Sexual function and wellbeing of women using modern contraceptive methods in Rwanda: a multicenter cross-sectional...

Family planning (FP) is essential for sustainable development, maternal health, and women's reproductive well-being. Despite its critical role, Rwanda continues to experience a highly unmet need for FP. Women's experiences and perceptions of contraceptive methods can significantly affect their adoption and use. This study aimed to assess the sexual function and well-being of women using modern FP methods in Rwanda.

A multicenter cross-sectional study involving 415 women aged ≥18 years who had used a modern FP method for at least ≥6 months was conducted across three urban and two rural FP clinics in Rwanda. Sexual function and well-being were evaluated via the Female Sexual Distress Scale-Revised (FSDS-R), with scores <11 indicating good sexual function. Utilizing R programming version 4.0.2, Logistic regression was used to examine associations between demographic/clinical factors and sexual distress.

Overall, 79.5% of women had good sexual function (FSDS-R < 11). Copper intrauterine device (IUD) users (96%) and those with permanent sterilization (84%) reported the highest sexual satisfaction. In multivariable analysis, underweight women (BMI <18.5) had 3.08-fold higher odds of sexual distress than normal-weight women (OR = 3.08; 95% CI 1.10-8.69). Conversely, IUD users had 86% lower odds of distress than implant users (OR = 0.14; 95% CI 0.03-0.42). Other factors, such as education level, were not significantly associated after adjustment.

The majority of Rwandan FP users in this study reported satisfactory sexual function. Contraceptive method and BMI were key predictors. These findings underscore the importance of integrating sexual health counseling into FP programs to reassure women about contraceptive side effects and support informed method choices that optimize reproductive well-being.