May 5, 2010 -- A new European study has found that women who use hormonal contraceptives such as the birth control pill are more likely to experience sexual dysfunction such as reduced desire and arousal than women who use non-hormonal contraception and women who do not use contraception.
Reporting in The Journal of Sexual Medicine, the German researchers also find that women who used non-hormonal contraceptives, such as condoms, were at a lower risk for female sexual dysfunction (FSD) when compared with women who didn’t use contraception.
A possible link between hormonal contraception and sexual dysfunction has been reported before, but the studies have often produced conflicting results.
The Pill and Sexual Dysfunction
Researchers led by Lisa-Maria Wallwiener, MD, of the University of Heidelberg, Germany, surveyed more than 1,000 medical students about their sex lives and contraception choices. More than 87% of the students reported they had used contraceptives in the last six months. Eighty percent said they were in stable relationships; 97% reported being sexually active in the previous four weeks.
The students were divided into four groups: those who used oral hormonal contraception; those who used non-oral hormonal contraception, such as a vaginal ring; those who used non-hormonal contraception; and those who didn’t use contraception. Overall, the study results showed that:
- 32.4% were at risk for female sexual dysfunction
- 8.7% were at risk for orgasm disorder
- 5.8% were at risk for hypoactive sexual desire disorder
- 2.6% were at risk for satisfaction problems
- 1% were at risk for arousal disorder
- 1.2% were at risk for decreased lubrication
- 1.1% were at risk for pain
In addition to contraception choices, stress, pregnancy, smoking, relationship status, and a desire for children all influenced sexual function. Women who were in stable relationships, were nonsmokers, who had not been pregnant, and were not actively trying to have a baby were more likely to use oral contraceptives like the birth control pill, the research team reports. Women not in stable relationships -- regardless of their contraception use -- had higher sexual desire but lower orgasm scores.
"Sexual problems can have a negative impact on both quality of life and emotional well-being, regardless of age," says Wallwiener, who lead the study. "FSD is a very common disorder, with an estimated prevalence of about two in five women having at least one sexual dysfunction, and the most common complaint appearing to be low desire."
Contraceptives Safe, Effective
Study co-author Alfred O. Mück, MD, PhD, tells WebMD in an email that any biological mechanisms behind hormonal contraceptive use and sexual dysfunction remain unclear at this point.
“Our study reveals only the association,” Mück says. “Hints at the biological mechanism could be received perhaps in the ongoing study in the future.”
Mück also notes the findings should not deter women from contraception. “Currently, there are no changes in the recommendations. Hormonal contraception is by far the most safe, non-invasive contraceptive method.”
Nazema Y. Siddiqui, MD, an ob-gyn at Duke University Medical Center in Durham, N.C., says the study was only observational and does not draw any cause-and-effect conclusions that should sway women toward one contraceptive choice or another. Moreover, she said, the participants selected for this study -- female medical students -- may not necessarily reflect other groups of women.
“You would have to assume that female medical students, who are highly educated and lead stressful lives, may be different than the general population,” Siddiqui tells WebMD in an email. “Therefore, if you are trying to understand the association between hormonal contraception and sexual dysfunction, a more diverse, general population would be preferred to answer this question. Because sex and desire can also be affected by stress, partner-related factors, and medical issues, it is hard to draw sweeping conclusions based on observational data.”