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EVALUATING THE EFFECTS OF BIRTH CONTROL PILLS ON SEXUALITY

Evaluating the effects of birth control pills on sexuality is tricky for a number of reasons. First of all, the pills used during the 1960s had much higher amounts of estrogen than today's pills have, and different effects seem to relate to the level of estrogen. Older research generally noted that long-term use of the pill had negative sexual effects, but more recent studies do not support this view. Second, there are many individual reasons why the pill helps or hinders a woman's sexual feelings and function. Some reasons are biological: a woman who develops a vaginal infection may have sexual problems as a result, or a woman who has less premenstrual and menstrual cramping may feel better physically and thus may be more sexually receptive and responsive. Some reasons are psychological. If a woman expects to have sexual side effects from the pill, her prophecy often becomes self-fulfilling. Some women may feel guilty about using the pill because of religious beliefs or conflicts between wanting children and using contraception. Alternatively, the psychological security of using a highly effective method of contraception reduces the fear of pregnancy and may therefore improve sexual interest and enjoyment (after all, it is harder to enjoy something when you are afraid). One woman told us, "After switching to the pill, I found that sex became more fun. I had my first orgasm during intercourse less than two months later." Since the pill also requires no interruptions at the time of sexual activity, it permits a degree of spontaneity and intimacy that other methods may not.

Most women using oral contraceptives today do not report significant changes in sexual interest, behavior, or enjoyment. Approximately 10 percent experience improved sexuality, which is about the same as the percent who note decreased sexual interest or responsiveness.

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