Contraception, Sexual Satisfaction, & Research Bias
This blog post is my opinions, stories relating to, and analyzation of the following article: Sexual Satisfaction, and Well Being Among Contraceptive Users: A Three-Month Assessment from the HER Salt Lake Contraceptive Initiative
Access the full article here (free!): https://doi.org/10.1080/00224499.2021.1873225
Research bias. I’ll admit it, I went into reading this article with a heavy research bias. I was on oral contraceptives (birth control/the pill) beginning at the age of 14 and went cold turkey in October of 2022, at 21 years old. When I was first put on the pill, it was for hormonal acne, extremely painful and long periods (missing days from school type pain), and my mom’s poorly hidden fear of my becoming pregnant. I was elated, truly. At the time, I was rounding the corner into my first sexual experiences, so it was good timing, honestly.
As the years passed, I thought nothing of my once daily pill ritual. It didn’t occur to me to care about what I was putting into my body until October 2021, when my hormonal balance went to hell. I distinctly remember the day my hair decided to become a grease pit; I was getting ready for a wedding and furiously drying sections of hair that seemingly refused to dry. When I finally gave up and ran my fingers through it, I was disgusted. My freshly washed hair felt like it was coated in olive oil. And I had a wedding to be at in mere hours.
Unfortunately, it didn’t end there. My menstrual cycles were oscillating between scarcely existent and the red tide, my acne was spiraling out of control once again and my mood swings were downright dangerous to all who were near me. I was both numb and wholly emotionally charged at all times. Something had to change. After a few months of at home hair-cleanses, Apple Cider Vinegar treatments, and journaling practices, I decided to go to the OBGYN.
They drew my blood and did a half-assed verbal examination as well as a pap-smear. At the end of the appointment, I was asked about my birth control pill. Turns out, what I had dismissed as a company rebrand was actually my pharmacy selling me the wrong fucking pill. Not kidding. For upwards of 8 months, I’d been on the wrong hormones. My doctor was rightfully upset, and I left livid, completely frustrated that not only had I just paid for a doctor’s visit deemed unnecessary by my insurance, but that my months of emotionally-draining symptoms were caused by a goddamn clerical error at a pharmacy.
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Suffice to say, that was the first step in my decision to get off the pill; but at the time I was in a relationship and keen to not be impregnated, so I waited. But the whole experience solidified my sneaking suspicion: those pills do more than just regulate your cycle; they impact your entire hormonal balance and regulation. When my relationship ended the following October, I decided it was time to quit and see what my hormonal system was like on its own. (disclaimer: you should talk to your care provider before quitting any medication)
My first few months off the pill were revolutionary. I was working at a coffee shop at the time and I remember practically jumping off the walls with energy—I felt like a kid again! I was not only able to remember memories and words that lived perpetually on the tip of my tongue, I was able to recall them in an instant! My seasonal depression was less difficult that year; still present but far less overwhelming. My type in men completely changed (though my type in women has remained steadfast) and I was attracted to people based on personality much more than physical traits. The world genuinely seemed brighter, and it still does. The only hormonal pills I take now are Plan B’s (levonorgestrel) when necessary, and I now do the fertility planning method as my form of contraception.
It’s now August of 2024 and I can confidently say that I have never felt better in my body, not even when I was 16 and exercising a bajillion hours a day; I truly am the happiest I’ve ever been in this body. I refuse to be quiet about my experience with contraceptives, and my general dislike of artificial hormones. All of this information, my story, my experience, gives me a pretty damn thick research bias. Going into this article, I thought I knew exactly what it was going to say; in fact, that’s why I chose it. So, when I got into the article, you can imagine my frustration when I read these results from the study:
Half [of the participants] reported their new method had made their sex life better; 15% reported it had made their sex life worse.
People who had experienced bleeding reductions had significantly higher odds of reporting more positive sexual perceptions with their methods.
In my desire to be proven right by a research article, I almost called the whole thing right there and found another article to cover. But no, that’s not my job! I am not here to only show you research that agrees with my bias, or to cover stories and topics that only align with my beliefs. My self imposed job is to give you the information, my experience, and allow you to make your own decisions.
So, you’ve heard my experience, now let’s get into what this study has told us based on their results of over 2,000 people surveyed. When reading journal articles based on studies like this, they typically start off with all the studies’ shortcomings (called limitations in research-speak); which is great for a few reasons. First, similarly to why I started off this blog post with my own bias disclaimer, it’s best to not give your reader a false impression of your limitations. Second, researchers and studies such as these should be held to a higher standard as far as their conduct practices.
Here’s what I found important from this study’s limitations: it was conducted in Utah, a culturally repressive area, which according to the Health & Human Services Committee, “ranks last in the nation for primary care physicians per 100,000 people.” This could affect the study in the following way: in predominantly religious areas, it is more difficult for low socio-economic classes to access birth control and contraceptives, so by offering free birth control to the study participants, the researchers incentivized the study and narrowed their testing field to those more likely to be in need of birth control. This theory can be substantiated by the statistics given in table 1 (below), which shows that 41% of participants are at or below the poverty level, and a total of 70% of participants were at average income level or lower. This shows us that the vast majority of participants could have joined the study for the incentive of free birth control (no hate at all queens, I would too).
When considering the goal of the study– to analyze sexual functioning on various methods of birth control– we must ponder this in consideration of my previously stated limitation of the study. Those who are not financially stable are likely not to desire children or additional children because of the cost associated. (What a great desire and we all deserve reproductive freedom!) So, in my opinion, I strongly believe that giving a person access to compensated birth control would increase their preference for and satisfaction with sex, as they are now able to enjoy the moment without considering the possible consequences of an unplanned pregnancy.
Here’s Table 1, imported from the article. I’ve highlighted what I found most important. The numbers farthest to the left in the “Overall” column are statistics that apply to the entire survey population of 2,157 people. The other columns give you the same statistics as detailed on the left, but are separated by what type of contraceptive chosen. I found both the age groupings and the poverty level to be most interesting; closely followed by the racial statistics and education completed.
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I raise this question, this theory, if you will, because I remember the solace I found in birth control when I was on the pill. Throughout many stages of my life, I encountered non consensual and abusive acts that could have left me with an unwanted pregnancy and I found so much peace in knowing that I was on a contraceptive that I had control over. Similarly, when I was in relationships, I felt so much more relaxed during sexual encounters knowing that we had many protective measures in place to ensure pregnancy wasn’t an issue. Peace of mind surrounding your financial status and removal of possible unwanted pregnancy allows one to be present in sexual encounters, therefore making the sex better.
All in all, is sex made better or worse by various methods of contraception? Maybe. Maybe not. It truly depends on your body– the way you respond to hormones or lack thereof, the dosage and brand of the contraceptive, and about a jillion other variables. According to this study, there’s a 50% chance of your perception of sex being a little or a lot better, and a 50% chance it stays the same or gets worse. Which brings us back to point A; not all research is life changing and some of it just plain disagrees with ya.
