Sexual Functioning, Satisfaction, and Well-Being Among Contraceptive Users: A Three-Month Assessment From the HER Salt Lake Contraceptive Initiative

Figures & data

Figure 1. Flowchart of inclusion criteria for analytic sample.

Table 1. Demographic characteristics, sample of family-planning clients initiating a new contraceptive method (N = 2,157)

	Overall (N = 2,157)	Implant (N = 503)	Copper IUD (N = 311)	LNg IUD (N = 669)	Injectable (N = 226)	Oral Contraceptives (N = 361)	Vaginal Ring (N = 87)	p Value, H or χ ^2 Test Statistic, and Degrees of Freedom^a
	%	%	%	%	%	%	%
Age
18–19	20.1	22.1	12.5	19.3	25.2	24.1	12.6	p < .001 (H = 60.55) df = 5
20–24	41.5	49.7	37.3	38.3	36.7	44.3	34.5
25–29	22.8	19.5	28.0	24.7	19.5	19.7	31.0
30–34	9.6	5.6	13.8	10.5	12.8	7.8	11.5
35+	5.9	3.2	8.4	7.3	5.8	4.2	10.3
Highest level of education completed
Did not complete high school	4.8	6.4	2.9	4.5	4.0	4.7	6.9	p < .001 (H = 50.04) df = 5
High school or GED	37.8	40.2	30.9	32.7	52.2	42.1	33.3
Some associate, vocational, technical training, or college	41.0	41.6	42.1	42.8	33.2	39.6	47.1
Completed four-year college or higher	16.4	11.9	24.1	20.0	10.6	13.6	12.6
Race and ethnicity
Non-Hispanic White	65.5	60.2	68.8	70.6	57.5	64.0	72.4	p < .001 (χ ^2 = 31.58) df = 10
Hispanic non-White	22.8	28.6	19.3	18.5	28.3	22.2	21.8
Non-White, non-Hispanic other^b	11.7	11.1	11.9	10.9	14.2	13.9	5.8
Poverty category
At or below poverty level	41.0	43.3	37.0	36.6	55.8	41.3	35.6	p < .001 (H = 35.92) df = 5
101%–199% above poverty level	29.0	27.6	27.7	29.6	23.5	34.4	29.9
200%–299% above poverty level	19.1	19.1	21.2	20.6	15.0	17.5	17.2
300% or more above poverty level	10.9	9.9	14.2	13.2	5.8	6.9	17.2
Relationship status
Married	12.3	12.7	12.5	13.2	11.1	11.1	10.3	p = .96 (χ ^2= 10.63) df = 10
Cohabiting or committed relationship	50.5	51.7	51.8	50.4	50.0	49.3	46.0
Actively dating	19.6	17.7	19.9	18.7	19.5	22.4	25.3
Single	11.3	11.9	9.3	12.0	13.3	9.7	11.5
Other^c	6.3	6.0	6.4	5.8	6.2	7.5	6.9
Sexual orientation
Heterosexual or mostly heterosexual	87.4	88.1	87.8	86.6	86.3	87.5	92.0	p = .76 (χ ^2 = 2.59) df = 10
Other^d	12.6	11.9	12.2	13.4	13.7	12.5	8.1

Note. Data presented are for complete cases on baseline variables, and percentages indicate the column proportion for the specific variable. Descriptive data are presented on the nonimputed original data set. Some columns may add to slightly less than or greater than 100%; these summations are due to rounding errors; LNg = levonorgestrel; IUD = intrauterine device.

^aP values reflect Kruskal–Wallis tests conditional on ties for ordinal variables (age, education, poverty) and χ² tests for categorical variables (race and ethnicity, relationship status, and sexual orientation).

^bOther category includes Asian, Native Hawaiian or Pacific Islander, American Indian or Alaska Native, African American or Black, and other.

^cOther category includes divorced or separated, widowed, and other.

^dOther category includes any category besides exclusively heterosexual.

