RESEARCH ARTICLE p-ISSN: 2580-0825 (Print) e-ISSN: 2599-1116 (Online)

THE RELATIONSHIP BETWEEN THE

DURATION OF DMPA WITH
DECREASED LIBIDO IN WOMEN OF
SUBURBAN AGE IN OMBEN VILLAGE
Isnaini Novitasari1, Taufiqurrahman1, Prastomo
Suhendro1, Musdalifah1 2
MIKIA: 1
Politeknik Negeri Madura, Indonesia
Mimbar Ilmiah Kesehatan Ibu dan Anak
(Maternal And Neonatal Health Journal) [email protected]

Article History ABSTRACT

Received: The use of injectable birth control is widely sought after by
Accepted: people in Indonesia, but long-term use can reduce libido.
Published Online: Decreased libido in 3-month injectable birth control acceptors
can be influenced by long-term hormonal changes that cause
sexual disorders after > 2 years of use. The purpose of this
* Corresponding Author: study was to analyze the relationship between the duration of
Tarsikah, Midwifery DMPA with decreased libido in women of suburban age in
Departement, Poltekkes Omben Village. Methods: This research design uses
Kemenkes Malang, Jalan quantitative research methods with a cross sectional approach.
Besar Ijen No 77C, Malang, The population and sample in this study were all mothers who
used hormonal contraceptives (injectable birth control)
Indonesia,
totaling 64 people in Omben Polindes. The technique used
E-mail: was total sampling. Data collection using a questionnaire
[email protected], sheet and analyzed using the Spearman Rho statistical test on
Phone: the SPSS application. Results: data were obtained by
+62 .............................. conducting interviews using a questionnaire. The research
was conducted in November 2022. Data were analyzed by
univariate and bivariate methods using frequency distribution
and Spearman Rho statistical test. The results showed that
there was a relationship between the duration of use of
hormonal contraceptives (injectable birth control) for 3
months with a decrease in libido in women of suburban age in
© This Journal is an open-
Omben Village (p-value = 0.000). Conclusion: Providing
access under the CC-BY-SA advice or counseling about household harmony, reproductive
License health in injectable family planning acceptors who experience
sexual libido disorders.
Keywords:
DMPA, Libido, and Women.

INTRODUCTION
Family planning is one of the most basic and main preventive health services for
women, although it is not always recognized as such. Family planning services are one of the
essential reproductive health services that need serious attention because quality

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family planning services will improve the level of welfare, infant and child health and
reproductive health (Suyati, 2013). Injectable family planning has the risk of side effects that
are often experienced such as menstrual disorders, weight changes, long-term use can reduce
libido, but the community tends to use injectable family planning. decrease libido, but people
tend to choose short-term contraceptive methods over long-term contraceptive methods.,
However, people tend to choose short-term contraceptive methods over long-term. Decreased
libido in 3-month injectable contraceptive acceptors can be influenced by psychological
disturbances and physical disorders and even hormonal changes in the long term cause sexual
disorders in use > 2 years (Nurgianti, 2017).
Data from WHO (2020) shows that injectable contraceptive users ranked first
worldwide above contraceptive pills, condoms and IUD, especially in developing countries.
Presentation of the use of contraceptive use is 35.3%, from the number of the world's
population using family planning, which is a total of 249 million (Walwiener, Milner, Seeger,
zipel and Bitzer. (2016). Basic Health Research Data (Riskesdas) in 2020, states that
contraceptive use in Indonesia 63.22% and dominated by the use of injectable contraceptives
(34.3%). (34.3%). In East Java, injectable family planning acceptors are almost half of other
family planning acceptors, which is 48.2%. (BKKBN 2017). Based on the data Sampang
Regency health profile in 2019 states that of the 87.12% the use of hormonal family planning
there are 54.7% of injectable family planning users. Data from Omben village polindes in
2022 obtained the number of women of childbearing age in Omben Village, Omben Sampang
Subdistrict who used contraceptives. Omben Subdistrict of Omben Sampang who use
injectable contraceptives for the last 5 years, namely 3-month injectable family planning as
many as 504 people and 1-month injectable family planning as many as 170 people. 1 month
injections as many as 170 people. From these data, it is known that the 3-month injectable
family planning is more attractive to women of childbearing age on the grounds that it is
cheaper and more efficient. While data from 2020 to 2023 women of childbearing age who
use 3-month injectable family planning in using 3-month injectable family planning in Omben
Village, Sampang, is 64 people.
The DMPA injectable family planning method provides effectiveness, reversibility and
long long-term use, one of the side effects of contraception that makes the makes the
acceptor's problem less comfortable in long-term use of DMPA contraceptives is menstrual
disorders, weight gain. long-term use of DMPA contraceptives are menstrual disorders,
weight gain, vaginal dryness, emotional disturbances, headaches, nervotonia. weight gain,
vaginal dryness, emotional disturbance, headache, nervotaxis and acne. Menstrual

