Oral Contraception and Female Sexual Dysfunction in Reproductive Women

Abstract

Abstract Introduction Oral contraception (OC) remains one of the most commonly used forms of family planning. It allows couples to continue sexual activity without the worry of unintended pregnancy. However, one possible side effect of OC use is female sexual dysfunction (FSD), of which many patients and even physicians are unaware. This would be counter to the original intent of an OC and thus could affect a couple's relationship. Aim To examine the prevailing evidence on the effect of OCs on FSD in women of reproductive age. Methods A search of PubMed and the Cochrane Central Register of Controlled Trials for all relevant studies was conducted in February 2016. Relevant studies pertaining to OCs and FSD in women of reproductive age were examined. Main Outcome Measures A comprehensive review of the current literature on FSD as measured by the Female Sexual Function Index. Results Most studies indicated that women who use OC pills have decreased sexual desire and libido. OCs also can cause dyspareunia owing to increased risk of vestibulitis and vaginal dryness. This risk is increased if OCs are used in adolescents and the duration of OC use is at least 2 years. Newer OCs containing drospirenone 3 mg plus ethinylestradiol (EE) 30 μg (drospirenone 3 mg + EE 30 μg; Yasmin; Bayer Healthcare Pharmaceuticals, Inc, Berkeley, CA, USA), non-antiandrogenic progestin gestodene 75 μg plus EE 20 μg (gestodene 75 μg + EE 20 μg; Meliane; Bayer Healthcare Pharmaceuticals, Inc), and estradiol valerate plus dienogest (Qlaira; Bayer AG, Leverkusen, Germany) or EE plus levonorgestrel (Jolessa; Teva Specialty Pharmaceuticals, Petah Tikva, Israel; and Seasonale; Duramed Pharmaceuticals, Augusta, GA, USA) do not seem to cause OC-related FSD symptoms. Conclusion This review suggests that OCs can cause FSD in reproductive women. Domains that include female sexual interest and arousal and genito-pelvic pain are affected. Newer OCs such as drospirenone 3 mg plus EE 30 μg (Yasmin) and gestodene 75 μg plus EE 20 μg (Meliane) could be better alternatives because FSD symptoms are less likely to occur.