"And Isn't that the point?": pleasure and contraceptive decisions

Objective: Previous survey research indicates that women and men experience reduced sexual pleasure when using condoms, especially compared to nonbarrier family planning methods. This study seeks to explore those experiences of reduced pleasure in-depth and how they affect contraceptive method decisions and use.

Study design: In-depth interviews with 30 men and 30 women between the ages of 18 and 36 years in the United States about their contraceptive decisions and use were analyzed.

Results: Both men and women complained about the way that condoms interfered with their sexual pleasure. Several women (and no men) complained that condoms actually hurt them, and the majority of couples had at least one member who reported disliking condoms. For hormonal methods and intrauterine devices, general side effects were usually one of the most important reasons that women continued or discontinued methods, but few sexual side effects were reported.

Conclusions: Interfering with sexual pleasure appears to be the most important reason that both men and women do not use condoms, and public health practitioners should recognize the limitations of condoms as a contraceptive technology. Despite problems with general side effects, most women (and men) prefer hormonal methods to condoms.

Implications: This study provides in-depth descriptions showing that young adult men and women in the United States use condoms less because condoms interfere with their sexual pleasure. Although women often say they experience general negative side effects from hormonal birth control, they usually perceive few sexual side effects from hormonal birth control. Since young heterosexual adults usually perceive themselves to be at much greater risk for pregnancy than sexually transmitted infections, they mostly perceive hormonal birth control to be a greatly superior contraceptive option compared to condoms.