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disorders that are often found in the form of a menstrual cycle that is shortening or
lengthening, heavy or light bleeding, irregular bleeding or spotting bleeding. irregular
bleeding or spotting, no menstruation at all (amenorrhea). In addition, an effect that is no less
disturbing, especially in young and fertile couples, is a decrease in libido due to a decrease in
sexual desire. and fertile couples is a decrease in libido due to changes in serum lipids that are
increasingly reduced (Widiastuti, 2017). Decreased libido as well as sexual dysfunction is a
low sexual desire in a person or the opposite sex, both men and women.
The effect of hormones on libido in long-term use of DMPA (up to two years) can
disrupt the balance of estrogen and progesterone in the body, resulting in normal cell changes
to abnormal. Progesterone in the contraceptive serves to thicken cervical mucus and reduce
the ability of the uterus to accept fertilized cells. However, this hormone also facilitates the
change of carbohydrates into fat, so that often the side effect is the accumulation of fat that
causes weight gain and decreased sexual desire (Nurgianti, 2017).
The results of previous research conducted by Aisyah (2015) showed that long-term use
of injectable birth control > 2 years can lead to a decrease in libido. result in decreased libido.
Based on data from the Supreme Court (MA) which explains, out of 155 divorce cases in
2021, the number of contested divorces is higher than the number of divorces. Even in some
areas such as Indramayu and Banyuwangi, the number exceeds the national average, there are
five factors and the highest is caused by no harmony as many as 97,615 cases including the
problem of unmet sexual needs (BKKBN 2017) The purpose of this study is the relationship
between the length of use of hormonal contraceptives (injectable birth control) 3 months with
a decrease in libido of women of childbearing age in Omben Village.

METHOD
The research design used in this study was correlational analytic with a cross sectional
approach. The population in this study were all women who used hormonal contraceptives
(injectable birth control) at Omben Polindes, totaling 64 people. The sampling technique used
was total sampling. Research instruments in the form of interviews and questionnaires of
Female Sexual Function Index (FSFI). The questionnaire was prepared by the researcher and
has been tested for validity and reliability. Data analysis technique using Spearman Rho
statistical test with SPSS 18.0 for windows program.

RESULTS
Table 1. Relationship between Length of Use of Hormonal

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Contraceptives (Injectable Birth Control) 3 Months with Decreased Libido of Women of
Fertile Age in Omben Village
Length of Tingkat penurunan libido Total
use the
injectable Mild loss of Moderate Severe loss of
birth control libido reduction in libido
DMPA libido
∑ % ∑ % ∑ % ∑ %
< 2 thn 16 84 0 0 0 0 16 25
≥ 2 thn 3 16 31 100 14 100 48 75
Total 9 100 31 100 14 100 64 100
Statistics α = 0,05
test
Ρ value =
0,000

The results of table 1 show that most of the respondents had a length of use of DMPA
injectable birth control ≥ 2 years with a decrease in libido as many as 48 people (75%). Based
on statistical test analysis results using SPSS (Statistic Product Service Solution) software
version 18.0 obtained the results of the Spearman rho test, showing that the value of ρ value
significant 0.000 which is smaller than the α value of 0.05. ρ value < α (0.000 <0.05), this
indicates that Ho is rejected and H1 is accepted, which means that there is a relationship
between the length of use of birth control injections. means that there is a relationship
between the length of use of DMPA injectable birth control and the the level of decreased
libido in women of childbearing age.

