Unwanted Sexual Activity History and Relationship Status Predict Sexual Side Effects of Hormonal Contraception Use
Authors: Jones HR , Sartin-Tarm A , Lorenz TK 
Published: July 2022

ABSTRACT

Introduction
Hormonal contraceptives (HC) have both nonsexual side effects (e.g, weight gain, headaches, nausea, acne) and sexual side effects (e.g., changes in sexual desire, lubrication, and pleasure) (Smith et al., 2014). Psychosocial factors may contribute to who experiences different kinds of side effect experiences; women reporting mood side effects of HC are more likely to be unmarried, while women reporting sexual side effects tend to be younger and have more education, (Wiebe et al., 2011). However, little is known about these side effects in college-aged women, and to date limited work has examined how experiencing unwanted sexual activity history influences women's reporting of HC side effects.

Objective
To identify characteristics of women who report sexual vs. nonsexual side effects of hormonal contraceptive use.

Methods
We surveyed 818 emerging adult women (mean age 19.88, SD = 2.60) in the Southeastern and Midwestern US. Participants reported their lifetime history of HC use, mental health disorders, unwanted sexual activity, and age of sexual debut, as well as current relationship status. Those who reported ever taking HC indicated if they had ever experienced sexual effects and/or non-sexual effects from a list of 16 items. Using a multivariate general linear model with logit link, we examined predictors of reporting sexual vs. non-sexual side effects among women who reported any history of using HC.

Results
543 women (66.4%) reported ever using HC. Of the women reporting lifetime HC use, 72% reported a history of any nonsexual side effect, while 28% reported experiencing a sexual side effect, (specifically, changes in sexual desire). Of the 152 women who reported changes in sexual desire, 87 (55%; 16% of total HC users) reported lower desire, while 65 (42%; 12% total HC users) reported higher desire, and 2 reported both.History of unwanted sexual activity and relationship status significantly predicted both sexual and non-sexual side effect reporting. Specifically, women who reported a history of unwanted sex were 3.04x more likely to report decreased desire with HC use, relative to women without such history. Similarly, women who were partnered were 1.86x more likely to report decreased desire, relative to single women. Increased desire was not predicted by any psychosocial factor. Neither mental health history nor age of first sexual relationship were associated with the likelihood of reporting either side effect type.

Conclusions
Women with a history of unwanted sexual activity were more likely to report decreased desire with HC use, suggesting that experiencing unwanted sex may influence perceptions of sexual effects of medication. Additionally, women who are dating or married are more likely to report decreased desire with HC use, contrary to previous literature. Understanding the characteristics of women who report sexual and nonsexual HC side effects may help inform patient/doctor interactions when counseling women about contraceptive use.

Disclosure
No