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“And Isn't that the point?”: pleasure and contraceptive decisions

      Abstract

      Objective

      Previous survey research indicates that women and men experience reduced sexual pleasure when using condoms, especially compared to nonbarrier family planning methods. This study seeks to explore those experiences of reduced pleasure in-depth and how they affect contraceptive method decisions and use.

      Study Design

      In-depth interviews with 30 men and 30 women between the ages of 18 and 36 years in the United States about their contraceptive decisions and use were analyzed.

      Results

      Both men and women complained about the way that condoms interfered with their sexual pleasure. Several women (and no men) complained that condoms actually hurt them, and the majority of couples had at least one member who reported disliking condoms. For hormonal methods and intrauterine devices, general side effects were usually one of the most important reasons that women continued or discontinued methods, but few sexual side effects were reported.

      Conclusions

      Interfering with sexual pleasure appears to be the most important reason that both men and women do not use condoms, and public health practitioners should recognize the limitations of condoms as a contraceptive technology. Despite problems with general side effects, most women (and men) prefer hormonal methods to condoms.

      Implications

      This study provides in-depth descriptions showing that young adult men and women in the United States use condoms less because condoms interfere with their sexual pleasure. Although women often say they experience general negative side effects from hormonal birth control, they usually perceive few sexual side effects from hormonal birth control. Since young heterosexual adults usually perceive themselves to be at much greater risk for pregnancy than sexually transmitted infections, they mostly perceive hormonal birth control to be a greatly superior contraceptive option compared to condoms.

      Keywords

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      References

      1. Gates Foundation, Grand Challenges in Global Health. Develop the Next Generation of Condoms. Accessed May 2013.

        • Aea Carballo-Diéguez
        Sexual pleasure and intimacy among men who engage in “bareback sex”.
        AIDS Behav. 2011; 15: 57-65
      2. Calabrese SK. The pleasure principle: The effect of perceived pleasure loss associated with condoms on unprotected anal intercourse among immigrant Latino men who have sex with men. AIDS Patient Care STDS 2012;26.

