Psychosexual impacts of contraception on partner relationship

Changes of partner relationship and sexual disorders induced by contraception in less-developed countries are studied and compared with the situation in other countries. Two hundred and twenty-seven women in Bangladesh received long acting hormonal contraceptives (159 implants and 68 injectable DMPA). All patients had a low socioeconomic level, were low-educated, had high parity with fulfilled or almost fulfilled family size and most of them were Muslim (religion: Islam). The Barrett-Lennard Relationship Inventory (BLRI) was used to study the basic attitudes and partner relationships. For sexual dimension we used a self-made questionnaire based on the diagnostic criteria mentioned in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Both tests applied after contraception were compared with the situation before contraception and were evaluated either before actually starting contraception or in a retrograde way. Forty-six of the 227 patients had sexual disorders (20%) and 36 (16%) had sexual problems in relation to the contraceptive therapy. The implant had to be removed in 17 (11%) of the 159 patients. In 88 couples (39%) partner relationships changed directly by contraception. The mean values of the BLRI showed a slight minor deterioration for level of regard (22 to 17), empathy (13.7 to 10.3), and congruence (9.7 to 4.9); no variation was noted for willingness (5.8 and 5.9) and unconditionality changed from (8.6 to 4.6). In about one quarter of the patients the deterioration exceeded the one standard deviation and in 1/3 of the patients the partner relationships improved. We conclude that contraception has a more profound, often negative impact on partner relationships and sexual well functioning in less developed countries than in other ones.