title: The sexuological impact of hormonal contraceptives based on their route of administration.
abstract: Evidence on the effects of hormonal contraceptives on female sexuality is conflicting. We enrolled 556 women, divided into six groups: two composed of subjects using a combined hormonal contraceptive (COC) containing 0.020 ("COC20") and 0.030 ("COC30") mg of ethynyl estradiol (EE), "natural", using COC containing 1.5 mg of estradiol (E2), "ring", using a vaginal ring releasing each day 0.015 mg of EE + 0.120 of etonogestrel, "subcutaneous", using a progestin only subcutaneous contraceptive implant releasing etonogestrel and "controls", using no hormonal contraceptive methods. The subjects were required to answer to the McCoy female sexuality questionnaire and were subjected to a blood test for hormonal evaluation. An ultrasound evaluation of the dorsal clitoral artery was also performed. The higher McCoy sexological value were recorded in the subdermal group; significant differences were recorded among the groups in terms of hormone distribution, with the higher levels of androstenedione in subdermal and control groups. The ultrasound evaluation of dorsal clitoral artery shows a significative correlation between pulsatility and resistance indices and orgasm parameters of McCoy questionnaire. The recorded difference in the sexual and hormonal parameters among the studied hormonal contraceptives may guide toward the personalization of contraceptive choice.
authors.affiliation: a Department of Medicine "Scuola Medica Salernitana" , University of Salerno , Salerno , Italy.|b Theoreo srl - spin-off of the University of Salerno , Salerno , Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Guida
authors.affiliation: c Department of Neurosciences and Reproductive Sciences , University of Naples Federico II , Naples , Italy , and.
authors.forename: Costantino
authors.initials: C
authors.lastname: Di Carlo
authors.affiliation: a Department of Medicine "Scuola Medica Salernitana" , University of Salerno , Salerno , Italy.|b Theoreo srl - spin-off of the University of Salerno , Salerno , Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Troisi
authors.affiliation: a Department of Medicine "Scuola Medica Salernitana" , University of Salerno , Salerno , Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Gallo
authors.affiliation: a Department of Medicine "Scuola Medica Salernitana" , University of Salerno , Salerno , Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Cibarelli
authors.affiliation: d Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause Unit, Dept of Obstetrics and Gynecology, IRCCS "S. Matteo Foundation", University of Pavia , Pavia , Italy.
authors.forename: Ellis
authors.initials: E
authors.lastname: Martini
authors.affiliation: d Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause Unit, Dept of Obstetrics and Gynecology, IRCCS "S. Matteo Foundation", University of Pavia , Pavia , Italy.
authors.forename: Lara
authors.initials: L
authors.lastname: Tiranini
authors.affiliation: d Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause Unit, Dept of Obstetrics and Gynecology, IRCCS "S. Matteo Foundation", University of Pavia , Pavia , Italy.
authors.forename: Rossella E
authors.initials: RE
authors.lastname: Nappi
mesh_terms: D000328:Adult; D002987:Clitoris / Q000098:blood supply / Q000000981:diagnostic imaging / Q000187:drug effects; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D003274:Contraceptive Devices, Female / Q000009:adverse effects; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000009:adverse effects; D017135:Desogestrel / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D004305:Dose-Response Relationship, Drug; D004343:Drug Implants; D004967:Estrogens / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D007558:Italy; D008535:Megestrol / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D009649:Norpregnadienes / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D009948:Orgasm / Q000187:drug effects; D011372:Progestins / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D012039:Regional Blood Flow / Q000187:drug effects; D057566:Self Report; D012725:Sexual Behavior / Q000187:drug effects*; D018608:Ultrasonography, Doppler; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D003277:Contraceptives, Oral, Combined; D003278:Contraceptives, Oral, Hormonal; D003692:Delayed-Action Preparations; D004343:Drug Implants; D004967:Estrogens; D009649:Norpregnadienes; D011372:Progestins; C044815:etonogestrel; D017135:Desogestrel; C038501:nomegestrol acetate; D008535:Megestrol
keywords: Combined hormonal contraceptive; McCoy female sexuality questionnaire; dorsal clitoral artery ultrasound; hormonal profile; personalized contraception