title: Combined Oral Contraceptives and Sexual Function in Women-a Double-Blind, Randomized, Placebo-Controlled Trial.
abstract: BACKGROUND
  There is a lack of knowledge about how oral contraceptives may affect sexual function.
  
  
  OBJECTIVE
  To determine whether there is a causal effect of oral contraceptives on sexuality. We hypothesized that a widely used pill impairs sexuality.
  
  
  METHODS
  A double-blind, randomized, placebo-controlled trial. Enrollment began in February 2012 and was completed in August 2015.
  
  
  METHODS
  Karolinska University Hospital, Stockholm, Sweden.
  
  
  METHODS
  A total of 340 healthy women, aged 18-35 years, were randomized to treatment, and 332 completed the study.
  
  
  METHODS
  A combined oral contraceptive (150 μg levonorgestrel and 30 μg ethinylestradiol) or placebo for 3 months of treatment.
  
  
  METHODS
  The primary outcome was the aggregate score on the Profile of Female Sexual Function (PFSF). Secondary outcomes were the seven domains of the PFSF, the Sexual Activity Log, and the Personal Distress Scale.
  
  
  RESULTS
  Overall sexual function was similar in women in the oral contraceptive and placebo groups. The PFSF domains desire (-4.4; 95% confidence interval [CI], -8.49 to -0.38; P = .032), arousal (-5.1; 95% CI, -9.63 to -0.48; P = .030), and pleasure (-5.1; 95% CI, -9.97 to -0.32; P = .036) were significantly reduced in comparison to placebo, whereas orgasm, concern, responsiveness, and self-image were similar between groups. The mean frequency of satisfying sexual episodes and personal distress were also similar between groups.
  
