title: The influence of combined oral contraceptives on female sexual desire: a systematic review.
abstract: OBJECTIVE
  To determine the relationship between the use of combined oral contraceptives (COCs) and sexual desire based on a systematic review of the literature.
  
  
  METHODS
  MEDLINE Complete, Google Scholar and the Cochrane Library were searched for articles published between 1975 and 2011, reporting the effects of oral contraceptives on sexual desire. Reports fully meeting all the predefined criteria were analysed and included in a final reference list. In addition, a review of the reference list of selected articles was carried out.
  
  
  RESULTS
  We evaluated 36 studies (1978-2011; 13,673 women). Of the COC users (n = 8,422), 85% reported an increase (n = 1,826) or no change (n = 5,358) in libido and 15% reported a decrease (n = 1,238). We found no significant difference in sexual desire in the case of COCs with 20-35 μg ethinylestradiol; libido decreased only with pills containing 15 μg ethinylestradiol.
  
  
  CONCLUSIONS
  The majority of COC users report no significant change in libido although in most studies a decline in plasma levels of free testosterone and an increase in those of sex hormone binding globulin were observed.
authors: Obstetrics and Gynaecology Department, 2nd Medical Faculty, Teaching Hospital Motol, Charles University, Prague, Czech Republic. pastor.zlatko@volny.cz
authors: Zlatko
authors: Z
authors: Pastor
authors: Katerina
authors: K
authors: Holla
authors: Roman
authors: R
authors: Chmel
mesh_terms: D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage*; D004997:Ethinyl Estradiol / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007989:Libido / Q000187:drug effects*; D010953:Plasma Volume / Q000502:physiology; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D012725:Sexual Behavior
chemical_list: D003277:Contraceptives, Oral, Combined; D012738:Sex Hormone-Binding Globulin; D004997:Ethinyl Estradiol