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Oral contraceptives vs injectable progestin in their effect on sexual behavior

Published:August 30, 2010DOI:https://doi.org/10.1016/j.ajog.2010.07.024

      Objective

      We sought to compare sexual function and hormone concentrations in combined oral contraceptive (COC) and injectable progestin users.

      Study Design

      Sexually active COC and depot medroxyprogesterone acetate (DMPA) users completed the Female Sexual Function Index (FSFI) questionnaire, a demographic data form, and had serum testosterone and estradiol levels measured. Multiple linear regression was used to measure associations of interest.

      Results

      Among 50 subjects enrolled, COC users had lower levels of free testosterone compared to DMPA users (0.2 vs 0.6 pg/mL; P < .0001) and higher levels of estradiol (75.8 vs 62.8 pg/mL; P = .0057), but scores of desire (4.2 vs 3.8; P = .27), scores of arousal (5.0 vs 4.8; P = .46), or total scores (30.1 vs 28.8; P = .28) were no different. Demographic characteristics were similar except for ethnicity, level of education, gravidity, parity, and frequency of intercourse. In multivariate analysis, birth control type was not significantly associated with desire score or total FSFI score.

      Conclusion

      While users of COC and DMPA have significantly different sex hormone levels, they are not different in sexual function as measured by the FSFI.

      Key words

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      References

        • Davis A.R.
        • Castano P.M.
        Oral contraceptives and libido in women.
        Annu Rev Sex Res. 2004; 15: 297-320
        • Schaffir J.
        Hormonal contraception and sexual desire: a critical review.
        J Sex Marital Ther. 2006; 32: 305-314
        • Sanders S.A.
        • Graham C.A.
        • Bass J.L.
        • Bancroft J.
        A prospective study of the effects of oral contraceptives on sexuality and well-being and their relationship to discontinuation.
        Contraception. 2001; 64: 51-58
        • Davis S.
        The clinical use of androgens in female sexual disorders.
        J Sex Marital Ther. 1998; 24: 153-163
        • Panzer C.
        • Wise S.
        • Fantini G.
        • et al.
        Impact of oral contraceptives on sex hormone-binding globulin and androgen levels: a retrospective study in women with sexual dysfunction.
        J Sex Med. 2006; 3: 104-113
        • Alexander G.M.
        • Sherwin B.B.
        • Bancroft J.
        • Davidson D.W.
        Testosterone and sexual behavior in oral contraceptive users and non-users: a prospective study.
        Horm Behav. 1990; 24: 388-402
        • Sarajari S.
        • Wickman D.S.
        • Marin C.M.
        • Berman J.R.
        Pilot study assessing the impact of hormonal contraceptives on serum testosterone levels and sexual function in pre-menopausal women.
        Fertil Steril. 2004; 82: S78-S79
        • Bachmann G.
        • Bancroft J.
        • Braunstein G.
        • et al.
        Female androgen insufficiency: the Princeton consensus statement on definition, classification, and assessment.
        Fertil Steril. 2002; 77: 660-665
        • Jeppsson S.
        • Gershagen S.
        • Johansson E.D.
        • et al.
        Plasma levels of medroxyprogesterone acetate, sex-hormone binding globulin, gonadal steroids, gonadotrophins and prolactin in women during long-term use of depo-MPA (Depo-Provera) as a contraceptive agent.
        Acta Endocrinol. 1982; 99 (Copenh): 339-343
        • Li R.H.W.
        • Lo S.S.T.
        • Teh D.K.G.
        • et al.
        Impact of common contraceptive methods on quality of life and sexual function in Hong Kong Chinese women.
        Contraception. 2004; 70: 474-482
        • Matson S.C.
        • Henderson K.A.
        • McGrath G.J.
        Physical findings and symptoms of depot medroxyprogesterone acetate use in adolescent females.
        J Pediatr Adolesc Gynecol. 1997; 10: 18-23
        • Rosen R.
        • Brown C.
        • Heiman J.
        • et al.
        The Female Sexual Function Index: a multidimensional self-report instrument for the assessment of female sexual function.
        J Sex Marital Ther. 2000; 26: 191-208
        • ter Kuile M.M.
        • Brauer M.
        • Laan E.
        The Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS): psychometric properties within a Dutch population.
        J Sex Marital Ther. 2006; 32: 289-304
        • Wiegel M.
        • Meston C.
        • Rosen R.
        The Female Sexual Function Index (FSFI): cross-validation and development of clinical cutoff scores.
        J Sex Marital Ther. 2005; 31: 1-20
        • Davis S.R.
        • Davison S.L.
        • Donath S.
        • Bell R.J.
        Circulating androgen levels and self-reported sexual function in women.
        JAMA. 2005; 294: 91-96
        • Nyunt A.
        • Stephen G.
        • Gibbin J.
        • et al.
        Androgen status in healthy premenopausal women with loss of libido.
        J Sex Marital Ther. 2005; 31: 73-80
        • Greco T.
        • Graham C.A.
        • Bancroft J.
        • Tanner A.
        • Doll H.A.
        The effects of oral contraceptives on androgen levels and their relevance to premenstrual mood and sexual interest: a comparison of two triphasic formulations containing norgestimate and either 35 or 25 μg of ethinyl estradiol.
        Contraception. 2007; 76: 8-17
        • Paul C.
        • Skegg D.C.G.
        • Williams S.
        Depot medroxyprogesterone acetate: patterns of use and reasons for discontinuation.
        Contraception. 1997; 56: 209-214
        • Miller L.
        • Patton D.L.
        • Meier A.
        • Thwin S.S.
        • Hooten T.M.
        • Eschenbach D.A.
        Depomedroxyprogesterone-induced hypoestrogenism and changes in vaginal flora and epithelium.
        Obstet Gynecol. 2000; 96: 431-439
        • Graham C.A.
        • Ramos R.
        • Bancroft J.
        • Maglaya C.
        • Farley T.M.M.
        The effects of steroidal contraceptives on the well-being and sexuality of women: a double-blind, placebo-controlled two-center study of combined and progestogen-only methods.
        Contraception. 1995; 52: 363-369
        • Heiman J.R.
        • Meston C.M.
        Evaluating sexual dysfunction in women.
        Clin Obstet Gynecol. 1997; 40: 616-629
        • Clayton A.H.
        Sexual function and dysfunction in women.
        Psychiatr Clin North Am. 2003; 26: 673-682