title: The effect of a drospirenone-containing combined oral contraceptive on female sexual function: a prospective randomised study.
abstract: OBJECTIVE
  The study investigated the effects on female sexual function of a progestogen-containing combined oral contraceptives (COCs) with an antiandrogenic profile taken in a continuous regimen.
  
  
  METHODS
  In this prospective randomised single-institution study, 80 healthy women with a monogamous partner and an active sexual life were randomised into two groups for a period of 3 months. Women in the exposed group (n = 40) took a COCs containing 30 μg ethinylestradiol (EE) and 3 mg drospirenone (DRSP) in a 21/7 regimen. Women in the control group (n = 40) used either a barrier contraceptive method (BCM) or a natural family planning method (NFPM). Participants were asked to complete a set of validated questionnaires to assess sociodemographic variables and measure Female Sexual Function Index (FSFI).
  
  
  RESULTS
  The total FSFI score (p < 0.0001), as well as the desire (p = 0.04) and arousal (p = 0.03) scores, were significantly lower in the COCs group after 3 months of hormonal contraceptive use compared with baseline. Women using BCM or NFPM showed an improvement in total FSFI score (p = 0.02). Hormonal contraception with DRSP increased the likelihood of worse sexual function in the desire (odds ratio [OR] 2.47; 95% confidence interval [CI] 1.22, 4.98; p = 0.01) and arousal domains (OR 2.85; 95%CI 1.34, 5.93; p = 0.005) and in total FSFI score (OR 2.01; 95%CI 1.45, 2.79; p < 0.001). The results remained statistically significant even after adjustment for smoking status.
  
  
  CONCLUSIONS
  The study found evidence that women taking a combined EE/DRSP COCs for 3 months may have a worsening of sexual function as measured by FSFI.
authors.affiliation: a Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences , Kaunas , Lithuania ;
authors.forename: Lina
authors.initials: L
authors.lastname: Čiaplinskienė
authors.affiliation: a Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences , Kaunas , Lithuania ;
authors.forename: Birutė
authors.initials: B
authors.lastname: Žilaitienė
authors.affiliation: a Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences , Kaunas , Lithuania ;
authors.forename: Rasa
authors.initials: R
authors.lastname: Verkauskienė
authors.affiliation: a Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences , Kaunas , Lithuania ;
authors.forename: Rimantas
authors.initials: R
authors.lastname: Žalinkevičius
authors.affiliation: b Clinic of Obstetrics and Gynaecology, Faculty of Medicine , Vilnius University , Vilnius , Lithuania ;
authors.forename: Žana
authors.initials: Ž
authors.lastname: Bumbulienė
authors.affiliation: c Department of Obstetrics and Gynaecology, Medical Academy , Lithuanian University of Health Sciences , Kaunas , Lithuania ;
authors.forename: Virginija
authors.initials: V
authors.lastname: Vanagienė
authors.affiliation: d Department of Obstetrics and Gynaecology , University Hospital Basel , Basel , Switzerland.
authors.forename: Johannes
authors.initials: J
authors.lastname: Bitzer
mesh_terms: D000328:Adult; D000736:Androstenes / Q000627:therapeutic use*; D042121:Contraception, Barrier; D003277:Contraceptives, Oral, Combined / Q000627:therapeutic use*; D004997:Ethinyl Estradiol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007989:Libido; D012252:Natural Family Planning Methods; D016017:Odds Ratio; D012307:Risk Factors; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology*; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000736:Androstenes; D003277:Contraceptives, Oral, Combined; C534342:drospirenone and ethinyl estradiol combination; D004997:Ethinyl Estradiol
keywords: Combined oral contraceptives; drospirenone; female sexual function