24299553
BACKGROUND	Oral contraceptives ( OC ) are effective for birth control and have good cycle control and tolerability .
BACKGROUND	However , the hormonal components could modify mood and libido .
OBJECTIVE	The aim of this study is to evaluate the genital vascular effects and sexual behavior of an OC containing 30 g ethinyl estradiol and 3 mg drospirenone in comparison with a flexible combined contraceptive vaginal ring .
METHODS	Forty women underwent a sonographic assessment of the clitoral anatomy and vascularization and were administered the McCoy Female Sexuality Questionnaire ( MFSQ ) and the Beck 's Depression Inventory questionnaire ( BDI ) .
METHODS	Estradiol , androstenedione , testosterone , and SHBG were assayed .
METHODS	Free Androgen Index ( FAI ) and Free Estrogen Index ( FEI ) were calculated .
METHODS	The patients were randomly submitted to OC ( group I ; n = 21 ) or vaginal ring ( group II ; n = 19 ) .
METHODS	Ultrasonographic clitoral volume , pulsatility index ( PI ) of dorsal clitoral arteries , MFSQ , BDI , and hormonal and biochemical assays were analyzed .
RESULTS	After therapy , the testosterone levels were reduced in both groups , whereas estradiol decreased only in group I women .
RESULTS	The SHBG increased in all the subjects , and both FAI and FEI decreased .
RESULTS	The clitoral volume decreased in all the women .
RESULTS	The PI of the dorsal clitoral artery increased only in patients on OC .
RESULTS	The hormonal contraception was associated , in both studied groups , with a significant decrease of the two-factor Italian MFSQ score , which was more marked in OC users .
RESULTS	In group I subjects , there was a reduction of the number of intercourse/week and a reduction of orgasm frequency during intercourse .
RESULTS	The pain during intercourse worsened after OC use .
RESULTS	The vaginal ring users reported a vaginal wetness .
CONCLUSIONS	Six-month treatment with hormonal contraception is associated with a diminished MFSQ score .
CONCLUSIONS	However , the frequency of sexual intercourse and orgasm was reduced only by the use of OC .
CONCLUSIONS	The OC use was associated with increased pain during intercourse .

