Sexual function, serum and hair testosterone levels after three months use of a combined oral contraceptive or placebo - a randomized, double-blind, controlled multicenter trial
ESC Congress Library. Lundin C. May 10, 2018; 208151; ESC219
Cecilia Lundin
Cecilia Lundin
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Abstract Background: Ever since its introduction, the effect of combined oral contraceptives on sexual function has been discussed, but causality has not been sufficiently investigated. Two recent randomized clinical trials have suggested that two combined oral contraceptives, containing ethinyl-estradiol and two different progestogens, affect some aspects of sexual function. Objective: This study aimed to investigate if an estradiol-containing combined oral contraceptive influences sexual function variables. Study Design: Healthy, non-obese women (n = 202) were included in this investigator-initiated, randomized, double-blinded, placebo-controlled clinical trial where a combined oral contraceptive (1.5 mg estradiol and 2.5 mg nomegestrol acetate) or placebo was administered during three 24/4 treatment cycles. Sexual function at baseline and during the last week of the final treatment cycle was evaluated by the McCoy Female Sexuality Questionnaire. Serum and hair testosterone levels were assessed at the same time points. Results: Compared to placebo, combined oral contraceptive use was associated with a decrease in sexual interest (combined oral contraceptive median change score: -2.0; interquartile range (IQR): -5.0-0.5 vs. placebo: -1.0; IQR: -3.0-2.0) and vaginal lubrication (combined oral contraceptive median change score: -2.0; IQR: -3.0-1.0 vs. placebo: 0; IQR: -1.0-2.0). However, the proportion of women who reported a clinically relevant deterioration in sexual interest and vaginal lubrication did not differ between women allocated to combined oral contraceptive or placebo. Change in other measured aspects of sexual function as well as total score of sexual function did not differ between the two treatments. Testosterone levels in hair remained unchanged throughout the study. Conclusions: In line with other recent randomized clinical trials, this study suggests that combined oral contraception, also including estradiol, is associated with reduced sexual interest and decreased lubrication. However, the changes are minute, and probably not clinically relevant.
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