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Gassen J, Mengelkoch S, Shanmugam D, Pearson JT, van Lamsweerde A, Benhar E, Hill SE. Longitudinal changes in sexual desire and attraction among women who started using the Natural Cycles app. Horm Behav 2024; 162:105546. [PMID: 38640590 DOI: 10.1016/j.yhbeh.2024.105546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 04/21/2024]
Abstract
Many women experience sexual side effects, such as decreased libido, when taking hormonal contraceptives (HCs). However, little is known about the extent to which libido recovers after discontinuing HCs, nor about the timeframe in which recovery is expected to occur. Given that HCs suppress the activities of multiple endogenous hormones that regulate both the ovulatory cycle and women's sexual function, resumption of cycles should predict libido recovery. Here, using a combination of repeated and retrospective measures, we examined changes in sexual desire and partner attraction (among partnered women) across a three-month period in a sample of Natural Cycles users (Survey 1: n = 1596; Survey 2: n = 550) who recently discontinued HCs. We also tested whether changes in these outcomes coincided with resumption of the ovulatory cycle and whether they were associated with additional factors related to HC use (e.g., duration of HC use) or relationship characteristics (e.g., relationship length). Results revealed that both sexual desire and partner attraction, on average, increased across three months after beginning to use Natural Cycles. While the prediction that changes in sexual desire would co-occur with cycle resumption was supported, there was also evidence that libido continued to increase even after cycles resumed. Together, these results offer new insights into relationships between HC discontinuation and women's sexual psychology and lay the groundwork for future research exploring the mechanisms underlying these effects.
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Affiliation(s)
- Jeffrey Gassen
- Texas Christian University, Department of Psychology, 2955 S. University Dr., Fort Worth, TX 76129, United States of America; University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, UCLA Medical Plaza 300, Los Angeles, CA 90095-7076, United States of America.
| | - Summer Mengelkoch
- Texas Christian University, Department of Psychology, 2955 S. University Dr., Fort Worth, TX 76129, United States of America; University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, UCLA Medical Plaza 300, Los Angeles, CA 90095-7076, United States of America
| | - Divya Shanmugam
- Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, Cambridge, MA 02139, United States of America
| | - Jack T Pearson
- Natural Cycles Nordic AB, Sankt Eriksgatan 63 B, 112 34 Stockholm, Sweden
| | | | - Eleonora Benhar
- Natural Cycles Nordic AB, Sankt Eriksgatan 63 B, 112 34 Stockholm, Sweden
| | - Sarah E Hill
- Texas Christian University, Department of Psychology, 2955 S. University Dr., Fort Worth, TX 76129, United States of America
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Schmidt NM, Hennig J, Munk AJL. Interplay between sexual excitation and inhibition: impact on sexual function and neural correlates of erotic stimulus processing in women. Front Behav Neurosci 2024; 18:1386006. [PMID: 38813468 PMCID: PMC11133591 DOI: 10.3389/fnbeh.2024.1386006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/26/2024] [Indexed: 05/31/2024] Open
Abstract
Background As outlined by the dual control model (DCM), individual differences in the regulation of sexual arousal following sexual stimulation depend on two distinct neurophysiological processes: sexual excitation (SE) and sexual inhibition (SI). Although associations with sexual function, behavior, and cue processing have been demonstrated in previous research, underlying neural correlates remain insufficiently explored. Moreover, interactive effects of SE/SI as proposed by the DCM, as well as factors impacting SE/SI properties, such as the use of oral contraceptives (OCs), have not received adequate attention in existing research. Methods 90 healthy, sexually active women (n = 51 using OCs, n = 39 naturally cycling) completed an Emotional-Picture-Stroop-Paradigm (EPSP) while a 64-channel EEG was recorded. LPP amplitudes toward erotic and neutral stimuli were consecutively computed as a marker of motivational salience and approach motivation. Additionally, women provided self-reports of SE/SI and sexual function. Moderation analyses were performed to assess interactive effects of SE/SI in predicting LPP amplitudes and sexual function. Results Sexual function was negatively associated with SI levels but unrelated to SE. Higher SI was associated with reduced LPP amplitudes in response to erotic stimuli. This negative association was, however, attenuated for women high in SE, suggesting interactive effects of SE/SI. Furthermore, women using OCs reported lower SE compared to naturally cycling women. Conclusion The observed findings provide additional psychophysiological evidence supporting the DCM and underscore the relevance of interactive SE/SI effects in stimulus processing and approach motivation. They also highlight the possible impact of OCs on psychosexual variables that warrants further research.
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Affiliation(s)
- Norina M. Schmidt
- Department of Differential and Biological Psychology, Justus-Liebig-University Giessen, Giessen, Germany
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Kohler T, Guidry JPD, Perrin P, Laestadius L. Oh Baby! A Content Analysis of Contraception Pins on Pinterest. HEALTH EDUCATION & BEHAVIOR 2023; 50:783-791. [PMID: 36734320 DOI: 10.1177/10901981231152238] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Social media platforms have become a popular source for health information despite concerns about the quality of content shared. We examined how oral contraceptive pills and intrauterine devices are framed on the platform Pinterest using the Health Belief Model (HBM), as well as how fertility awareness methods are portrayed as an alternative to hormonal contraception. METHODS We collected pins in February 2021 using searches for birth control, oral contraceptives, and intrauterine devices. After excluding paid ads and pins not relevant to contraceptive use, we conducted a content analysis of 404 pins using a coding framework grounded in the HBM. We carried out descriptive statistics for all variables in the final sample. RESULTS Following coding, we found that 54.7% of pins mentioned oral contraceptive pills, 41.58% mentioned intrauterine devices, and 11.63% mentioned fertility awareness methods. Fertility awareness pins had the highest percentage of benefits conveyed (70.21%), followed by intrauterine devices (44.05%), then oral contraceptive pills (38.91%). Pill pins had the highest percentage of barriers conveyed (52.94%) and fertility awareness had the least (25.53%). Side effects were the most mentioned barrier among pill (37.10%) and intrauterine device pins (23.21%). Very few pins were made by (2.48%) or originated with medical institutions (5.45%). CONCLUSIONS Oral contraceptive pills are often negatively framed on Pinterest, whereas intrauterine devices and fertility awareness methods are more positively framed. This suggests a need for clear communication from clinicians regarding all contraceptive options and their relative merits and risks.
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Affiliation(s)
| | | | - Paul Perrin
- University of Virginia, Charlottesville, VA, USA
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The effects of smoking on female sexual dysfunction: a systematic review and meta-analysis. Arch Womens Ment Health 2022; 25:1021-1027. [PMID: 36445469 DOI: 10.1007/s00737-022-01281-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/24/2022] [Indexed: 12/02/2022]
Abstract
The increased number of female smokers is considered a global health challenge in recent years. One of the detrimental effects of smoking is sexual hormone fluctuation causing female sexual dysfunction (FSD). This systematic review and meta-analysis aimed to investigate the effects of smoking leading to FSD. Electronic databases (PubMed, Scopus, Web of Science, Embase, Science Direct, and Google Scholar) were hired for systematic searching. Until June 2022, whole qualified studies reporting the consequences of smoking on FSD were gathered for data analysis based on the random effects model (CMA software, v.2). Study heterogeneity and publication bias were also assessed using I2 index and Egger test, respectively. Ten eligible studies with a sample size of 15,334 female smokers (18-79 years) were selected. Following data analysis, the odds ratio representing the effects of smoking on FSD was found 1.48 (95%CI: 1.2-1.83), indicating that female smokers were 48% more susceptible to FSD than non-smokers. Also, the publication bias was reported as non-significant (p = 0.178). Since smoking is an increasingly common phenomenon in females and women smokers are 48% more susceptible to the FSD, preparation of necessary health measures by the health policymakers to reduce the number of female smokers and subsequent health services seems necessary.
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Negri M, de Souza E, Torloni MR, Ribeiro MC, Araujo E, Guazzelli CAF. Sexual function in Brazilian female adolescents and young adults: a cross-sectional study. Rev Assoc Med Bras (1992) 2022; 68:1210-1215. [PMID: 36228252 PMCID: PMC9575009 DOI: 10.1590/1806-9282.20220232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/23/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate and compare the sexual function of Brazilian adolescents and young women who were using popular contraceptive methods. METHODS This cross-sectional study took place in 2012-2014 in a free family planning clinic of a tertiary teaching hospital in Brazil. Participants were female adolescents (10-19 years) and young adults (20-24 years) who were using barrier (condom) or hormonal contraceptive methods. The Female Sexual Function Index questionnaire was used to assess the sexual function in the last 4 weeks. RESULTS A total of 199 women (128 adolescents and 71 young adults) were included. There were no significant differences in the mean total Female Sexual Function Index scores of adolescents and young adults (26.6±5.7 versus 27.6±6.2, respectively, p=0.264). Compared to young adults, adolescents had significantly lower mean scores for orgasm (3.9±1.5 versus 4.4±1.4, p=0.020) and dyspareunia (4.4±1.6 versus 5.2±1.5, p=0.001; lower scores indicate more dyspareunia). There were no significant differences in the proportion of adolescents versus adults classified as being at risk for sexual dysfunction (38.3 versus 42.3%, p=0.651) or at risk of low desire (18.0 versus 21.1%, p=0.579). CONCLUSION Nearly 40% of Brazilian female adolescents and young adults are at risk for sexual dysfunctional symptoms and 19% have low desire, without significant differences between the two age groups.
