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Contraception and Sexual
Function
A person’s
attitudes toward sexuality and her or his own sexual relationships affect
the choice of contraceptive method. One’s perception as to whether
a contraceptive method enhances or diminishes sexual pleasure also influences
use of a method. For example, studies have shown that women are less
likely to be satisfied with their contraceptive method if they believe
that the method will make sex less pleasurable.
This list highlights
considerations to support informed decision making and successful contraception.
- Abstinence (refraining
from sexual activities; nonpenetrative sexual behavior) reduces the
risk of STIs; enhances alternative expressions of sexuality.
- Coitus interruptus
(withdrawal). Learning this technique may increase men’s sensitivity
to the erotic sensations leading to orgasm, thereby helping them manage
premature ejaculation; may reduce pleasure by interrupting the plateau-to-orgasm
stage.
- Fertility awareness
(abstinence from intercourse during fertile periods) may increase
sexual pleasure with the removal of the fear of pregnancy; enhances
creativity in sexual expression when avoidance of penile-vaginal contact
is required.
- Lactational amenorrhea
(breastfeeding) may increase sexual pleasure with the removal of the
fear of pregnancy. Increased breast size may be arousing; breast sensations
during breastfeeding may be erotic. Low estrogen can result in diminished
vaginal lubrication; the woman may experience reduced desire or loss
of desire. Sexual activity with a breastfeeding woman may be taboo in
some cultures.
- Condoms (male) may
increase sexual pleasure with the removal of the fear of pregnancy;
can reduce penile sensation; may prevent or minimize premature ejaculation;
reduce risk of HIV and STI transmission; may cause latex allergy; use
may interrupt intercourse. Some men may not be able to maintain an erection
with condom use.
- Condoms (female)
may increase sexual pleasure with the removal of the fear of pregnancy;
reduce risk of HIV and STI transmission; do not significantly reduce
penile sensation; may be noisy; may be considered unattractive; insertion
may interrupt intercourse.
- Spermicides may
increase sexual pleasure with the removal of the fear of pregnancy;
increase vaginal lubrication; reduce the occurrence of certain infections
(e.g., gonorrhea, trichomonas); may have an unpleasant taste (during
oral-genital sex); may irritate genitalia of woman or man; may increase
occurrence of urinary tract infections; insertion may interrupt intercourse.
- Diaphragm/cervical cap
may increase sexual pleasure with the removal of the fear of pregnancy;
may protect cervix from cancer; may cause pelvic discomfort if too large;
insertion may interrupt intercourse.
- IUD removes the
fear of pregnancy; may increase the likelihood of pelvic inflammatory
disease if STI is present.
- Combined orals/injectables
may increase sexual pleasure with the removal of the fear of pregnancy;
improve perimenopausal symptoms; decrease vaginal lubrication; reduce
free testosterone, resulting in diminished or loss of desire.
- Progestin-only orals/injectables/implants
may increase sexual pleasure with the removal of the fear of pregnancy;
may reduce sexual activity in settings where sex with bleeding (spotting)
in women is taboo or if sex in the presence of vaginal bleeding is not
appealing.
- Tubal occlusion/vasectomy
may increase sexual pleasure with the removal of the fear of pregnancy.
© 2007 EngenderHealth
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