The effect of a drospirenone-containing combined oral contraceptive on female sexual function: a prospective randomised study

Abstract

Objectives: The study investigated the effects on female sexual function of a progestogen-containing combined oral contraceptives (COCs) with an antiandrogenic profile taken in a continuous regimen.

Methods: In this prospective randomised single-institution study, 80 healthy women with a monogamous partner and an active sexual life were randomised into two groups for a period of 3 months. Women in the exposed group (n = 40) took a COCs containing 30 μg ethinylestradiol (EE) and 3 mg drospirenone (DRSP) in a 21/7 regimen. Women in the control group (n = 40) used either a barrier contraceptive method (BCM) or a natural family planning method (NFPM). Participants were asked to complete a set of validated questionnaires to assess sociodemographic variables and measure Female Sexual Function Index (FSFI).

Results: The total FSFI score (p < 0.0001), as well as the desire (p = 0.04) and arousal (p = 0.03) scores, were significantly lower in the COCs group after 3 months of hormonal contraceptive use compared with baseline. Women using BCM or NFPM showed an improvement in total FSFI score (p = 0.02). Hormonal contraception with DRSP increased the likelihood of worse sexual function in the desire (odds ratio [OR] 2.47; 95% confidence interval [CI] 1.22, 4.98; p = 0.01) and arousal domains (OR 2.85; 95%CI 1.34, 5.93; p = 0.005) and in total FSFI score (OR 2.01; 95%CI 1.45, 2.79; p < 0.001). The results remained statistically significant even after adjustment for smoking status.

Conclusions: The study found evidence that women taking a combined EE/DRSP COCs for 3 months may have a worsening of sexual function as measured by FSFI.

Chinese abstract

目的: 本研究探讨按疗程连续服用屈螺酮复方口服避孕药(COCs)具有抗雄激素活性对女性性功能的影响。

方法: 在这一前瞻性随机单中心研究中, 80名有唯一性伴侣和活跃性生活的健康妇女被随机分为两组, 进行3个月的实验。暴露组的女性(n=40)服用含有30μg炔雌醇(EE)和3mg屈螺酮(DRSP)的COCs, 遵循21/7原则。对照组的女性(n=40)使用屏障避孕法(BCM)或自然避孕法(NFPM)。她们被要求完成一套经过验证的调查问卷以评价社会人口统计变量和测量女性性功能指数(FSFI)。

结果: 服用3个月激素类避孕药的COCs组总FSFI分数(p < 0.0001)、欲望分数(p=0.04)和唤起分数(p=0.03)与基线相比显著降低。使用BCM或NFPM的妇女总FSFI分数有所提高(p=0.02)。含DRSP的激素类避孕药增加了在性欲 (比值比[OR] 2.47; 95% 置信区间[CI] 1.22, 4.98; p=0.01)和性唤起 (OR 2.85; 95%CI 1.34, 5.93; p=0.005)方面性功能以及总FSFI分数(OR 2.01; 95%CI 1.45, 2.79; p < 0.001) 变差的可能性。甚至在吸烟状况调整后结果仍有显著的统计学差异。

结论: 本研究证明服用3个月EE/DRSP复方口服避孕药的妇女经FSFI评估有可能性功能变差。

Keywords:

• Combined oral contraceptives
• drospirenone
• female sexual function

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.