning. J Sex Res. 2013;50:207–46.

    Article  PubMed  Google Scholar 

  13. Grimes DA, Schulz KF. Nonspecific side effects of oral contraceptives: nocebo or noise? Contraception. 2011;83:5–9.

    Article  CAS  PubMed  Google Scholar 

  14. Tone A. Devices and desires: a history of contraceptives in America. New York: Hill and Wang; 2001.

    Google Scholar 

  15. Watkins ES. On the pill: A social history of oral contraceptives, 1950–1970. Baltimore: Johns Hopkins University Press; 1998.

    Book  Google Scholar 

  16. Burrows LJ, Basha M, Goldstein AT. The effects of hormonal contraceptives on female sexuality: a review. J Sex Med. 2012;9:2213–23.

    Article  CAS  PubMed  Google Scholar 

  17. De Castro Coelho F, Barros C. The potential of hormonal contraception to influence female sexuality. Int J Reprod Med. 2019;2019:9701384.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Gabalci E, Terzioglu F. The effect of family planning methods used by women of reproductive age on their sexual life. Sex Disabil. 2010;28:275–85.

    Article  Google Scholar 

  19. Graham CA, Bancroft J, Doll HA, Greco T, Tanner A. Does oral contraceptive-induced reduction in free testosterone adversely affect the sexuality or mood of women? Psychoneuroendocrinology. 2007;32:246–55.

    Article  CAS  PubMed  Google Scholar 

  20. Casey PM, MacLaughlin KL, Faubion SS. Impact of contraception on female sexual function. J Women’s Health (Larchmt). 2017;26:207–13.

    Article  Google Scholar 

  21. Bancroft J, Davidson DW, Warner P, Tyrer G. Androgens and sexual behaviour in women using oral contraceptives. Clin Endocrinol. 1980;12:327–40.

    Article  CAS  Google Scholar 

  22. Pastor Z, Holla K, Chmel R. The influence of combined oral contraceptives on female sexual desire: a systematic review. Eur J Contracept Reprod Health Care. 2013;18:27–43.

    Article  CAS  PubMed  Google Scholar 

  23. Smith NK, Jozkowski KN, Sanders SA. Hormonal contraception and female pain, orgasm and sexual pleasure. J Sex Med. 2014;11:462–70.

    Article  PubMed  Google Scholar 

  24. Wallwiener CW, Wallwiener LM, Seeger H, Schönfisch B, Mueck AO, Bitzer J, et al. Are hormonal components of oral contraceptives associated with impaired female sexual function? A questionnaire-based online survey of medical students in Germany, Austria, and Switzerland. Arch Gynecol Obstet. 2015;292:883–90.

    Article  CAS  PubMed  Google Scholar 

  25. Caruso S, Malandrino C, Cicero C, Ciancio F, Cariola M, Cianci A. Quality of sexual life of women on oral contraceptive continued-regimen: pilot study. J Sex Med. 2013;10:460–6.

    Article  CAS  PubMed  Google Scholar 

  26. Burrows LJ, Goldstein AT. The treatment of vestibulodynia with topical estradiol and testosterone. Sex Med. 2013;1:30–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Davis SR. Should women receive androgen replacement therapy, and if so, how? Clin Endocrinol. 2010;72:149–54.

    Article  CAS  Google Scholar 

  28. Caruso S, Agnello C, Romano M, Cianci S, Lo Presti L, Malandrino C, Cianci A. Preliminary study on the effect of four phasic estradiol valerate and dienogest (E2V/DNG) oral contraceptive on the quality of sexual life. J Sex Med. 2011;8:2841–50.

    Article  CAS  PubMed  Google Scholar 

  29. Bancroft J, Hammond G, Graham C. Do oral contraceptives produce irreversible effects on women’s sexuality? J Sex Med. 2006;3:567; author reply, 568–570.

    Article  PubMed  Google Scholar 

  30. Guzick DS, Huang L-S, Broadman BA, Nealon M, Hornstein MD. Randomized trial of leuprolide versus continuous oral contraceptives in the treatment of endometriosis-associated pelvic pain. Fertil Steril. 2011;95:1568–73.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Caruso S, Rugolo S, Agnello C, Romano M, Cianci A. Quality of sexual life in hyperandrogenic women treated with an oral contraceptive containing chlormadinone acetate. J Sex Med. 2009;6:3376–84.

