Relationship Satisfaction Linked with Changing Use of Contraception

Women’s sexual satisfaction in long-term heterosexual relationships may be influenced by changes in hormonal contraceptive use, research from the University of Stirling shows.

The study, published in Psychological Science, a journal of the Association for Psychological Science, was carried out by researchers from the universities of Stirling, Glasgow, Newcastle, Northumbria and Charles University in Prague.

The team looked at a sample of 365 couples, and investigated how satisfaction levels -  in both sexual and non-sexual aspects of long-term relationships -  were influenced by women’s current and historical use of hormonal contraception.

“Our findings showed women who had met their partner while taking the pill and were still currently taking it - as well as those who had never used the pill at any point -  reported greater sexual satisfaction than those women who had begun or stopped using the pill during the course of the relationship,” says lead researcher Craig Roberts from Stirling’s Division of Psychology.

“In other words, the congruence of women’s pill use throughout the relationship had a greater influence on sexual satisfaction levels than either simply being on the pill or not being on the pill.”

The team found there was no difference in the non-sexual aspects of relationship satisfaction between the groups of women. Additionally, women’s history of pill use was also found to make no difference to their male partners’ relationship satisfaction in both sexual and non-sexual contexts.

Types of hormonal methods of contraception
There are several different hormonal methods of birth control. The differences among them involve

  the type of hormone,
  the amount of hormone, and
  the way the hormone enters a woman’s body.

The hormones can be estrogen and/or progesterone. These hormones may be taken orally (taken by mouth), implanted into body tissue, injected under the skin, absorbed from a patch on the skin, or placed in the vagina. The mode of delivery determines whether the hormonal exposure is continuous or intermittent.

The different hormonal types of birth control are comparable in that they are all highly effective and all are reversible. However, none of the hormonal methods of birth control protect a woman against sexually transmitted infections.

“Previous research has shown that hormonal contraceptives, such as the pill, subtly alter women’s ideal partner preferences and that often women who are using the pill when they meet their partner find the same partner less physically attractive when they come off the pill,” says Roberts.

Relationship Satisfaction Linked with Changing Use of Contraception “Our new results support these earlier findings but, crucially, they also point to the impact a change in hormonal contraceptive use during a relationship -  either starting or stopping -  can have on a woman’s sexual satisfaction with her partner.”

According to Roberts, “The pill has been a tremendously positive social force, empowering women and giving them greater control over their lives, but there is also a lot of controversy surrounding the question of whether hormonal contraceptives alter women’s libido and sexual satisfaction.”

Hormonal methods of birth control contain estrogen and progestin, or progestin only, and are a safe and reliable way to prevent pregnancy for most women. There are several ways that the hormone(s) can be delivered:

● A daily pill taken by mouth

● A skin patch that is changed weekly

● An injection that is given once every three months

● An implant that is worn under the skin for up to three years

● A ring worn in the vagina that is changed every month

● An intrauterine device (IUD)

“These results show that examining current use is not enough to answer this question. What seems to be important is whether a woman’s current use matches her use when she began the relationship with her partner. We hope our results will help women understand why they might feel the way they do about their partner when they change use,” Roberts concludes.

Co-authors on the study include Anthony C. Little and Kelly D. Cobey of the University of Stirling, Robert P. Burriss of the University of Stirling and Northumbria University, Kateřina Klapilová andJan Havlíček of Charles University (Czech Republic), Benedict C. Jones and Lisa DeBruine of the University of Glasgow, and Marion Petrie of Newcastle University.

This work was funded by the Economic and Social Research Council (Grant ES/I008217/1) and was conducted with support of the Glasgow Science Centre. S. C. Roberts is supported by a British Academy Mid-Career Fellowship; A. C. Little was supported by the Royal Society; J. Havlíček and K. Klapilová are supported by the Czech Science Foundation (Grants 14-02290S and P407/12/P819, respectively) and by the Charles University Research Centre (UNCE 204004); and B. C. Jones is supported by the European Research Council (Starting Grant 282655 OCMATE).

The combined oral contraceptive pill (‘the Pill’)

Combined oral contraception (COC or ‘the Pill’) contains an estrogen and a progestogen hormone. The most commonly used estrogen in COC is ethinylestradiol, a synthetic form of estrogen. The strength of combined contraceptives is based on the amount of estrogen that they contain. Most pills contain between 20 micrograms and 35 micrograms ethinylestradiol. Low-strength preparations contain 20 micrograms ethinylestradiol and standard-strength preparations generally contain 30 micrograms or 40 micrograms ethinylestradiol.

The British National Formulary contains a list of currently marketed products. Some of the more recently approved products contain a different estrogen called estradiol.

A number of different types of progestogens (a synthetic form of progesterone) are used in combined oral contraceptives and include:

  nomegestrol acetae

Most COC come as packs of 21 pills, where one pill is taken daily for 3 weeks, followed by a break of 7 days. A few types of COC come as packs of 28 pills, where one ‘active’ pill is taken every day for 3 weeks, followed by an ‘inactive’ or placebo pill (which does not contain any hormones) for seven days. Other preparations that combine different numbers of active and placebo pills are also becoming available.

COCs can be started at any point during the menstrual cycle provided there is no risk of existing pregnancy. If COC is not started during the first 5 days of bleeding, additional contraception such as condoms should also be used for the first 7 days of taking contraceptive pill. See our section on when to start taking combined oral contraceptives, and refer to the information leaflet that accompanies each medicine.

As well as preventing unwanted pregnancies, combined oral contraceptives can reduce menstrual blood loss and relieve painful menstruation, and may help with premenstrual symptoms in some women. Long-term use of combined oral contraceptives is also associated with a reduction in the incidence of ovarian cancer (see below) and endometrial cancer.


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