Contraception Clinical Trial
Official title:
Effect of Hormonal Contraception on Lower Urinary Tract Symptoms& Sexual Function
Effect of hormonal contraception on lower urinary tract symptoms& sexual function
It is generally accepted that female sex hormones influence the morphology and physiology of
vaginal tissues. Peripheral estrogen affects urogenital connective tissue composition and
structure, vaginal blood flow, and thickness of vaginal epithelium. Estrogen and progestagen
receptors are also abundantly present in the lower urinary tract, which has the same
embryonic origin as the vagina. decline in circulating estrogen levels may result in atrophy
of vaginal, urethral and bladder trigonal epithelium, as well as initiate metabolic changes
in the subepithelial supportive tissues. This process forms the biological rationale for the
common clinical practice of prescribing hormone treatment to menopausal women with lower
urinary and genital tract symptoms.
Contrary to widespread belief, the Womens Health Initiative (WHI) randomised trial showed
that menopausal hormone therapy with conjugated estrogen alone, or in combination with
progestagen, increased the risk of de novo or aggravated urinary incontinence after one year
of treatment. In premenopausal women, oral contraception is the most common source of hormone
intake but very few studies have endeavored to determine the effects of oral contraception on
premenopausal urinary incontinence. The aim of this nationwide cohort study was to assess the
influence of contraceptives on the risk for lower urinary tract dysfunction in young
female.at is time-related with the beginning of hormonal contraception, health care providers
should give information about other methods and try to switch them to a method less
associated with sexual dysfunction. However, there are contradictory results between the
different studies regarding the association between sexual dysfunction and hormonal
contraceptives, so it could be firmly said that additional research is needed.
Meanwhile, it could be said that hormonal contraception has been associated with different
alterations in sexual functioning.
To conclude, a multidisciplinary approach to the management of female sexual dysfunction is
mandatory, and health care providers should give lifestyle counselling apart from proposing
different treatment options. An adequate relationship with the patient, as well as the
routine monitoring of possible sexual dysfunction, are essential in addressing these
difficulties. Undoubtedly, the best contraceptive is one that fulfills the women's needs with
acceptable side effects and agreed with the prescribed
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