Table 2. Contraceptive users’ experiences of methods over three months: ordinal variables, sample of family-planning clients using a new contraceptive method for three months (N = 3,762 observations)

	Overall (N = 3,762)	Implant (N = 900)	Copper IUD (N = 572)	LNg IUD (N = 1,198)	Injectable (N = 372)	Oral Contraceptives (N = 574)	Vaginal Ring (N = 146)	p Value and Skillings–Mack Statistic
	%	%	%	%	%	%	%
In the last four weeks, would you say that your birth control method has:								p = .66 (SM = .09)
Made my sex life much worse	2.3	2.8	2.1	2.2	4.0	1.2	1.4
Made my sex life a little worse	12.4	11.2	10.7	15.2	14.8	8.4	13.7
Had no effect on my sex life	33.9	33.8	29.0	30.6	40.1	39.7	43.8
Improved my sex life a little	25.7	24.4	27.6	27.1	19.9	27.0	24.0
Improved my sex life a lot	25.7	27.8	30.6	25.0	21.2	23.7	17.1
Which of the following best describes your vaginal bleeding in the last four weeks?								p < .001 (SM = 81.28)
I’ve had no vaginal bleeding	16.2	22.2	5.9	10.9	41.7	10.3	19.9
I’ve had less bleeding than before	32.4	30.6	12.6	43.3	24.2	38.3	30.1
I’ve had no change from before	13.5	9.9	14.9	7.9	6.2	28.4	34.9
I’ve had more bleeding than before	38.0	37.3	66.6	37.8	28.0	23.0	15.1

Note. Frequencies reflect pooled distributions of variables at one- and three-month follow-up surveys. Data presented are for complete cases in the later regression model, and percentages indicate the column proportion for the specific variable. Descriptive data are presented on the nonimputed original data set. Some columns may add to slightly less than or greater than 100%; these summations are due to rounding errors. P values reflect comparison of outcome by contraceptive methods using the Skillings–Mack statistic, conditional on tied rankings; LNg = levonorgestrel; IUD = intrauterine device.

Table 3. Changes in contraceptive users’ experiences of methods over three months: continuous variables, sample of family-planning clients using a new contraceptive method for three months (N = 1,881 observations)

	Overall (N = 1,881)	Implant (N = 450)	Copper IUD (N = 286)	LNg IUD (N = 599)	Injectable (N = 186)	Oral Contraceptives (N = 287)	Vaginal Ring (N = 73)	p and F Values and Degrees of Freedom
	M ±SD	M ±SD	M ±SD	M ±SD	M ±SD	M ±SD	M ±SD
Change in New Sexual Satisfaction Scale (scale 20–100, where a higher score indicates better sexual satisfaction)^a	−.8 ±8.7	−1.3 ±8.3	.06 ±8.2	−1.2 ±9.0	−.6 ±9.1	−.5 ±8.6	−.4 ±10.2	p = .42 (F = 1.00) df = 5
Change in FSFI-6 (scale 5–30, where a higher score indicates better sexual function)^b	−.1 ±2.8	−.4 ±2.7	.1 ±2.4	.07 ±2.8	−.8 ±2.9	−.03 ±3.0	−.05 ±3.3	p = .003 (F = 3.64) df = 5
Menstrual Symptom Questionnaire: change in average experience and frequency of physical side effects (scale 0–5, where 5 represents highest frequency; symptoms include headaches, bloating, breast tenderness, acne flare-up, cramping, weight gain, weight loss, and gastrointestinal symptoms)	.1 ±.4	.1 ±.4	.1 ±.4	.09 ±.4	.2 ±.5	.08 ±.4	.08 ±.5	p = .16 (F = 1.60) df = 5
Menstrual Symptom Questionnaire: change in average experience and frequency of mood side effects (scale 0–5, where 5 represents highest frequency; symptoms include moodiness or irritability and depression)	.1 ±.7	.3 ±.7	−.003 ±.6	.07 ±.7	.3 ±.8	.1 ±.7	.00 ±.6	p < .001 (F = 8.80) df = 5
Change in WHO Well-Being Scale (scale 0–25, where a higher score indicates better overall health and well-being)	−.4 ±2.6	−.7 ±2.7	−.3 ±2.4	−.2 ±2.5	−.9 ±2.8	−.5 ±2.4	−.2 ±2.3	p = .01 (F = 2.90) df = 5

