Het vrouwelijk seksueel verlangen en de invloed van hormonale contraceptie

Abstract

In 1960, the first contraceptive pill was introduced. Nowadays, over 100 million women worldwide use some form of hormonal contraception (HC). General side effects of HC are well known, but research on the effects of HC on female sexual functioning and desire remains underfunded and scarce. Starting with the combined contraceptive pill, most methodologically sound studies found no negative impact on sexual desire in the majority of pill starters, while a negative effect was seen in 15%. When using the vaginal ring, most women didn’t report adverse sexual desire changes, although some studies observed an increase in sexual desire. Too few recent studies investigating the link between the progestogenonly pill, the subdermal implants or the injectable progestin and female sexual functioning were available to make a conclusion on their effect. Next, intrauterine devices (IUD) did not influence sexual functioning in the majority of women. Also, the role of other biopsychosocial factors in the process of female sexual functioning was investigated. HC use led to reduced androgen levels, but most studies didn’t observe an effect on sexual desire. Although most women using HC probably don’t experience change in their sexual functioning, a significant minority will. It is important to pay attention to those at risk for developing an impaired sexual function or even a sexual dysfunction. Female sexual functioning is a complex process, not merely driven by androgens. Our review of the recent literature states the urgent need for prospective, randomized trials, in starters of HC, paying attention to a range of relevant biopsychosocial factors.