Female sexual dysfunction with combined oral contraceptive use

Abstract

Combined oral contraceptive pills (COCs) remain one of the most popular forms of contraception to prevent unwanted pregnancy in women. While it is known that COCs can cause sexual dysfunction in women, there is currently no recommendation to screen for sexual function before and after initiation of COCs. We propose that, based on the evidence available, assessment of sexual function should be done at initiation of COCs, as well as at regular intervals thereafter. This would allow COC-related sexual dysfunction to be managed early, such as by switching the patient to newer-generation COCs or other forms of contraception. Mrs Lim’s COC was switched to drospirenone 3 mg and ethinylestradiol 30 mcg. She was co-managed by a psychologist for her fear and anxiety and a physiotherapist for pelvic muscle stretching and exercises. After about three months, her libido improved and she reports that she no longer has discomfort during sexual intercourse.