The influence of combined oral contraceptives on female sexual desire: a systematic review
Pastor, Z.; Holla, K.; Chmel, R.
European Journal of Contraception and Reproductive Health Care the Official Journal of the European Society of Contraception 18(1): 27-43
2013
ISSN/ISBN: 1473-0782 PMID: 23320933 DOI: 10.3109/13625187.2012.728643Document Number: 565570
To determine the relationship between the use of combined oral contraceptives (COCs) and sexual desire based on a systematic review of the literature. MEDLINE Complete, Google Scholar and the Cochrane Library were searched for articles published between 1975 and 2011, reporting the effects of oral contraceptives on sexual desire. Reports fully meeting all the predefined criteria were analysed and included in a final reference list. In addition, a review of the reference list of selected articles was carried out. We evaluated 36 studies (1978-2011; 13,673 women). Of the COC users (n = 8,422), 85% reported an increase (n = 1,826) or no change (n = 5,358) in libido and 15% reported a decrease (n = 1,238). We found no significant difference in sexual desire in the case of COCs with 20-35 μg ethinylestradiol; libido decreased only with pills containing 15 μg ethinylestradiol. The majority of COC users report no significant change in libido although in most studies a decline in plasma levels of free testosterone and an increase in those of sex hormone binding globulin were observed.