The Effect of hormonal contraceptive with anti-androgenic progestin on female sexual function

Abstract

Objective: to investigate the effects of a COCs containing a progestin with anti-androgenic profile (0.03 mg of ethinylestradiol/3 mg of drospirenon) in a continuous-regimen on female's sexual function. Design & methods: in presented prospective, randomized single institution study 80 healthy women with a permanent partner and active sexual life were randomized over two groups according to computer randomize function for 3 cycles. A COC containing 0.03 mg of ethinylestradiol/ 3 mg of drospirenon (EE/DRSP) was administered for the study group (n=40). The control group (n=40) used natural family planning methods and barrier contraception methods (NFPM/BCM). All study participants were asked to fill out a set of validated questionnaires, including the Female Sexual function Index (FSFI) and Dyadic Adjustment Scale (DAS). The main outcome of interest was the changes of total FSFI scores between baseline and cycle 3. Secondary outcomes included the changes of all the FSFI domains, the total DAS scores and all the DAS domains over 3 study cycles. Results: the difference (δ) in mean baseline to 3 months change in sexual function between hormonal contraception method users and non-hormonal contraception method users was significant in arousal (δ = -0.49± SD 1.07 vs δ = -0.53 ± SD 1.47; p= 0.03) and total FSFI scores (δ = 9.56 ± SD 8.50 vs δ = -0.80 ± SD 4.01; p<0.001) of COC users. The use of COCs was found to have no impact on couple's adjustment. No changes of DAS differences (δ) were observed between NFPM/BCM and COC users, p>0.05. Hormonal contraception increased the likelihood of worse sexual function in terms of arousal (OR 2.85; 95% PI1.01-8.04; p=0.04) and the total FSFI score (OR 2.01; 95% PI 1.27-3.19; p=0.003) even after adjusting for the subject\s age (Arousal OR 3.72; 95% PI 1.09-12.66; p=0.04 and the total FSFI score OR 2.03; 95% PI 1.23-3.35; p=0.006) and education level ( Arousal OP 3.08; 95% PI 1.08-8.76; p=0.04 and the total FSFI score O