Combined estrogen-progestin oral contraceptives and female sexuality: an updated review.

IF 3.6 2区 医学 Q1 UROLOGY & NEPHROLOGY Sexual medicine reviews Pub Date : 2024-06-26 DOI:10.1093/sxmrev/qeae011
Jill M Krapf, Andrew T Goldstein
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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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雌激素-孕激素复合口服避孕药与女性性行为:最新综述。
简介:口服联合避孕药(COCs)的性副作用尚未得到充分认识,但越来越多的证据表明,应进行更广泛的风险/效益评估,并将其纳入避孕选择咨询中:本研究旨在探讨雌激素-孕激素联合口服避孕药对女性性欲的影响,包括性欲、泌尿生殖系统解剖变化、润滑、性高潮、前庭大腺炎、幸福感、身体形象、伴侣偏好和关系稳定性:在 2023 年 4 月至 2024 年 1 月期间进行了一项文献综述,探讨复方口服避孕药与性健康之间的关系:结果:尽管COCs会降低游离睾酮,但目前尚不清楚COCs是否会影响性功能,包括性欲。抗雄激素类药物似乎对性兴奋、润滑和性高潮有负面影响。诱发性前庭大腺炎可能与过早服用化学合成药物、低雌激素药片和抗雄激素孕激素有关。情绪和性方面的副作用是导致停用 COC 的重要因素。纵向数据表明,在认识和选择伴侣时使用化学合成物会影响性满意度和关系的持续时间。随着时间的推移,COC 中雌激素和孕激素的剂量和形式发生了变化,这使得数据分析变得复杂:结论:缺乏随机安慰剂对照研究以及研究设计的不确定性,阻碍了关于 COC 对性功能影响的一般性陈述。尽管存在这些挑战,但在介绍和开具激素避孕处方时考虑性功能障碍对于知情同意、共同决策和确保可靠的避孕选择至关重要。
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来源期刊
Sexual medicine reviews
Sexual medicine reviews UROLOGY & NEPHROLOGY-
CiteScore
7.60
自引率
8.30%
发文量
5
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