孕激素
雌激素
医学
高潮
激素避孕
女性性功能障碍
中止
药丸
性欲
妇科
性功能
生殖健康
人类性学
性功能障碍
生理学
产科
计划生育
人口
内科学
研究方法
环境卫生
性别研究
药理学
社会学
作者
Jill M. Krapf,Andrew T. Goldstein
标识
DOI:10.1093/sxmrev/qeae011
摘要
Abstract Introduction Sexual side effects of combined oral contraceptives (COCs) have not been fully understood, but increasing evidence prompts broader risk/benefit evaluation and merits inclusion in counseling on contraceptive options. Objectives The study sought to explore the impact of combined estrogens–progestin oral contraceptives on components of female sexuality, including sexual desire, anatomic genitourinary changes, lubrication, orgasm, provoked vestibulodynia, well-being, body image, partner preference, and relationship stability. Methods A literature review was performed between April 2023 and January 2024 exploring the association between combined oral contraceptive pills and sexual health. Results Although COCs decrease free testosterone, it is unclear if COCs affect sexual function, including desire. Antiandrogenic COCs do seem to have a negative effect on sexual arousal, lubrication, and orgasm. Provoked vestibulodynia may be related to early onset of COC use, low-estrogen pills, and antiandrogenic progestins. Emotional and sexual side effects are strong predictors of COC discontinuation. Longitudinal data indicate that using COCs when meeting and selecting a partner has implications on sexual satisfaction and relationship length. Analysis of data is complicated by various doses and forms of estrogen and progestin in COCs, which have changed over time. Conclusion Lack of randomized placebo-controlled studies and heterogenicity in study design hampers generalized statements about the effects of COCs on sexual function. Despite these challenges, consideration of sexual dysfunction when presenting and prescribing hormonal contraception is essential for informed consent, shared decision making, and ensuring reliable contraceptive choices.
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