Change to either a nonandrogenic or androgenic progestin-containing oral contraceptive preparation is associated with improved sexual function in women with oral contraceptive-associated sexual dysfunction

Published, Journal of Sexual Medicine online September 12, 2013

Combined oral contraceptive pills (COC) contain both an oestrogen and a progestin. Some contain a progestin that has testosterone-like action (androgenic) and others contain a progestin that acts as an anti-androgen. Pills with anti-androgen progestins are often prescribed for women with acne or excess body pair, and are very often used for women with polycystic ovarian syndrome.

It is a commonly held belief that COCs containing a androgenic progestin may be less likely to impair sexual function than COCs containing an anti-androgenic progestin. So we undertook a study to address this.

213 women from 32 centres in Australia, Austria, Belgium, Germany, Italy, Spain, and Thailand participated in this study between January 2009 and July 2010. To participate a woman was required to have developed impaired sexual function while using her present contraceptive. Women were then randomised to receive either a COC containing estradiol valerate +dienogest (anti-androgenic progestin) or ethinyl estradiol + levonorgestrel (androgenic progestin) and took their treatment over 6 cycles.

Of 276 women screened, 213 received treatment and 191 completed the study. Both groups demonstrated a mean increase in sexual desire and arousal measured by the Females Sexual Function Index, compared to baseline with no difference between the groups. Both COCs reduced the distress associated with female sexual dysfunction, as indicated by reduced female sexual distress questionnaire scores.

This study dispels the myth that COCs containing anti-androgenic progestins have adverse effects on female sexual function compared to other COCs.

Davis SR, Bitzer J, Giraldi A, Palaccios S, Parke S, Serrani M, Mellinger U and Nappi R. Change to Either a Non-Androgenic or Androgenic Progestin-Containing Oral Contraceptive Preparation is Associated with Improved Sexual Function in Women with Oral Contraceptive-Associated Sexual Dysfunction J Sex Med 2013 Sep 12.