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The contraceptives killing your libido

The use of hormonal birth control drugs has been linked to lower sexual function in women, a study released by the Aga Khan University Hospital Nairobi (AKUHN) has reported.

The most affected women are those using implants, followed by those on the pill.

Up to 63 per cent of women using implants, the study says, had low sexual function, while among those on the pill, 57 per cent were affected.

Overall, the study, published in the current issue of the African Journal of Primary Health Care & Family Medicine, reports almost a third of 566 participating women had low sexual function, or female sexual dysfunction (FSD).

“We found a high prevalence of FSD in the study population... We also noted a strong association of FSD with the use of hormonal contraception,” said the study.

The overall prevalence of FSD was 38.7 per cent, meaning 219 out of the 566 study participants had low sex function.

The prevalence of FSD in the women using hormonal contraception was 51.5 per cent, compared to 29.6 per cent among those using non-hormonal contraception like condoms.

The authors, who were from the Department of Obstetrics and Gynaecology at AKUHN, said the high incidence of a low sex drive in this group was of concern and requires further research.

A majority of the participants in the study had high education levels, financial security, health insurance and most were employed – factors thought to favour positive sex function.

Age gaps

The study participants were noted to be generally young, with small age gaps between them and their partners. The average age of the women was 32 and their partners about four years older.

The study coincides with the three-day International Conference on Population and Development (ICPD25) forum in Nairobi, which ended yesterday, where access to contraceptives was a central issue.

“There are many issues that affect women and girls, but contraceptives are the most powerful tool for sexual reproductive rights,” Melinda Gates, the co-chair of the Bill and Melinda Gates Foundation, told the meeting.

The conference, which galvanised the world around women’s issues, drew thousands of delegates from across the world.

On Monday, Health Cabinet Secretary Sicily Kariuki said Kenya was on track to increasing the use of contraceptives.

“A lot has happened since we committed to reduce the unmet need for family planning during the Cairo summit of 1994. We must consistently advocate for more investments to attain the goal of zero unmet need for contraceptives,” she said.

Accelerated use

Ms Kariuki was speaking at the launch of the Family Planning 2020 (FP2020) Women at the Center report, which listed Kenya among seven African countries with accelerated use of contraceptives.

“In Kenya, an estimated 6.1 million women are using a modern method of contraception - almost two million more since the launch of FP2020 in 2012,” said the report.

The most common method was injectables, where a woman is injected with a birth control hormone, usually once every three months, with 47.9 per cent coverage.

This was followed by implants at 18.2 per cent, pills at 14.1 per cent, and male condoms at 7.9 per cent.

But in the Aga Khan University Hospital study, more women were using non-hormonal contraceptives than hormonal ones. In this fairly young population, male and female condoms, and the natural cycle were the most prevalent birth control methods.

“This is contrary to the report of the Kenya Demographic and Health Survey, which stated a higher prevalence of hormonal contraception, with majority using injectable methods,” it said.

In the study, led by Dr Momin Butt, more women in Kenya were found to be using hormonal contraception, but with high rates of discontinuation of use attributed to side effects like weight loss and loss of libido.

The study, which involved women aged between 18 and 49 who attended the AKUHN clinics, also investigated other factors known to affect sex drive, such as drinking alcohol, smoking, financial instability, chronic illnesses and use of medicines.

The authors report only a small number of women, 12.9 per cent, had any chronic illness, with less than 10 per cent using chronic medication.

Financially stable

Further, of the total participants, 492 were either in salaried or self-employment.

“It is assumed that women who are more financially stable are likely to have higher levels of confidence and self-esteem, contributing to higher sexual satisfaction scores than unemployed women.”

However, despite the high rates of employment, the authors still recorded low sexual function in the group.

A majority of the women, 381, were married, 116 were single, nine separated and five divorced. Further, there was relatively modest use of alcohol and tobacco in the group.

Having weighed all these factors, the authors concluded that the low sexual function in the group was due to the use of hormonal contraceptives.

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