Abstract
Objectives To determine the relationship between the use of combined oral contraceptives (COCs) and sexual desire based on a systematic review of the literature. Methods MEDLINE Complete, Google Scholar and the Cochrane Library were searched for articles published between 1975 and 2011, reporting the effects of oral contraceptives on sexual desire.
Reports fully meeting all the predefi ned criteria were analysed and included in a fi nal reference list. In addition, a review of the reference list of selected articles was carried out.
Results We evaluated 36 studies (1978 – 2011; 13,673 women). Of the COC users ( n 8,422), 85% reported an increase ( n 1,826) or no change ( n 5,358) in libido and 15% reported a decrease ( n 1,238).
We found no signifi cant difference in sexual desire in the case of COCs with 20 – 35 μ g ethinylestradiol; libido decreased only with pills containing 15 μ g ethinylestradiol. Conclusions The majority of COC users report no signifi cant change in libido although in most studies a decline in plasma levels of free testosterone and an increase in those of sex hormone binding globulin were observed.