Hormonal contraception linked to female sexual dysfunction

The physiology of female hormonal contraception and its associated problems is an important and extensive topic.  This study just published in The Journal of Sexual Medicine addresses one sensitive aspect: the deleterious effect of hormonal contraception on female sexual function. The aim of the authors was:

"To investigate the prevalence and types of FSD (female sexual dysfunction) and the relationship between hormonal contraception (HC) and FSD in female German medical students."

They analyzed data obtained from 1,086 female German students from six medical schools for sexual dysfunction associated with orgasm, desire, satisfaction, lubrication, pain and arousal included in the Female Sexual Function Index (FSFI). What did the data show?

"The method of contraception and smoking were factors with significant effect on the total FSFI score whereby hormonal contraception was associated with lower total FSFI scores and lower desire and arousal scores than no contraception and non-hormonal contraception only."

The subjects at lowest risk for female sexual dysfunction (those who had the highest FSFI score) were the ones using condoms or other non-hormonal contraception. The authors state in their conclusion:

"The contraception method has a significant effect on the sexual functioning score and women using contraception, especially hormonal contraception, had lower sexual functioning scores."

This makes sense, since inhibition of ovarian testosterone production and an increase of sex hormone binding globulin that "locks up" the available testosterone are among the dysregulating effects of hormonal contraception (free fraction bioactive testosterone is necessary for normal female arousal and satisfaction).