The contraception question: study shows how much men really know about female contraception

2016-12-05

Show a man a female condom or an intrauterine device (IUD) and there’s a fairly good chance he’ll be stumped.

An IUD looks more like a wind-up toy than a device that effectively prevents pregnancy 99 per cent of the time, and a vaginal ring is reminiscent of an entirely separate sexual act best not mentioned in polite company.

But men are more enlightened on the subject of contraception than conventionally thought, Sydney researchers suggest.

There are, however, still big knowledge gaps when it comes to long acting reversible contraception (LARC), the most reliable and effective methods available to prevent pregnancy.

More than 80 per cent of men had heard of each available method of contraception, a survey of 2438 heterosexual men on the dating site RSVP found.

“There was really good awareness and also use of contraception among these men,” lead researcher Dr Mary Stewart at Family Planning NSW said.

But some of the more esoteric methods of female contraception still raised eyebrows, according to the research presented at the Australasian Sexual Health Conference in November.

Too many men still did not know enough about LARCs, including the implant, the injection and IUDs, Dr Stewart said.

One in 10 had never heard of an IUD, some 18 per cent had never come across a contraceptive injection, 14 per cent had not heard of an implant and 19 per cent had never heard of a vaginal ring.

One of the aims of the research was to understand why so few Australian women used long acting reversible contraception (LARC).

Roughly 4 to 8 per cent of Australian women report using LARC, compared with 10-32 per cent in Europe and 10 per cent in the US, previous research showed.

“There is just so little data on this … but we know men’s attitudes influence what method their partner chooses so it’s important men have got good knowledge around what’s available ,” Dr Stewart said.

Encouragingly, the study found that general perception that contraception is women’s business appeared to be crumbling, as men voice their desire to share the decision-making role when it comes to the kind of contraception used to prevent pregnancy.

Most men surveyed did not believe contraception was the woman’s job, with more than 90 per cent of men believing both the man and woman should decide which contraceptive method to use.

When it came to casual partners, roughly one in four believed it was a mutual decision, while just over half thought the same was true for a one-night stand.

“They showed they really did want to be involved in the discussion around the type of contraception used,” Dr Stewart said.

But misconceptions around the harms of some forms of contraception meant their decisions may not be based on accurate information.

Almost one in three believed emergency contraception – the morning after pill – might be harmful for women, which was indicative of a general misunderstanding among the public about how the pill actually works.

“People get a bit confused about what the emergency contraception pill does,” Dr Stewart,

Many people in the community think it functions in a similar way to an abortion pill, terminating a fetus.

“Men can access [the emergency contraception pill], but if they think it’s harmful it will affect their decision to go to the pharmacy and buy it for their partners,” Dr Stewart said.

Some 30 per cent of the men surveyed believed the contraceptive pill could be harmful. Some 20 per cent believed the injection could cause harm.

“There’s quite a lack of knowledge around the harms of most of the female methods, but a lot of confidence around male methods,” Dr Stewart said.

More than half of the men surveyed said male condoms reduced their interest in sex and more than three in four said they reduced their sexual pleasure.

The withdrawal method was a turn off for many, reducing interest in sex among 40 per cent and dudding pleasure among 57 per cent.

One in four said the morning after pill would make them less keen for sex and, among those who had used a female condom, the same proportion said it reduced their sexual pleasure.

“Many women talk about the effect of the pill on their libido, but it’s likely many men aren’t aware of this,” Dr Stewart said.

LARC contraception: How it works

Contraceptive implant – a small, flexible rod inserted under the skin of the inner upper arm that slowly releases a progestogen hormone to prevent ovulation for up to three years. (99.9 per cent effective).

Copper IUD – a small, plastic T-shaped device with copper wire wrapped around its stem. The IUD is placed inside the uterus by a doctor. Two types of copper IUDs are available in Australia; one lasts up to five years, the other lasts up to 10 years. (99 per cent effective).

Hormone-releasing IUD – The same T-shaped device releases the hormone levonorgestrel, which makes the mucus in the cervix thicker so that sperm cannot get into the uterus. It also affects the ability of the sperm and egg to move through the uterus and fallopian tubes, which reduces the chance of an egg being fertilised. (99 per cent effective).

Contraceptive Injection – DMPA, or Depot Medroxyprogesterone Acetate, is similar to the hormone progesterone, produced in the body by the ovaries. It stops the ovaries from releasing eggs, preventing ovulation. (94-99 per cent effective).