Prolonged Use of Oral Contraceptives & Hormonal Changes

Beginning with its introduction in 1960, millions of women embraced the birth control pill as an effective, convenient method of controlling their fertility. The pill, especially in its earliest incarnation, carried some strong hormonal side effects including dangerous ones such as an increased risk of blood clots and stroke. While most women know the pill's temporary hormonal effects, some studies indicate they might also carry a risk of permanent hormonal changes.

Significance

• Researchers in a January 2006 study published in the Journal of Sexual medicine discovered elevated levels of Sex Hormone Binding Globulin (SHBG), the protein that binds testosterone, in women actively taking birth control pills and those who had discontinued pill use at least 120 days prior to the study.

Types

• The study surmises that the decreased access to testosterone in hormonal birth control users might potentially cause side effects ranging from sexual dysfunction to metabolic disorders. While many doctors acknowledge that decreased libido can be a side effect of hormonal birth control while women are taking it, this is the first study to indicate women might still struggle with this side effect after discontinuing the pills.

Considerations

• The pill is currently used by over 10 million women in the USA and 80 percent of those born after 1945 used it at one point or another. Despite numerous complaints of sexual dysfunction and decreased libido over the last 40 years of pill usage, few people are aware that these pills can negatively affect sex drive. In fact, for years many doctors dismissed women's complaints as mental rather than physiological. According to Dr. Drew Pinsky, the host of TV's "Love Line," doctors have been somewhat negligent for failing to fully disclose the profound effects hormonal birth control pills might have on the female libido.

Expert Insight

• The study's lead researcher, urologist Dr. Irwin Goldstein, says "This work is the culmination of 7 years of observational research in which we noted in our practice many women with sexual dysfunction who had used the oral contraceptive but whose sexual and hormonal problems persisted despite stopping the birth control pill. There are approximately 100 million women worldwide who currently use oral contraceptives, so it is obvious that more extensive research investigations are needed. The oral contraceptive has been around for over 40 years, but no one had previously looked at the long-term effects of SHBG in these women. The larger problem is that there have been limited research efforts in women's sexual health problems in contrast to investigatory efforts in other areas of women's health or even in male sexual dysfunction."

Prevention/Solution

• Prior to prescribing hormonal birth control, doctors should discuss potential sexual side effects including diminished sexual desire, decreased lubrication and increased pain with intercourse. Birth control pill users who suffer from these side effects should seek a doctor's assistance and advice. Changing the type of hormonal pill might be helpful, since some women find that triphasic pills in which hormonal levels differ on a weekly basis have less effect on their sex drive than monophasic ones, which offer static hormone delivery levels.