How can oral contraceptives affect sexuality?

Perhaps the most controversial topic of debate that has been discussed in the field of sexual medicine is that of oral contraceptive and its influence on female sexual function. Again, the data are conflicting with respect to research and hormones. The opponents of oral contraceptive pills tout the increased levels of a protein called sex hormone binding globulin (SHBG) as a result of the oral estrogen component of the oral pills. This increase in SHBG results in a lowered free testosterone level, which many have translated into a lowered sexual interest. Although androgens including testosterone are linked to sexuality and female sexual interest, the extent to which these hormones play in female sensuality and sexuality remains to be elucidated.

Interestingly, many other studies do not support the claim of changes in sexual function with the use of oral contraceptive pills. Many report neutral effects on sexual function given their chemical and hormonal make-up, like Loestrin 24, by Warner Chicott. This pill has a shorter pill-free interval, so women who suffer from premenstrual syndrome-like symptoms have increased symptomatic relief and henceforth increased sexual interest. The same can be said for Yaz (Bayer Pharmaceuticals); since it is often prescribed for acne, this may help eliminate social isolation in the acne sufferers who may experience a boost in sexual self-esteem on the medication. There are recent concerns regarding this medication and overstated efficacy as well as potential problems with increased potassium. Donnerstein, a noted sexual medicine specialist in Australia, published research indicating that women's sexual function is more closely linked to their partners health than to their androgen levels.

Some potential benefits of birth control pills include lessened premenstrual syndrome, less bleeding, decreased anemia, and stabilization of pain from endometriosis. If these symptoms contribute to your sexual complaints, minimizing them may be associated with renewed interest in sexuality. Other studies support the notion that women who are on birth control pills have an increased sexual freedom—freedom from fear of unintended pregnancy is often liberating for the sensual woman.

Before automatically jumping to conclusions and assuming that oral contraceptives are the answer to your sexual complaints, be certain to undergo a comprehensive assessment, which should include a history, physical examination, and laboratory work. Although the pills may be a minor contributor to solutions, it is wise to seek professional care from your sexual healthcare specialist.

If, in your case, there are issues with oral contraceptive pills, safe alternatives for effective contraception include the intrauterine device (IUD), implantable contraception that releases hormones, abstinence, condoms (male and female), and permanent, irreversible sterilization. These can be effective methods of contraception with varying failure rates.

Raye comments:

Oral contraception is not liked by everyone. Some women cannot tolerate it for different reasons; however, I personally think it does have many positive influences on sexuality. With birth control comes more sexual freedom. With more sexual freedom you may experience more interest in sex as well as an increase in your overall libido. The Pill can be positive because it decreases cramps and blood flow, and most important it protects you from pregnancy. Not having to worry about that alone might make you more sexual.

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