Reduction in genital sexual arousal varies by type of oral contraceptive pill

Background Although oral contraceptive pills (OCPs) have been associated with decrements in self-reported genital arousal and vaginal lubrication, (,) little is known about how these outcomes vary across types of OCPs. Aim The present study examined differences in physiological lubrication and vaginal blood flow, as well as rates of self-reported vulvovaginal atrophy and female sexual arousal disorder, among women using OCPs with varying androgenic properties. Methods Participants in this study were 130 women: 59 naturally cycling control women, 50 women taking androgenic OCPs, and 21 women taking antiandrogenic OCPs. Participants watched sexual films while their sexual arousal responses were measured, completed questionnaires, and participated in a clinical interview. Outcomes Vaginal blood flow, vaginal lubrication, self-reported vulvovaginal atrophy, and female sexual arousal disorder were assessed. Results Results indicated deficits in vaginal pulse amplitude and lubrication for women taking either form of OCP, with marked inhibitory effects found in women taking antiandrogenic OCPs. Rates of self-reported vulvovaginal atrophy and female sexual arousal disorder were also significantly greater in the antiandrogenic group compared with the control group. Clinical Implications It is recommended that prescribing clinicians consult patients on such physiological effects of OCPs. Strengths and Limitations To our knowledge, this was the first study to compare multiple measures of physiological sexual arousal across groups of women taking OCPs with varying hormonal profiles. Because all OCPs included in this study contained low doses of ethinylestradiol, we were able to identify the specific effects of the androgenic properties on women's sexual arousal responses. However, the self-administered lubrication test strip was subject to user error. Additionally, the generalizability of findings is limited by the largely heterosexual and college-aged sample. Conclusion Compared with naturally cycling women, women taking OCPs that contain antiandrogenic progestins experienced decreased vaginal blood flow and lubrication as well as higher rates of self-reported vaginal bleeding and female sexual arousal disorder.

Automated summary

This study examined the differences in physiological lubrication and vaginal blood flow as well as rates of vulvovaginal atrophy and female sexual arousal disorder among women using oral contraceptive pills with varying androgenic properties. The results showed that women taking antiandrogenic OCPs experienced decreased vaginal blood flow and lubrication, as well as higher rates of vulvovaginal atrophy and female sexual arousal disorder.