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The Pill and Relationship Satisfaction, aka the power of interpretation

The views expressed are those of the author and are not necessarily those of Scientific American.

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I sometimes think I could write an entirely different blog, devoted entirely to oral contraceptives. I don’t know that it would make any difference, but there is just SO much misinformation out there. Similarly, I sometimes feel I could devote an entire blog to debunking over-interpreted science. The two blogs would frequently overlap.

There’s just so much misinformation about “the Pill”. And there seems almost to be glee in the way people spread it. No one seems to spread this kind of misinformation about condoms. Or Nyquil. Or cholesterol medications. There’s something about taking a PILL (condoms don’t seem to have this, and the Ring has it less, too, I think because those are physical things and thus give themselves to a different mindset) that just makes people feel they are messing with their physiology, messing with their MINDS, messing with themSELVES, and feel it on another level entirely. Even psychiatric medications, it seems to me, don’t get this kind of bad rap.

And of course all this misinformation is compounded by all the sexual worries that go along with it. It’s The Pill! It’s HORMONES! It’s your SEX DRIVE. And humans, as you probably well know, attach a huge amount of importance to their sex drive, or lack thereof.

And then you get a study. A study that is not bad, but not what I’d call great. Heck, it’s barely even novel, it’s more a different interpretation of a similar set of data. But it’s about oral contraceptives. And it’s about…*whispers*…sex. So you immediately get headlines like this:

The Pill Makes You Pick A Loving Mate Who’s Bad In Bed

You know, every time I think I run out of rage…

Roberts et al. “Relationship satisfaction and outcome in women who meet their partner while using oral contraception” Proceedings of the Royal Society B, 2011.

We’ll start with what the paper did. The paper asked two groups of women, those who were ON oral contraceptives when they met a partner, and those who were not, a set of questions. When determining relationship length, they stuck with women who had had their first child with the partner in question. They asked a series of questions about sexual satisfaction, relationship satisfaction (independent of sexual satisfaction), and asked the women to rate the attractiveness of the partner. From this they concluded that women who met their partner while on oral contraceptives reported less sexual satisfaction and increased general satisfaction independent from sexual satisfaction. The women on oral contraceptives also had lower frequencies of separation. Observe:

Now, there are several issues with this. While they divided women by whether or not they were on the pill at the time of MEETING their partner, they did not break down whether they were on the pill NOW, to work out what kind of influence that might have had. I find their measure of first child as a measure of relationship length to be…suspect at best. Me, I’d have looked for women who were, say, 5 years out from marriage, and asked them, though of course you have issues with how long people were together before marriage, it’s a very difficult variable to control for. I’m not certain that the aspects of non-sexual relationship satisfaction are really indicative (they asked for loyalty and financial security, but not, um, actual affection). But still, the finding is fine, and interesting, and says something interesting about female choice while on oral contraceptives.

What it does NOT say is this:

Apparently the key to being happy for the rest of your life is to go on the pill, find a less attractive dude, and engage in some mediocre sex.


Or this:

women taking oral contraception tended to choose mates who lacked sexual prowess.


There is NOTHING in this study saying that the men are bad in bed. The only thing the study says is that women who met their partners while on oral contraceptives report less sexual satisfaction. NOT that their partners suck. Though I imagine it sounds better that way.

Here’s the thing. There’s one VERY BIG THING this study did not ask. It is a VERY BIG THING that is a side effect of many oral contraceptives, and it’s something that really brings their results into a very different light.

They didn’t ask about libido.

One of the most reported side effects of oral contraceptives is a decrease in libido. They did not ask about this, and when you consider that women on oral contraceptives might HAVE decreased libido, it makes those results look VERY different. After all, you ARE likely to report decreased sexual satisfaction if you’re having trouble getting off. And I have to wonder if a lot of the sexual satisfaction scores could be explained by decreased libido and increased difficulty in orgasm.

The authors also state that their findings go along with previous findings which show that women on oral contraceptives choose men with similar MHC complexes, while those not on oral contraceptives do not. The MHC, the major histocompatability complex, is a large gene region playing an important role in your immune system. There’s a good bit of mate preference research out there showing that most people prefer to mate with MHC complexes different from their own, which increases the immune diversity of your offspring. More research has shown that when women are on oral contraceptives, they tend to choose mates that are more MHC SIMILAR. This seems a little odd. Scientists usually try to explain this by hypothesizing something about how you want family around you supporting your kid for the long haul, and the low levels of hormones promote that, but I don’t know how backed up that is. What they do know is that women who are MHC similar to their partners report reduced sexual satisfaction. Yet again, this does NOT mean that the MHC similar guys are bad lovers. This could be differences in sexual attraction, or again, possible differences in libido (though I think the attraction may be more likely here).

But while the authors here talk about how they think these women chose MHC similar mates (and they have done MHC studies in the past) they did not actually TEST the MHC complexes of the women or their partners. I’d be very interested to see if MHC similarity correlated with sexual dissatisfaction and how that impacted relationship outcome.

Anyway. Let’s talk about what this paper DID find.

