The Sexual Acceptability of Intrauterine Contraception: A Qualitative Study of Young Adult Women.

CONTEXT The IUD is extremely effective but infrequently used by young adult women, who disproportionately experience unintended pregnancies. Research has not examined how IUD use may affect sexuality, which could in turn affect method acceptability, continuation and marketing efforts. METHODS Focus group discussions and interviews were conducted in 2014 with 50 women between the ages of 18 and 29-either University of Wisconsin students or women from the surrounding community who received public assistance-to explore their thoughts about whether and how IUD use can affect sexual experiences. A modified grounded theory approach was used to identify common themes in terms of both experienced and anticipated sexual acceptability of the IUD. RESULTS Six themes emerged: security (IUD's efficacy can reduce sexual inhibition), spontaneity (IUD can allow for free-flowing sex), sexual aspects of bleeding and cramping (IUD's side effects can affect sex), scarcity of hormones (IUD has a low level of or no hormones, and reduces libido less than hormonal methods, such as the pill), string (IUD's string can detract from a partner's sexual experience) and stasis (IUD use can have no impact on sex). Some reported sexual aspects of IUD use were negative, but most were positive and described ever-users' method satisfaction and never-users' openness to use the method. DISCUSSION Future research and interventions should attend to issues of sexual acceptability: Positive sexual aspects of the IUD could be used promotionally, and counseling about sexual concerns could increase women's willingness to try the method.