Control is an important theme in psychosexual medicine. The matter of who is in control colours many psychosexual problems. Impotence may be a dumb protest against a controlling partner. Desire for sex can evaporate when advances are rebuffed, or one partner demands attention in circumstances that they know are unevenly disempowering. Vaginismus enters self-perpetuating cycles when the woman is kept from being allowed to take charge of herself. Premature ejaculation is frequently a feature of a man frightened of what could happen if his feelings were truly out of control.

Likewise it is useful to look at how contraceptive decisions are made and where the power base lies in the compromise. Many men were keen to explain how their decision had been made jointly with their partner. However, when given the opportunity to talk further it often became clear that one partner had relinquished more control than the other.

In the following sections some of the conscious and unconscious feelings about the common methods are dicussed.

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