Effects of OCs may persist after Rx discontinuation.(Gynecology)

WASHINGTON -- The hypoandrogenic effects of oral contraceptives may not be completely reversible after discontinuation of their use, Claudia Panzer, M.D., reported at the annual meeting of the American Association of Clinical Endocrinologists.

OCs are known to decrease serum testosterone levels by decreasing ovarian production of testosterone and increasing production of sex hormone-binding globulin (SHBG) by the liver. Higher SHBG levels lower the amount of free testosterone that reaches the tissues. Such changes have been associated with decreases in sexual interest, arousal, vaginal lubrication, and frequency of sexual intercourse.

It has long been assumed that these changes are reversible after discontinuation of OC use, but findings from a retrospective review of 124 premenopausal women with female sexual dysfunction suggest otherwise, said Dr. Panzer, an endocrinologist at Boston University.

Among the subjects were 62 current OC users, 39 former users, and 23 who had never used OCs. None of the subjects had used OCs for reasons other than birth control. The "never users" were older than the current users (36 vs. 32 years), and had a longer duration of sexual dysfunction than current and former OC users (9 years vs. 6 years in both OC groups).

Those who had never used OCs also scored higher on the Female Sexual Function Index, indicating better function (21 points, vs. 15 points for the current OC users and 10 points for the former users). Women on OCs had lower scores in the domain of sexual desire, compared with those who had never used them, and also complained more about sexual pain.