DISCUSSION
Injectable contraceptives are contraceptives in the form of a liquid containing the
hormone progestron which is injected into the body periodically (once a month or once every
3 months). The advantages of using injectable birth control are practical, effective and safe
with a success rate of more than 99%. success rate of more than 99%. There is no age limit
and the injectable birth control drugs that are three and once a month that does not affect
breast milk and is suitable for breastfeeding mothers (Irianto, 2014).
Women of childbearing age at the age of 26-30 years on average already have children,
Therefore, women who are in productive reproductive conditions prefer to use hormonal
injectable birth control for a long period of time or more than 2 years. more than 2 years is
actually more practical without having to be afraid of forgetting and having to remember
every day like the Pill for example or the remember every day like birth control pills for

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example or also the reason is more comfortable compared to other contraceptives such as
AKA. compared to other contraceptives such as IUDs that cause discomfort during
intercourse (Yosin, 2016).
According to Patmahwati (2018), many family planning acceptors use DMPA injections
longer because this injection method is very easy and safe. In addition, one of the benefits of
DMPA injectable contraception is long-term, this causes many acceptors to want to use it
longer, women do not need to remember to take birth control pills every day, and do not need
to come to the health service to do contraceptive injections every month. so that family
planning acceptors only need to come to the health service every 3 months. Many family
planning acceptors have been using injectable contraceptives for longer because the injectable
method is very easy and practical, and the price is relatively cheap and safe. This causes many
acceptors to want to use it longer.
Based on table 1, it shows that almost half of the respondents' level of decreased libido
is a moderate decrease in libido as many as 31 respondents (48%). FSFI is a measuring tool in
the form of a valid and accurate questionnaire or question to assess female sexual function.
Therefore, FSFI is used to measure female sexual function including sexual desire and sexual
response. which describes a woman's sexual function in the last four weeks. The mechanism
of action of DMPA injectable birth control with decreased libido where there are factors
associated with decreased libido, namely psychological, physical disorders and
contraceptives, namely DMPA injections which contain the hormone 19-progesterone, in
long-term use. Symptoms or complaints of decreased libido caused by the accumulation of
progesterone hormones in the body so that the esterogen hormone is suppressed. This
decrease in esterogen hormone will affect the release of testosterone. Whereas this hormone
triggers sexual arousal or libido, causing vaginal dryness.
DMPA injections only contain the progesterone hormone which has the main effect of
preventing ovulation with high levels of progestin will inhibit the surge of LH (Lutenizing
Hormone) surge effectively. This will eventually lead to impaired sexual function in the form
of decreased libido and other sexual potency. Level long term low levels of estradiol can
inhibit the growth of the endometrial tissue that lines the uterus, resulting in atrophy (MOH
RI, 2015).

CONCLUSION
There is a relationship Therefore, it is expected for health workers. Providing advice or
counseling about household harmony, reproductive health in injectable family planning

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acceptors who experience sexual libido disorders.

ABBREVIATIONS
DMPA: Depo Medroxy Progesterone Acetate
LH: Lutenizing Hormone
SPSS: Statistic Product Service Solution
FSFI: Female Sexual Function Index
IUD : Intrauterine Device

COMPETING INTEREST
The authors declare that we have no competing financial interests or personal relationships
that could influence the work reported in this study.

AUTHORS’ CONTRIBUTION
The authors conceptualized, designed and prepared the initial draft and framework and
interpreted the data.

ACKNOWLEDGMENT
This research was supported by many people. We would like to thank them for their
contributions.

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