Sexual Function and Metabolic/Hormonal Changes in Women Using Long-Term Hormonal and Non-Hormonal Contraceptives: A pilot study.

Abstract

Background: Female sexual dysfunction is a common condition that negatively impacts the emotional health and quality of life of the affected individuals. Long-acting reversible contraceptives (LARCs) are becoming increasingly popular due to their effectiveness and convenience. LARCs can be hormonal (etonogestrel releasing implant—ENG and Levonorgestrel intrauterine system—LNG) or non-hormonal (copper intrauterine device—CuIUD and copper-silver intrauterine device—SIUD). There are very few studies that assess the influence on LARCS on sexual function are lacking. This study aimed to assess changes in sexual function as well as metabolic and hormonal parameters in women after implantation with LARCs. Methods: In this prospective cohort study, we assessed 80 women who visited the Military Police Hospital in Brazil for LARCs placement. The study participants were divided into 4 groups according to the type of LARC received: ENG n=17; LNG n=22, CuIUD n=18 and SIUD n=23. The four groups were evaluated twice (prior to LARC placement and approximately 3 months later) for sexual function, using the Female Sexual Function Index (FSFI) and Female Sexual Quotient (QS-F) questionnaires. Metabolic and hormonal parameters were also assessed using blood tests. Results: ENG worsened sexual function according to FSFI and QS-F, across all domains. A decrease in sex hormone-binding globulin (SHBG) between stages was observed for all groups. We observed an improvement in sexual function for non-hormonal LARCs, specially SIUD. However this improvement was not statistically significant. Conclusion: The use of non-hormonal LARCS improved sexual function. Etonogestrel implants, had a negative influence on sexual function, probably by blocking ovarian function, and thus reducing the production of androgens and estrogens.

Effect of Contraceptive Methods on Female Sexual Function

“…regarding IUCD, the current study showed non-significant difference between IUCD users and controls regarding total and domain scores of FSFI. Similarly, the study of Moreira et al (28) showed that sexual function not significantly changed after using either CuIUD (copper intrauterine device), SIUD group (silver intrauterine device) for 3 months with non-significant data suggesting an improvement in sexual function.…”

“…Indeed the current findings can be attributed to the fact that these devices can reduce the fear of unwanted pregnancy, promoting a more relaxed and pleasurable sexual experience and, thus, improving the user's sexual function. This may be possible because a satisfactory sexual response and the perception of sexual pleasure during intercourse is influenced by a complex multifactorial set, involving biological, psychological, and environmental factors (28) .…”