    Article  CAS  PubMed  Google Scholar 

  32. Graham CA, Sanders SA, Milhausen RR. McBride KR. Turning on and turning off: A focus group study of the factors that affect women’s sexual arousal. Arch Sex Behav. 2004;33:527–38.

    Article  PubMed  Google Scholar 

  33. Benson Gold R. Rekindling efforts to prevent unplanned pregnancy: a matter of “equity and common sense”. Guttmacher Policy Rev. 2006;9:2–6.

    Google Scholar 

  34. Rosenberg MJ, Meyers A, Roy V. Efficacy, cycle control, and side effects of low- and lower-dose oral contraceptives: a randomized trial of 20 micrograms and 35 micrograms estrogen preparations. Contraception. 1999;60:321–9.

    Article  CAS  PubMed  Google Scholar 

  35. Caruso S, Agnello C, Intelisano G, Farina M, Di Mari L, Cianci A. Sexual behavior of women taking low-dose oral contraceptive containing 15 microg ethinylestradiol/60 microg gestodene. Contraception. 2004;69:237–40.

    Article  CAS  PubMed  Google Scholar 

  36. Coenen CMH, Thomas CMG, Borm GF, Hollanders JMG, Rollands R. Changes in androgens during treatment with four low-dose contraceptives. Contraception. 1996;53:171–6.

    Article  CAS  PubMed  Google Scholar 

  37. Greco T, Graham CA, Bancroft J, Tanner A, Doll HA. The effects of oral contraceptives on androgen levels and their relevance to premenstrual mood and sexual interest: A comparison of two triphasic formulations containing norgestimate and either 35 or 25 microg of ethinyl estradiol. Contraception. 2007;76:8–17.

    Article  CAS  PubMed  Google Scholar 

  38. Sanders SA, Graham CA, Bass JL, Bancroft J. A prospective study of the effects of oral contraceptives on sexuality and well-being and their relationship to discontinuation. Contraception. 2001;64:51–8.

    Article  CAS  PubMed  Google Scholar 

  39. Schaffir J. Hormonal contraception and sexual desire: a critical review. J Sex Marital Ther. 2006;32:305–14.

    Article  PubMed  Google Scholar 

  40. Wiebe ER, Brotto LA, MacKay J. Characteristics of women who experience mood and sexual side effects with use of hormonal contraception. J Obstet Gynaecol Can. 2011;33:1234–40.

    Article  PubMed  Google Scholar 

  41. Sabatini R, Cagiano R. Comparison profiles of cycle control, side effects and sexual satisfaction of three hormonal contraceptives. Contraception. 2006;74:220–3.

    Article  PubMed  Google Scholar 

  42. Caruso S, Panella M, Giunta G, Matarazzo MG, Cianci A. Comparative randomized study on the sexual function and quality of life of women on contraceptive vaginal ring containing ethinylestradiol/etonogestrel 3.47/11.00mg or 2.7/11.7mg. Gynecol Endocrinol. 2019;16:1–5.

    Article  CAS  Google Scholar 

  43. Novák A, de la Loge C, Abetz L, van der Meulen EA. The combined contraceptive vaginal ring, NuvaRing: an international study of user acceptability. Contraception. 2003;67:187–94.

    Article  PubMed  Google Scholar 

  44. Timmer CJ, Mulders TM. Pharmacokinetics of etonogestrel and ethinylestradiol released from a combined contraceptive vaginal ring. Clin Pharmacokinet. 2000;39:233–42.

    Article  CAS  PubMed  Google Scholar 

  45. Gracia CR, Sammel MD, Charlesworth S, Lin H, Barnhart KT, Creinin MD. Sexual function in first-time contraceptive ring and contraceptive patch users. Fertil Steril. 2010;93:21–8.

    Article  PubMed  Google Scholar 

  46. Veres S, Miller L, Burington B. A comparison between the vaginal ring and oral contraceptives. Obstet Gynecol. 2004;104:555–63.