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Affiliation(s)
- Mariana Negri
- Universidade Federal de São Paulo, Paulista School of Medicine, Department of Obstetrics – São Paulo (SP), Brazil
| | - Eduardo de Souza
- Universidade Federal de São Paulo, Paulista School of Medicine, Department of Obstetrics – São Paulo (SP), Brazil
| | - Maria Regina Torloni
- Universidade Federal de São Paulo, Paulista School of Medicine, Department of Internal Medicine – São Paulo (SP), Brazil
| | - Meireluci Costa Ribeiro
- Centro Universitário Salesiano de São Paulo, Postgraduate Program in Sex Therapy – São Paulo (SP), Brazil
| | - Edward Araujo
- Universidade Federal de São Paulo, Paulista School of Medicine, Department of Obstetrics – São Paulo (SP), Brazil
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Schäffeler N, Beckmann J, Schenk B, Schöller D, Wallwiener D, Enck P, Teufel M, Zipfel S, Rall K, Brucker S. [Burden of Affected Persons with MRKH Syndrome: Effect of an Intervention to Support Surgical Neovaginal Placement]. Psychother Psychosom Med Psychol 2022; 72:473-480. [PMID: 35504296 DOI: 10.1055/a-1778-5194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The diagnosis of Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS), a rare variant of female sexual development, is usually made during puberty. The uncertainty in self-image and the impos-sibility of becoming pregnant often lead to considerable stress. Although psychosomatic support is consistently recommended in the literature, there have been only a few studies on the psychological aspects of MRKHS. The aim of the present study is to investigate the quality of life or distress of women with MRKHS undergoing neovaginal surgery and, on the other hand, to evaluate effects of the intervention for support during treatment. Methods In an explorative quasi-experimental pre-post study at a national centre for neovaginal surgery, all patients were offered a psychosomatic intervention (intervention group IG, n=23) and their sexual function (FSFI), psychological distress (PHQ-D) and health-related quality of life (SF-12) were assessed before surgery (t0) and six months after (t1). These were compared with data from a sample collected before and after the intervention period (comparison group VG, n=30). Results While the physical quality of life (SF-12) of both groups was unremarkable at both time points, there was a significant impairment in the psychological quality of life. Both groups (IG, VG) improved from t0 to t1 in their sexual function (FSFI) and showed lower depression scores (PHQ-D). The specific intervention developed was well accepted by those affected and rated as helpful. However, this subjectively perceived effectiveness of the intervention was not reflected by improvement on the quality of life scale (SF-12) and depression scale (PHQ-D). Conclusion Those affected show a clear, clinically relevant distress (SF-12), but this is not reflected in the form of psychological comorbidity (PHQ-D). This apparent discrepancy points to psychologically stable women with acute distress due to the diagnosis of variant sex de-evolution. For them, a low-threshold support service with a supportive character seems to be necessary and helpful during the surgical treatment. The reconstructive therapy for the creation of a neovagina seems to have a positive influence on the psychological quality of life. The fact that pregnancy is still not possible due to the missing uterus could be a reason for not reaching the quality of life of the average population.
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Affiliation(s)
- Norbert Schäffeler
- Abteilung Psychosomatische Medizin und Psychotherapie, Medizinische Universitätsklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Julia Beckmann
- Abteilung Psychosomatische Medizin und Psychotherapie, Medizinische Universitätsklinik, Universitätsklinikum Tübingen, Tübingen, Germany.,Institut für transkulturelle Gesundheitsforschung, Duale Hochschule Baden-Württemberg - Villingen Schwenningen, Villingen-Schwenningen, Germany
| | - Bernadette Schenk
- Universitäts-Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Dorit Schöller
- Universitäts-Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | | | - Paul Enck
- Abteilung Psychosomatische Medizin und Psychotherapie, Medizinische Universitätsklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Martin Teufel
- Abteilung Psychosomatische Medizin und Psychotherapie, Medizinische Universitätsklinik, Universitätsklinikum Tübingen, Tübingen, Germany.,Klinik für Psychosomatische Medizin und Psychotherapie, LVR-Klinikum Essen, Essen, Germany
| | - Stephan Zipfel
- Abteilung Psychosomatische Medizin und Psychotherapie, Medizinische Universitätsklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Katharina Rall
- Universitäts-Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Sara Brucker
- Universitäts-Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Germany
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Valeiro C, Matos C, Scholl J, van Hunsel F. Drug-Induced Sexual Dysfunction: An Analysis of Reports to a National Pharmacovigilance Database. Drug Saf 2022; 45:639-650. [PMID: 35386045 DOI: 10.1007/s40264-022-01174-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Sexual dysfunction (SD) is a problem that can affect any phase of the sexual response cycle (such as sexual desire, arousal and orgasm) and individuals of any age. SD can be caused by physical reasons, such as medical conditions, alcoholism or drug abuse; psychological factors, such as stress and anxiety; and different medicines, such as selective serotonin reuptake inhibitors (SSRIs), and their associated adverse effects. AIM The aim of this study was to characterise drugs suspected to have caused SD adverse drug reactions (ADRs) in patients, by conducting a descriptive study based on pharmacovigilance reports. METHODS Reports submitted to the Netherlands Pharmacovigilance Centre Lareb from January 2003 to December 2019 were used to investigate drug-induced sexual disorders. Selected reports had at least one ADR reported in the Medical Dictionary for Regulatory Activities (MedDRA®) System Organ Class (SOC) 'Reproductive system and breast disorders' and the SOC 'Psychiatric disorders' relating to sexual disorders and corrected for drug utilisation (expenditure) for the Dutch population. RESULTS A total of 2815 SD ADRs were reported in the observed period. Data were divided according to three variables: pharmacotherapeutic group, the drug itself, and sex. A total of 722 different SD/pharmacotherapeutic group pairs were observed. The pharmacotherapeutic groups with the highest frequency of SD reports were SSRIs (n = 488, 17.58%), other antidepressants (n = 172, 6.20%) and HMG-CoA reductase inhibitors (n = 149, 5.37%). Distinguishing ADRs by sex, men suffered more from erectile dysfunction, decreased libido and ejaculation disorders, while among women, libido disorders, dyspareunia and SD were the most common ADRs. CONCLUSION Different reactions and disproportionality of reactions were detected between the sexes. Antidepressants, antihypertensives, oral contraceptives, α-blockers, and anti-androgens were the pharmacotherapeutic groups with the highest number of SD reports and corresponding high odds ratios.
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Affiliation(s)
- Carolina Valeiro
- Instituto Politécnico De Coimbra, ESTESC-Coimbra Health School, Farmácia, Coimbra, Portugal
| | - Cristiano Matos
- Instituto Politécnico De Coimbra, ESTESC-Coimbra Health School, Farmácia, Coimbra, Portugal.
| | - Joep Scholl
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
| | - Florence van Hunsel
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
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Alshehri KM, Althobaiti RA, Alqurashi AI, Algethami NE, Alswat KA. Prevalence of Sexual Dysfunction in Women with Type 1, 2 Diabetes and Thyroid Disorder: A Cross-Sectional Study in Taif City, Saudi Arabia. Int J Womens Health 2022; 14:385-394. [PMID: 35321084 PMCID: PMC8937313 DOI: 10.2147/ijwh.s343065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/22/2021] [Indexed: 11/23/2022] Open
Abstract
Background Women with diabetes mellitus or thyroid disorders are at risk of sexual dysfunction. This study aimed to estimate the prevalence of female sexual dysfunction (FSD) in women with diabetes and/or thyroid disorders and the impact of disease control on the ASEX score. Methods A cross-sectional study for female patients who had a routine clinic visits was included. The Arizona Sexual Experience Scale (ASEX) was used to evaluate for FSD. Those with a total score of ≥19 or scored ≥5 on any item or ≥4 on three items were considered to have FSD. Results A total of 253 female patients with a mean age of 39.1 ± 7.3 years were included. Two-thirds of the participants have no FSD. More than half (57.7%) of the participants had a strong desire for sex, and about 20% of the participants were unsatisfied with their orgasm. Compared to those with no FSD, those with FSD had lower BMI (P = 0.375), more likely to have a master's degree or higher (P = 0.117), diabetes (P = 0.879), hypothyroidism (P = 0.625), diabetes-related microvascular and macrovascular complications (P = 0.049), higher HbA1c, fasting glucose, and TSH (P = 0.731, P = 0.161, and P = 0.561, respectively), lower total cholesterol and LDL (P = 0.368 and P = 0.339, respectively), and exercise more regularly (P = 0.929). Conclusion FSD was highly prevalent in our study population. Those with type 1 diabetes had the highest ASEX scores. We showed non-significant negative correlations between total ASEX score and both BMI and TSH, as well as a non-significant positive correlation between total ASEX score and both HbA1c and fasting glucose value.
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Affiliation(s)
- Khalid M Alshehri
- Medicine and Endocrinology, AlHada Armed Forced Hospital, Taif, Saudi Arabia
| | - Raghad A Althobaiti
- Obstetrics and Gynecology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Athar I Alqurashi
- Internal Medicine Department, King Abdulaziz Specialist Hospital, Taif, Saudi Arabia
| | | | - Khaled A Alswat
- Department of Medicine, School of Medicine, Taif University, Taif, 21944, Saudi Arabia
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Schmidt NM, Hennig J, Munk AJL. Event-Related Potentials in Women on the Pill: Neural Correlates of Positive and Erotic Stimulus Processing in Oral Contraceptive Users. Front Neurosci 2022; 15:798823. [PMID: 35058744 PMCID: PMC8764149 DOI: 10.3389/fnins.2021.798823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background/Aims: Exposure toward positive emotional cues with - and without - reproductive significance plays a crucial role in daily life and regarding well-being as well as mental health. While possible adverse effects of oral contraceptive (OC) use on female mental and sexual health are widely discussed, neural processing of positive emotional stimuli has not been systematically investigated in association with OC use. Considering reported effects on mood, well-being and sexual function, and proposed associations with depression, it was hypothesized that OC users showed reduced neural reactivity toward positive and erotic emotional stimuli during early as well as later stages of emotional processing and also rated these stimuli as less pleasant and less arousing compared to naturally cycling (NC) women. Method: Sixty-two female subjects (29 NC and 33 OC) were assessed at three time points across the natural menstrual cycle and corresponding time points of the OC regimen. Early (early posterior negativity, EPN) and late (late positive potential, LPP) event-related potentials in reaction to positive, erotic and neutral stimuli were collected during an Emotional Picture Stroop Paradigm (EPSP). At each appointment, subjects provided saliva samples for analysis of gonadal steroid concentration. Valence and arousal ratings were collected at the last appointment. Results: Oral contraceptive users had significantly lower endogenous estradiol and progesterone concentrations compared to NC women. No significant group differences in either subjective stimulus evaluations or neural reactivity toward positive and erotic emotional stimuli were observed. For the OC group, LPP amplitudes in reaction to erotic vs. neutral pictures differed significantly between measurement times across the OC regimen. Discussion: In this study, no evidence regarding alterations of neural reactivity toward positive and erotic stimuli in OC users compared to NC was found. Possible confounding factors and lines for future research are elaborated and discussed.
