Switching to a different oral contraceptive might improve sexual function for women who have contraceptive-related sexual problems, researchers have found.
Many women experience sexual side effects, including desire and arousal problems, when they take combined oral contraceptives (COCs). Some COCs affect the production of testosterone, a hormone linked to sex drive. When women take these COCs, the ovaries produce less testosterone. Also, the production of sex hormone-binding globulin (SHBG) increases, limiting the amount of free testosterone.
Combined, these effects can interfere with sexual function. Some experts believe that changing the medication to one that contains an androgenic progestin – one that does not affect testosterone as much – will help.
Researchers from Europe and Australia felt that evidence for this theory was lacking, however.
Their study, published online last month in the Journal of Sexual Medicine, examined two types of COCs. One, estradiol valerate /dienogest (E2V/DNG), contained an anti-androgenic progestin; the other, ethinyl estradiol/levonorgestrel (EE/LNG) contained an androgenic progestin.
Two hundred seventeen women between the ages of 18 and 50 (mean age 30.5) participated in the study. All of the women were taking a COC that they believed was diminishing their sexual desire.
The women were randomized into two treatment groups. One received E2V/DNG; the other received EE/LNG. Each medication was dispensed in 28-day cycles for 6 cycles.
Periodically throughout the cycles, the women were checked for adverse events. They also completed assessments on their sexual function, vaginal health, psychological well-being, and levels of distress associated with sexual dysfunction.
One hundred ninety-one women finished the study.
Women in both groups saw improvements in sexual function, with scores on the desire and arousal domains of the Female Sexual Function Index (FSFI) increasing a mean of 5.90 points for the E2V/DNG group and a mean of 5.79 points for the EE/LNG group.
Overall scores on the FSFI also improved, along with scores on distress and vaginal health assessments.
“That both COCs improved desire and arousal in conjunction with lessened personal distress is likely to have positive follow-on effects in terms of relationship satisfaction and well-being,” the authors commented.
The researchers noted that these findings cannot be generalized to other types of oral contraceptives.
However, they explained that their results “[challenge] the perception that COCs containing anti-androgenic progestins have a detrimental effect on sexual function relative to those containing androgenic progestins.”
Resources
The Journal of Sexual Medicine
Davis, Susan, MD, PhD, et al.
“Change to Either a Nonandrogenic or Androgenic Progestin-Containing Oral Contraceptive Preparation is Associated with Improved Sexual Function in Women with Oral Contraceptive-Associated Sexual Dysfunction”
(Full-text. First published online: September 12, 2013)
http://onlinelibrary.wiley.com/doi/10.1111/jsm.12310/full