Contraceptive satisfaction but not sexual satisfaction or sexual frequency predicts contraceptive switches

Estimates of the causal effects of hormonal contraceptives on psychological outcomes are likely distorted by contraceptive discontinuation (including starting or stopping a method and switching between methods) because of side effects. Few studies examine contraceptive discontinuation and most are based on correlational cross-sectional data. The literature suggests method- and sexuality-related variables as predictors of contraceptive discontinuation. The current study therefore analyzed type of contraceptive method, contraceptive satisfaction and usage duration, as well as sexual frequency and sexual satisfaction as predictors of contraceptive switches, which is one form of contraceptive discontinuation. In addition, we examined the sensitivity of the reported effects to unobserved selection effects. Analyses were based on longitudinal data from the Continuity and Change in Contraceptive Use Study with a sample of up to 1,993 women. We found substantial and robust effects of contraceptive method and contraceptive satisfaction on contraceptive switches, but no clear evidence on interaction effects between contraceptive method and contraceptive satisfaction. Furthermore, we found no effects of sexual satisfaction or frequency across all analyses.