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Affiliation(s)
- Norina M. Schmidt
- Department of Differential and Biological Psychology, University of Giessen, Giessen, Germany
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10
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Trigo ACM, Maron CDC, Pinheiro MSDA, da Silva SBL, Brito MB. Female sexual function in women using LARC methods. Gynecol Endocrinol 2022; 38:68-72. [PMID: 34672861 DOI: 10.1080/09513590.2021.1993813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE This study aims to assess sexual function (SF) and quality of life (QoL) among women using copper intrauterine devices (Cu-IUD), levonorgestrel-releasing intrauterine system (LNG-IUS) or etonogestrel(ENG)-releasing subdermal implant. METHODS This is a cross-sectional study involving 213 women who are sexually active, using Cu-IUD, LNG-IUS or ENG implant for at least one year. SF assessment was carried out through the Female Sexual Function Index (FSFI) and QoL was made through The Short Form Health Research. RESULTS Frequency of sexual dysfunction score in Cu-IUD users was 33.8%; 47.2% in LNG-IUS users and 47.8% in ENG-implant users, without difference between groups. Desire domain had higher score in Cu-IUD users (Cu-IUD:4.20 ± 1.15 × LNG-IUS:3.76 ± 1.17 × ENG-implant:3.63 ± 1.15; p = .009). Between Cu-IUD and LNG-IUS users there was no difference in FSFI score. Total FSFI score was higher in Cu-IUD group when compared only to ENG-implant (Cu-IUD:27.48 ± 6.14 × Implant:25.07 ± 6.89; p = .029). Regarding the QoL score, difference was found only in general health domain (Cu-IUD:65.22 ± 14.91 × LNG-IUS:62.61 ± 19.04 × Implant:58.33 ± 16.46; p = .034), with lower score for implant group. CONCLUSION There was no difference in the SF total score between the users of Cu-IUD, LNG-IUS and ENG implant. However, the score of the FSFI desire domain and general health status were higher among users of the Cu-IUD.
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Affiliation(s)
| | | | | | | | - Milena Bastos Brito
- Bahiana School of Medicine and Public Health (BSMPH), Salvador, Brazil
- Department of Gynecology and Obstetrics, Bahia Federal University, Salvador, Brazil
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11
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Dong M, Xu X, Li Y, Wang Y, Jin Z, Tan J. Impact of infertility duration on female sexual health. Reprod Biol Endocrinol 2021; 19:157. [PMID: 34627263 PMCID: PMC8501599 DOI: 10.1186/s12958-021-00837-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 09/25/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Infertility, an important source of stress, could affect sexual life. Extensive studies suggest that the incidence of sexual dysfunction is highly prevalent in infertile women. As the duration of infertility increases, the level of stress is also likely to increase even further, and this could aggravate psychological pain and cause sexual dysfunction. However, the effect of infertility duration on sexual health is unclear. METHODS We conducted a case-control study in which 715 patients participated between September 1,2020 and December 25, 2020. We included patients diagnosed with infertility (aged between 20 to 45), who were divided into four groups according to their infertility durations: ≤ 2 years (Group I, n = 262), > 2 years but ≤ 5 years (Group II, n = 282), > 5 years but ≤ 8 years (Group III, n = 97), and > 8 years (Group IV, n = 74). A questionnaire survey on female sexual functions and psychological depression was administered to participants, and their female sexual functions and depression status were measured using the Female Sexual Function Index (FSFI) and Patient Health Questionnaire (PHQ-9), respectively. RESULTS As the number of years of infertility increased, the PHQ-9 score as well as the incidence of psychological depression increased significantly (p < 0.05), but the total score of FSFI and those of its six domains/sub-scales were not significantly different among the four groups. An analysis of the relevant factors affecting sexual functions, using the multivariable logistic regression model, revealed that when the infertility duration was greater than 8 years, there was a significant increase in the incidence of sexual dysfunction [adjusted odds ratios (AOR) = 5.158, 95% confidence interval (CI): 1.935-13.746, P = 0.001], arousal disorder (AOR = 2.955, 95% CI: 1.194-7.314, P = 0.019), coital pain (AOR = 3.811, 95% CI: 1.045-13.897, P = 0.043), and lubrication disorder (AOR = 5.077, 95% CI: 1.340-19.244, P = 0.017). CONCLUSIONS An increasing infertility duration is a risk factor for the occurrence of sexual dysfunction. Hence, as the infertility duration increases, the incidence of female sexual dysfunction and psychological distress could also increase, especially when the infertility duration is more than 8 years.
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Affiliation(s)
- Meng Dong
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, 110072, Shenyang, China
- Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodelling of Liaoning Province, Shenyang, 110072, China
- School of Life Sciences, China Medical University, Shenyang, 110122, China
| | - Xiaoyan Xu
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, 110072, Shenyang, China
- Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodelling of Liaoning Province, Shenyang, 110072, China
| | - Yining Li
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, 110072, Shenyang, China
- Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodelling of Liaoning Province, Shenyang, 110072, China
| | - Yixian Wang
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, 110072, Shenyang, China
- Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodelling of Liaoning Province, Shenyang, 110072, China
| | - Zhuo Jin
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, 110072, Shenyang, China
- Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodelling of Liaoning Province, Shenyang, 110072, China
| | - Jichun Tan
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, 110072, Shenyang, China.
- Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodelling of Liaoning Province, Shenyang, 110072, China.
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TOPSAKAL Ö, YANIKKEREM E. Evaluation of Sexual Functions in Women Who Used Hormonal or Nonhormonal Contraceptives. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.769735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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13
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van 't Hof SR, Cera N. Specific factors and methodological decisions influencing brain responses to sexual stimuli in women. Neurosci Biobehav Rev 2021; 131:164-178. [PMID: 34560132 DOI: 10.1016/j.neubiorev.2021.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 08/29/2021] [Accepted: 09/06/2021] [Indexed: 11/19/2022]
Abstract
Most of the neuroimaging studies on sexual behavior have been conducted with male participants, leading to men-based models of sexual arousal. Here, possible factors and methodological decisions that might influence brain responses to sexual stimuli, specifically for the inclusion of women, will be reviewed. Based on this review, we suggest that future studies consider the following factors: menstrual phase, hormonal contraception use, history of sexual or psychiatric disorders or diseases, and medication use. Moreover, when researching sexual arousal, we suggest future studies assess sexual orientation and preferences, that women should select visual sexual stimuli, and a longer duration than commonly used. This review is thought to represent a useful guideline for future research in sexual arousal, which hopefully will lead to a higher inclusion of women and therefore more accurate neurobiological models of sexual arousal.
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Affiliation(s)
| | - Nicoletta Cera
- Centre for Psychology at University of Porto -CPUP, Faculty of Psychology and Education Sciences, University of Porto, Portugal
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Tian X, Ruan X, Du J, Wang J, Yin D, Cheng J, Ju R, Mueck AO. Sexual Function in Chinese Women with Polycystic Ovary Syndrome and Correlation with Clinical and Biochemical Characteristics. Reprod Sci 2021; 28:3181-3192. [PMID: 34076876 PMCID: PMC8526448 DOI: 10.1007/s43032-021-00612-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 05/10/2021] [Indexed: 12/20/2022]
Abstract
To investigate sexual function in Chinese women with polycystic ovary syndrome (PCOS) and to explore the correlation with clinical and biochemical characteristics. A cross-sectional study was designed in 1000 PCOS women, aged 18–45 years, via the Chinese version of Female Sexual Function Index (FSFI) evaluating sexual function, with additional questions possibly related to sexual life. Clinical and biochemical characteristics likely to affect sexual function were determined, including anthropometric indicators, serum levels of hormones, luteinizing hormone to follicle-stimulating hormone ratio (LH/FSH ratio), prolactin (PRL), total testosterone (TT), free androgen index (FAI), sex-hormone-binding globulin (SHBG), glucose, and lipid metabolism indicators. Nine hundred ten PCOS women participated in the study, 685 patients were included after screening, and 211 were suitable to detect correlations of clinical and biochemical characteristics with sex function parameters. The mean total FSFI score was 24.19 ± 2.8; 79.56% of the women were at risk of female sexual dysfunction (FSD). Women doing regular aerobic exercise and use of contraception had higher FSFI scores, while those with a desire to conceive and clinical signs of hyperandrogenism had lower FSFI scores. There were negative associations of FSFI scores with age and body fat distribution. No significant associations between FSFI scores and hormonal factors (surprisingly including SHBG) were found, except for total testosterone and satisfaction (OR = 0.976, p = 0.002). HOMA-IR was significantly related to reduced desire score (OR = 0.914, p = 0.004) and lubrication score (OR = 0.964, p = 0.044). PCOS was associated with a high risk of FSD (defined according to FSFI) in about 80% of the women in our study, and clinical characteristics play a more important role.
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Affiliation(s)
- Xuanxuan Tian
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China. .,Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany.
| | - Juan Du
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Juan Wang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Dongmei Yin
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Jiaojiao Cheng
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Rui Ju
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Alfred O Mueck
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.,Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany
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15
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Xiao P, Liu M, Cui L, Ding S, Xie J, Cheng AS. Sexual dysfunction and activity avoidance in female kidney transplant patients. Clin Transplant 2021; 35:e14363. [PMID: 33998698 DOI: 10.1111/ctr.14363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/27/2021] [Accepted: 05/10/2021] [Indexed: 02/05/2023]
Abstract
Sexual dysfunction is common after kidney transplantation and has an adverse effect on patients' quality of life. This paper aims to evaluate the female sexual function, activity avoidance, and kidney function among a convenience sample of patients who had a kidney transplant. A cross-sectional study was conducted that included 250 patients had undergone a kidney transplant procedure >3 months ago, from multiple transplant centers and answered a self-reported sociodemographic questionnaire, the female version of the Arizona Sexual Experience Scale, and the Tampa Scale for Kinesiophobia-13. A correlation was found between sexual function and activity avoidance (r = .361, p < .001, n = 250) as well as between activity avoidance and kidney function (r = .198, p = .012, n = 250). Less education, having no child, post-transplant time for <36 months, and smoking (active and passive) were risk factors for female sexual dysfunction after kidney transplantation. The results suggest that physicians that the importance of recognize the relationship between fear of sexual activity and sexual function and that they should provide patients with more education and guidance on post-transplant sexual behaviors.
