Original Article

The effect of the copper intrauterine device (Cu-IUD) and the injectable depo-medroxyprogesterone acetate (DMPA) use on women’s sexual satisfaction and depression

Abstract

Background & Aim: Intrauterine device and depo-medroxyprogesterone acetate are among the most effective reversible contraception in the world, still few consensuses exist about sexual and mood changes of these two conventional methods. The present study has compared the sexual satisfaction and depression level in these two methods.
Methods & Materials: A cross-sectional study was conducted between August 2017 and January 2018, in 300 married women aged 19-50 year, in Tehran, Iran. One hundred and fifty IUD users and 150 DMPA consumers, 12-18 months after starting the current method, recruited to the study from 34 health centers of Tehran University of Medical Sciences by convenience sampling. Two standard questionnaires of Index of sexual satisfaction (ISS) and Patient Health Questionnaire (PHQ) were used for assessing sexual satisfaction and depression, respectively. Chi-square and independent t-test were used for the homogeneity of the two groups. The linear logistic regression analysis was conducted to estimate the strength of associations.
Results: There was not any significant difference between two groups in demographic characteristics such as age, marriage duration, education level, number of children and breastfeeding condition (P>0.05). Significantly higher sexual satisfaction (P<0.001) and lower depression level (P<0.001) reported in IUD users than DMPA consumers in the t-test. A multivariate regression confirmed that sexual satisfaction increased 6.4 scores in the IUD group in comparison to DMPA users (P= 0.003, B= -6.4), and with increase 1 year to duration of the marriage, sexual satisfaction increase 0.33 score. For depression, the only significant variable was the contraceptive methods, and depression level increase 1.24 scores in DMPA users than IUD consumers. (P=0.006, B= - 1.24). Although in univariate analysis, some variables showed effects on sexual satisfaction and depression, multivariate regression results did not confirm any significant relationships.
Conclusion: Both sexual satisfaction and mood level was higher among IUD users. This paper reconfirmed that IUD is a preferable method in women who are eligible to use both methods.

1. United Nations. Department of Economic and Social Affairs. Population Division. Trends in Contraceptive Use Worldwide 2015. New York, 2015. Available at: https://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf
2. World Health Organization. Reproductive Health. Family planning: a global handbook for providers: evidence-based guidance developed through worldwide collaboration. Johns Hopkins Ccp-Info; 2007.
3. United Nations, Department of Economic and Social Affairs, Population Division). Estimates and Projections of Family Planning Indicators 2019. New York: 2019. Available at: http://www.un.org/en/development/desa/population/theme/family-planning/cp_model.shtml.
4. Burrows LJ, Basha M, Goldstein AT. The effects of hormonal contraceptives on female sexuality: a review. The journal of sexual medicine. 2012 Sep 1;9(9):2213-23.5.
5. Higgins JA, Davis AR. Contraceptive sex acceptability: a commentary, synopsis and agenda for future research. Contraception. 2014 Jul 1;90(1):4-10.
6. Boozalis MA, Tutlam NT, Robbins CC, Peipert JF. Sexual desire and hormonal contraception. Obstetrics and gynecology. 2016 Mar;127(3):563.
7. Higgins JA, Sanders JN, Palta M, Turok DK. Women’s sexual function, satisfaction, and perceptions after starting long-acting reversible contraceptives. Obstetrics and gynecology. 2016 Nov;128(5):1143.
8. Ott MA, Shew ML, Ofner S, Tu W, Fortenberry JD. The influence of hormonal contraception on mood and sexual interest among adolescents. Archives of sexual behavior. 2008 Aug 1;37(4):605-13.
9. Dianat S, Fox E, Ahrens K, Upadhyay U, Zlidar V.era M, et al. Side effects and health benefits of depot medroxyprogesterone acetate: a systematic review. Obstetrics & Gynecology. 2019;133(2): 332-341
10. Singata-Madliki M, Hofmeyr GJ, Lawrie TA. The effect of depot medroxyprogesterone acetate on postnatal depression: a randomised controlled trial. J Fam Plann Reprod Health Care. 2016 Jul 1;42(3):171-6.
11. Hudson WW, Harrison DF, Crosscup PC. A short‐form scale to measure sexual discord in dyadic relationships. Journal of Sex Research. 1981 May 1;17(2):157-74.
12. Kroenke K, Spitzer RL, Williams JB. The PHQ‐9: validity of a brief depression severity measure. Journal of general internal medicine. 2001;16(9):606-13.
13. Khamseh ME, Baradaran HR, Javanbakht A, Mirghorbani M, Yadollahi Z, Malek M. Comparison of the CES-D and PHQ-9 depression scales in people with type 2 diabetes in Tehran, Iran. BMC psychiatry. 2011 Dec;11(1):61.
14. Sanders JN, Smith NK, Higgins JA. The intimate link: a systematic review of highly effective reversible contraception and women’s sexual experience. Clinical obstetrics and gynecology. 2014 Dec 1;57(4):777-89.
15. del Mar Sánchez-Fuentes M, Santos-Iglesias P, Sierra JC. A systematic review of sexual satisfaction. International journal of clinical and health psychology. 2014;14(1):67-75.
16. Smith NK, Jozkowski KN, Sanders SA. Hormonal contraception and female pain, orgasm and sexual pleasure. The journal of sexual medicine. 2014 Feb 1;11(2):462-70.
17. Malmborg A, Persson E, Brynhildsen J, Hammar M. Hormonal contraception and sexual desire: A questionnaire-based study of young Swedish women. The European Journal of Contraception & Reproductive Health Care. 2016 Mar 3;21(2):158-67.
18. Fortenberry JD, Hensel DJ. The association of sexual interest and sexual behaviors among adolescent women: A daily diary perspective. Hormones and behavior. 2011 May 1;59(5):739-44.
19. Worly BL, Gur TL, Schaffir J. The relationship between progestin hormonal contraception and depression: a systematic review. Contraception. 2018 Jun 1;97(6):478-89.
Files
IssueVol 7 No 1 (2020): Winter QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/npt.v7i1.2300
Keywords
copper intra uterine device; depo-medroxyprogesterone acetate; sexual satisfaction; depression; contraception

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How to Cite
1.
Hagh-Mohammadi Pasanad S, Farnam F, Damghanian M. The effect of the copper intrauterine device (Cu-IUD) and the injectable depo-medroxyprogesterone acetate (DMPA) use on women’s sexual satisfaction and depression. NPT. 2020;7(1):53-60.