Oral contraceptives (OCs) ameliorate hyperandrogenism and regulate menstrual cycles. To
reduce androgenic side effects of first- and second-generation progestins, several new
progestins derived from progesterone or spironolactone have been developed in the last few
decades. These progestins, such as drospirenone, cyproterone acetate and NOMAC, are designed
to bind specifically to the progesterone receptor and to have no androgenic, estrogenic or
glucocorticoid actions.
However, OCs with a more pronounced anti-androgenic effects are more likely to induce sexual
dysfunction, mainly hypoactive sexual desire disorder, which can highly impact patient and
partner's quality of life. Moreover, available data indicate that OC use might increase
adiposity in adolescents and might be associated with central redistribution of body fat in
young women with Polycystic ovary syndrome (PCOS) without a recognizable difference in
clinical anthropometric measurements, including body mass index and waist circumference.
In this context, it would be worth to evaluate the effects of combined OCs on metabolic and
sexual health (sexual desire, arousal, and other parameters of sexual health), body image and
mood.