Low-Dose Oral Contraceptives May Increase Risk of Pelvic Pain During Sexual Climax

SAN DIEGO, May 3, 2013 /PRNewswire-USNewswire/ -- Low-dose (low estrogen) oral contraceptives (OCPs) may increase a woman's risk for chronic pelvic pain symptoms (CPPS) and even pain during sexual climax, according to a new study. This study will be presented to reporters at the 108th Annual Scientific Meeting of the American Urological Association (AUA) during a press conference at the San Diego Convention Center, San Diego, CA on May 7 at 11:00 a.m. PDT.

Oral contraceptives have been available in the United States for more than half a century and while considered innocuous today (because of lower doses of estrogen) than even 25 years ago, their effects on conditions such as CPPS are not yet fully understood. Therefore researchers from New York University and Waitemata District Health Board in Auckland, New Zealand conducted a study to compare CPPS between young women who are current OCP users and non-users.

Researchers used data collected from an anonymous, Internet-based survey of women 18-39 years of age within large university populations. The researchers did not include women who were pregnant or had a history of endometriosis or pelvic pain, and gathered demographic data as well as information on the type of OCP, duration of use, and indication for usage. Once data was collected, respondents were sorted into the following groups:

• Not using an OCP
• Taking a low-dose of estrogen
• Taking a normal dose (>20mcg) of estrogen

Additionally, respondents were classified as having CPPS if their total index pain score was greater than or equal to four. The researchers then compared the responses between the groups.

Of the 932 respondents who were eligible for the study, 605 were categorized as non-OCP users and 327 were categorized as OCP users, with 169 using low-dose and 171 using normal dose OCPs. The researchers found significant differences in the incidence of individual pelvic pain symptoms between OCP users and non−users and further differences with low−dose use. Specifically, results showed:

• Low−dose OCP users were more likely to report pelvic pain symptoms and more likely to have CPPS than non−users (27.1 percent vs. 17.5 percent, p=0.045).
• Low-dose OCP users had almost twice the incidence of pain or discomfort during or after sexual climax compared to controls, and there was no difference between normal dose OCP users and controls.
• Normal dose OCP users were less likely to have pelvic pain symptoms than non OCP users.
• Forty-four percent of respondents reported onset of pain after beginning OCP use and were more likely to fulfill CPPS criteria than those who had symptoms prior to OCP use (62 percent vs. 30.3 percent, p<0.001).

"This study reveals valuable insights into the relationship between oral contraceptives, pelvic pain and how effects may differ depending on hormone dosage," said Dr. Kristene Whitmore, chair of urology and female pelvic medicine and reconstructive surgery and professor of urology and OBGYN at Drexel University College of Medicine. "It also has been recently reported that patients have an increased incidence of vulvodynia when taking low dose OCPs, therefore additional research is needed to determine if the chronic pelvic pain noted in this study is related to vulvar pain or the hormone dosage."

About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is a leading advocate for the specialty of urology, and has more than 19,000 members throughout the world. The AUA is a premier urologic association, providing invaluable support to the urologic community as it pursues its mission of fostering the highest standards of urologic care through education, research and the formulation of health policy.

SOURCE American Urological Association

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