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Risk of sexual dysfunction with progestin-based contraceptives in women of child-bearing age

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

To examine whether there is a positive association between sexual dysfunction (SD) and different types of progestin-based contraceptives.

Methods

Nested case-control study in women of child-bearing age (15–45 years) from the IQVIA® Ambulatory electronic medical record database from 2008 to 2018. Cases defined by diagnosis of sexual dysfunction identified by international classification for disease clinical modification code 9th and 10th. Each case was matched to four controls and rates of prescriptions of the following were compared: levonorgestrel intra-uterine device (IUD), progestin, and ethinyl estradiol (EE) combined oral contraceptive (COC) formulations including levonorgestrel, norgestimate, drospirenone, desogestrel, norethindrone, and norgestrel; etonogestrel vaginal ring; and medroxyprogesterone injection.

Results

Overall, 6689 cases of patients with SD were matched to 26,756 matched controls. Compared with matched controls, more subjects with SD used levonorgestrel IUD (OR 1.24, 95% CI 1.08–1.44), EE-levonorgestrel COC (OR 1.18, 95% CI 1.00–1.41), EE-drospirenone (OR 1.28, 95% CI 1.00–1.67), and medroxyprogesterone (OR 1.38, 95% CI 1.12–1.70). The use of norgestrel exhibited a protective effect (OR 0.83, 95% CI 0.73–0.95). When using the EE-levonorgestrel COC as a comparator, norgestrel users exhibited a protective effect (OR 0.70, 95% CI 0.57–0.87) while no other contraceptives showed a statistically significant difference in association with SD.

Conclusion

Our study found an increase in the use of levonorgestrel (COC and IUD), drospirenone, and medroxyprogesterone in subjects with SD. The risk of contraceptives did not differ when compared with oral levonorgestrel. The small association size and lack of difference between drug formulations suggest a minimal impact of progestin-based contraceptives on sexual dysfunction.

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Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Department of Surgery, University of British Columbia, Vancouver, BC, Canada

    Michael Y. Guo

  2. Department of Ophthalmology and Visual Sciences, Faculty of Medicine, Department of Anesthesia, Pharmacology and Therapeutics, The Eye Care Center, University of British Columbia, Room 323-2550 Willow Street, Vancouver, BC, V5Z 3N9, Canada

    Mohit Sodhi & Mahyar Etminan

  3. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada

    Farzin Khosrow-Khavar

Authors
  1. Michael Y. Guo
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  2. Mohit Sodhi
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  3. Farzin Khosrow-Khavar
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  4. Mahyar Etminan
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Michael Guo, Farzin Khrosrow-Khavar, and Mahyar Etminan. The first draft of the manuscript was written by Michael Guo and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Mahyar Etminan.

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Conflict of interest

The authors declare that they have no conflict of interest.

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This is an observational study. The University of British Columbia Research Ethics Committee has confirmed that no ethical approval is required.

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Appendix

Appendix

Table 4 Crude and adjusted odds ratios of exposure to different contraceptives stratified among women less than or equal to 30 years of age
Full size table
Table 5 Crude and adjusted odds ratios of exposure to different contraceptives stratified among women greater than 30 years
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Table 6 Crude and adjusted odds ratios of exposure to different using oral contraceptives containing levonorgestrel as a comparator stratified to ≤ 30
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Table 7 Crude and adjusted odds ratios of exposure to different contraceptives when using oral contraceptives containing levonorgestrel as a comparator stratified to women greater 30 years of age
Full size table

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Guo, M.Y., Sodhi, M., Khosrow-Khavar, F. et al. Risk of sexual dysfunction with progestin-based contraceptives in women of child-bearing age. Eur J Clin Pharmacol 77, 133–140 (2021). https://doi.org/10.1007/s00228-020-02983-0

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  • DOI: https://doi.org/10.1007/s00228-020-02983-0

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