Birth Control Dilemma

When Neither Partner Wants to Use Birth Control

In heterosexual relationships, birth control decisions can become a major source of conflict when both partners refuse responsibility. One common dilemma: the man does not want to use condoms, and the woman does not want to use hormonal or device-based contraception. Resentment, mistrust, and emotional distance can result as both dig their heels in.

There are real reasons people avoid birth control methods. Some men report reduced physical sensation with condoms. They may also experience psychological resistance, seeing condoms as barriers to intimacy. However, condom use is a shared responsibility, not a burden to avoid. It is currently the only method that protects against both pregnancy and sexually transmitted infections.

For women, hormonal birth control can bring a range of side effects. These include mood changes, lowered libido, weight gain, and medical risks such as blood clots. Devices like IUDs may cause pain or discomfort. Understandably, many women are reluctant to alter their bodies to accommodate sexual activity.

Yet there are positive effects too. Hormonal birth control can regulate periods, reduce menstrual cramps, and lower the risk of certain cancers. Some women feel more sexual freedom knowing pregnancy risk is low.

When neither partner is willing to compromise, the core issue is often relational–not just medical. Each person wants sex without consequences, but without personal sacrifice. This leads to stalemates that breed blame and erode connection. Desire doesn’t often co-exist with fear, frustration, mistrust or disappointment.

Partners facing this must have open, honest conversations about shared responsibility, bodily autonomy, and risk. They must ask: Are we willing to make space for each other’s needs? Are we willing to accept some discomfort in service of intimacy?

Avoiding the discussion leads to more disconnection and neither partner getting their needs for touch fulfilled. Addressing it directly can build stronger, more respectful sexual relationships. There is no “right” answer, however I do encourage engagement and for both partners to try and consider the other’s position and perspective. After all, this tug of war over birth control is likely a snapshot into how they handle other conflicts and consider one another’s needs in the larger relationship.

If you need support in this journey reach out to meet with one of our therapists who can help you navigate some of the couples dynamics that might make it feel tricky to discuss. If you’re interested, we’re here to help—visit Riviera Therapy.

Do you have sexy topics you want discussed? Reach out and let Dr. Jenn know.