https://orcid.org/0000-0002-1387-0932
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Abstract
Purpose
To correlate the sexual desire levels with sexual hormone binding globulin and free androgen index in women taking different types of hormonal contraceptives (HCs) containing ethinylestradiol (EE), oestradiol valerate (E2V), 17β-oestradiol (E2), or estetrol (E4), combined or in phasic formulation with different progestogens having antiandrogenic properties.
Methods
Three hundred and sixty-seven women (age range 18-46) participated in the study. SHBG and total testosterone (TT) were measured, and the Free Androgen Index (FAI) was calculated. The Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS) questionnaires were used to assess sexual function and distress, respectively.
Results
The highest SHBG values and the lowest FAIs were obtained of women on HCs containing EE than those of women on HCs containing E2V/17β E2 or E4 (p < 0.001). Desire scores and FSFI total scores were lower in women on HCs with EE than in those using HCs containing E2V, 17β E2, or E4 (p ≤ 0.001). The women who were on HCs containing EE reported FSDS levels higher than those containing all the other types of oestrogen. Finally, sexual desire and FSFI total scores had a negative correlation with the SHBG values and a positive correlation with FAI percentage (p ≤ 0.0001).
Conclusions
A minority of women using HCs with EE might experience a decreased sexual desire. This was not observed in women on HCs containing E2V, 17 E2, or E4. To avoid HC discontinuation, due to sexual desire reduction, HCs having minor antiandrogenic effects could be taken into consideration.
摘要
目的: 研究服用含有炔雌醇(EE)、戊酸雌二醇(E2V)、17β-雌二醇(E2)或雌四醇(E4)的不同类型激素避孕药(HCs)的女性的性欲水平与性激素结合球蛋白(SHBG)和游离雄激素指数的相关性, 这些HCs可以单独使用或与具有抗雄激素作用的不同孕激素混合使用。
方法: 共有367名女性(年龄范围18-46岁)参与了研究。测定了SHBG和总睾酮(TT), 并计算游离雄激素指数(FAI)。使用女性性功能指数(FSFI)和女性性困扰量表(FSDS)问卷评估了性功能和困扰。
结果: 与使用含有E2V、17β-E2或E4的HCs的女性相比, 使用含有EE的HCs的女性的SHBG值最高, FAI值最低(p < 0.001)。使用含有EE的HCs的女性的性欲得分和FSFI总分低于使用含有E2V、17β-E2或E4的HCs的女性(p ≤ 0.001)。使用含有EE的HCs的女性报告的FSDS水平高于含有其他类型雌激素的HCs的女性。最后, 性欲和FSFI总分与SHBG值呈负相关, 与FAI百分比呈正相关(p ≤ 0.0001)。
结论: 少数使用含有EE的HCs的女性可能会出现性欲降低。而使用含有E2V、17β-E2或E4的HCs的女性没有观察到这种情况。为避免因性欲减退而停用HC, 可以考虑使用具有较小抗雄激素作用的HCs。
Disclosure statement
The authors report no conflicts of interest. The authors alone are responsible for the content and the writing of the paper.