Natural Estrogens as a Component of Hormonal Contraceptives: Impact on Sexual Function, Depression, and Quality of Women’s Life

Study Objective: To evaluate the impact of combined oral contraceptives (COCs) containing 17β-estradiol/nomegestrol acetate and ethinylestradiol/drospirenone, on the sexual function, depression prevalence and severity, and quality of women’s life.

Study Design: Randomised prospective non-interventional comparative parallel-group clinical study.

Materials and Methods. The study included 90 women requiring contraception aged 18 to 45 years old (mean age: 29.9 (6.2) years old). Patients were randomised into two groups: group I (n = 45) took 1.5 mg of 17β-estradiol and 2.5 mg of nomegestrol acetate (E2/NОMAC); group II (n = 45) — 20 µg of ethinylestradiol and 3 mg of drospirenone (20EE/DRSP). Health Survey Short Form 36 (SF-36) of the Female Sexual Function Index (FSFI-6), Beck Depression Inventory initially and after 6 months of COC were used for questionnaire.

Study Results. After 6 months of E2/NОMAC therapy, patients had better lubrication (from 4 [3; 4] to 5 [5; 5] [points, p < 0.001) and higher female sexual function index (from 24 [22; 26] to 26 [24; 28] points, p = 0.01); reduced depression prevalence and intensity on Beck Inventory (from 7 [5, 11] to 6 [3, 7] points, p = 0.005); improved quality of life in the domain “physical functioning” (from 95 [80; 100] to 95 [95; 100] points, р = 0.03), and improved overall mental health component (from 34 [31; 38] to 38 [34; 41] points, р = 0.005). When 20EE/DRSP was used, there was no dynamics in FSFI-6 Questionnaire and Beck Inventory; however, patients demonstrated improved overall mental health component (from 43.7 [34; 51] to 48.6 [43; 52] points, р = 0.02) as well as improved physical (from 100 [95; 100] to 100 [100; 100] points, р = 0.03) and emotional functioning (from 100 [67; 100] to 100 [100; 100] points, р = 0.04).

Conclusion. 6-month therapy with E2/NОMAC-containing COCs has positive effect on sexuality and promotes reduction in depression intensity, unlike COCs containing 20EE/DRSP which improve the quality of women’s life to a greater extent.

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