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A Qualitative Study of the Contraceptive Effect on Women's Sexual Experiences

Beyond Hormonal Effects

Lu, Connie F. BS, BA; Vargas, Sara E. PhD; Guillen, Melissa BA; Ramirez, Jaime J. BA; Carbone, Sofia L. MPH; Getz, Melissa L. BA; Frimpong, Yaa ScB; Smith, Kelley Alison MA, MPH; Shaw, Julia G. MPH; Tong, Iris MD; Hill, Melanie MS, WHNP-BC; Berry, Robert E. MD; Guthrie, Kate M. PhD

doi: 10.1097/AOG.0000000000003331
Contents: Sexuality: Original Research

OBJECTIVE: To elucidate the effects of the intravaginal ring, oral contraceptive pill (OCP), and spermicide plus condom on women's sexual experiences through an in-depth understanding of the physical characteristics of these contraceptive methods.

METHODS: We conducted qualitative in-depth interviews with women (aged 18–45 years) who used up to three contraceptive methods (intravaginal ring, OCP, and spermicide plus condom). Women completed in-depth interviews after each 3-month use period. We used a summarized matrix framework and thematic content analysis to explore how each method affected participants' sexual experiences.

RESULTS: Sixteen women completed interviews, yielding 33 transcripts. Women reported physical effects on their sexual experiences while using the intravaginal ring and spermicide plus condom. The OCP was often discussed as lacking these physical effects. Discussion themes included product administration (eg, navigating intravaginal ring removal) and physical product awareness (eg, spermicide as a lubricant). From these experiences, women often altered and individualized their use and subsequent opinions of the contraceptive method.

CONCLUSION: The range of contraceptive effects on women's sexual experiences shape their use and opinions of the product, leading to either increased motivation and consistent use or poor adherence and discontinuation. Awareness of these individualized experiences can help providers better understand and guide their patients towards successful contraceptive use.

The physical characteristics of contraceptive methods can affect the sexual experiences of women and their partners, shaping their subsequent opinions of each method.

Warren Alpert Medical School at Brown University, the Centers for Behavioral and Preventive Medicine, Miriam Hospital, Brown University School of Public Health, and the Women's Medicine Collaborative, Lifespan, Providence, Rhode Island; and the Cambridge Health Alliance, Cambridge, Massachusetts.

Corresponding author: Kate M. Guthrie, PhD, Centers for Behavioral and Preventive Medicine, Miriam Hospital, Providence, RI; email:

Supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), award K24HD062645 (Guthrie, KM: PI).

Financial Disclosure The authors did not report any potential conflicts of interest.

Presented in part at the Annual Clinical and Scientific Meeting of the American College of Obstetricians and Gynecologists, May 3–6, 2019, Nashville, Tennessee.

The authors thank the participants for their time and contributions to Project WISH.

Each author has confirmed compliance with the journal's requirements for authorship.

Peer reviews and author correspondence are available at

© 2019 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.