Background: Some women who use the Levonorgestrel-intrauterine system (Lng-IUS) report systemic effects and discontinuation rates are somewhat higher compared with Copper-intrauterine device (Cu -IUD). Few studies, with contradictory results, have evaluated intrauterine contraceptives with or without levonorgestrel and sexual function specifically. Objective: To compare aspects of sexual function in women who use the Levonorgestrel-intrauterine system with those using the Copper-intrauterine device. Design and methods: Cross-sectional, questionnaire based study in Linköping, Sweden, a university city with approximately 150,000 inhabitants. All women turning 22, 25 or 28 years during 2013 were eligible. Totally 153 IUC users (103 Cu-IUD and 50 Lng-IUS) answered the questionnaire, which was part of a survey of contraceptive use in Sweden, conducted in 2013. The only inclusion criterion was intrauterine contraceptive use. All respondents answered a three-part validated questionnaire, one part regarding demographic background, the other regarding current contraceptive method and satisfaction with that method as well as considerations about ending or changing use of the method. The third part concerned different aspects of sexuality with questions based upon the validated FSFI (female sexual function index) and the MFSQ (McCoy Female Sexuality Questionnaire). Main Outcome Measures: Reported sexual desire changes related to contraceptive method, and aspects of sexual functioning; sexual desire level, sexual activity, orgasm frequency, satisfaction with sex life and satisfaction of desire level, compared between Lng-IUS and Cu-IUD users. Results: A negative effect on sexual desire due to contraceptive method was reported by 27.1% of the Lng-IUS users and by 10.9% of the Cu-IUD users (p < 0 .05), results more marked after adjusting for age, body mass index, depression, parity, and partnership (OR 4.98; 95% CI: 1.81-13.75). The risk of reporting low sexual desire level (never or almost never feeling sexual desire) (OR 3.45; 95% CI: 1.06-11.20) as well as low satisfaction with sex life (OR 2.67; CI: 1.16-6.20) was higher in the Lng-IUS group (adjusted for same confounders). Conclusion Young Swedish women using the Lng-IUS, more often report negative sexual desire effects of their contraception as well as lower sexual desire level compared with women using the Cu-IUD. Our findings emphasize that in the clinical contraceptive counselling setting it is important to raise the question of sexual function and perceived sexual function adverse effects in order to optimize the method recommended for the individual woman.
Background: Some women who use the Levonorgestrel-intrauterine system (Lng-IUS) report systemic effects and discontinuation rates are somewhat higher compared with Copper-intrauterine device (Cu -IUD). Few studies, with contradictory results, have evaluated intrauterine contraceptives with or without levonorgestrel and sexual function specifically. Objective: To compare aspects of sexual function in women who use the Levonorgestrel-intrauterine system with those using the Copper-intrauterine device. Design and methods: Cross-sectional, questionnaire based study in Linköping, Sweden, a university city with approximately 150,000 inhabitants. All women turning 22, 25 or 28 years during 2013 were eligible. Totally 153 IUC users (103 Cu-IUD and 50 Lng-IUS) answered the questionnaire, which was part of a survey of contraceptive use in Sweden, conducted in 2013. The only inclusion criterion was intrauterine contraceptive use. All respondents answered a three-part validated questionnaire, one part regarding demographic background, the other regarding current contraceptive method and satisfaction with that method as well as considerations about ending or changing use of the method. The third part concerned different aspects of sexuality with questions based upon the validated FSFI (female sexual function index) and the MFSQ (McCoy Female Sexuality Questionnaire). Main Outcome Measures: Reported sexual desire changes related to contraceptive method, and aspects of sexual functioning; sexual desire level, sexual activity, orgasm frequency, satisfaction with sex life and satisfaction of desire level, compared between Lng-IUS and Cu-IUD users. Results: A negative effect on sexual desire due to contraceptive method was reported by 27.1% of the Lng-IUS users and by 10.9% of the Cu-IUD users (p < 0 .05), results more marked after adjusting for age, body mass index, depression, parity, and partnership (OR 4.98; 95% CI: 1.81-13.75). The risk of reporting low sexual desire level (never or almost never feeling sexual desire) (OR 3.45; 95% CI: 1.06-11.20) as well as low satisfaction with sex life (OR 2.67; CI: 1.16-6.20) was higher in the Lng-IUS group (adjusted for same confounders). Conclusion Young Swedish women using the Lng-IUS, more often report negative sexual desire effects of their contraception as well as lower sexual desire level compared with women using the Cu-IUD. Our findings emphasize that in the clinical contraceptive counselling setting it is important to raise the question of sexual function and perceived sexual function adverse effects in order to optimize the method recommended for the individual woman.
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