Sexual Behavior and Oral Contraception: A Pilot Study

Abstract

Introduction Oral contraceptives (OCs) induce mood and libido changes. Aim The aim of this study was to evaluate in young, eumenorrheic, healthy women the sexual behavior and the genital vascular effects of an OC containing 30 µg ethinylestradiol (EE) and 3 mg drospirenone (DRSP). Main Outcome Measures The main outcome measures are McCoy Female Sexuality Questionnaire (MFSQ), the labia minora thickness and vaginal introitus area, the pulsatility index (PI) of clitoral and labia minora arteries, and hormonal and biochemical assays. Methods Twenty-two adult, eumenorrheic, healthy women were administered the two-factor Italian MFSQ. The labia minora thickness was studied by two-dimensional ultrasonographic, and the clitoral and labia minora arteries were evaluated by color Doppler; three-dimensional static volumes of the vulvar area were calculated. Hormonal (estradiol, androstenedione, and testosterone) and biohumoral (sex hormone binding globulin) parameters were assayed. Subjects were studied in baseline conditions and after 3 months of therapy with an OC (Yasmin®, Bayer-Schering Italia, Milan, Italy; −30 µg EE + 3 mg DRSP). Results After 3-month treatment, the labia minora thickness and the vaginal introitus area significantly decreased in comparison with the baseline values, whereas the PI of the dorsal clitoral artery and the posterior labial artery significantly increased. The OC use induced a significant decrease of the two-factor Italian MFSQ score, a reduction of the number of intercourse/week, and a reduction of the frequency of orgasm during intercourse. The item 18 (pain during intercourse) worsened after OC. Conclusions The treatment with Yasmin® (Bayer-Schering Italia) is associated with increased pain during intercourse, with decreased libido and spontaneous arousability, and with diminished frequency of sexual intercourse and orgasm.

Combined Hormonal Contraception and Women’s sexual function: a cross-sectional pilot study in a Cohort of Danish women

“…We found that more women using CHC containing anti-androgenic progestin reported sexual problems and sexual distress than women using CHC containing other progestins. Consistent with our results, Battaglia et al (2012) , in an interventional study of 22 women, reported an increase in pain and a decrease in sexual function, measured using the McCoy Female Sexuality Questionnaire, after 3 months with a CHC containing an anti-androgenic progestin (Battaglia et al 2012). In contrast, Wallwiener et al (2010) found no difference in full-scale FSFI score between women using CHC containing androgenic or anti-androgenic progestins in a cross-sectional setting, and Davis et al (2013) found equal improvement in FSFI Desire and Arousal domain scores in women randomized to CHCs containing either androgenic or anti-androgenic progestin (Davis et al 2013;Wallwiener et al 2010b).…”

“…The reported negative effects of OC on sexual function have mainly been on desire and sexual thoughts, but some reports describe negative effects on lubrication and pain (Battaglia et al 2012; Davis and Castano 2004). Research on OC effects on sexuality show varied results with reports of both improved and worsened sexual function correlated to OC.…”

Restoring testosterone levels by adding dehydroepiandrosterone to a drospirenone containing combined oral contraceptive: II. Clinical effects

“…In some studies the EE/DRSP COC used has been shown to improve the MDQ domains Water retention and Negative affect [40][41][42], but this was not observed in our study. Several publications report positive effects of EE/DRSP COCs on mood and sexual function [40][41][42][43][44][45], whereas others report negative effects [1,2].…”

“…Only a few studies report combined investigations of the effect of COCs on androgens and the occurrence of behavioral side effects and those studies also report conflicting results [1,2,5,27,[46][47][48][49][50][51]. Potential reasons for these inconsistences include differences in subject characteristics such as age, BMI, genetic factors including individual sensitivities to androgen reduction, and differences in study design such as endpoints, type of oral contraception and duration of treatment [3,5,15,27].…”

“…The use of combined oral contraceptives (COCs) has been associated with negative effects on sexual function and mood in some women [1][2][3][4][5][6][7][8][9]. These side effects may result in discontinuation of COCs [7,[10][11][12], and may have an adverse impact on quality of life [13].…”