        • Graham C.A.
        Condom use in the context of sex research: a commentary.
        Sex Health. 2012; 9: 103-108
        • Graham C.A.
        • Crosby R.A.
        • Milhausen R.R.
        • Sanders S.A.
        • Yarber W.L.
        Incomplete use of condoms: the importance of sexual arousal.
        AIDS Behav. 2011; 15: 1328-1331
        • Graham C.A.
        • Crosby R.
        • Yarber W.L.
        • et al.
        Erection loss in association with condom use among young men attending a public STI clinic: potential correlates and implications for risk behaviour.
        Sex Health. 2006; 3: 255-260
        • Crosby R.
        • Milhausen R.
        • Yarber W.L.
        • Sanders S.A.
        • Graham C.A.
        Condom ‘turn offs’ among adults: an exploratory study.
        Int J STD AIDS. 2008; 19: 590-594
        • Randolph M.E.
        • Pinkerton S.D.
        • Bogart L.M.
        • Cecil H.
        • Abramson P.R.
        Sexual pleasure and condom use.
        Arch Sex Behav. 2007; 36: 844-848
        • Higgins J.A.
        • Tanner A.E.
        • Janssen E.
        Arousal loss associated with condoms and risk of pregnancy: implications for women's and men's sexual risk behaviors.
        Perspect Sex Reprod Health. 2009; 41: 150-157
        • Higgins J.
        • Hirsch J.
        Pleasure and power: incorporating sexuality, agency, and inequality into research on contraceptive use.
        Am J Public Health. 2008; 98: 1803-1813
        • Martin-Loeches M.
        • Orti R.
        • Monfort M.
        • Ortega E.
        • Rius J.
        A comparative analysis of the modification of sexual desire of users of oral hormonal contraceptives and intrauterine contraceptive devices.
        Eur J Contracep Reprod. 2003; 8: 129-134
        • Davis A.R.
        • Castaño P.M.
        Oral contraceptives and libido in women.
        Annu Rev Sex Res. 2004; 15: 297-320
        • Guida M.
        • Sardo A.D.S.
        • Bramante S.
        • 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: 1100-1106
        • Caruso S.
        • Agnello C.
        • Intelisano G.
        • et al.
        Prospective study on sexual behavior of women using 30 μg ethinylestradiol and 3 mg drospirenone oral contraceptive.
        Contraception. 2005; 72: 19-23
        • Pastor Z.
        • Holla K.
        • Chmel R.
        The influence of combined oral contraceptives on female sexual desire: a systematic review.
        Eur J Contracept Reprod. 2013; 18: 27-43
        • Burrows L.J.
        • Basha M.
        • Goldstein A.T.
        The effects of hormonal contraceptives on female sexuality: a review.
        J Sexual Med. 2012; 9: 2213-2223
        • Sanders S.A.
        • Graham C.A.
        • Bass J.L.
        • Bancroft J.
        A prospective study of the effects of oral contraceptives on sexuality and well-being and their relationship to discontinuation.
        Contraception. 2001; 64: 51-58
        • Grigg-Spall H.
        Sweetening the pill: or how we got hooked on hormonal birth control.
        Zero, New Alresford, UK2013
        • Grimes D.A.
        • Schulz K.F.
        Nonspecific side effects of oral contraceptives: Nocebo or noise?.
        Contraception. 2011; 83: 5-9
        • Jones R.K.
        Beyond birth control: the overlooked benefits of oral contraceptive pills.
        Alan Guttmacher Institute, 2011
        • Littlejohn K.E.
        Hormonal contraceptive use and discontinuation because of dissatisfaction: differences by race and education.
        Demography. 2012; 49: 1433-1452
        • Stuart J.E.
        • Secura G.M.
        • Zhao Q.
        • Pittman M.E.
        • Peipert J.F.
        Factors associated with 12-month discontinuation among contraceptive pill, patch, and ring users.
        Obstet Gynecol. 2013; 121: 330-336
        • Vaughan B.
        • Trussell J.
        • Kost K.
        • Singh S.
        • Jones R.
        Discontinuation and resumption of contraceptive use: results from the 2002 national survey of family growth.
        Contraception. 2008; 78: 271-283
        • Moreau C.
        • Cleland K.
        • Trussell J.
        Contraceptive discontinuation attributed to method dissatisfaction in the United States.
        Contraception. 2007; 76: 267-272
        • Frost J.J.
        • Singh S.
        • Finer L.B.
        Factors associated with contraceptive use and non-use, United States, 2004.
        Perspect Sex Reprod Health. 2007; 39: 90-99
        • Wilson E.K.
        • Samandari G.
        • Koo H.P.
        • Tucker C.
        Adolescent mothers' postpartum contraceptive use: a qualitative study.
        Perspect Sex Reprod Health. 2011; 43: 230-237
        • Brunner Huber L.R.
        • Hogue C.J.
        • Stein A.D.
        • et al.
        Contraceptive use and discontinuation: findings from the contraceptive history, initiation, and choice study.
        Obstet Gynecol. 2006; 194: 1290-1295
        • Cheung E.
        • Free C.
        Factors influencing young women's decision making regarding hormonal contraceptives: a qualitative study.
        Contraception. 2005; 71: 426-431
        • Higgins J.A.
        • Hoffman S.
        • Graham C.A.
        • Sanders S.A.
        Relationships between contraceptive method and sexual pleasure and satisfaction: results from the Women's wellbeing and sexuality study.
        Sex Health. 2008; 5: 321-330
        • Oddens B.J.
        Women's satisfaction with birth control: a population survey of physical and psychological effects of oral contraceptives, intrauterine devices, condoms, natural family planning, and sterilization among 1466 women.
        Contraception. 1999; 59: 277-286
        • Afifi W.A.
        Harming the ones we love: relational attachment and perceived consequences as predictors of safe-sex behavior.
        J Sex Res. 1999; 36: 198-206
        • Corbett A.M.
        • Dickson-Gómez J.
        • Hilario H.
        • Weeks M.R.
        A little thing called love: condom use in high-risk primary heterosexual relationships.
        Perspect Sex Reprod Health. 2009; 41: 218-224
        • Philpott A.
        • Knerr W.
        • Boydell V.
        Pleasure and prevention: when good sex is safer sex.
        Reprod Health Matters. 2006; 14: 23-31https://doi.org/10.1016/S0968-8080(06)28254-5
        • Philpott A.
        • Knerr W.
        • Maher D.
        Promoting protection and pleasure: amplifying the effectiveness of barriers against sexually transmitted infections and pregnancy.
        Lancet. 2006; 368: 2028-2031
        • Knerr W.
        • Philpott A.
        Putting the sexy back into safer sex: the pleasure project.
        IDS Bull. 2006; 37: 105-109