Contraceptive use, decision-making and impulsivity in a community sample of women

Background: Women who use dual methods such as hormonal birth control with condoms for sexually transmitted disease prevention have less depression and lower impulsivity compared to women who do not use dual methods.

Objective:  To determine whether impulsivity is associated with hormonal contraceptive use.

Methods:  372 community-based women completed the Reproductive Health Questionnaire (RHQ), Risk Behavior Assessment (RBA) and the Eysenck Impulsivity Scale (EIS). 

Results:  The majority of participants (184/372; 49%) were African American.  Mean age was 33 years (SD=10.4).  The majority of women (87%) reported not using any method to avoid pregnancy (281/321). The majority reported that use or non-use of contraception was their individual decision (69%; 191/274); 22% of women reported that it was a joint decision involving themselves and their partners (61/274).  A minority of women (3%) reported that their partner alone made the decision concerning contraception.  Only 3% of women reported using dual methods in the past 12 months.  The mean impulsivity score was higher (M=11.62, SD=4.13) for women who chose not to use any contraception compared to women who used any form (hormonal or non-hormonal) of contraception (M=10.2, SD=4.35), t(335) = 3.05, p=.0025.  With respect to impulsivity and decision-making, women who reported making contraception decisions by themselves had higher mean impulsivity (M=11.25, SD 4.23) compared to women who made the decision jointly with their sexual partner (M=10.93, SD=4.10) and those whose partner made the decision (M=6.62, SD=5.85), F(2, 306) = 4.61, p=.01.

Conclusion:  Women with high impulsivity are   using hormonal contraception sub-optimally.