A multivariate analysis of the factors that influence the modification of sexual desire in oral hormonal contraceptive (OC) users

Mariano Martin-Loeches, Yadira Pallas, Pedro Lopez Sanchez, Manuel Lloret, Jose Jesús Lopez-Galvez

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DOI: 10.4236/ojog.2011.13024                

Abstract

Objective. This work studied the influencing factors of age, level of education, family planning awareness, relationship with partner, the age at which sexual relationships were initiated, parity, the method of contraceptive previously used, the type of contraceptive pill used and the duration of oral hormonal contraception (OC) use in relation to the modification of sexual desire in OC users. Materials and Methods. Prospective study of 760 OC users at the Family Planning Center “Marina Alta” in Alicante (Spain). A logistical regression analysis was carried out to study the relative risk of reduction in libido, taking other risk factors into account. Results. In the simple analysis, women who initiated sexual relationships between 18 and 25 years of age had a lower sexual desire in comparison with women who were sexually active before the age of 18 (OR = 2.11; CI: 1.15 - 3.91). Nulliparous women had a reduced sexual desire compared with those women that had given birth (OR = 2.32; CI: 1.41 - 3.82). An OC use of between 6 months and 1 year reduced sexual desire in comparison with a use of less than 6 months (OR = 0.24; CI: 0.09 - 0.64). In the multivariate analysis, age (OR = 1.12; CI: 1.01 - 1.21) and the use of OC within an initial 6 month to a year period (OR = 0.24; CI: 0.09 - 0.64) presented a statistically significant relationship with the modification of sexual desire. The level of education, family planning awareness, relationship with partner, the method of contraception previously used and the type of contraceptive pill prescribed showed no statistical significance with the modification of sexual desire in OC users. Conclusions. Sexual desire in OC users decreases as a woman’s age increases and in an early stage of use in the first six months after beginning OC treatment.

