Genital sexual arousal, which includes lubrication and good vaginal blood flow in women, is crucial for healthy sexual functioning. This genital sexual response is regulated by hormones like estrogens and androgens, which can be affected by certain medications. In particular, oral birth control pills, also called oral contraceptive pills (OCPs), are widely used and have a notable effect on the body’s hormone levels. Despite their prevalent use, their influence on sexual function remains unclear.

Some studies suggest that OCPs may affect lubrication, vaginal blood flow, and/or the structure of the vaginal tissues negatively. The authors of a new study sought to expand on this data by examining two different types of OCPs and their effects on women’s sexual arousal, vaginal health, and sexual arousal disorder.

A total of 130 sexually active women between the ages of 18 to 35 participated in this study. Of the 130 participants, 59 women were naturally cycling, so they formed the control group. Fifty women were taking androgenic OCPs, which have a mild effect on increasing the levels of androgens, like testosterone, in the body. The remaining 21 women were taking antiandrogenic OCPs, which reduce the levels of androgens in the body.

The researchers explored the effects that the different types of OCPs can have on one’s genital sexual arousal by using the following tools: a vaginal photoplethysmograph to assess genital blood flow, Schirmer Tear Test strips to detect changes in vaginal lubrication, and a 5-item self-reported vulvovaginal atrophy assessment to determine the health of the vaginal tissues.

For the study, participants arrived at a lab, answered a short interview about their sexual arousal, and were given instructions on how to complete the vaginal lubrication measurement, insert the vaginal photoplethysmograph, and attach the heart rate monitoring electrodes. The participants then watched two sexual films while their sexual arousal responses were measured with a short break in between the films. After all the tests, participants filled out demographic self-report surveys.

Ultimately, the researchers observed that the different types of OCPs do affect women’s sexual arousal and vaginal health differently. For example, the study showed that women taking birth control pills with antiandrogenic progestins had lower levels of vaginal blood flow and lubrication compared to those on androgenic pills or no birth control. (The women on androgenic pills showed sexual arousal results between those on antiandrogenic pills and those who were not on birth control at all.)

Furthermore, the data suggested that women taking birth control pills, especially antiandrogenic ones, were more likely to experience female sexual arousal disorder. This finding could be the result of reduced sexual desire due to lower androgen levels in the body.

While birth control pills are very effective for preventing unwanted pregnancy, these findings should be taken into account for patients who are at risk of sexual arousal issues because OCPs may affect this aspect of sexual functioning.

References:

• Handy, A. B., McMahon, L. N., Goldstein, I., & Meston, C. M. (2023). Reduction in genital sexual arousal varies by type of oral contraceptive pill. The Journal of Sexual Medicine, 20(8), 1094-1102. https://doi.org/10.1093/jsxmed/qdad072