Do Oral Combined Contraceptive Pills Modify Body Image and Sexual Function?

Abstract Background. The effect of hormonal contraceptives on sexual function and body image is still controversial. Existing studies have not come to definite conclusion on the associate between hormonal contraceptive use and sexual function/presence of sexual dysfunction nor changes in body image perception. Thus, this study aimed to evaluate the prevalence of sexual problems/dysfunction in Polish women in the reproductive age (18-45 years) and to assess to what extend oral combined contraceptive pills (OCCP) impact body image, sexual function and prevalence of Female Sexual Dysfunction – FSD. Methods. 495 women were included in this cross-sectional questionnaire-based study. Sexual function was assessed by Changes in Sexual Function Questionnaire - CSFQ, prevalence of FSD by DSM-5 criteria and body image by Body Exposure during Sexual Activity Questionnaire (BESAQ). 237 women using OCCP were study group (HC), the rest were controls (CG). Regression model was used to evaluate the influence of selected variable on sexual function and the presence of FSD. Results. The prevalence of FSD was 7.5% in HC and 2.6% in CG. 22% compared to 14% of women in HC and CG, respectively, reported sexual problems (CSFQ). Contraceptive group was characterized by significantly higher importance of sex (4.03 vs 3.79), worse partner’s’ attitude toward sex (4.35 vs 4.47), worse self-attitude towards sex (4.35 vs 4.47), and worse body image (BESAQ) compared to controls. Among all variables lower level of anxiety (t=-1.99), positive attitudes toward sex (t=2.05), watching erotic videos (t=5.58) and higher importance of sex (t=5.66) were predictive for better sexual function (R2 – 0.38, F=28.9, p=0.0001). Conclusion. Sexual behaviors and function are different in those using OCCP’s compared to non-users. The prevalence of sexual problems and dysfunction is higher in those using hormonal method, however using OCCP is not a risk factor for neither worse sexual function nor sexual dysfunction. Partner’s attitude toward sex and general anxiety level are factors contributing to sexual function and risk of sexual dysfunction in the population of women in reproductive age and should be routinely evaluated in clinical practice, especially before prescribing hormonal contraceptives.