Sexual behavior and oral contraception: a pilot study

J Sex Med. 2012 Feb;9(2):550-7. doi: 10.1111/j.1743-6109.2011.02597.x. Epub 2011 Dec 21.


Introduction: Oral contraceptives (OCs) induce mood and libido changes.

Aim: The aim of this study was to evaluate in young, eumenorrheic, healthy women the sexual behavior and the genital vascular effects of an OC containing 30 µg ethinylestradiol (EE) and 3 mg drospirenone (DRSP).

Main outcome measures: The main outcome measures are McCoy Female Sexuality Questionnaire (MFSQ), the labia minora thickness and vaginal introitus area, the pulsatility index (PI) of clitoral and labia minora arteries, and hormonal and biochemical assays.

Methods: Twenty-two adult, eumenorrheic, healthy women were administered the two-factor Italian MFSQ. The labia minora thickness was studied by two-dimensional ultrasonographic, and the clitoral and labia minora arteries were evaluated by color Doppler; three-dimensional static volumes of the vulvar area were calculated. Hormonal (estradiol, androstenedione, and testosterone) and biohumoral (sex hormone binding globulin) parameters were assayed. Subjects were studied in baseline conditions and after 3 months of therapy with an OC (Yasmin®, Bayer-Schering Italia, Milan, Italy; -30 µg EE + 3 mg DRSP).

Results: After 3-month treatment, the labia minora thickness and the vaginal introitus area significantly decreased in comparison with the baseline values, whereas the PI of the dorsal clitoral artery and the posterior labial artery significantly increased. The OC use induced a significant decrease of the two-factor Italian MFSQ score, a reduction of the number of intercourse/week, and a reduction of the frequency of orgasm during intercourse. The item 18 (pain during intercourse) worsened after OC.

Conclusions: The treatment with Yasmin® (Bayer-Schering Italia) is associated with increased pain during intercourse, with decreased libido and spontaneous arousability, and with diminished frequency of sexual intercourse and orgasm.

MeSH terms

  • Adolescent
  • Adult
  • Androstenedione / blood
  • Androstenes / adverse effects*
  • Contraceptives, Oral / adverse effects*
  • Estradiol / blood
  • Ethinyl Estradiol / adverse effects*
  • Female
  • Genitalia, Female / anatomy & histology
  • Genitalia, Female / diagnostic imaging
  • Genitalia, Female / drug effects*
  • Gonadal Steroid Hormones / blood*
  • Humans
  • Imaging, Three-Dimensional
  • Libido / drug effects
  • Orgasm / drug effects
  • Pilot Projects
  • Sex Hormone-Binding Globulin / analysis
  • Sexual Behavior / drug effects*
  • Surveys and Questionnaires
  • Testosterone / blood
  • Ultrasonography, Doppler, Color
  • Young Adult


  • Androstenes
  • Contraceptives, Oral
  • Gonadal Steroid Hormones
  • Sex Hormone-Binding Globulin
  • drospirenone and ethinyl estradiol combination
  • Testosterone
  • Androstenedione
  • Ethinyl Estradiol
  • Estradiol