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Affiliation(s)
- Panpan Xiao
- Xiangya Nursing School, Central South University, Changsha, China
| | - Min Liu
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Lina Cui
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Siqing Ding
- The Third Xiangya Hospital, Central South University, Changsha, China.,Clinical Nursing Safety Management Research Center, Central South University, Changsha, China
| | - Jianfei Xie
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Andy Sk Cheng
- Department of Rehabilitation Sciences, the Hong Kong Polytechnic University, Kowloon, Hong Kong
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Ghorbani M, Ashrafizaveh A, Azmoude E. Effects of progestin contraceptive methods on sexual function in reproductive age women: a meta-analysis. J Psychosom Obstet Gynaecol 2021; 42:3-14. [PMID: 32048542 DOI: 10.1080/0167482x.2020.1725464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
AIM The aim of this study was to investigate the effects of progestin contraceptive methods on sexual function in reproductive-age women. METHODS The published literature was identified via a systematic search in medical databases of PubMed, SCOPUS, ISI Web of Sciences, Embase, Cochrane library and Google Scholar up to December 2019 using relevant search terms. All randomized controlled trials or before-after studies which assessed the effects of progestin contraceptive method on sexual function in human were included in the analysis. Data extraction was done separately by two independent reviewers. A random-effects meta-analysis was performed to calculate the overall mean effect sizes. Heterogeneity was assessed using Q test and I2 index. Publication bias was performed by visual inspection of funnel plots and Egger bias test. RESULTS A total of 5244 articles were found in primary search, of which 19 studies (N = 710 participants) met the inclusion criteria for the meta-analysis. The results of the random effects meta-analysis suggested no effect of implant on sexual function three months after insertion (WMD: 1.85; 95% CI: -0.34 to 4.04; p = .098). In contrast, this method has a positive effect on sexual function six months after insertion (WMD: 3.48; 95% CI: 2.78 to 4.19; p = .001). Furthermore, the results of random effects models indicated that there was no significant effect of LNG-IUS on female sexual function until 12 months after insertion (WMD: 3.20; 95% CI: -1.56 to 7.98; p = .188). Any evidence of publication bias was found. CONCLUSIONS The findings showed a positive or neutral effect of implant and LNG-IUS on female sexual function. Given the importance of examining sexuality in contraceptive users, this study provides new evidence, which can be offered to women during contraceptive counseling.
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Affiliation(s)
- Mohammad Ghorbani
- Department of Public Health, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,The Collaboration Center of Meta-Analysis Research, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Akram Ashrafizaveh
- The Collaboration Center of Meta-Analysis Research, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Department of Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Elham Azmoude
- Department of Midwifery, Neyshabur University of Medical Sciences, Neyshabur, Iran
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17
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Guo MY, Sodhi M, Khosrow-Khavar F, Etminan M. Risk of sexual dysfunction with progestin-based contraceptives in women of child-bearing age. Eur J Clin Pharmacol 2020; 77:133-140. [PMID: 32803291 DOI: 10.1007/s00228-020-02983-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/11/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To examine whether there is a positive association between sexual dysfunction (SD) and different types of progestin-based contraceptives. METHODS Nested case-control study in women of child-bearing age (15-45 years) from the IQVIA® Ambulatory electronic medical record database from 2008 to 2018. Cases defined by diagnosis of sexual dysfunction identified by international classification for disease clinical modification code 9th and 10th. Each case was matched to four controls and rates of prescriptions of the following were compared: levonorgestrel intra-uterine device (IUD), progestin, and ethinyl estradiol (EE) combined oral contraceptive (COC) formulations including levonorgestrel, norgestimate, drospirenone, desogestrel, norethindrone, and norgestrel; etonogestrel vaginal ring; and medroxyprogesterone injection. RESULTS Overall, 6689 cases of patients with SD were matched to 26,756 matched controls. Compared with matched controls, more subjects with SD used levonorgestrel IUD (OR 1.24, 95% CI 1.08-1.44), EE-levonorgestrel COC (OR 1.18, 95% CI 1.00-1.41), EE-drospirenone (OR 1.28, 95% CI 1.00-1.67), and medroxyprogesterone (OR 1.38, 95% CI 1.12-1.70). The use of norgestrel exhibited a protective effect (OR 0.83, 95% CI 0.73-0.95). When using the EE-levonorgestrel COC as a comparator, norgestrel users exhibited a protective effect (OR 0.70, 95% CI 0.57-0.87) while no other contraceptives showed a statistically significant difference in association with SD. CONCLUSION Our study found an increase in the use of levonorgestrel (COC and IUD), drospirenone, and medroxyprogesterone in subjects with SD. The risk of contraceptives did not differ when compared with oral levonorgestrel. The small association size and lack of difference between drug formulations suggest a minimal impact of progestin-based contraceptives on sexual dysfunction.
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Affiliation(s)
- Michael Y Guo
- Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Mohit Sodhi
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, Department of Anesthesia, Pharmacology and Therapeutics, The Eye Care Center, University of British Columbia, Room 323-2550 Willow Street, Vancouver, BC, V5Z 3N9, Canada
| | - Farzin Khosrow-Khavar
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Mahyar Etminan
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, Department of Anesthesia, Pharmacology and Therapeutics, The Eye Care Center, University of British Columbia, Room 323-2550 Willow Street, Vancouver, BC, V5Z 3N9, Canada.
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18
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Not All Progestins are Created Equally: Considering Unique Progestins Individually in Psychobehavioral Research. ADAPTIVE HUMAN BEHAVIOR AND PHYSIOLOGY 2020. [DOI: 10.1007/s40750-020-00137-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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19
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Wisniewski A, Georg GI. BET proteins: Investigating BRDT as a potential target for male contraception. Bioorg Med Chem Lett 2020; 30:126958. [PMID: 32019712 PMCID: PMC7023680 DOI: 10.1016/j.bmcl.2020.126958] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/01/2020] [Accepted: 01/02/2020] [Indexed: 02/06/2023]
Abstract
While many contraception options are available for women, birth control methods for men are limited to condoms and vasectomy. Past research into male contraceptives has focused on hormonal options but the associated side effects have thus far precluded this method from reaching the market. Non-hormonal male contraceptives and vas occlusion have also been explored, but to date no method has progressed past clinical testing. Recent interest in epigenetic research has unveiled a new potential non-hormonal male contraceptive target: the testis-specific bromodomain BRDT. Potent inhibitors for bromodomain-containing proteins are described in the literature, but a BRDT-specific compound has yet to be designed, prepared and tested. The high similarity between bromodomain proteins of the BET family makes development of selective and specific inhibitors both difficult and necessary. Selective inhibition of BRDT by a small molecule is an exciting new target in the search for a new non-hormonal male contraceptive.
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Affiliation(s)
- Andrea Wisniewski
- Department of Medicinal Chemistry and Institute for Therapeutics Discovery and Development, College of Pharmacy, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414, United States
| | - Gunda I Georg
- Department of Medicinal Chemistry and Institute for Therapeutics Discovery and Development, College of Pharmacy, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414, United States.
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20
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Impact of stress and burnout on the sexual desire of trainee doctors at Hôtel-Dieu de France hospital: A single-institution survey. Encephale 2019; 45:371-375. [DOI: 10.1016/j.encep.2019.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/23/2019] [Accepted: 02/11/2019] [Indexed: 01/23/2023]
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21
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Abstract
OBJECTIVES This is a cross sectional study conducted in order to determine sexual dysfunction in healthy women and risk factors. PATIENTS AND METHODS The population of the study consisted of 282 women. The whole of the population, without sample selection, was included in the study. For data, questionnaire and Female Sexual Function Index-FSFI, whose Turkish validity and reliability study was conducted, were used. Student t and chi-square significant tests and logistic regression analysis were used to carry out statistical analysis. RESULTS It was found that 35.8% of 282 women who participated in the study were in the age range of 30-39 years, 54.6% had high school educational level or above, and 59.6% worked. Prevalence was determined as 53.2% FSFI score < 26 according to Female Sexual Function Index FSFI; 23% of the women had complaints about urinary incontinence UI. According to logistic regression results, it is determined that CFB risk is increased in patients with age and urination problem. It was determined that there was no significant correlation between income, number of children, prceived economic status, dyspareunia, having problem with the partner, experiencing premenstrual syndrome, and SD. CONCLUSION In this study, approximately half of healthy women had SD and development of SD was affected based on some descriptive characteristics. As sexual life was considered as a factor increasing life quality, it was thought that it is fairly important to discuss the questioning of problems related to sexual life for systematic evaluation of patients, as well.
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Affiliation(s)
- Meral Kılıç
- Ataturk University Faculty of Health Sciences, Erzurum, Turkey
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22
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23
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de Castro Coelho F, Barros C. The Potential of Hormonal Contraception to Influence Female Sexuality. Int J Reprod Med 2019; 2019:9701384. [PMID: 30941356 PMCID: PMC6421036 DOI: 10.1155/2019/9701384] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 01/30/2019] [Indexed: 02/02/2023] Open
Abstract
The association between female sexual function and hormonal contraception is controversial. Recognition and management of sexual side effects in women using hormonal contraceptives are challenging. An unsatisfactory number of studies report the influence of the available contraceptives on female sexuality. This article provides an updated narrative review regarding the effect and the magnitude of the impact that hormonal contraceptives play in female sexual function.
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Affiliation(s)
- Filipa de Castro Coelho
- Department of Gynecology and Obstetrics, Hospital Dr. Nélio Mendonça, Serviço de Saúde da Região Autónoma da Madeira, E.P.E., Funchal, Portugal
| | - Cremilda Barros
- Department of Gynecology and Obstetrics, Hospital Dr. Nélio Mendonça, Serviço de Saúde da Região Autónoma da Madeira, E.P.E., Funchal, Portugal
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24
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Rodrigues RC, Belham FS, Garcia A, Satler C, Tomaz C, Tavares MCH. Continuous Use of Combined Hormonal Contraceptive and the Effect on Blood Coagulation Factors in Female Capuchin Monkeys ( Sapajus libidinosus). Int J Endocrinol 2019; 2019:2047803. [PMID: 31001334 PMCID: PMC6436371 DOI: 10.1155/2019/2047803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 04/29/2018] [Accepted: 01/02/2019] [Indexed: 11/18/2022] Open
Abstract
This study aimed at evaluating the availability of the primate Sapajus libidinosus as an animal model for research assessing the physiological effects of the continuous use of combined hormonal contraceptives. In order to do this, six reproductively active female S. libidinosus from the Primate Research Center of the University of Brasília were selected to take part in this experiment. Every 21 days or so, each female received a single dose of combined hormonal contraceptive (algestone acetophenide and 17-enanthate estradiol) in a total of five doses throughout the experiment. The physiological parameters were accessed by means of 13 blood samples from each female, whereas three were gathered during the baseline and 10 samples were collected during the treatment phase. The results showed that the contraceptive use provoked changes in hematological coagulation factors such as an increase in the amount of platelets (p = 0.039) and a reduction in both prothrombin (p < 0.001) and thromboplastin coagulation time (p < 0.001). These results are similar to what has been observed in human patients; thus, it is concluded that S. libidinosus can be successfully used in studies about the physiological impact of hormonal contraceptives.
