The aim of contraception is to avoid unwanted pregnancies and ensure a satisfactory sexual life free of procreative risks (1). In Spain, the contraceptive method most commonly used by women in their sexual relations is the condom, followed by the pill. It is important to emphasize that there has been no change in the pattern of use since 1997 despite the marketing of many other types of more effective and comfortable contraceptive methods that can be used during sexual intercourse (2). The literature includes studies that analyze the factors associated with the choice of contraceptive in relation to the sexual life of women. These studies highlight variables such as the subjective characteristics of the woman, and the availability and ease of use of the method (3–5).

In addition, the cost associated with unwanted pregnancies is high. The majority of unintended pregnancies (26%) occur in women aged 30–34 years, while an estimated 69% of the total cost burden is attributable to poor adherence to contraceptive methods, with such a cause most likely being avoidable with the intervention of a health professional (6).

Adequate identification of the sexual acceptability of contraceptive methods is key for designing health promotion interventions, assessing their impacts, and increasing their effectiveness. Currently, there are almost no standard instruments in the scientific literature to assess the sexual acceptability of contraceptive methods. Although one tool has been published recently to measure how the contraceptive method affects women’s sexuality, this cannot be used as a means of matching the contraceptive method with women’s sexual preferences (7). Thus, there is a need for instruments that can be used in any context to determine which contraceptive method is preferred by women according to various factors, including their relationships.

This study aimed to develop and validate a Sexual acceptability of Contraceptive Methods questionnaire to explore women’s preferences according to their epidemiological characteristics and their partner relationships. This instrument is called the Sexual Acceptability of Contraceptive Methods Questionnaire [in Spanish, Aceptabilidad Sexual de los Métodos Anticonceptivos (ASMA)].

The study methodology included questionnaire development and validation.

This is one of the first studies to develop and validate a tool to assess the sexual acceptability of contraceptive methods. The ASMA questionnaire evaluates the acceptability of contraceptive methods considering epidemiological factors as well as lifestyle, socioemotional aspects, educational level, and religious beliefs.

Until now, the scientific literature has only presented a single questionnaire for studying the Contraceptive Sexual Acceptability (CSA scale) (7). These authors developed a tool based on the conceptual model of the sexual acceptability of contraception (5, 13, 14). This recent scale provides a measure that asks women to rate their satisfaction with physical (including sexual functioning, quality, frequency of orgasm, and arousal), psychological (emotional openness or capacity for surrender) and interpersonal domains. The CSA scale was created to identify the acceptability of contraceptives and to measure the changes in sexuality that users attribute to a new contraceptive method. This scale is based on classic questionnaires in the literature (FSFI, NSSS), which evaluate the various aspects of female sexual response during the use of contraceptive methods. In this regard, the ASMA scale can be used in women seeking contraception, allowing the clinician to recommend the most suitable method according to the woman’s sexual preferences and particularities.

Caruso et al. (15) analyzed the impact of hormonal contraception on women’s sexuality, focusing on aspects such as their components, route, and regimen (15). In this regard, the ASMA questionnaire was created to identify key elements of the contraceptive sexual acceptability construct. Another novel aspect of our questionnaire instrument compared with that described by Caruso et al. (15) is that the ASMA questionnaire seeks to evaluate women’s preferences according to epidemiological characteristics, where we include age and sexual orientation and type of partner relationship, along with socioeconomic, educational, and religious factors.

The central aim of the ASMA questionnaire was to identify profiles of factors associated with the different types of contraceptives. Therefore, this instrument is the first to comprehensively assess women’s contraceptive needs with the aim of achieving full satisfaction in their sexual relationships.

All of the items included in the scale are critical for evaluating the sexual acceptability of contraceptives. The questionnaire begins with demographic and clinical questions about the woman’s medical history that may affect her sexual relations or preference for a particular type of contraceptive. This is followed by personal and family economic questions, as well as the type of relationship and cohabitation with the partner. All these questions are of great relevance for establishing a woman’s profile for a given type of contraceptive method. In refining this part of the scale, statistically informed decisions were made based on the results of the analysis. The second part of the scale consists of questions related to the reality of their sexual lives, enquiring about aspects that can be influenced by the various contraceptive methods. The responses can then be used as a basis for providing contraceptive counseling.

Although the questionnaire is a helpful tool for contraceptive counseling and prescription, we must always bear in mind that during the consultation the user might also communicate other individual variables not reflected in the questionnaire, and such information could also be decisive in the choice of contraceptive method.

The internal theoretical structure of the initial questionnaire was slightly modified, maintaining 3 factors but slightly changing the way of grouping the items.

However, all these constructs are theoretically consistent and present good internal consistency and reliability. In future studies, it will be useful to explore the correlations between factors.

The datasets presented in this article are not readily available because of data protection law. Requests to access the datasets should be directed to isalahoz@yahoo.com.

Written informed consent to participate in this study was provided by the participants. The studies involving human participants were reviewed and approved by the Aragon Research Ethics Committee-CEICA with protocol number PI20/488.

IL-P: Conceptualization, Investigation, Software, Writing – original draft, Writing – review & editing. AJ-L: Data curation, Methodology, Supervision, Writing – original draft. RJ-V: Funding acquisition, Resources, Visualization, Writing – original draft. IS-A: Funding acquisition, Resources, Visualization, Writing – original draft. RR: Funding acquisition, Resources, Visualization, Writing – original draft. SR-L: Formal analysis, Project administration, Writing – original draft. ST: Methodology, Project administration, Supervision, Validation, Writing – original draft. MD-V: Data curation, Formal analysis, Investigation, Software, Writing – original draft. AL-M: Investigation, Methodology, Resources, Writing – original draft. NM-L: Conceptualization, Formal analysis, Methodology, Supervision, Writing – original draft, Writing – review & editing.