    Article  PubMed  Google Scholar 

  47. Lete I, Cuesta MC, Marín JM, Guerra S. Vaginal health in contraceptive vaginal ring users—a review. Eur J Contracept Reprod Health Care. 2013;18:234–41.

    Article  PubMed  Google Scholar 

  48. Guida M, Di Spiezio Sardo A, Bramante S, Sparice S, Acunzo G, Tommaselli GA, et al. Effects of two types of hormonal contraception—oral versus intravaginal—on the sexual life of women and their partners. Hum Reprod. 2005;20:1100–6.

    Article  CAS  PubMed  Google Scholar 

  49. Elaut E, Buysse A, De Sutter P, De Cuypere G, Gerris J, Deschepper E, et al. Relation of androgen receptor sensitivity and mood to sexual desire in hormonal contraception users. Contraception. 2012;85:470–9.

    Article  CAS  PubMed  Google Scholar 

  50. Caruso S, Cianci S, Malandrino C, Cicero C, Lo Presti L, Cianci A. Quality of sexual life of women using the contraceptive vaginal ring in extended cycles: preliminary report. Eur J Contracept Reprod Health Care. 2014;19:307–14.

    Article  PubMed  Google Scholar 

  51. Mohamed AM, El-Sherbiny WS, Mostafa WA. Combined contraceptive ring versus combined oral contraceptive (30-𝜇g ethinylestradiol and 3-mg drospirenone). Int J Gynecol Obstet. 2011;114:145–8.

    Article  CAS  Google Scholar 

  52. WHO. WHO medical eligibility criteria for contraceptive use. 4th ed. Geneva: WHO; 2009. http://www.who.int/reproductivehealth/publications/family_planning/9789241563888/en/index.html.

    Google Scholar 

  53. Graham CA, Ramos R, Bancroft J, Maglaya C, Farley TMM. The effects of steroidal contraceptives on the well-being and sexuality of women: a double-blind, placebo-controlled, two-centre study of combined and progestogen-only methods. Contraception. 1995;52:363–9.

    Article  CAS  PubMed  Google Scholar 

  54. McCoy NL, Matyas JR. Oral contraceptives and sexuality in university women. Arch Sex Behav. 1996;25:73–90.

    Article  CAS  PubMed  Google Scholar 

  55. Jung-Hoffman C, Kuhl H. Divergent effects of two low-dose oral contraceptives on sex hormone-binding globulin and free testosterone. Am J Obstet Gynecol. 1987;156:199–203.

    Article  Google Scholar 

  56. Bitzer J, Tschudin S, Meier-Burgoa J, Armbruster U, Schwendke A. Effects on the quality of life of a new oral contraceptive containing 30 mcg EE and 3 mg drospirenone (Yasmin). Praxis (Bern 1994). 2003;92:1177–84.

    Article  CAS  Google Scholar 

  57. Secura GM, Allsworth JE, Madden T, Mullersman JL, Peipert JF. The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception. Am J Obstet Gynecol. 2010;203:115.e1–7.

    Article  PubMed  Google Scholar 

  58. Rose SB, Lawton BA. Impact of long-acting reversible contraception on return for repeat abortion. Am J Obstet Gynecol. 2012;206:37.e1–6.

    Article  PubMed  Google Scholar 

  59. Cristobal I, Neyro J-L, Lete I. The new LNG-releasing IUS: a new opportunity to reduce the burden of unintended pregnancy. Eur J Obstet Gynecol Reprod Biol. 2015;90:58–64.

    Article  CAS  Google Scholar 

  60. Grunloh DS, Casner T, Secura GM, Peipert JF, Madden T. Characteristics associated with discontinuation of long-acting reversible contraception within the first 6 months of use. Obstet Gynecol. 2013;122:1214–21.

    Article  CAS  PubMed  Google Scholar 

  61. Sanders JN, Higgins JA, Adkins DE, Stoddard GJ, Gawron LM, Turok DK. The impact of sexual satisfaction, functioning, and perceived contraceptive effects on sex life on IUD and implant continuation at 1 year. Womens Health Issues. 2018;28:401–7.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Gomez AM, Clark JB. The relationship between contraceptive features preferred by young women and interest in IUDs: an exploratory analysis. Perspect Sex Reprod Health. 2014;46:157–63.