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Affiliation(s)
- Rosângela C. Rodrigues
- Department of Biological Sciences, State University of Feira de Santana, Avenida Transnordestina, s/n - Novo Horizonte CEP, 44036-900 Feira de Santana, Bahia, Brazil
- Laboratory of Neuroscience and Behaviour, University of Brasilia, Brasilia, Brazil
| | - Flávia Schechtman Belham
- Laboratory of Neuroscience and Behaviour, University of Brasilia, Brasilia, Brazil
- Institute of Cognitive Neuroscience, University College London (UCL), London WC1N 3AZ, UK
| | - Ana Garcia
- Laboratory of Neuroscience and Behaviour, University of Brasilia, Brasilia, Brazil
- Euro-American University Center (UNIEURO), Brasilia, Brazil
| | - Corina Satler
- Faculty of Ceilandia, University of Brasilia, Brasilia, Brazil
| | - Carlos Tomaz
- Neuroscience Research Program, CEUMA University, São Luís, Brazil
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Gürtler MA, Brunner P, Dürsteler-MacFarland KM, Wiesbeck GA. [Sexual Dysfunction in Primary Health Care]. PRAXIS 2019; 108:23-30. [PMID: 30621544 DOI: 10.1024/1661-8157/a003172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
UNLABELLED Sexual Dysfunction in Primary Health Care Abstract. In primary health care, sexual dysfunctions are usually only insufficiently recorded. At the same time, these disorders are relatively common and often remain untreated. This study investigated sexual dysfunction and how it is influenced by lifestyle in patients in a general practitioner's practice (HP). METHODS A sample of HP patients was asked about their sexuality, psychosocial situation and lifestyle, using validated questionnaires. RESULTS The sample consisted of 30 women and 37 men. Of these, about two thirds have never spoken to a physician about their sex life and more than four fifths have never been asked about it by a phyisican. In 75 % of the sample there was no evidence of sexual dysfunction. Men with questionnaire values indicating sexual dysfunction showed significantly higher psychological stress than those with inconspicuous values. CONCLUSION Despite an inconspicuous anamnesis regarding risk factors of sexual dysfunction, about a quarter of the sample found evidence of sexual dysfunction. An inconspicuous anamnesis in the areas of alcohol/tobacco consumption and depression does not make a targeted questioning about sexual dysfunction superfluous. Particularly for men, acute psychological stress should be a sufficient reason to address the topic of sexuality and to deepen it if necessary.
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Affiliation(s)
| | - Patrick Brunner
- 2 Zentrum für Psychiatrie und Psychotherapie, Psychiatrische Klinik Zugersee
| | | | - Gerhard A Wiesbeck
- 3 Zentrum für Abhängigkeitserkrankungen, Universitäre Psychiatrische Kliniken Basel
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26
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Leca JB, Gunst N, Shimizu K, Huffman MA, Takahata Y, Vasey PL. Hormonal contraceptive affects heterosexual but not homosexual behavior in free-ranging female Japanese macaques over 17 mating seasons. Horm Behav 2018; 105:166-176. [PMID: 30171829 DOI: 10.1016/j.yhbeh.2018.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 08/18/2018] [Accepted: 08/24/2018] [Indexed: 11/25/2022]
Abstract
We assessed the effect of a progestin-based contraceptive treatment (chlormadinone acetate) on female heterosexual and homosexual behaviors in a free-ranging group of Japanese macaques (Macaca fuscata) living at Arashiyama-Kyoto, Central Japan. The data included estimated intensity of fertility cues, sexual solicitations and mounting behaviors collected daily during 17 consecutive mating seasons (1995-2012) from 159 females. Females that were on contraception: (1) exhibited less intense cues of putative fertility and for shorter periods; (2) were solicited by fewer males, and those males that did solicit them did so less often (i.e., lower heterosexual attractivity); (3) solicited fewer males and when they did perform sexual solicitations they did so less often (i.e., lower heterosexual proceptivity); (4) engaged in shorter heterosexual consortships with fewer male partners (i.e., lower heterosexual receptivity), compared with females that were not on contraception. In contrast, contraceptive treatment had no significant effect on the prevalence, occurrence, frequency, or duration of female homosexual behaviors. Even though heterosexual and homosexual behaviors can both be considered sexual in character and under hormonal control, our results suggested they are, to some extent, dissociable. Because females engaging in homosexual interactions showed less intense cues of putative fertility than those engaging in heterosexual interactions, regardless of contraceptive treatment, we argued that the hormonal threshold required for the expression of heterosexual behavior by females was associated with elevated sex hormones levels compared to homosexual behavior. We discussed the hormonal correlates of sexual behavior and partner preferences in Japanese macaques.
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Affiliation(s)
| | - Noëlle Gunst
- Department of Psychology, University of Lethbridge, Lethbridge, Japan
| | - Keiko Shimizu
- Department of Zoology, Okayama University of Science, Okayama, Japan
| | | | - Yukio Takahata
- School of Policy Studies, Kwansei Gakuin University, Sanda City, Japan
| | - Paul L Vasey
- Department of Psychology, University of Lethbridge, Lethbridge, Japan
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27
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McCool-Myers M, Theurich M, Zuelke A, Knuettel H, Apfelbacher C. Predictors of female sexual dysfunction: a systematic review and qualitative analysis through gender inequality paradigms. BMC WOMENS HEALTH 2018; 18:108. [PMID: 29929499 PMCID: PMC6013982 DOI: 10.1186/s12905-018-0602-4] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 06/07/2018] [Indexed: 11/10/2022]
Abstract
Background Female sexual dysfunction affects 41% of reproductive-age women worldwide, making it a highly prevalent medical issue. Predictors of female sexual dysfunction are multifaceted and vary from country to country. A synthesis of potential risk factors and protective factors may aid healthcare practitioners in identifying populations at risk, in addition to revealing modifiable factors to prevent sexual dysfunction among reproductive-age women. Methods Observational studies which assessed the prevalence and predictors of female sexual dysfunction in reproductive-age women were systematically sought in relevant databases (2000–2014). Significant predictors were extracted from each included publication. A qualitative analysis of predictors was performed with a focus on types of sexual regimes and level of human development. Results One hundred thirty-five studies from 41 countries were included in the systematic review. The types of predictors varied according to the location of the study, the type of sexual regime and the level of gender inequality in that country/region. Consistently significant risk factors of female sexual dysfunction were: poor physical health, poor mental health, stress, abortion, genitourinary problems, female genital mutilation, relationship dissatisfaction, sexual abuse, and being religious. Consistently significant protective factors included: older age at marriage, exercising, daily affection, intimate communication, having a positive body image, and sex education. Some factors however had an unclear effect: age, education, employment, parity, being in a relationship, frequency of sexual intercourse, race, alcohol consumption, smoking and masturbation. Conclusions The sexual and reproductive lives of women are highly impacted by female sexual dysfunction, and a number of biological, psychological and social factors play a role in the prevalence of sexual dysfunction. Healthcare professionals who work with women should be aware of the many risk factors for reproductive-age women. Future prevention strategies should aim to address modifiable factors, e.g. physical activity and access to sex education; international efforts in empowering women should continue. Electronic supplementary material The online version of this article (10.1186/s12905-018-0602-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Megan McCool-Myers
- Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, Dr. Gessler Strasse 17, 93051, Regensburg, Germany.
| | - Melissa Theurich
- LMU - Ludwig-Maximilians-Universität Munich, Div Metabolic and Nutritional Medicine, Dr von Hauner Children's Hospital, Univ. of Munich Medical Center, Lindwurmstr. 4, 80337, Munich, Germany
| | - Andrea Zuelke
- Institute of Sociology, Friedrich-Schiller-University of Jena, Fürstengraben 1, 07737, Jena, Germany
| | - Helge Knuettel
- University Library of Regensburg, Universitaetsstrasse 3, 93053, Regensburg, Germany
| | - Christian Apfelbacher
- Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, Dr. Gessler Strasse 17, 93051, Regensburg, Germany
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AlAwlaqi A, Amor H, Hammadeh ME. Role of hormones in hypoactive sexual desire disorder and current treatment. J Turk Ger Gynecol Assoc 2017; 18:210-218. [PMID: 29278235 PMCID: PMC5776161 DOI: 10.4274/jtgga.2017.0071] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Over the decades, female sexual dysfunction (FSD) has grown to be an increasingly potential problem that complicates the quality of life among women. In the current review, FSD refers to recurrent and persistent problems with sexual orgasm, desire, or response. One of the most common subtypes of FSD that has evoked increased research interest in the scientific community is hyposexuality. Today, there is a consensus that hyposexuality is a multifactorial condition that manifests with reduced sexual desire resulting in significant interpersonal distress. The objective of the current review was to examine how hormonal profile triggers propagate hypoactive sexual desire disorder (HSDD), and to highlight effective treatment interventions that can be used to manage the condition. The current review describes HSDD as a sexual dysfunction characterized by the absence or lack of sexual desire and fantasies for sexual activities. The review argues that even if the role of sexual hormones is essential in modulating HSDD through therapeutic interventions, an effective comprehension of the biologic mechanisms underlying HSDD is necessary. There is a consensus in the literature that HSDD still poses significant challenges due to the lack of properly formulated treatment regimens and absence of clear clinical guidelines. That is, a better intervention consisting of both psycho-relational and biologic aspects is compulsory if tailored management and accurate diagnosis of HSDD in clinical practice are to be realised. The review concludes that, to date, a reliable clinical intervention to manage hyposexuality is still absent and more interventions, in terms of safety and efficacy, are required. Thus, additional investigation is required to document precise hormonal or non-hormonal pharmacotherapeutic agents for individualised care among patients with HSDD.
