James A. Simon, MD, CCD, NCMP, IF, FACOG, Sheryl A. Kingsberg, PhD, IF, and Anita L. Nelson, PhD, IF present Roundtable: Practitioner/Patient Partnership in Family Planning with FABMs (Part I)

Cheryl, so one of the concerns that patients often don't voice is their concerns about the impact, the safety in fact, of birth control.

birth control pills, birth control hormonal devices, et cetera.

How might fear of the side effects actually impact a woman's sexual function and how do we get clinicians to think about sexual function and not only fertility effectiveness?

Look, Jim.

The birth control pill really did revolutionize women's empowerment and their ability to control fertility.

and in that way help their sexuality.

But it comes with some consequences.

And women are aware that for some women, being on the pill is going to cause sexual side effects.

And that really, talking about throwing the prescription out in the wastebasket as they're leaving, is going to prevent women from using that method because they don't want that.

And one of the things we're trying to do besides control fertility, is to enhance sexuality.

And so learning about different methods that will not have those same side effects, not every woman is going to have those side effects, but the worry about them absolutely makes a difference.

On the other side is the worry of getting pregnant when they don't want to that's going to impair their sexuality as well.

If you're distracted worrying, is tonight a night I might get pregnant, there is no way you are going to be in the mood to have a sexual encounter.

So taking that fear away, knowing they can track and have that information right at their fingertips, or on their wrist to say, or looking at their phone, is going to make a huge difference in taking that fear away.

Because even women on the pill are not quite sure that they are not going to get pregnant.

They have to rely on that.

They have to rely on taking the pill every day, or even if they have an IUD, they have to rely on hoping it's not going to fail, whereas with using the tracker, they can feel empowered to look, feel safe, and turn down the volume on that anxiety.

And this is really important, that although the sexual impacts from the pill are really confined to a very narrow group of women, it is the concern about those things.

And if a woman believes that she's going to suffer side effect, we know how that's going to amplify the risk that she faces in doing it.

So sensing where she's coming from, how firmly does she believe she's going to gain weight when she takes the pill, or that it will affect her libido adversely, then that may guide you in either first educating her, and then if that doesn't work as well, making her feel comfortable with it, then moving on to something where she may feel much more comfortable using the method.