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Original research
Factors affecting female sexual well-being: a 5-year follow-up of a randomised clinical trial on post-abortion contraception
  1. Janina Bosas1,
  2. Elena Toffol1,
  3. Elina Pohjoranta1,2,
  4. Maarit J Mentula1,2,
  5. Ritva Hurskainen1,
  6. Satu Suhonen1,
  7. Oskari Heikinheimo1,2
  1. 1 University of Helsinki Faculty of Medicine, Helsinki, Finland
  2. 2 Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland
  1. Correspondence to Professor Oskari Heikinheimo, University of Helsinki Faculty of Medicine, Helsinki, Uusimaa, Finland; oskari.heikinheimo{at}helsinki.fi

Abstract

Introduction Sexual well-being is associated with general well-being. Several factors, such as overweight, infertility, anxiety and sex hormones, also play a role, but the effects of hormonal contraception remain a point of debate. We characterised the factors associated with sexual well-being in fertile-aged women following induced abortion.

Methods A 5-year follow-up of a nested, longitudinal, cohort study examining the effects of routine provision of intrauterine contraception as part of abortion care. Sexual well-being, anxiety and quality of life were assessed annually using validated questionnaires (McCoy Female Sexuality Questionnaire, State-Trait Anxiety Inventory and EuroQoL), along with data on general and reproductive health, and relationship status. Of the 742 women participating in the trial, 290 (39%) provided sufficient follow-up data and were included in this study.

Results Based on trajectories of McCoy scores across the 5-year follow-up, two groups were identified: those with stable and higher (n=223, 76.9%) and those with declining sexual well-being (n=67, 23.1%). Women in the group of declining sexual well-being had significantly higher levels of anxiety and lower quality of life at all time points. They also had chronic diseases more often and were less happy in their relationships. No differences were found in method of contraception when classified as hormonal versus non-hormonal, or long-acting versus short-acting reversible contraception.

Conclusions Lower anxiety and higher quality of life are associated with stable and higher sexual well-being. Method of contraception or relationship status are not associated with sexual well-being during long-term follow-up in fertile-aged women.

  • hormonal contraception
  • Sexual Health
  • abortion, induced
  • surveys and questionnaires

Data availability statement

Data are available upon reasonable request and appropriate approvals and agreement. The authors are willing to share anonymous participant data. Possible data are available from the corresponding author Oskari Heikinheimo (oskari.heikinheimo@helsinki.fi).

https://doi.org/10.1136/bmjsrh-2023-201879

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    Data availability statement

    Data are available upon reasonable request and appropriate approvals and agreement. The authors are willing to share anonymous participant data. Possible data are available from the corresponding author Oskari Heikinheimo (oskari.heikinheimo@helsinki.fi).

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    Footnotes

    • Contributors All authors contributed to interpretation of the results and accepted the final version of the manuscript. JB: investigation, data curation, formal analysis, writing - original draft, writing - reviewing and editing. ET: methodology, investigation, data curation, formal analysis, writing - reviewing and editing. EP: conceptualisation, investigation, data curation, formal analysis, writing - reviewing. MJM: conceptualisation, investigation, writing - reviewing. RH: conceptualisation, methodology, writing - reviewing. SS: conceptualisation, methodology, investigation, funding acquisition, writing - reviewing, editing. OH: guarantor, conceptualisation, funding acquisition, methodology, investigation, formal analysis, writing - reviewing and editing.

    • Funding The study was supported by the Yrjö Jahnsson Foundation (ET; grant number 20207328), the Finnish Cultural Foundation (ET; grant number 00211101) and research funds of the Helsinki University Hospital.

    • Competing interests OH serves occasionally on scientific advisory boards organised by Bayer AG and Gedeon-Richter, and has lectured at educational events organised by these companies. None of the other authors have any competing interests.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.