Oral contraceptives vs injectable progestin in their effect on sexual behavior

Schaffir, Jonathan; Isley, Michelle M.; Woodward, Megan

doi:10.1016/j.ajog.2010.07.024

Cited by 23 publications

(21 citation statements)

References 21 publications

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“…In addition, no SD or SEM reported for total T concentrations at pretreatmentOranratanaphan and Taneepanichskul (2006)Not able to obtain a copy of the full textGraham et al (2007)Publication combines results of two studies; results of one of these studies are also reported by Greco et al (2007). The latter has been used in the meta-analysis, but publication of Graham et al (2007) was also used to obtain additional informationWinkler and Sudik (2009)Results were judged to be of insufficient quality; SHBG converted, but after conversion values do not seem to be correct; all measurements for free T values during treatment are 2.08 pmol/l, therefore no SD can be reported (assumed that LOQ of assay was 2.08 pmol/l, therefore free T concentrations could not be measured and the LOQ has been reported.Schaffir et al . (2010)Observational study and wrong study population (women are using a COC at pretreatment)Heiman et al .…”

Section: Resultsmentioning

confidence: 99%

The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysis

Zimmerman

et al. 2013

Human Reproduction Update

245

151

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BACKGROUNDCombined oral contraceptives (COCs) reduce levels of androgen, especially testosterone (T), by inhibiting ovarian and adrenal androgen synthesis and by increasing levels of sex hormone-binding globulin (SHBG). Although this suppressive effect has been investigated by numerous studies over many years, to our knowledge no systematic review concerning this issue had been performed. This systematic review and meta-analysis was performed to evaluate the effect of COCs on concentrations of total T, free T and SHBG in healthy women and to evaluate differences between the various types of COCs (e.g. estrogen dose, type of progestin) and the assays used to assess total T and free T.METHODSA review of the literature was performed using database searches (MEDLINE, EMBASE and the Cochrane Central Register of Clinical Trials) and all publications (from inception date until July 2012) investigating the effect of COCs on androgen levels in healthy women were considered eligible for selection. Three reviewers were involved in study selection, data extraction and critical appraisal. For the meta-analysis, data on total T, free T and SHBG were extracted and combined using random effects analysis. Additional subgroup analyses were performed to evaluate differences between the various types of COCs (e.g. estrogen dose, type of progestin) and the assays used to assess total T or free T.RESULTSA total of 151 records were identified by systematic review and 42 studies with a total of 1495 healthy young women (age range: 18–40 years) were included in the meta-analysis. All included studies were experimental studies and 21 were non-comparative. Pooling of the results derived from all the included papers showed that total T levels significantly decreased during COC use [mean difference (MD) (95% confidence interval, CI) −0.49 nmol/l (−0.55, −0.42); P < 0.001]. Significantly lower levels of free T were also found [relative change (95% CI) 0.39 (0.35, 0.43); P < 0.001], with a mean decrease of 61%. On the contrary, SHBG concentrations significantly increased during all types of COC use [MD (95% CI) 99.08 nmol/l (86.43, 111.73); P < 0.001]. Subgroup analyses revealed that COCs containing 20–25 µg EE had similar effects on total and free T compared with COCs with 30–35 µg EE. In addition, suppressive effects on T levels were not different when comparing different types of progestins. However, subgroup analyses for the estrogen dose and the progestin type in relation to changes in SHBG levels did show significant differences: COCs containing second generation progestins and/or the lower estrogen doses (20–25 µg EE) were found to have less impact on SHBG concentrations.CONCLUSIONSThe current literature review and meta-analysis demonstrates that COCs decrease circulating levels of total T and free T and increase SBHG concentrations. Due to the SHBG increase, free T levels decrease twice as much as total T. The estrogen dose and progestin type of the COC do not influence the decline of total and free T, but both affect SHBG. The clinica...

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Section: Resultsmentioning

confidence: 99%

The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysis

Zimmerman

et al. 2013

Human Reproduction Update

245

151

View full text Add to dashboard Cite

show abstract

“…A study on sexual function in women in United States showed there was no significant difference among effects of injectable contraceptive method on sexual function in women using them (Schaffir et al . ).…”

Section: Discussionmentioning

confidence: 97%

Sexual function in Iranian women using different methods of contraception

Ghadirian

Marjan

Rezaee

et al. 2013

Journal of Clinical Nursing

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“…Most research on OCs and sexuality examines libido [17, 21, 50]. Oral contraceptives with estrogen reduce total and free testosterone, and decreased androgens are cited as a plausible biological mechanism for reduced libido in OC users [53].…”

Section: Method-specific Considerationsmentioning

confidence: 99%

“…Progestin methods that strongly suppress ovarian function and reduce endogenous estradiol could impact sexual functioning by contributing to vaginal dryness, especially in peri-menopausal women. Some recent contraceptive research benefits from use of the validated Female Sexual Functioning Index (FSFI) [13], which contains domains on desire, arousal, lubrication, orgasm, pain, and other sexual functions [14–17]. …”

Section: Ways In Which Contraception Can Affect Sexual Functioning Anmentioning

confidence: 99%

Contraceptive sex acceptability: a commentary, synopsis and agenda for future research

Higgins

Davis

2014

Contraception

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Oral contraceptives vs injectable progestin in their effect on sexual behavior

Cited by 23 publications

References 21 publications

The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysis

The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysis

Sexual function in Iranian women using different methods of contraception

Contraceptive sex acceptability: a commentary, synopsis and agenda for future research

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