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Affiliation(s)
- Ahmed AlAwlaqi
- Department of Obstetrics and Gynaecology, University of Saarland, Homburg, Germany
| | - Houda Amor
- Department of Obstetrics and Gynaecology, University of Saarland, Homburg, Germany
| | - Mohamed E Hammadeh
- Department of Obstetrics and Gynaecology, University of Saarland, Homburg, Germany
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Johnson-Agbakwu C, Brown L, Yuan J, Kissling R, Greenblatt DJ. Effects of Flibanserin on the Pharmacokinetics of a Combined Ethinylestradiol/Levonorgestrel Oral Contraceptive in Healthy Premenopausal Women: A Randomized Crossover Study. Clin Ther 2017; 40:64-73. [PMID: 29198449 DOI: 10.1016/j.clinthera.2017.08.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 08/21/2017] [Accepted: 08/31/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aimed to investigate the effect of steady-state exposure to flibanserin, a 5-HT1A agonist/5-HT2A antagonist approved for the treatment of hypoactive sexual desire disorder in premenopausal women, on the single-dose pharmacokinetics of the contraceptive steroids ethinylestradiol and levonorgestrel in healthy premenopausal women. METHODS Healthy female volunteers (N = 24) received 2 single doses of a combined oral contraceptive containing ethinylestradiol 30 μg and levonorgestrel 150 μg, either alone (reference) or preceded by treatment with flibanserin 100 mg once daily for 14 days (test). The 2 treatments were given in randomized order, with a 4-week washout period following the last administration of the first treatment. Plasma concentrations of ethinylestradiol and levonorgestrel were measured over 48 hours after dosing for the determination of pharmacokinetic parameters; the primary end points were Cmax and AUC0-∞ of ethinylestradiol and levonorgestrel. FINDINGS Of the 24 women enrolled (mean age, 38.0 years), 23 completed the study. Mean (SD) Cmax and AUC0-∞ values of ethinylestradiol were 66.7 (16.3) pg/mL and 693 (268) pg · h/mL, respectively, following the oral contraceptive alone, and 72.7 (25.5) pg/mL and 740 (235) pg · h/mL, respectively, when the oral contraceptive was preceded by flibanserin. In both cases, the 90% CIs of the reference/test ratios of Cmax and AUC0-∞ were within the range of 80% to 125%, indicating that flibanserin had no significant effect on the pharmacokinetic properties of ethinylestradiol. Similarly, the mean (SD) Cmax and AUC0-∞ values of levonorgestrel were 5.0 (1.6) ng/mL and 52.2 (18.7) ng · h/mL, respectively, with the oral contraceptive alone, and 5.0 (1.6) ng/mL and 53.3 (20.4) ng · h/mL, respectively, following flibanserin; again, in both cases, the 90% CIs of the reference/test ratios were within the range of 80% to 125%, indicating that flibanserin had no significant effect on the pharmacokinetic properties of levonorgestrel. All adverse events were mild to moderate in intensity (incidence: 12.5% and 70.8% with ethinylestradiol/levonorgestrel treatment alone and following administration of flibanserin, respectively). IMPLICATIONS Pretreatment with flibanserin 100 mg once daily for 2 weeks did not produce a clinically relevant change in oral contraceptive drug exposure following single-dose administration of ethinylestradiol/levonorgestrel. This finding is relevant to women with hypoactive sexual desire disorder who might prefer oral contraceptives to other forms of birth control. EudraCT No: 2006-006960-46.
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Affiliation(s)
| | - Louise Brown
- Valeant Pharmaceuticals North America LLC, Bridgewater, New Jersey
| | - James Yuan
- Valeant Pharmaceuticals North America LLC, Bridgewater, New Jersey
| | - Robert Kissling
- Valeant Pharmaceuticals North America LLC, Bridgewater, New Jersey
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Nekoolaltak M, Keshavarz Z, Simbar M, Nazari AM, Baghestani AR. Women’s orgasm obstacles: A qualitative study. Int J Reprod Biomed 2017. [DOI: 10.29252/ijrm.15.8.479] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Gabr AA, Omran EF, Abdallah AA, Kotb MM, Farid EZ, Dieb AS, Belal DS. Prevalence of sexual dysfunction in infertile versus fertile couples. Eur J Obstet Gynecol Reprod Biol 2017; 217:38-43. [PMID: 28843867 DOI: 10.1016/j.ejogrb.2017.08.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 07/02/2017] [Accepted: 08/15/2017] [Indexed: 01/23/2023]
Abstract
OBJECTIVES The primary aim of this study was to test the hypothesis that sexual dysfunction is higher in infertile females in relation to normal healthy women through comparing total and sexual domains scores in both groups. The secondary objectives were: to determine factors affecting occurrence of female sexual dysfunction (FSD) in all sample and to determine factors affecting the different sexual domain scores within the infertile group. STUDY DESIGN This cross sectional study was done at Cairo University Hospital. 200 infertile and 200 control females were evaluated using the Female Sexual Function Index (FSFI) questionnaire. Total score less than 26.55 signified sexual dysfunction. Husbands were evaluated by Sexual Health Inventory for Men (SHIM) questionnaire. A score less than 22 signified erectile dysfunction (ED). RESULTS Proportion of females with sexual dysfunction was higher in the infertile versus control group (47% versus 30%, 95%CI for the difference: 8%, 26%, p-value:<0.001). Total, orgasm, satisfaction and pain scores were significantly lower in infertile versus control group (mean±SD: 26.8±3.8 versus 27.9±3.5, p-value: 0.003; 4.2±0.7 versus 4.6±0.6, p-value: 0.01; 4.9±0.5 versus 5.2±0.5, p-value: 0.004 and 3.9±0.9 versus 4.4±0.7, p-value:<0.001 respectively). Husband SHIM erectile score was significantly lower in the infertile group (median score (range): 19 (5, 25) versus 22 (12, 25), p-value: 0.001). After adjustment for 15factors by logistic regression, the odds ratio of having FSD was 2.6 (95%CI: 1.5, 4.5, p-value: 0.001) in the infertile relative to control females. Secondary (versus primary) infertility was negatively correlated with arousal score (B (95%CI): -0.6 (-0.02, -1.2), p-value: 0.003) while duration of infertility was negatively correlated with arousal, satisfaction and pain domains scores (B (95%CI): -0.2 (-0.08, -0.32), p-value: 0.04; -0.2 (-0.1, -0.3), p-value: 0.005; -0.2 (-0.06, -0.34), p-value: 0.03 respectively). CONCLUSION sexual dysfunction is more prevalent in infertile versus control group. Infertility clinicians should be aware of this problem to assess and treat their patients to improve their quality of life.
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Affiliation(s)
- Amir A Gabr
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Eman F Omran
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Ahmed A Abdallah
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed M Kotb
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Eman Z Farid
- Department of Obstetrics and Gynecology, Benisuef University, Benisuef, Egypt
| | - Amira S Dieb
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Doaa S Belal
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
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Du J, Ruan X, Gu M, Bitzer J, Mueck AO. Prevalence of and risk factors for sexual dysfunction in young Chinese women according to the Female Sexual Function Index: an internet-based survey. EUR J CONTRACEP REPR 2017; 21:259-63. [PMID: 27181621 DOI: 10.3109/13625187.2016.1165198] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Female sexual dysfunction (FSD) is a very common sexual health problem worldwide. The prevalence of FSD in Chinese women is, however, unknown. This is the first study to investigate a large number of young women throughout China via the internet, to determine the prevalence and types of FSD and to identify the risk factors for FSD. METHODS The primary endpoint was the Female Sexual Function Index (FSFI) score, with additional questions on contraception, sexual activity, relationship stability, pregnancy and other factors which may influence sexual function. The online questionnaire was completed by women from 31 of the 34 Chinese provinces. RESULTS A total of 1618 completed questionnaires were received, and 1010 were included in the analyses after screening (62.4%). The mean age of the respondents was 25.1 ± 4.5 years. The mean total FSFI score was 24.99 ± 4.60. According to FSFI definitions (cut-off score 26.55), 60.2% of women were at risk of FSD. Based on domain scores, 52 were considered at high risk of dysfunction for pain (5.1%), 35 for orgasm (3.5%), 33 for desire (3.3%), 20 for arousal (2.0%), 6 for satisfaction (0.6%) and 2 for lubrication (0.2%). CONCLUSIONS The prevalence of FSFI scores indicating risk of sexual dysfunction was about 60% in Chinese women. An unstable relationship, pressure to become pregnant, non-use of contraception, negative self-evaluation of appearance and increasing age were significantly associated with FSD in young Chinese women.
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Affiliation(s)
- Juan Du
- a Department of Gynecological Endocrinology , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , People's Republic of China
| | - Xiangyan Ruan
- a Department of Gynecological Endocrinology , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , People's Republic of China ;,b Section of Endocrinology and Menopause, Department of Women's Health , University of Tübingen , Tübingen , Germany
| | - Muqing Gu
- a Department of Gynecological Endocrinology , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , People's Republic of China
| | | | - Alfred O Mueck
- a Department of Gynecological Endocrinology , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , People's Republic of China ;,b Section of Endocrinology and Menopause, Department of Women's Health , University of Tübingen , Tübingen , Germany
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Guida M, Di Carlo C, Troisi J, Gallo A, Cibarelli F, Martini E, Tiranini L, Nappi RE. The sexuological impact of hormonal contraceptives based on their route of administration. Gynecol Endocrinol 2017; 33:218-222. [PMID: 27908210 DOI: 10.1080/09513590.2016.1249841] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Evidence on the effects of hormonal contraceptives on female sexuality is conflicting. We enrolled 556 women, divided into six groups: two composed of subjects using a combined hormonal contraceptive (COC) containing 0.020 ("COC20") and 0.030 ("COC30") mg of ethynyl estradiol (EE), "natural", using COC containing 1.5 mg of estradiol (E2), "ring", using a vaginal ring releasing each day 0.015 mg of EE + 0.120 of etonogestrel, "subcutaneous", using a progestin only subcutaneous contraceptive implant releasing etonogestrel and "controls", using no hormonal contraceptive methods. The subjects were required to answer to the McCoy female sexuality questionnaire and were subjected to a blood test for hormonal evaluation. An ultrasound evaluation of the dorsal clitoral artery was also performed. The higher McCoy sexological value were recorded in the subdermal group; significant differences were recorded among the groups in terms of hormone distribution, with the higher levels of androstenedione in subdermal and control groups. The ultrasound evaluation of dorsal clitoral artery shows a significative correlation between pulsatility and resistance indices and orgasm parameters of McCoy questionnaire. The recorded difference in the sexual and hormonal parameters among the studied hormonal contraceptives may guide toward the personalization of contraceptive choice.
