Combined Oral Contraceptives and Sexual Function in Women-a Double-Blind, Randomized, Placebo-Controlled Trial

Context: There is a lack of knowledge about how oral contraceptives may affect sexual function. Objective: To determine whether there is a causal effect of oral contraceptives on sexuality. We hypothesized that a widely used pill impairs sexuality. Design: A double-blind, randomized, placebo-controlled trial. Enrollment began in February 2012 and was completed in August 2015. Setting: Karolinska University Hospital, Stockholm, Sweden. Participants: A total of 340 healthy women, aged 18-35 years, were randomized to treatment, and 332 completed the study. Interventions: A combined oral contraceptive (150 mu g levonorgestrel and 30 mu g ethinylestradiol) or placebo for 3 months of treatment. Main Outcome Measures: The primary outcome was the aggregate score on the Profile of Female Sexual Function (PFSF). Secondary outcomes were the seven domains of the PFSF, the Sexual Activity Log, and the Personal Distress Scale. Results: Overall sexual function was similar in women in the oral contraceptive and placebo groups. The PFSF domains desire (-4.4; 95% confidence interval [CI], -8.49 to -0.38; P =.032), arousal (-5.1; 95% CI, -9.63 to -0.48; P=.030), and pleasure (-5.1; 95% CI, -9.97 to -0.32; P =.036) were significantly reduced in comparison to placebo, whereas orgasm, concern, responsiveness, and self-image were similar between groups. The mean frequency of satisfying sexual episodes and personal distress were also similar between groups. Conclusions: This study shows no negative impact of a levonorgestrel-containing oral contraceptive on overall sexual function, although three of seven sexual function domains were adversely affected.