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COCs and progestin-only pills showed no consistent worsening of mood or sexual health

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Research area:medicine-clinical

What the study found

The review found no consistent evidence that combined oral contraceptives or progestin-only pills worsen psychological well-being or sexual function in women with endometriosis. Most included studies reported no increased risk of psychological dysfunction, and none reported increased sexual dysfunction.

Why the authors say this matters

The authors conclude that the findings support continued use of these treatments for long-term management, provided pain remission is achieved. The study suggests that concerns about mood and sexual health should not automatically rule out these first-line treatments for endometriosis.

What the researchers tested

The researchers conducted a systematic review of PubMed, Embase, and Scopus up to August 1, 2025. They included randomized controlled trials and non-randomized studies comparing combined oral contraceptives or progestin-only pills with no treatment in women with endometriosis, and they assessed adverse events plus patient-reported mood and sexual health measures.

What worked and what didn't

Seven studies met the criteria: four randomized controlled trials and three observational studies. Six of seven studies reported no increased psychological dysfunction, and none reported increased sexual dysfunction; six studies that reported on dyspareunia, or pain during sex, found benefit with treatment over placebo. Most studies also reported significant pain reduction, and no discontinuations for psychological or sexual adverse events were observed when pain remission was achieved.

What to keep in mind

The evidence base was small, outcome measures varied, and follow-up was short, with a mean of 6 months. The included observational studies had moderate-to-serious risk of bias, so the findings are limited by the available studies.

Key points

  • Seven studies were included: four randomized controlled trials and three observational studies.
  • Most studies reported no increased psychological dysfunction with combined oral contraceptives or progestin-only pills.
  • No study reported increased sexual dysfunction among users.
  • Six studies found treatment benefit for dyspareunia compared with placebo.
  • The review notes short follow-up, variable measurement tools, and a small evidence base.

Disclosure

Research title:
COCs and progestin-only pills showed no consistent worsening of mood or sexual health
Authors:
Noemi Salmeri, Martina Piccini, Francesca Caprara, Edgardo Somigliana, Paola Viganò, Paolo Vercellini
Institutions:
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, University of Milan, University of Milan, University of Milan, University of Milan, University of Milan
Publication date:
2026-03-12
DOI:
10.1111/aogs.70183
OpenAlex record:
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AI provenance: This post was generated by gpt-5.4-mini (OpenAI). The original authors did not write or review this post.

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