Sexual Function and Metabolic/Hormonal Changes in Women Using Long-Term Hormonal and Non-Hormonal Contraceptives: A pilot study.

Abstract

Background: Female sexual dysfunction is a common condition that negatively impacts the emotional health and quality of life of the affected individuals. Long-acting reversible contraceptives (LARCs) are becoming increasingly popular due to their effectiveness and convenience. LARCs can be hormonal (etonogestrel releasing implant—ENG and Levonorgestrel intrauterine system—LNG) or non-hormonal (copper intrauterine device—CuIUD and copper-silver intrauterine device—SIUD). There are very few studies that assess the influence on LARCS on sexual function are lacking. This study aimed to assess changes in sexual function as well as metabolic and hormonal parameters in women after implantation with LARCs.Methods: In this prospective cohort study, we assessed 80 women who visited the Military Police Hospital in Brazil for LARCs placement. The study participants were divided into 4 groups according to the type of LARC received: ENG n=17; LNG n=21, CuIUD n=18 and SIUD n=23. The four groups were evaluated twice (prior to LARC placement and approximately 3 months later) for sexual function, using the Female Sexual Function Index (FSFI) and Female Sexual Quotient (QS-F) questionnaires. Metabolic and hormonal parameters were also assessed using blood tests. Results: ENG worsened sexual function according to FSFI and QS-F, across all domains. A decrease in sex hormone-binding globulin (SHBG) between stages was observed for all groups. We observed an improvement in sexual function for non-hormonal LARCs, specially SIUD. However this improvement was not statistically significant. Conclusion: The use of non-hormonal LARCS improved sexual function. Etonogestrel implants, had a negative influence on sexual function, probably by blocking ovarian function, and thus reducing the production of androgens and estrogens.

Evaluation of Sexual Functions in Women Using Hormonal or Non-Hormonal Contraceptives

“…In literature, there were different studies examined the effect of contraceptives on sexuality. FSD was lower in women who used hormonal methods in our study, which was consistent with previous research (25,37), but contradictory to those of other research (3,12,28,47,48). In women who used hormonal methods, studies found that desire (14), arousal (12,14,18), orgasm (12), and total FSFI scores (14,47) were low, but vaginal dryness (12) and pain (18) were high According to these studies, contraceptive has a negative impact on sexuality by decreasing circulating testosterone levels as well as serum levels of estradiol and progesterone.…”

Effects of Depot Medroxyprogesterone Acetate Intramuscular Injection, Copper Intrauterine Device and Levonorgestrel Implant Contraception on Estradiol Levels: An Ancillary Study of the ECHO Randomized Trial

“…In a previous randomized trial, we found reduced sexual activity among participants randomized to injectable progestogens vs. the copper T 380 intrauterine device (IUD) ( 10 , 11 ). The etonogestrel implant and the DMPA-IM have been associated with impaired sexual function ascribed to suppressed estrogen and/or androgen levels ( 12 , 13 ).…”