Oral contraception and sexuality

Abstract

A search of the literature has been carried out to determined how oral contraceptives affect sexuality in women. Some studies featured a high incidence of loss of libido. This could perhaps be attributed to preparations containing progestational compounds. However, no adequate double-blind trial has confirmed this observation. Some psychological and pharmacological aspects of contraceptions are discussed. More research is needed to ascertain why women often lose their sexual interest when taking oral contraceptives.

PIP: This reports a search of the literature on the effects of oral contraceptives on loss of libido in women. Little adequate research has been done and reports are conflicting. Those which report loss of libido in 5% or more of women were mostly retrospective studies with an overrepresentation of psychiatric patients or very small sample size. Criteria for a double-blind study are set forth. Female rhesus monkeys demonstrated increased copulatory activity when administered estradiol, decreased with progesterone. Most reports of loss of libido occur with highly protestational compounds. The women who complain about loss of interest in sex have an initial negative attitude toward oral contraceptives, a higher incidence of depression, previous psychiatric symptoms and treatment, and a poor sexual adjustment. These women also discontinue the pill quickly and often become pregnant before seeking alternate contraception. This woman may be threatened by the very thing that increases sexual enjoyment for others, the removal of the fear of pregnancy. She may now have to admit she does not enjoy intercourse for other reasons. It is also recommended decreasing the progesterone content of pill used when a woman complains of loss of libido.