1) It found that women who MET their partners on oral contraceptives reported less sexual satisfaction down the road.

2) It found that women who met their partners on oral contraceptives reported increased financial satisfaction, and almost significant increases in intelligence and support.

3) It found that women who met their partners on oral contraceptives reported lower rates of separation compared to those who were not on oral contraceptives when they met.

That is what it found. Did it find that women on oral contraceptives choose bad lovers? NOPE. Not at all. It did find differences in how women felt down the road about their mate choice. That’s it. That’s ALL. And that’s plenty! You’re probably not bad lovers, guys. You can relax now.

It’s really too bad those other headlines sounded so good.

Scicurious About the Author: Scicurious is a PhD in Physiology, and is currently a postdoc in biomedical research. She loves the brain. And so should you. Follow on Twitter @Scicurious.

The views expressed are those of the author and are not necessarily those of Scientific American.

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  1. 1. eegiorgi 10:17 am 10/18/2011

    I’m not a psychologist, so I can’t comment on the measures used in this study. I am a statistician and as such, I want to leave my warning that once you have the data and look at it in a million possible ways, eventually you will find something. You find a p-value of 0.05 ore less 5% of the times — that’s the definition of a p-value.

    I’m not criticizing the work of fellow scientists. And these studies do make great punchlines. But people should be mindful of the caveats. They point to trends (which the human brain is biased to find anyways). They certainly shouldn’t “box” human behavior.

    The problem is, once studies like this are out, the media will take the punchline only and leave all the caveats behind.

    Link to this
  2. 2. RowanMcGregger 11:48 am 10/18/2011

    Thank you for this so much. Peer review is so important when studies like this are posted to the general public where the Media is allowed to ‘spin’ it. It turns interesting science that is the beginnings of understanding something into junk science, which is unfortunate.

    Link to this
  3. 3. niel_malan 1:30 pm 10/18/2011

    I notice that there is no correction for socio-econmic status. Women who use oral contraceptives tend to be of higher socio-economic status. Women of higher socio-econmic status tend to mate with men of higher socio-economic status. So, if users of oral contraceptives report less sexual satisfaction, the headline might have to read “Rich men are bad in bed.”

    Link to this
  4. 4. kclancy 6:27 am 10/19/2011

    Just reading this over again, Sci, you said everything I would have said and more. Absolutely brilliant! And I appreciate the earlier commenter’s point about how finding statistical trends shouldn’t be cause to “box” human behavior.

    The libido issue just drives me nuts. I mean, that’s probably the number one side effect of the pill — it is a meaningful and true one, unlike, as you say, all the other misinformation out there. It suppresses ovarian function, so it suppresses pretty much the only source in a woman’s body for androgens. Androgens play a big role in libido. Ergo, birth control lowers libido for a huge number of women.

    Link to this
  5. 5. JDahiya 7:39 am 10/19/2011

    niel_malan, you are absolutely right. If the study in fact ‘shows’ anything, it is just this! The level of sexual satisfaction is less, but financial provision is more. Rich men = poor lovers, muwahahaha.

    Or, maybe, “Women on OCP prefer richer men with paunches” would be a better headline, if we are going to stretch the research anyway. And, bonus, it can be published in family media too.

    Link to this
  6. 6. mostlycurious 5:31 pm 10/19/2011

    “the assessment of current relationship satisfaction may be influenced by current hormonal state, but we controlled for this in the relevant analyses by excluding women using OC and those who were pregnant at the time of the survey.”

    See page six, toward the top of the second column.

    Link to this
  7. 7. 2:48 am 10/21/2011

    I really enjoyed your article. You make some great points! It’s always tempting to make the correlation=causation assumption error. This link between preferring similar/different MHC when you’re on/off the pill has always seemed unimportant to me–so what if you future baby might get a few more colds? This is the 21st Century–buy some Robitussin. I’d love to see solid regression-level research showing that the pill is a causal factor leading to a less satisfying sex life 3 yrs into marriage, or that it is a major factor in relationships that end in affairs or divorce. Then we could start getting more worried.

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  8. 8. Peter Howie 5:46 pm 10/21/2011

    As I read this article I also became aware of the dishonest (rather than just silly) and continuing use by many science writers of the scientific term ‘significance’, and the colloquial use of the term, as though they mean the same thing. I have to to continually ask myself whether the colloquial use is being used or the scientific use. This is one reason why measures such as ‘how many people need to be treated to get the effect being measured (healing etc)’ have been developed. I mean, even in the above article it uses the wonderfully ludicrous ‘almost significant’ as something to describe a non significant effect. May as well say ‘almost levitated and almost read their mind’.
    If something is colloquially significant (lets call it ‘really important’ in day to day life) then I would assume it requires real thought, immediately to assess the implications. If something is scientifically significant then I need to a) check the data and see what that means, b) see if it implies further research, c) not take any hypothesising for granted that is not also related to data, d) ask myself how that could be put to a lay person.
    Maybe a measure of ‘the average net difference in wealth of women who met their partners while on the pill’ could let us know what it actually means and whether or not the significance is significant.

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