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Objective: To investigate the relationship between combined hormonal contraception (CHC) and women’s sexual function with special emphasis on the type of progestin in the CHC Methods: A community sample of 252 healthy, sexually active women aged 18 to 35 completed a questionnaire including the Female Sexual Function Index (FSFI), the Female Sexual Distress Scale (FSDS), and questions about contraception use. Participants were divided into 151 users of CHC, also subdivided into progestin-type subgroups, and 101 users of non-hormonal or no contraception (non-HC). Results: Significantly fewer women using CHC reported sexual distress (p=0.038) compared to non-HC users, but the number reporting sexual problems did not differ (p=0.081). In subgroup analyses, significantly fewer women in the ‘other progestin’-CHC group reported sexual problems (p<0.001) and sexual distress (p=0.008) compared to women in the anti-androgenic progestin-CHC group. Significantly, fewer women in the ‘other progestin’-CHC group reported sexual problems (p=0.003) and sexual distress (p=0.006) versus women in the non-HC group. Results remained significant after controlling for age, relationship, children living at home, alcohol consumption, and smoking. Conclusions: Women using CHC containing anti-androgenic progestins more often reported sexual problems and sexual distress than women using CHC with other types of progestins.

Combined Hormonal Contraception and Women’s sexual function: a cross-sectional pilot study in a Cohort of Danish women