title: Comparison of androgens in women with hypoactive sexual desire disorder: those on combined oral contraceptives (COCs) vs. those not on COCs.
abstract: BACKGROUND
  Approximately one out of four sexually active women in the United States uses some form of hormonal contraceptive method because they provide the most effective reversible method of birth control available. However, little attention has been paid to possible adverse effects of combined oral contraceptives (COCs) on sexual functioning.
  
  
  OBJECTIVE
  The aim of this study was to examine the potential effects of COCs on women with hypoactive sexual desire disorder (HSDD). It was hypothesized that female patients with generalized, acquired HSDD on COCs have lower androgen levels than those not on COCs.
  
  
  METHODS
  The patients were healthy premenopausal women with HSDD, aged 22-50 years. Subjects had a history of adequate sexual desire, interest, and functioning. Participants were required to be in a stable, monogamous, heterosexual relationship and were screened for any medication or medical or psychiatric disorders that impact desire. The patients met operational criteria for global, acquired HSDD. The 106 patients were divided into two groups: those on COCs (N = 43) and those not on COCs (N = 63). A two-tailed t-test comparison was made between the two groups comparing free and total testosterone and sex hormone-binding globulin (SHBG).
  
  
  METHODS
  The main outcome measures are the differences between the two groups comparing free testosterone, total testosterone, and SHBG.
  
  
  RESULTS
  These patients with HSDD on COCs had significantly lower free and total testosterone levels compared with those who were not on COCs. The SHBG was significantly higher in the group on COCs compared with those who were not on COCs.
  
  
  CONCLUSIONS
  The result of this study suggests that COCs in premenopausal women with HSDD are associated with lower androgen levels than those not on COCs. Further research is required to determine if low androgen levels secondary to COCs impact female sexual desire.
authors.affiliation: University of Oklahoma-Psychiatry, Tulsa, OK, USA. Electronic address: julia-warnock@ouhsc.edu.
authors.forename: Julia K
authors.initials: JK
authors.lastname: Warnock
authors.affiliation: University of Virgina Health System-Department of Psychiatric Medicine, Charlottesville, VA, USA.
authors.forename: Anita
authors.initials: A
authors.lastname: Clayton
authors.affiliation: The Croft Group Research Center, San Antonio, TX, USA.
authors.forename: Harry
authors.initials: H
authors.lastname: Croft
authors.affiliation: MetroHealth-Psychiatry, Cleveland, OH, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Segraves
authors.affiliation: University of Oklahoma-Psychiatry, Tulsa, OK, USA.
authors.forename: Faye C
authors.initials: FC
authors.lastname: Biggs
mesh_terms: D000328:Adult; D000728:Androgens / Q000378:metabolism*; D001143:Arousal; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007989:Libido; D008875:Middle Aged; D015203:Reproducibility of Results; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced / Q000175:diagnosis / Q000378:metabolism* / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced / Q000175:diagnosis / Q000378:metabolism* / Q000523:psychology; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood; D016387:Women's Health
chemical_list: D000728:Androgens; D003277:Contraceptives, Oral, Combined; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone