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Birth Control

Over 100 million women worldwide have used oral contraceptives since 1945. There are multiple benefits associated with their use besides being a highly effective, totally reversible contraceptive agent. Use of the birth control pill increases control of the menstrual cycle and decreases the days of menstrual bleeding, the volume of menstrual blood, and the intensity and frequency of menstrual cramps, and decreases the risk of ovarian and uterine cancer, as well as the occurrence of benign ovarian cysts, endometriosis, and pelvic inflammatory disease. Oral contraceptives are also effective treatments for acne and facial hair growth or hirsutism. A medication that is safe and effective and decreases the fear of unwanted pregnancy, painful gynecologic conditions, social inhibition and embarrassment from acne and hirsutism, and menstrual bleeding, can increase sexual interest

Oral contraceptives are made up of a synthetic estradiol (ethinyl estradiol) and a synthetic progesterone. These two agents reduce metabolic activity of the ovary and suppress ovulation, effectively preventing pregnancy. Because ethinyl estradiol is a highly potent sex steroid with approximately 600 times more affinity for the estradiol receptor than the bioidentical 17 beta estradiol, its use leads to diminished FSH and LH and reduced ovarian metabolic activity and decreased circulating levels of androgens and estrogens. Oral contraception causes a marked increase in synthesis of sex hormone binding globulin, the major binding protein for sex steroid hormones in the circulation. The result is a decrease in androgen hormone levels, in particular, unbound testosterone.

Ethinyl estradiol-based contraception use is reported to be associated with sexual side effects, including diminished sexual interest, decreased frequency of sexual intercourse, diminished vaginal lubrication, decreased sexual arousal, and increased pain during intercourse. Women who started using oral contraceptives before age 17 have a higher risk of having dyspareunia compared to women who have never used oral contraceptive pills.

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