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  • Title: Methodological problems in the evaluation of drug induced sexual dysfunction for oral contraceptives.
    Author: Guichoux JY.
    Journal: Therapie; 1993; 48(5):447-51. PubMed ID: 8146823.
    Abstract:
    Some oral contraceptive (OC) users experience sexual dysfunction. For example, recent studies on sexual dysfunction suggest that 0.5-1% of OC users experience a decreased libido, and 33% of them drop-out of the studies. Even though there are many OC users, researchers have not exerted much energy in studying sex al dysfunction. Sexuality surveys do not tend to yield reliable data. Researchers tend not to consider OCs as normal drugs. Thus, it is difficult to understand the link between adverse effects and OC use. Problems in studies of female sexuality revolve around assessment criteria. Clinical criteria related to female sexuality in the literature are usually decreased libido, vaginal dryness, and lack of orgasm. Yet, the studies rarely scale, standardize, or really validate the severity of these criteria. Various questionnaires used to assess female sexuality in OC users include well-being, sexual interest questionnaire, sex role behavior scale, sexual experience scale, and questions addressing sexual daydreaming and sexual fantasies. They tend to go beyond basic clinical parameters and raise more questions than they provide solid answers. To concretely compare OC users and nonusers, researchers need to obtain a baseline value on sexual activity 1 month before cases begin OC use. No large study with solid assessment criteria has yet included both comparable groups and placebo groups. Thus, both biases and confounding factors render the data unreliable. Perhaps the way to expand knowledge on OCs' relationship with female sexuality is to consider quality of life, i.e., sexuality as a parameter that can be improved or worsened. Standard studies and common methodology do not lend themselves to investigating OC use and female sexuality.
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