Keywords

Oral Contraceptive; Sexual Desire; Sex Hormones

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Van, L.R.H. and Laan, E. (1997) Sex, hormones and brain. The European Journal of Contraception and Reproductive Health Care, 2, 247-251. doi:10.3109/13625189709165302
[2]	Bancroft, J. (1991) Oral, contraceptives, androgens and the sexuality of young women: I. A comparison of sexual experience, sexual attitudes and gender role in oral contraceptive users and nonusers. Archives of Sexual Behavior, 20, 105-120. doi:10.1007/BF01541938
[3]	Bancroft, J. (1991) Oral contraceptives, androgens and the sexuality of young women: II. the role of androgens. Archives of Sexual Behavior, 20, 121-135. doi:10.1007/BF01541939
[4]	Davis, A.R. and Castano, P.M. (2004) Oral contraceptives and libido in women. Annual Review of Sex Research, 15, 297-320.
[5]	Bamji, M.S. (1985) Vitamin supplements to Indian women using low dosege oral contraceptives. Contraception, 32, 405-416. doi:10.1016/0010-7824(85)90044-7
[6]	Greco, T., Graham, C.A., Bancroft, J., Tanner, A. and Doll, H.A. (2007) The effects of oral contraceptives on androgen levels and their relevance to premenstrual mood and sexual interest: A comparison of two triphasic formulations containing norgestimate and either 35 or 25 microg of ethinyl estradiol. Contraception, 76, 8-17. doi:10.1016/j.contraception.2007.04.002
[7]	Stuckey, B.G. (2008) Female sexual function and dysfunction in the reproductive years: The influence of endogenous and exogenous sex hormones. Journal of Sexual Medicine, 5, 2282-2290. doi:10.1111/j.1743-6109.2008.00992.x
[8]	Strufaldi, R., Pompei, L.M., Steiner, M.L., Cunha, E.P., Ferreira, J.A. et al. (2010) Effects of two combined hormonal contraceptives with the same composition and different doses on female sexual function and plasma androgen. Contraception, 82, 147-154. doi:10.1016/j.contraception.2010.02.016
[9]	Meuwissen, I. and Over, R., (1992) Sexual arousal across phases of the human menstrual cycle. Archives of Sexual Behavior, 21, 101-119. doi:10.1007/BF01542588
[10]	Warner, P. and Bancroft, J. (1988) Mood, sexuality, oral contraceptives and the menstrual cycle. Journal of Psychosom Research, 32, 417-427. doi:10.1016/0022-3999(88)90025-6
[11]	Creatsas, G.K. (1993) Sexuality: Sexual activity and contraception during adolescence. Current Opinion Obstetrics and Gynecology, 5, 774-783.
[12]	Wallwiener, C.W., Wallwiener, L.M., Seeger, H., Muco, A.O., Bitzer, J. and Wallwiener, M. (2010) Prevalence of sexual dysfunction and impact of contraception in female German medical students. Journal of Sexual Medicine, 7, 2139-2148.
[13]	Taylor, J.F., Rosen, R.C. and Leiblum, S.R. (1994) Self-report assessment of female sexual function: Psychometric evaluation of the brief index of sexual functioning for women. Archives of Sexual Behavior, 23, 627- 643. doi:10.1007/BF01541816
[14]	Rosen, R., Brown, C., Heiman, J. et al. (2000) The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex Marital Therapy, 26, 191-208. doi:10.1080/009262300278597
[15]	Van G.S.H., Wiegant, V.M., Endert, E., Helmond, F.A. and Van, D.P.N.E. (1997) Psychoendocrinological assement of the menstrual cycle: The relationship between hormones, sexuality and mood. Archives of Sexual Behavior, 26, 359-382. doi:10.1023/A:1024587217927
[16]	Lindman, R.E., Koskelainen, B.M. and Eriksson, C.J. (1999) Drinking, menstrual circle and female sexuality: A diary study. Alcohology Clinical Experiment Research, 23, 169-173.
[17]	Graham, C.A. (1993) The relationship between mood and sexuality in women using an oral contraceptive as a treatment for premenstrual symptoms. Phychoneuro, 4, 273-281. doi:10.1016/0306-4530(93)90024-F
[18]	Gladkova, A.I. (1999) The regulation of male sexual behavior by the sex hormones. Usp Fiziol Nauk, 30, 97-105.
[19]	Alexander, G.M. (1993) Sex steroids, sexual behavior and selection attention for erotic stimuli in women using oral contraceptives. Psychoneuro, 18, 91-102. doi:10.1016/0306-4530(93)90060-X
[20]	Hutchinson, K.A. (1995) Androgens and sexuality. American Journal of Medicine, 98, 111-115. doi:10.1016/S0002-9343(99)80068-0
[21]	Warnock, J.K., Clayton, A., Croft, H., Segraves, R. and Biggs, F.C. (2006) Comparison of androgens in women with hypoactive sexual desire disorder: Those on combined oral contraceptives (COCs) versus those not on COCs. Journal of Sexual Medicine, 3, 8788-8882. doi:10.1111/j.1743-6109.2006.00294.x
[22]	Graham, C.A., Ramos, R., Bancroft, J., Maglaya, C. and Farley, T.M. (1995) The effects of steroidal contraceptives on the well-being and sexuality of women: A double-blind, placebo-controlled, two-centre study of combined and progestogen-only methods. Contraception, 52, 363-369. doi:10.1016/0010-7824(95)00226-X
[23]	Sabatini, R. and Casiano, R. (2006) Comparison profiles of cycle control, side effects and sexual satisfaction of three hormonal contraceptives. Contraception, 74, 220-223. doi:10.1016/j.contraception.2006.03.022
[24]	Bastianelli, C. (1993) Estroprogesticini e desiderio sessuale. Giorn It Ost Gin, 9, 655-657.
[25]	Renier, M. (1991) Poen prospective multicentric trial with a new monophasic contraceptive combination containing gestoden. Contraception, 43, 413-421. doi:10.1016/0010-7824(91)90132-Y
[26]	Gomez, M.A. (1997) Satisfacción y aceptabilidad de la anticon-cepción hormonal oral y del dispositivo intrauterino. Clin Inves Gin Obst, 24, 144-150.
[27]	Caruso, S., Iraci, S.M., Agnello, C., Romano, M., Lo, P.L. et al. (2011) Conventional versus extended-cycle oral contraceptives on the Quality of sexual life: Comparison between two regimens containing 3 mg Drospirenone and 20 microg Ethinyl estardiol. Journal of Sexual Medicine, 16, 1743-1761.
[28]	Oddens, B.J. (1999) Women’s satisfaction with birth control: A population survey of physical and psychological effects of oral contraceptives, intrauterine devices, condoms, natural family planning and sterilization among 1466 women. Contraception, 59, 277-286. doi:10.1016/S0010-7824(99)00034-7
[29]	Byne, W. and Parsons, B. (1993) Human sexual orientation. The biologic theories reappraised. Archives of General Psychiatry, 50, 228-239.
[30]	Lachowsky, M. (1996) What did hormonal contraception change for women. Contracept Fertil Sex, 24, 816-818.
[31]	McCoy, N.L. (1996) Oral contraceptives and sexuality in university women. Archives of Sexual Behavior, 1, 73-90. doi:10.1007/BF02437907