O impacto do uso de métodos contraceptivos orais na função sexual de mulheres em idade reprodutiva / The impact of the use of oral contraceptive methods on the sexual function of women of reproductive age

Objetivo: Investigar o impacto dos contraceptivos orais hormonais na função sexual de mulheres. Métodos: Estudo transversal realizado por meio do questionário traduzido e validado "Índice da Função Sexual Feminina", capaz de estimar o risco de disfunção sexual feminina. Dados sociodemográficos, ginecológicos, medicamentosos e outros foram avaliados e correlacionados estatisticamente a esse escore, estimando possíveis causas da disfunção sexual, com destaque para o uso de anticoncepcional oral. O estudo foi baseado em uma amostragem por conveniência, incluindo mulheres > 18 anos em idade reprodutiva, de 04/01/2021 a 04/01/2022, obedecendo aos critérios de inclusão e exclusão. Resultados: Participaram deste estudo 105 mulheres com média e desvio-padrão de idade de 23,4 ± 3,8 anos, predominantemente heterossexuais (84,0%) e bissexuais (13,2%). A maioria delas (93,4%) utiliza métodos contraceptivos, sendo esses anticoncepcional oral (45,3%), DIU hormonal (19,8%) e camisinha (17,0%). A composição hormonal mais utilizada foi levonorgestrel (26,4%) e etinilestradiol (25,5%). Oitenta por cento das mulheres são sexualmente ativas, 69,3% delas têm parceria fixa, 42,5% tinham relações quase sempre e 33,0% referiam que as relações sexuais eram sempre satisfatórias. Houve boa adequação da amostra (0,865) e significância estatística (p < 0,0001). Utilizar ou não método contraceptivo apresentou diferença nos domínios desejo, satisfação e dor. Contudo, as questões do histórico sexual foram as que mais apresentaram relevância estatística em relação aos domínios. Conclusão: Apesar de outros estudos serem necessários para provar a hipótese de que os contraceptivos orais têm impacto negativo na função sexual feminina, é clara a importância de os profissionais de saúde já estarem cientes dessa possibilidade e saberem como abordá-la.

Objective: To investigate the impact of hormonal oral contraceptives on women's sexual function. Methods: Cross-sectional study carried out using the translated and validated questionnaire "Index of Female Sexual Function", capable of estimating the risk of female sexual dysfunction. Sociodemographic, gynecological, medication and other data were evaluated and statistically correlated to this score, estimating possible causes of sexual dysfunction, with emphasis on the use of oral contraceptives. The study was based on a convenience sample, including women > 18 years of reproductive age, from 01/04/2021 to 01/04/2022, following inclusion and exclusion criteria. Results: The study included 105 women with a mean and standard deviation of (23.4 ± 3.8) years old, predominantly heterosexual (84.0%) and bisexual (13.2%). Most of them (93.4%) use contraceptive methods, these being (45.3%) oral contraceptives, (19.8%) hormonal IUDs and (17.0%) condoms. The most used hormonal composition was levonorgestrel (26.4%) and ethinylestradiol (25.5%). Eighty percent of the women are sexually active, 69.3% of them have a steady partner, 42.5% almost always had sex and 33.0% said that sex was always satisfactory. There was good sample adequacy (0.865) and statistical significance (p < 0.0001). Using or not using a contraceptive method showed a difference in the desire, satisfaction and pain domains. However, sexual history questions were the ones that showed the most statistical relevance in relation to the domains. Conclusion: Although further studies are needed to prove the hypothesis that oral contraceptives have a negative impact on female sexual function, it is clear that health professionals are already aware of this possibility and know how to approach it.

Factores asociados con la aparición de disfunciones sexuales en una población femenina

Se realiza un estudio explicativo para determinar la frecuencia de las disfunciones sexuales y algunos de los factores biológicos, psicosociales, culturales y ambientales asociados con la aparición de éstas en el período de 1 año, a partir de agosto de 1993 en Alamar. Se expresa que la muestra está compuesta por 48 mujeres mayores de 15 años, un grupo de estudio de 24, e igual cantidad de controles. Se les aplica una encuesta de 30 preguntas, cuyos resultados se muestran en 5 tablas y se utiliza el cálculo porcentual para estimar la frecuencia y odds ratio con intervalo de confianza al 95 %, para valorar fuerza de asociación entre las variables. Se encuentra que las difunciones sexuales femeninas de mayor frecuencia son el deseo sexual inhibido y la anorgasmia, que las variables ingestión de fármacos, ausencia de salud física, poco deseo sexual, comunicación deficiente de pareja y no recibir educación sexual, son factores de riesgo que están fuertemente asociados con la aparición de disfunciones sexuales en nuestras mujeres y tienen relación causal con ellas. Se señala que los factores ambientales no se asocian con la aparición de disfunciones sexuales.

An explanatory study was conducted to determine the frequency of sexual dysfunctions and some of the biological, psychosocial, cultural and environmental factors associated with the appearance of these disorders from August, 1993, to August, 1994, in Alamar. The sample was composed of 48 women over 15, a case-base study consisting of 24 women, and the same number of controls. A survey with 30 questions was applied and the results were shown in 5 tables. Percentage was calculated to estimate the frequency and odds ratio with a confidence interval at 95 % so as to assess the force of association among the variables. It was found that the most frequent female sexual dysfunctions are the inhibited sexual desire and the anorgasmy, and that drug taking, the absence of physical health, the defficient communication with their partners, the little sexual desire, and the lack of sexual education are risk factors which are strongly associated with the appearance of sexual dysfunctions among our women and have a causal relationship with them. It is stressed that the environmental factors are not connected with the appearance of sexual dysfunctions.