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MESH Headings
- Adult
- Clitoris/blood supply
- Clitoris/diagnostic imaging
- Clitoris/drug effects
- Contraceptive Agents, Female/administration & dosage
- Contraceptive Agents, Female/adverse effects
- Contraceptive Agents, Female/blood
- Contraceptive Agents, Female/pharmacokinetics
- Contraceptive Devices, Female/adverse effects
- Contraceptives, Oral, Combined/administration & dosage
- Contraceptives, Oral, Combined/adverse effects
- Contraceptives, Oral, Combined/blood
- Contraceptives, Oral, Combined/pharmacokinetics
- Contraceptives, Oral, Hormonal/administration & dosage
- Contraceptives, Oral, Hormonal/adverse effects
- Contraceptives, Oral, Hormonal/blood
- Contraceptives, Oral, Hormonal/pharmacokinetics
- Delayed-Action Preparations/administration & dosage
- Delayed-Action Preparations/adverse effects
- Desogestrel/administration & dosage
- Desogestrel/adverse effects
- Desogestrel/blood
- Desogestrel/pharmacokinetics
- Dose-Response Relationship, Drug
- Drug Implants
- Estrogens/administration & dosage
- Estrogens/adverse effects
- Estrogens/blood
- Estrogens/pharmacokinetics
- Female
- Humans
- Italy
- Megestrol/administration & dosage
- Megestrol/adverse effects
- Megestrol/blood
- Megestrol/pharmacokinetics
- Norpregnadienes/administration & dosage
- Norpregnadienes/adverse effects
- Norpregnadienes/blood
- Norpregnadienes/pharmacokinetics
- Orgasm/drug effects
- Progestins/administration & dosage
- Progestins/adverse effects
- Progestins/blood
- Progestins/pharmacokinetics
- Regional Blood Flow/drug effects
- Self Report
- Sexual Behavior/drug effects
- Ultrasonography, Doppler
- Young Adult
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Affiliation(s)
- Maurizio Guida
- a Department of Medicine "Scuola Medica Salernitana" , University of Salerno , Salerno , Italy
- b Theoreo srl - spin-off of the University of Salerno , Salerno , Italy
| | - Costantino Di Carlo
- c Department of Neurosciences and Reproductive Sciences , University of Naples Federico II , Naples , Italy , and
| | - Jacopo Troisi
- a Department of Medicine "Scuola Medica Salernitana" , University of Salerno , Salerno , Italy
- b Theoreo srl - spin-off of the University of Salerno , Salerno , Italy
| | - Alessandra Gallo
- a Department of Medicine "Scuola Medica Salernitana" , University of Salerno , Salerno , Italy
| | - Francesca Cibarelli
- a Department of Medicine "Scuola Medica Salernitana" , University of Salerno , Salerno , Italy
| | - Ellis Martini
- d Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause Unit, Dept of Obstetrics and Gynecology, IRCCS "S. Matteo Foundation", University of Pavia , Pavia , Italy
| | - Lara Tiranini
- d Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause Unit, Dept of Obstetrics and Gynecology, IRCCS "S. Matteo Foundation", University of Pavia , Pavia , Italy
| | - Rossella E Nappi
- d Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause Unit, Dept of Obstetrics and Gynecology, IRCCS "S. Matteo Foundation", University of Pavia , Pavia , Italy
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Wallwiener CW, Wallwiener LM, Seeger H, Schönfisch B, Mueck AO, Bitzer J, Zipfel S, Brucker SY, Wallwiener S, Taran FA, Wallwiener M. Sexual Function, Contraception, Relationship, and Lifestyle in Female Medical Students. J Womens Health (Larchmt) 2017; 26:169-177. [DOI: 10.1089/jwh.2015.5731] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Affiliation(s)
- Christian W. Wallwiener
- Department of Women's Health, Research Institute for Women's Health, University of Tübingen, Tübingen, Germany
| | - Lisa-Maria Wallwiener
- Department of Obstetrics and Gynecology, Ludwig Maximilian University of Munich, Munich, Germany
| | - Harald Seeger
- Department of Women's Health, Research Institute for Women's Health, University of Tübingen, Tübingen, Germany
| | - Birgitt Schönfisch
- Department of Women's Health, Research Institute for Women's Health, University of Tübingen, Tübingen, Germany
| | - Alfred O. Mueck
- Department of Women's Health, Research Institute for Women's Health, University of Tübingen, Tübingen, Germany
| | - Johannes Bitzer
- Department of Obstetrics and Gynecology, University of Basel, Basel, Switzerland
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Sara Y. Brucker
- Department of Women's Health, Research Institute for Women's Health, University of Tübingen, Tübingen, Germany
| | - Stephanie Wallwiener
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Florin-Andrei Taran
- Department of Women's Health, Research Institute for Women's Health, University of Tübingen, Tübingen, Germany
| | - Markus Wallwiener
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
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Garneau-Fournier J, McBain S, Torres T, Turchik J. Sexual Dysfunction Problems in Female College Students: Sexual Victimization, Substance Use, and Personality Factors. JOURNAL OF SEX & MARITAL THERAPY 2017; 43:24-39. [PMID: 26683983 DOI: 10.1080/0092623x.2015.1113595] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Little empirical information is available on sexual dysfunction (SD) among college women even though college years represent a critical period in the development of sexuality. The current study aimed to identify factors associated with the presence, number, and type of SD problems among 547 female college students in the United States. Racial minority status, problematic drinking behaviors, and past sexual victimization were positively related to the presence of SD problems, whereas hormonal contraceptive use and past sexual victimization were associated with a greater number of SD problems. These findings highlight the importance of assessment, treatment, and prevention of sexual health issues on college campuses.
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Affiliation(s)
- Jade Garneau-Fournier
- a Pacific Graduate School of Psychology at Palo Alto University and Center of Innovation to Implementation, VA Palo Alto Health Care System , Palo Alto , California , USA
| | - Sacha McBain
- a Pacific Graduate School of Psychology at Palo Alto University and Center of Innovation to Implementation, VA Palo Alto Health Care System , Palo Alto , California , USA
| | - Tammy Torres
- b Pacific Graduate School of Psychology-Stanford Consortium Psy.D. Program and Center of Innovation to Implementation, VA Palo Alto Health Care System , Palo Alto , California , USA
| | - Jessica Turchik
- c Center of Innovation to Implementation, VA Palo Alto Health Care System, National Center for PTSD , VA Palo Alto Health Care System, Palo Alto , California , USA
- d Department of Psychiatry and Behavioral Sciences , Stanford University , Menlo Park , California , USA
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Direkvand-Moghadam A, Suhrabi Z, Akbari M, Direkvand-Moghadam A. Prevalence and Predictive Factors of Sexual Dysfunction in Iranian Women: Univariate and Multivariate Logistic Regression Analyses. Korean J Fam Med 2016; 37:293-8. [PMID: 27688863 PMCID: PMC5039121 DOI: 10.4082/kjfm.2016.37.5.293] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 04/25/2016] [Accepted: 04/25/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Female sexual dysfunction, which can occur during any stage of a normal sexual activity, is a serious condition for individuals and couples. The present study aimed to determine the prevalence and predictive factors of female sexual dysfunction in women referred to health centers in Ilam, the Western Iran, in 2014. METHODS In the present cross-sectional study, 444 women who attended health centers in Ilam were enrolled from May to September 2014. Participants were selected according to the simple random sampling method. Univariate and multivariate logistic regression analyses were used to predict the risk factors of female sexual dysfunction. Diffe rences with an alpha error of 0.05 were regarded as statistically significant. RESULTS Overall, 75.9% of the study population exhibited sexual dysfunction. Univariate logistic regression analysis demonstrated that there was a significant association between female sexual dysfunction and age, menarche age, gravidity, parity, and education (P<0.05). Multivariate logistic regression analysis indicated that, menarche age (odds ratio, 1.26), education level (odds ratio, 1.71), and gravida (odds ratio, 1.59) were independent predictive variables for female sexual dysfunction. CONCLUSION The majority of Iranian women suffer from sexual dysfunction. A lack of awareness of Iranian women's sexual pleasure and formal training on sexual function and its influencing factors, such as menarche age, gravida, and level of education, may lead to a high prevalence of female sexual dysfunction.
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Affiliation(s)
- Ashraf Direkvand-Moghadam
- Psychosocial Injuries Research Center, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Zainab Suhrabi
- Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Malihe Akbari
- Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
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Čiaplinskienė L, Žilaitienė B, Verkauskienė R, Žalinkevičius R, Bumbulienė Ž, Vanagienė V, Bitzer J. The effect of a drospirenone-containing combined oral contraceptive on female sexual function: a prospective randomised study. EUR J CONTRACEP REPR 2016; 21:395-400. [DOI: 10.1080/13625187.2016.1217324] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Lina Čiaplinskienė
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Birutė Žilaitienė
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rasa Verkauskienė
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rimantas Žalinkevičius
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Žana Bumbulienė
- Clinic of Obstetrics and Gynaecology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Virginija Vanagienė
- Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Johannes Bitzer
- Department of Obstetrics and Gynaecology, University Hospital Basel, Basel, Switzerland
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Higgins JA, Smith NK. The Sexual Acceptability of Contraception: Reviewing the Literature and Building a New Concept. JOURNAL OF SEX RESEARCH 2016; 53:417-56. [PMID: 26954608 PMCID: PMC4868075 DOI: 10.1080/00224499.2015.1134425] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
How contraceptives affect women's sexual well-being is critically understudied. Fortunately, a growing literature focuses on sexual aspects of contraception, especially hormonal contraception's associations with libido. However, a more holistic approach to contraceptive sexual acceptability is needed to capture the full range of women's sexual experiences. We conducted a narrative literature review of this topic, working with an original sample of 3,001 citations published from 2005 to 2015. In Part 1, we draw from a subset of this literature (264 citations) to build a new conceptual model of sexual acceptability. Aspects include macro factors (gender, social inequality, culture, and structure), relationship factors (dyadic influences and partner preferences), and individual factors (sexual functioning, sexual preferences, such as dis/inhibition, spontaneity, pleasure, the sexual aspects of side effects, such as bleeding, mood changes, sexual identity and sexual minority status, and pregnancy intentions). In Part 2, we review the empirical literature on the sexual acceptability of individual methods (103 citations), applying the model as much as possible. Results suggest contraceptives can affect women's sexuality in a wide variety of positive and negative ways that extend beyond sexual functioning alone. More attention to sexual acceptability could promote both women's sexual well-being and more widespread, user-friendly contraceptive practices.