Note. Frequencies reflect average change in variables from baseline to one-month follow-up, and from one-month to three-month follow-up at the respondent level. Data presented are for complete cases in the later regression model. Descriptive data are presented on the nonimputed original data set. F values and p values compare outcome by contraceptive method using one-way analyses of variance (df = 5); ; LNg = levonorgestrel; IUD = intrauterine device.

^aSample size for this item was 1,595 observations.

^bSample size for this item was 1,741 observations.

Table 4. Ordered, multilevel, logistic regression odds ratios predicting association between covariates and family-planning clients’ reported impact of method on sex life, one to three months after enrollment (N = 3,762 observations)

	Adjusted Odds Ratio	Confidence Interval	Level of Significance
Baseline method
Oral contraceptives (reference)	—	—	—
Implant	1.19	(.95–1.50)	p = .13
Copper IUD	1.88	(1.45–2.44)	p ≤ .001
LNg IUD	1.15	(.92–1.42)	p = .22
Three-month injectable	.74	(.55–.98)	p = .04
Vaginal ring	.82	(.59–.1.15)	p = .25
Bleeding changes
I’ve had no vaginal bleeding	1.36	(1.09–1.71)	p = .01
I’ve had less bleeding than before	1.43	(1.18–1.74)	p ≤ .001
I’ve had no change from before (reference)	—	—	—
I’ve had more bleeding than before	.77	(.63–.94)	p = .01
Menstrual Symptom Questionnaire: Physical side effects (scale 0–5)	.77	(.69–.86)	p ≤ .001
Menstrual Symptom Questionnaire: Mood side effects (scale 0–5)	.99	(.92–1.06)	p = .75
WHO-5 Well-Being Scale (scale 0–25)	1.07	(1.06–1.09)	p ≤ .001
Age
18–19 (reference)	—	—	—
20–24	.79	(.65–.97)	p = .02
25–29	.74	(.58–.94)	p = .01
30–34	.55	(.40–.74)	p ≤ .001
35 and older	.61	(.43–.86)	p = .01
Highest level of education completed
Did not complete high school (reference)	—	—	—
High school or GED	.96	(.67–1.37)	p = .82
Some associate, vocational, technical training, or college	.88	(.61–1.28)	p = .50
Completed four-year college or higher	.85	(.57–1.28)	p = .44
Race and ethnicity
Non-Hispanic White (reference)	—	—	—
Hispanic non-White	.87	(.72–1.06)	p = .16
Non-White, non-Hispanic other	1.21	(.95–1.54)	p = .13
Poverty category
At or below poverty level (reference)	—	—	—
101%–199% above poverty level	1.00	(.84–1.21)	p = .96
200%–299% above poverty level	1.01	(.81–1.25)	p = .95
300% or more above poverty level	.95	(.74–1.22)	p = .69
Relationship status
Married (reference)	—	—	—
Cohabiting or committed relationship	1.14	(.90–1.45)	p = .28
Actively dating	1.24	(.94–1.64)	p = .13
Single	.74	(.56–.99)	p = .04
Other^†	1.20	(.82–1.78)	p = .35
Sexual orientation
Heterosexual or mostly heterosexual (reference)	—	—	—
Other^‡	1.04	(.83–1.30)	p = .76
Study-related fixed controls: enrollment site, study period, wave	$\surd$
Individual fixed controls: number of bleeding days, interval between surveys	$\surd$
df	51
N	3,762

Note. LNg = levonorgestrel; IUD = intrauterine device. The bold value corresponds to odds ratio that are statistically significant at the p < .05 level.