Androgens and sexual behaviour in women using oral contraceptives

Abstract

Twenty women using oral contraceptives and complaining of impaired sexual function were compared with twenty women without sexual problems, matched for age and oral contraceptive. Whilst the sexual behaviour differed in the two groups, the plasma testosterone, androstenedione, oestradiol and SHBG concentrations were very similar. The total androgen levels were low in both groups. Plasma testosterone and oestradiol concentrations were correlated with measures of sexual interest in the no-problem group, but not in the problem group. Administration of exogenous androstenedione to women in the problem group, using a double blind cross-over comparison with a placebo, failed to improve their sexual function except in one case. The majority of women showed a rise in androgen and oestradiol between day 24 of one pill cycle and day 4 of the next. The possible behavioural indications of this pattern are discussed.

PIP: Women who complained of sexual impairment which they attributed to use of oral contraceptives (OCs) (n=20) were matched with controls to determine the possible role of androgens in determining normal sexual responsiveness. 2 principal modes of investigation were used: 1) comparison of endocrine status and sex behavior; and 2) administration of exogenous hormones to increase androgen levels (oral androstenedione). Endocrine parameters for hormonal profiles measured were plasma testosterone, androstenedione, estradiol, and sex hormone-binding globulin. In the comparative part of the study, though cases and controls reported varying sexual behavior, their hormonal profiles were virtually identical. In both no-problem and problem groups in the comparative study, total androgen levels were low. Plasma testosterone and estradiol concentrations were correlated with measures of sexual interest in the no-problem group, but not among women reporting sexual problems. In a double-blind crossover manner, women were administered androstenedione if they reported sexual problems; no effect of the exogenous hormone was noted generally, though 1 case reported improvement of sexual function. In most women, a rise in androgen and estradiol was noted between Day 24 of 1 OC cycle and Day 4 of the next, and a positive correlation between assessors' rating of sexual interest and these increased hormone levels is discussed.