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Peixoto C, Botelho F, Tomada I, Tomada N. Comportamento sexual de estudantes de medicina portugueses e seus fatores preditivos. Rev Int Androl 2016. [DOI: 10.1016/j.androl.2015.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Scheele D, Plota J, Stoffel-Wagner B, Maier W, Hurlemann R. Hormonal contraceptives suppress oxytocin-induced brain reward responses to the partner's face. Soc Cogn Affect Neurosci 2015; 11:767-74. [PMID: 26722017 DOI: 10.1093/scan/nsv157] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 12/17/2015] [Indexed: 11/14/2022] Open
Abstract
The hypothalamic peptide oxytocin (OXT) has been identified as a key modulator of pair-bonding in men, but its effects in women are still elusive. Moreover, there is substantial evidence that hormonal contraception (HC) influences partner preferences and sexual satisfaction, which constitute core domains of OXT function. We thus hypothesized that OXT effects on partner-related behavioral and neural responses could be significantly altered in women using HC. In this functional magnetic resonance imaging study involving 40 pair-bonded women, 21 of whom were using HC, we investigated whether a 24-IU nasal dose of OXT would modulate brain reward responses evoked by the romantic partner's face relative to the faces of familiar and unfamiliar people. Treatment with OXT increased the perceived attractiveness of the partner relative to other men, which was paralleled by elevated responses in reward-associated regions, including the nucleus accumbens. These effects of OXT were absent in women using HC. Our results confirm and extend previous findings in men that OXT interacts with the brain reward system to reinforce partner value representations, indicating a common OXT-dependent mechanism underlying partner attraction in both sexes. This mechanism may be disturbed in women using HC, suggesting that gonadal steroids could alter partner-specific OXT effects.
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Affiliation(s)
- Dirk Scheele
- Department of Psychiatry and Division of Medical Psychology,
| | - Jessica Plota
- Department of Psychiatry and Division of Medical Psychology
| | - Birgit Stoffel-Wagner
- Department of Clinical Chemistry and Clinical Pharmacology, University of Bonn, 53105 Bonn, Germany, and
| | - Wolfgang Maier
- Department of Psychiatry and German Center for Neurodegenerative Diseases (DZNE), 53175 Bonn, Germany
| | - René Hurlemann
- Department of Psychiatry and Division of Medical Psychology
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Gunst A, Jern P, Westberg L, Johansson A, Salo B, Burri A, Spector T, Eriksson E, Sandnabba NK, Santtila P. A Study of Possible Associations Between Single Nucleotide Polymorphisms in the Estrogen Receptor 2 Gene and Female Sexual Desire. J Sex Med 2015; 12:676-84. [DOI: 10.1111/jsm.12753] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Peleg-Sagy T, Shahar G. Female Medical Students' (Silencing the) Self: Effects on Depression and Dyadic/Sexual Dissatisfaction. SELF AND IDENTITY 2015. [DOI: 10.1080/15298868.2015.1008031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Abstract
BACKGROUND Previous research shows that smoking status is unrelated to female sexual difficulties. However, degree of nicotine dependence has not been measured, and the assessment of sexual functioning has not specified penile-vaginal intercourse (henceforth, intercourse), which is more clearly impaired by sexual difficulties than other sexual behaviors. OBJECTIVES To test if smoking status is associated with poorer female sexual function during intercourse, and if nicotine dependence rather than smoking status is related to poorer female sexual function. METHODS During 2012, 129 Portuguese community women reported their smoking status, and completed the Fagerström Test for Nicotine Dependence, the Female Sexual Function Index (FSFI), and an adaptation of the FSFI to assess sexual functioning specifically during intercourse, as well as the desire thereof. RESULTS Smokers reported higher desire for intercourse and were more likely to have actually engaged in it in the past 4 weeks. Among the coitally active women in the preceding 4 weeks, nicotine dependence correlated with lower desire for intercourse. Smoking status and nicotine dependence were unrelated to arousal, lubrication, orgasm, satisfaction, pain. CONCLUSIONS The findings are consistent with many studies that fail to demonstrate an increased risk of sexual difficulties among female smokers. However, nicotine dependence, rather than smoking status per se, might be associated with lower libido. The results suggest the possibility of an inverse U-shaped relationship between smoking and libido with a moderate use of tobacco being associated with higher sexual desire.
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Laparoscopically assisted neovaginoplasty in vaginal agenesis: a long-term outcome study in 240 patients. J Pediatr Adolesc Gynecol 2014; 27:379-85. [PMID: 25256875 DOI: 10.1016/j.jpag.2014.02.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 02/02/2014] [Accepted: 02/10/2014] [Indexed: 11/23/2022]
Abstract
STUDY OBJECTIVE To assess the long-term outcome of an optimized minimally invasive neovaginoplasty technique in vaginal agenesis. DESIGN Combined retrospective and prospective study. SETTING University hospital. PARTICIPANTS 240 patients with congenital vaginal agenesis. INTERVENTIONS Patients with an indication for neovagina creation underwent laparoscopically assisted neovaginoplasty involving vaginoabdominal blunt perforation and intracorporeal traction using tension threads and an abdominally positioned extracorporeal traction device. MAIN OUTCOME MEASURES Long-term anatomic success, functional success compared with similar-aged controls, long-term complications, and incidence of human papilloma virus (HPV) infections. RESULTS During median follow-up for 16 (range 11-141) months, mean functional neovaginal length remained stable at 9.5 cm in all patients, including those who had no sexual intercourse and had stopped wearing the vaginal dummy. Median dummy wearing time was 8.6 months. Time to epithelialization depended on the time of onset and frequency of sexual intercourse. At long-term follow-up, median total Female Sexual Function Index score was 30.0, comparable with similar-aged controls. No common long-term complications occurred. Four patients required cauterization of granulation tissue. 7/240 (2.9%) patients were HPV-positive with low- to high-grade squamous intraepithelial lesions, 3 patients reverting to HPV-negative status at long-term follow-up. CONCLUSIONS Our technique creates a neovagina of adequate size and secretory capacity for normal coitus, requiring no prolonged dilation postoperatively, even in the absence of sexual intercourse. The procedure is fast, effective and minimally traumatic, has a very low long-term complication rate and provides very satisfactory long-term functional results.
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Lello S, Cavani A. Ethynilestradiol 20 mcg plus Levonorgestrel 100 mcg: Clinical Pharmacology. Int J Endocrinol 2014; 2014:102184. [PMID: 25477960 PMCID: PMC4247926 DOI: 10.1155/2014/102184] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 10/27/2014] [Indexed: 11/17/2022] Open
Abstract
Estroprogestins (EPs) are combinations of estrogen and progestin with several actions on women's health. The different pharmacological composition of EPs is responsible for different clinical effects. One of the most used low-dose EP associations is ethinylestradiol 20 mcg plus levonorgestrel 100 mcg in monophasic regimen (EE20/LNG100). This review summarizes clinical pharmacology, cycle control, and effects on lipid and glucose metabolism, coagulation, body weight/body composition, acne, and sexuality of EE20/LNG100. Overall, EE20/LNG100 combination is safe and well tolerated, and in several studies the incidence of adverse events in the treated group was comparable to that of the placebo group. Cycle control was effective and body weight/body composition did not vary among treated and untreated groups in most studies. The EE20/LNG100 combination shows mild or no effect on lipid and glucose metabolism. Lastly, EE20/LNG100 is associated with a low risk of venous thromboembolism (VTE). In conclusion, in the process of decision making for the individualization of EPs choice, EE20/LNG100 should be considered for its favorable clinical profile.
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Affiliation(s)
- Stefano Lello
- Gynecological Endocrinology, Pathophysiology of Menopause and Osteoporosis, IDI-IRCCS, Via Monti di Creta 104, 00167 Rome, Italy
| | - Andrea Cavani
- Laboratory of Experimental Immunology, IDI-IRCCS, 00167 Rome, Italy
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Abstract
Depending on the type, duration and intensity of cigarette smoking, the efficacy of endogenous and exogenous estrogen can be reduced or completely cancelled. Not only does smoking diminish the beneficial effects of estrogen on hot flushes and urogenital symptoms and its positive effects on lipid metabolism, but smoking also can reduce estrogen's ability to prevent osteoporosis and perhaps also cardiovascular diseases. This is mainly caused by dose-dependent elevated hepatic clearance, partially in conjunction with lower estrogen levels, and has been demonstrated so far only with oral estrogen applications. Compensation for the failure of therapeutic action should not be made by increasing the dose in smokers since this might result in the production of potentially mutagenic estrogen metabolites associated with a higher risk of breast cancer. Since the favorable effects of estrogens seem to be not lost in smokers when estrogens are applied transdermally, this route should be preferred in smokers. The most important conclusion from the data presented is that the effects of smoking are very complex and dependent on a multiplicity of factors, so that different types of clinically relevant negative effects must be expected. Women who continue to smoke despite all warnings should be informed that smoking, in addition to all its other negative effects, can also jeopardize the success of hormone replacement therapy.
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Affiliation(s)
- X Ruan
- * Beijing Obstetrics & Gynecology Hospital, Capital Medical University , China
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Higgins JA, Davis AR. Contraceptive sex acceptability: a commentary, synopsis and agenda for future research. Contraception 2014; 90:4-10. [PMID: 24792147 PMCID: PMC4247241 DOI: 10.1016/j.contraception.2014.02.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 02/27/2014] [Accepted: 02/28/2014] [Indexed: 12/11/2022]
Affiliation(s)
- Jenny A Higgins
- Gender and Women's Studies, University of Wisconsin-Madison, 475 North Charter Street, 3414 Sterling Hall, Madison, WI 53706, USA.
| | - Anne R Davis
- Columbia University Medical Center, 630 West 168th Street, New York, NY 10032, USA
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Davis SR, Bitzer J, Giraldi A, Palacios S, Parke S, Serrani M, Mellinger U, Nappi RE. 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. J Sex Med 2013; 10:3069-79. [DOI: 10.1111/jsm.12310] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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