  
  CONCLUSIONS
  This study shows no negative impact of a levonorgestrel-containing oral contraceptive on overall sexual function, although three of seven sexual function domains were adversely affected.
authors.affiliation: Department of Learning, Informatics, Management and Ethics (N.Z.), Karolinska Institutet, 171 77 Stockholm, Sweden; Department of Economics (A.D., M.J.), Stockholm School of Economics, 113 83 Stockholm, Sweden; Department of Economics (E.R.), University of Zurich, 8006 Zurich, Switzerland; Department of Women's and Children's Health (L.B., B.v.S., A.L.H), Karolinska Institutet, and Department of Obstetrics and Gynecology, Karolinska University Hospital, 171 76 Stockholm, Sweden; and Laval University (F.L.), Quebec City G1V 0A6, Canada.
authors.forename: Niklas
authors.initials: N
authors.lastname: Zethraeus
authors.affiliation: Department of Learning, Informatics, Management and Ethics (N.Z.), Karolinska Institutet, 171 77 Stockholm, Sweden; Department of Economics (A.D., M.J.), Stockholm School of Economics, 113 83 Stockholm, Sweden; Department of Economics (E.R.), University of Zurich, 8006 Zurich, Switzerland; Department of Women's and Children's Health (L.B., B.v.S., A.L.H), Karolinska Institutet, and Department of Obstetrics and Gynecology, Karolinska University Hospital, 171 76 Stockholm, Sweden; and Laval University (F.L.), Quebec City G1V 0A6, Canada.
authors.forename: Anna
authors.initials: A
authors.lastname: Dreber
authors.affiliation: Department of Learning, Informatics, Management and Ethics (N.Z.), Karolinska Institutet, 171 77 Stockholm, Sweden; Department of Economics (A.D., M.J.), Stockholm School of Economics, 113 83 Stockholm, Sweden; Department of Economics (E.R.), University of Zurich, 8006 Zurich, Switzerland; Department of Women's and Children's Health (L.B., B.v.S., A.L.H), Karolinska Institutet, and Department of Obstetrics and Gynecology, Karolinska University Hospital, 171 76 Stockholm, Sweden; and Laval University (F.L.), Quebec City G1V 0A6, Canada.
authors.forename: Eva
authors.initials: E
authors.lastname: Ranehill
authors.affiliation: Department of Learning, Informatics, Management and Ethics (N.Z.), Karolinska Institutet, 171 77 Stockholm, Sweden; Department of Economics (A.D., M.J.), Stockholm School of Economics, 113 83 Stockholm, Sweden; Department of Economics (E.R.), University of Zurich, 8006 Zurich, Switzerland; Department of Women's and Children's Health (L.B., B.v.S., A.L.H), Karolinska Institutet, and Department of Obstetrics and Gynecology, Karolinska University Hospital, 171 76 Stockholm, Sweden; and Laval University (F.L.), Quebec City G1V 0A6, Canada.
authors.forename: Liselott
authors.initials: L
authors.lastname: Blomberg
authors.affiliation: Department of Learning, Informatics, Management and Ethics (N.Z.), Karolinska Institutet, 171 77 Stockholm, Sweden; Department of Economics (A.D., M.J.), Stockholm School of Economics, 113 83 Stockholm, Sweden; Department of Economics (E.R.), University of Zurich, 8006 Zurich, Switzerland; Department of Women's and Children's Health (L.B., B.v.S., A.L.H), Karolinska Institutet, and Department of Obstetrics and Gynecology, Karolinska University Hospital, 171 76 Stockholm, Sweden; and Laval University (F.L.), Quebec City G1V 0A6, Canada.
authors.forename: Fernand
authors.initials: F
authors.lastname: Labrie
authors.affiliation: Department of Learning, Informatics, Management and Ethics (N.Z.), Karolinska Institutet, 171 77 Stockholm, Sweden; Department of Economics (A.D., M.J.), Stockholm School of Economics, 113 83 Stockholm, Sweden; Department of Economics (E.R.), University of Zurich, 8006 Zurich, Switzerland; Department of Women's and Children's Health (L.B., B.v.S., A.L.H), Karolinska Institutet, and Department of Obstetrics and Gynecology, Karolinska University Hospital, 171 76 Stockholm, Sweden; and Laval University (F.L.), Quebec City G1V 0A6, Canada.
authors.forename: Bo
authors.initials: B
authors.lastname: von Schoultz
authors.affiliation: Department of Learning, Informatics, Management and Ethics (N.Z.), Karolinska Institutet, 171 77 Stockholm, Sweden; Department of Economics (A.D., M.J.), Stockholm School of Economics, 113 83 Stockholm, Sweden; Department of Economics (E.R.), University of Zurich, 8006 Zurich, Switzerland; Department of Women's and Children's Health (L.B., B.v.S., A.L.H), Karolinska Institutet, and Department of Obstetrics and Gynecology, Karolinska University Hospital, 171 76 Stockholm, Sweden; and Laval University (F.L.), Quebec City G1V 0A6, Canada.
authors.forename: Magnus
authors.initials: M
authors.lastname: Johannesson
authors.affiliation: Department of Learning, Informatics, Management and Ethics (N.Z.), Karolinska Institutet, 171 77 Stockholm, Sweden; Department of Economics (A.D., M.J.), Stockholm School of Economics, 113 83 Stockholm, Sweden; Department of Economics (E.R.), University of Zurich, 8006 Zurich, Switzerland; Department of Women's and Children's Health (L.B., B.v.S., A.L.H), Karolinska Institutet, and Department of Obstetrics and Gynecology, Karolinska University Hospital, 171 76 Stockholm, Sweden; and Laval University (F.L.), Quebec City G1V 0A6, Canada.
authors.forename: Angelica Lindén
authors.initials: AL
authors.lastname: Hirschberg
mesh_terms: D000293:Adolescent; D000328:Adult; D001143:Arousal / Q000187:drug effects; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects*; D004311:Double-Blind Method; D004338:Drug Combinations; D004997:Ethinyl Estradiol / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016912:Levonorgestrel / Q000009:adverse effects*; D059012:Lost to Follow-Up; D010352:Patient Dropouts; D017060:Patient Satisfaction; D057181:Pleasure / Q000187:drug effects; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced* / Q000503:physiopathology; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced* / Q000523:psychology; D013315:Stress, Psychological / Q000139:chemically induced / Q000523:psychology; D013548:Sweden; D055815:Young Adult
chemical_list: D003277:Contraceptives, Oral, Combined; D004338:Drug Combinations; C072593:ethinyl estradiol, levonorgestrel drug combination; D004997:Ethinyl Estradiol; D016912:Levonorgestrel