    Article  PubMed  Google Scholar 

  63. Caruso S, Cianci S, Vitale SG, Fava V, Cutello S, Cianci A. Sexual function and quality of life of women adopting the levonorgestrel-releasing intrauterine system (LNG-IUS 13.5 mg) after abortion for unintended pregnancy. Eur J Contracept Reprod Health Care. 2018;23:24–31.

    Article  CAS  PubMed  Google Scholar 

  64. Neri M, Piras B, Paoletti AM, Piras B, Vallerino V, Corda V, Ronchetti C, Taccori V, Pilloni M, Zedda P, Capobianco G, Dessole S, Melis GB, Mais V. Long-acting reversible contraception (LARC) with the intrauterine system with levonorgestrel (6mcg/d): observational study on the acceptability, quality of life, and sexuality in Italian women. Gynecol Endocrinol. 2018;34:532–5.

    Article  CAS  PubMed  Google Scholar 

  65. Higgins JA, Ryder K, Skarda G, Koepsel E, Bennett EA. The sexual acceptability of intrauterine contraception: a qualitative study of young adult women. Perspect Sex Reprod Health. 2015;47:115–22.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Tazegül Pekin A, Seçilmiş Kerimoğlu O, Kebapcılar AG, Yılmaz SA, Benzer N, Celik C. Depressive symptomatology and quality of life assessment among women using the levonorgestrel-releasing intrauterine system: an observational study. Arch Gynecol Obstet. 2014;290:507–11.

    Article  PubMed  CAS  Google Scholar 

  67. Higgins JA, Smith NK. The sexual acceptability of contraception: reviewing the literature and building a new concept. J Sex Res. 2016;53:417–56.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Blumenthal PD, Gemzell-Danielsson K, Marintcheva-Petrova M. Tolerability and clinical safety of Implanon. Eur J Contracept Reprod Health Care. 2008;13:29–36.

    Article  CAS  PubMed  Google Scholar 

  69. Apter D. Contraception options: aspects unique to adolescent and young adult. Best Pract Res Clin Obstet Gynaecol. 2018;48:115–27.

    Article  PubMed  Google Scholar 

  70. Walsh-Buhi ER. Helmy HL. Trends in long-acting reversible contraceptive (LARC) use, LARC use predictors, and dual-method use among a national sample of college women. J Am Coll Heal. 2018;66:225–36.

    Article  Google Scholar 

  71. Di Carlo C, Sansone A, De Rosa N, Gargano V, Tommaselli GA, Nappi C, Bifulco G. Impact of an implantable steroid contraceptive (etonogestrel-releasing implant) on quality of life and sexual function: a preliminary study. Gynecol Endocrinol. 2014;30:53–6.

    Article  PubMed  CAS  Google Scholar 

  72. Guida M, Farris M, Aquino CI, Rosato E, Cipullo LMA, Bastianelli C. Nexplanon subdermal implant: assessment of sexual profile, metabolism, and bleeding in a cohort of Italian women. Biomed Res Int. 2019;2019:3726957.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Guida M, Di Carlo C, Troisi J, Gallo A, Cibarelli F, Martini E, Tiranini L, Nappi RE. The sexuological impact of hormonal contraceptives based on their route of administration. Gynecol Endocrinol. 2017;33:218–22.

    Article  CAS  PubMed  Google Scholar 

  74. Higgins JA, Hoffman S, Graham CA, Sanders SA. Relationships between condoms, hormonal methods, and sexual pleasure and satisfaction: an exploratory analysis from the Women’s Well-Being and Sexuality Study. Sex Health. 2008;5:321–30.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Higgins JA, Hirsch JS. Pleasure and power: incorporating sexuality, agency, and inequality into research on contraceptive use and unintended pregnancy. Am J Public Health. 2008;98:1803–13.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Salvatore Caruso .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Caruso, S., Fava, V., Rapisarda, A.M.C. (2021). Contraception and Sexuality. In: Meriggiola, M.C., Gemzell-Danielsson, K. (eds) Female and Male Contraception. Trends in Andrology and Sexual Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-70932-7_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-70932-7_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-70931-0

  • Online ISBN: 978-3-030-70932-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics