Hormonal Contraceptives, Female Sexual Dysfunction, and Managing Strategies: A Review

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usa-input-error-message selection-validation-message"> Name must be less than 100 characters </div> </div> <div class="action-panel-control-wrap existing-collections-controls"> <label for="collections-action-panel-add-to-existing" class="action-panel-label"> Choose a collection: </label> <select id="collections-action-panel-add-to-existing" class="action-panel-selector collections-action-add-to-existing" data-ga-category="save_share" data-ga-action="select_collection" data-ga-label="($('#collections-action-add-to-existing').val() === 'Favorites') ? 'Favorites' : 'non_favorites_collection'"> </select> <div class="collections-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your collection due to an error<br> <a href="#">Please try again</a> </div> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore data-ga-category="save_share" data-ga-action="collections" data-ga-label="add"> Add </button> <button class="action-panel-cancel" aria-label="Close 'Add to Collections' panel" ref="linksrc=close_collections_panel" aria-controls="collections-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="collections" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="bibliography-action-panel" class="bibliography-action-panel action-panel in-progress-dots-panel" aria-hidden="true" data-bibliography-open-panel-enabled="false" data-bibliography-open-panel-url-hash="#open-bibliography-panel"> <div class="inner-wrap"> <h3 class="action-panel-heading"> Add to My Bibliography </h3> <form id="bibliography-action-panel-form" class="bibliography-action-panel-form action-panel-content action-form action-panel-smaller-selectors" data-add-to-bibliography-max-amount="100" data-add-to-bibliography-batch-size="10" data-bibliography-delegates-url="/list-bibliography-delegates/" data-add-to-bibliography-url="/add-to-bibliography/" data-get-article-ids-by-search-url="/get-article-ids-by-search/" data-mybib-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/mybibliography/"> <input type="hidden" name="csrfmiddlewaretoken" value="WZAF2kWVD5GxQtdbUpLUPOetHSl4FHSqfjIyZVXUNaIGLoxTGFgE2DijtswPC58d"> <div class="action-panel-control-wrap bibliographies-controls"> <div class="choice-group"> <ul class="bibliographies-action-add radio-group-items"> <li> <input name="bibliography" id="my-bibliography" class="my-bibliography" type="radio" checked/> <label for="my-bibliography">My Bibliography</label> </li> </ul> </div> </div> <div class="bibliographies-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your delegates due to an error<br> <a href="#">Please try again</a> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore> Add </button> <button class="action-panel-cancel" aria-label="Close 'Add to bibliography' panel" ref="linksrc=close_bibliography_panel" aria-controls="bibliography-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="mybib" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="saved-search-action-panel" class="saved-search-action-panel action-panel " aria-hidden="true" data-saved-search-open-panel-enabled="false" data-saved-search-open-panel-url-hash="#open-saved-search-panel"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Your saved search </h2> <form id="saved-search-action-panel-form" class="saved-search-action-panel-form action-panel-content action-form" data-create-saved-search-url="/create-saved-search/" data-try-search-terms-url="/try-search-term/" data-saved-search-root-url="https://www.ncbi.nlm.nih.gov/myncbi/searches/"> <input type="hidden" name="csrfmiddlewaretoken" value="WZAF2kWVD5GxQtdbUpLUPOetHSl4FHSqfjIyZVXUNaIGLoxTGFgE2DijtswPC58d"> <div class="action-panel-control-wrap"> <label for="saved-search-name" class="action-panel-label saved-search-name-label required-field-asterisk"> Name of saved search: </label> <input maxlength="200" type="text" name="saved-search-name" id="saved-search-name" class="saved-search-name" value="" required pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/"> </div> <div class="action-panel-control-wrap"> <label for="saved-search-term" class="action-panel-label required-field-asterisk"> Search terms: </label> <textarea name="saved-search-term" id="saved-search-term" class="saved-search-term" required></textarea> </div> <div class="test-search-term-wrap"> <a href="#" class="try-search-term">Test search terms</a> </div> <div class="choice-group action-panel-extra-margin-top"> <span class="action-panel-label" id="fieldset-label"> Would you like email updates of new search results? </span> <fieldset id="saved-search-alert" aria-describedby="fieldset-label"> <legend class="usa-sr-only">Saved Search Alert Radio Buttons</legend> <ul class="radio-group-items"> <li> <input type="radio" id="saved-search-alert-yes" class="saved-search-alert-yes" name="saved-search-alert" value="yes" checked> <label for="saved-search-alert-yes" class="action-panel-label">Yes</label> </li> <li> <input aria-label="No radio input" type="radio" id="saved-search-alert-no" class="saved-search-alert-no" name="saved-search-alert" value="no"> <label for="saved-search-alert-no" class="action-panel-label">No</label> </li> </ul> </fieldset> </div> <div class="alert-schedule-wrap"> <div class="action-panel-control-wrap"> <label class="action-panel-label"> Email: </label> <span aria-label="Email address" id="saved-search-email" class="action-panel-label"><span class="action-panel-label-bold"></span> (<a class="myncbi-account-settings" href="https://www.ncbi.nlm.nih.gov/account/settings/">change</a>)</span> </div> <div class="action-panel-control-wrap action-panel-extra-margin-top"> <label for="saved-search-frequency" class="action-panel-label"> Frequency: </label> <select id="saved-search-frequency" class="no-border-panel-selector saved-search-frequency"> <option value="monthly">Monthly</option> <option value="weekly">Weekly</option> <option value="daily">Daily</option> </select> </div> <div class="action-panel-control-wrap saved-search-monthly-additional"> <label for="saved-search-monthly-on-day" class="action-panel-label"> Which day? </label> <select id="saved-search-monthly-on-day" class="no-border-panel-selector"> <option value="Sunday">The first Sunday</option> <option value="Monday">The first Monday</option> <option value="Tuesday">The first Tuesday</option> <option value="Wednesday">The first Wednesday</option> <option value="Thursday">The first Thursday</option> <option value="Friday">The first Friday</option> <option value="Saturday">The first Saturday</option> <option value="day">The first day</option> <option value="weekday">The first weekday</option> </select> </div> <div class="action-panel-control-wrap saved-search-weekly-additional"> <label for="saved-search-weekly-on-day" class="action-panel-label"> Which day? </label> <select id="saved-search-weekly-on-day" class="no-border-panel-selector saved-search-weekly-on-day"> <option value="Sunday">Sunday</option> <option value="Monday">Monday</option> <option value="Tuesday">Tuesday</option> <option value="Wednesday">Wednesday</option> <option value="Thursday">Thursday</option> <option value="Friday">Friday</option> <option value="Saturday">Saturday</option> </select> </div> <div class="action-panel-control-wrap"> <label for="saved-search-report" class="action-panel-label"> Report format: </label> <select id="saved-search-report" class="no-border-panel-selector saved-search-report"> <option value="DocSum">Summary</option> <option value="DocSumText">Summary (text)</option> <option value="Abstract">Abstract</option> <option value="AbstractText">Abstract (text)</option> <option value="MEDLINE">PubMed</option> </select> </div> <div class="action-panel-control-wrap"> <label for="saved-search-amount" class="action-panel-label"> Send at most: </label> <select id="saved-search-amount" class="no-border-panel-selector saved-search-amount"> <option value="1">1 item</option> <option value="5" selected>5 items</option> <option value="10">10 items</option> <option value="20">20 items</option> <option value="50">50 items</option> <option value="100">100 items</option> <option value="200">200 items</option> </select> </div> <div> <input type="checkbox" id="saved-search-send-if-no-result" class="saved-search-send-if-no-result" name="saved-search-send-if-no-result"> <label for="saved-search-send-if-no-result" class="action-panel-label smaller-checkbox"> Send even when there aren't any new results </label> </div> <div class="action-panel-control-wrap option-text-in-email-wrap"> <label for="saved-search-email-text" class="action-panel-label"> Optional text in email: </label> <textarea name="saved-search-email-text" id="saved-search-email-text" class="saved-search-email-text"></textarea> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Saving..." data-ga-category="save_share" data-ga-action="alert" data-ga-label="save"> Save </button> <button class="action-panel-cancel" aria-label="Close 'Your saved search' panel" ref="linksrc=close_saved_search_panel" aria-controls="saved-search-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="alert" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="citation-manager-action-panel" class="citation-manager-action-panel action-panel" aria-hidden="true"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Create a file for external citation management software </h2> <form id="citation-manager-action-panel-form" class="action-panel-content action-form" action="/results-export-ids/" data-by-search-action="/results-export-search-data/" data-by-ids-action="/results-export-ids/" method="post" data-by-search-method="post" data-by-ids-method="post"> <input type="hidden" name="csrfmiddlewaretoken" value="WZAF2kWVD5GxQtdbUpLUPOetHSl4FHSqfjIyZVXUNaIGLoxTGFgE2DijtswPC58d"> <input name="results-format" type="hidden" value="pubmed"/> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Sending..." data-ga-category="save_share" data-ga-action="citation_manager" data-ga-label="save"> Create file </button> <button class="action-panel-cancel" aria-label="Close 'Send citations to citation manager' panel" ref="linksrc=close_citation_manager_panel" aria-controls="citation-manager-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="citation_manager" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="rss-action-panel" class="rss-action-panel action-panel " aria-hidden="true"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Your RSS Feed </h2> <form id="rss-action-panel-form" class="rss-action-panel-form action-panel-content action-form" data-create-rss-feed-url="/create-rss-feed-url/" data-search-form-term-value=""> <input type="hidden" name="csrfmiddlewaretoken" value="WZAF2kWVD5GxQtdbUpLUPOetHSl4FHSqfjIyZVXUNaIGLoxTGFgE2DijtswPC58d"> <div class="action-panel-control-wrap"> <label for="rss-name" class="action-panel-label required-field-asterisk"> Name of RSS Feed: </label> <input maxlength="200" placeholder="Name" type="text" name="rss-name" id="rss-name" class="rss-name" value='' required pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/"> </div> <div class="rss-limit-wrap"> <div class="action-panel-control-wrap action-panel-extra-margin-top"> <label for="rss-limit" class="action-panel-label"> Number of items displayed: </label> <select id="rss-limit" class="no-border-panel-selector rss-limit"> <option value="5">5</option> <option value="10">10</option> <option value="15" selected="selected">15</option> <option value="20">20</option> <option value="50">50</option> <option value="100">100</option> </select> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Creating..." data-ga-category="save_share" data-ga-action="alert" data-ga-label="save"> Create RSS </button> <button class="action-panel-cancel" aria-label="Close 'Your RSS' panel" ref="linksrc=close_rss_panel" aria-controls="rss-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="alert" data-ga-label="cancel"> Cancel </button> </div> <div class="action-panel-control-wrap rss-link-copy-wrap"> <label for="rss-link" class="usa-sr-only">RSS Link</label> <input placeholder="Your RSS Feed Link" type="text" name="rss-link" id="rss-link" class="rss-link" title="RSS Link"> <button type="button" disabled class="rss-link-copy-button disabled" data-ga-category="save_share" data-ga-action="rss" data-ga-label="copy"> Copy </button> </div> </form> </div> </div> </div> </div> <div class="article-page" id="article-page" data-article-pmid="31242625"> <aside class="page-sidebar"> <div class="inner-wrap"> <div class="full-text-links"> <div class="full-view"> <h3 class="title"> Full text links </h3> <div class="full-text-links-list"> <a class="link-item dialog-focus" href="https://www.mdpi.com/resolver?pii=jcm8060908" target="_blank" rel="noopener" ref="linksrc=fulltextorjournal_fulltext&is_pmc=False&PrId=6383&itool=Abstract-def&log$=linkouticon&uid=31242625&db=pubmed&nlmid=101606588" title="See full text options at MDPI" data-ga-category="full_text" data-ga-action="MDPI" data-ga-label="31242625" ><img src="https://cdn.ncbi.nlm.nih.gov/corehtml/query/egifs/https:--res.mdpi.com-data-pubmed-linkout.png" alt="MDPI full text link"><span class="text"> MDPI </span></a><a class="link-item pmc " href="https://pmc.ncbi.nlm.nih.gov/articles/pmid/31242625/" target="_blank" rel="noopener" ref="linksrc=fulltextorjournal_fulltext&is_pmc=True&PrId=3494&itool=Abstract-def&log$=linkouticon&uid=31242625&db=pubmed&nlmid=101606588" title="Free full text at PubMed Central" data-ga-category="full_text" data-ga-action="PMC" data-ga-label="31242625" ><span class="text"> Free PMC article </span></a> </div> </div> <div class="short-view"> <a href="#" class="full-text-links-button full-text-links-dialog-trigger"> Full text links </a> </div> </div> <div class="actions-buttons sidebar"><h3 class="title">Actions</h3><div class="inner-wrap"><button class="citation-button citation-dialog-trigger" aria-label="Open dialog with citation text in different styles" data-ga-category="save_share" data-ga-action="cite" data-ga-label="open" data-all-citations-url="/31242625/citations/" data-citation-style="nlm" data-pubmed-format-link="/31242625/export/"><span class="button-label">Cite</span></button><link type="text/css" href="ncbi-overlay-block/src/overlay-block.css"><div class="collections-button-container" data-article-id="31242625" data-article-db="pubmed"><button class="collections-button collections-dialog-trigger" aria-label="Save article in MyNCBI collections." data-ga-category="collections_button" data-ga-action="click" data-ga-label="collections_button" data-collections-open-dialog-enabled="false" data-collections-open-dialog-url="https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F31242625%2F%23open-collections-dialog" data-in-collections="false"><span class="button-label">Collections</span></button><div class="overlay" role="dialog"><div id="collections-action-dialog" class="dialog collections-dialog" aria-hidden="true"><div class="title">Add to Collections</div><div class="collections-action-panel action-panel"><form id="collections-action-dialog-form" class="collections-action-panel-form action-panel-content action-form action-panel-smaller-selectors" data-existing-collections-url="/list-existing-collections/" data-add-to-existing-collection-url="/add-to-existing-collection/" data-create-and-add-to-new-collection-url="/create-and-add-to-new-collection/" data-myncbi-max-collection-name-length="100" data-collections-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/"><input type="hidden" name="csrfmiddlewaretoken" value="WZAF2kWVD5GxQtdbUpLUPOetHSl4FHSqfjIyZVXUNaIGLoxTGFgE2DijtswPC58d"><div class="choice-group" role="radiogroup"><ul class="radio-group-items"><li><input type="radio" id="collections-action-dialog-new" class="collections-new" name="collections" value="new" data-ga-category="collections_button" data-ga-action="click" data-ga-label="collections_radio_new"><label for="collections-action-dialog-new">Create a new collection</label></li><li><input type="radio" id="collections-action-dialog-existing" class="collections-existing" name="collections" value="existing" checked="true" data-ga-category="collections_button" data-ga-action="click" data-ga-label="collections_radio_existing"><label for="collections-action-dialog-existing">Add to an existing collection</label></li></ul></div><div class="controls-wrapper"><div class="action-panel-control-wrap new-collections-controls"><label for="collections-action-dialog-add-to-new" class="action-panel-label required-field-asterisk"> Name your collection: </label><input type="text" name="add-to-new-collection" id="collections-action-dialog-add-to-new" class="collections-action-add-to-new" pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/" maxlength="100" data-ga-category="collections_button" data-ga-action="create_collection" data-ga-label="non_favorties_collection"><div class="collections-new-name-too-long usa-input-error-message selection-validation-message"> Name must be less than 100 characters </div></div><div class="action-panel-control-wrap existing-collections-controls"><label for="collections-action-dialog-add-to-existing" class="action-panel-label"> Choose a collection: </label><select id="collections-action-dialog-add-to-existing" class="action-panel-selector collections-action-add-to-existing" data-ga-category="collections_button" data-ga-action="select_collection" data-ga-label="($('.collections-action-add-to-existing').val() === 'Favorites') ? 'Favorites' : 'non_favorites_collection'"></select><div class="collections-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your collection due to an error<br><a href="#">Please try again</a></div></div></div><div class="action-panel-actions"><button class="action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore data-ga-category="collections_button" data-ga-action="click" data-ga-label="add"> Add </button><button class="action-panel-cancel" aria-label="Close 'Add to Collections' panel" ref="linksrc=close_collections_panel" aria-controls="collections-action-panel" aria-expanded="false" data-ga-category="collections_button" data-ga-action="click" data-ga-label="cancel"> Cancel </button></div></form></div></div></div></div><button class="more-actions-button more-actions-dialog-trigger" title="Open dialog with more actions to take" ref="linksrc=more_actions_btn"></button><div class="display-options" 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resources</option> </select> </nav> </div> </aside> <main class="article-details" id="article-details">   <header class="heading" id="heading"> <div class="full-view" id="full-view-heading"> <div class="article-citation"> <div class="publication-type" >Review</div> <div class="article-source"> <div class="journal-actions dropdown-block"><button id="full-view-journal-trigger" class="journal-actions-trigger trigger" ref="linksrc=journal_actions_btn" title="Journal of clinical medicine" tabindex="0" aria-controls="full-view-journal" aria-expanded="false" aria-label="Toggle dropdown menu for journal Journal of clinical medicine" data-pinger-ignore> J Clin Med </button><div id="full-view-journal" class="journal-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for journal Journal of clinical medicine"><div class="title">Actions</div><div class="content"><ul class="journal-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22J+Clin+Med%22%5Bjour%5D&sort=date&sort_order=desc" data-href="/?term=%22J+Clin+Med%22%5Bjour%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_journal_name_link&journal_abbrev=J Clin Med" data-ga-category="search" data-ga-action="journal_link" data-ga-label="J Clin Med"> Search in PubMed </a></li><li><a class="search-in-nlm-catalog-link dropdown-block-link" ref ="linksrc=search_in_nlm_catalog_link" href="https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Clin+Med%22%5BTitle+Abbreviation%5D" data-ga-category="search_catalog" data-ga-action="journal_link" data-ga-label="J Clin Med"> Search in NLM Catalog </a></li><li><a class="add-to-search-link dropdown-block-link" ref ="linksrc=add_to_search_link" role="button" data-search-term='"J Clin Med"[jour]' data-ga-category="search" data-ga-action="add_to_search" data-ga-label='"J Clin Med"[jour]' href="#"> Add to Search </a></li></ul></div></div></div><span class="period">. </span><span class="cit">2019 Jun 25;8(6):908.</span> </div> <span class="citation-doi"> doi: 10.3390/jcm8060908. </span> </div> <h1 class="heading-title"> Hormonal Contraceptives, Female Sexual Dysfunction, and Managing Strategies: A Review </h1> <div class="inline-authors"> <div class="authors"> <div class="authors-list"> <span class="authors-list-item "><a class="full-name" href="/?term=Casado-Espada+NM&cauthor_id=31242625" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Nerea M Casado-Espada">Nerea M Casado-Espada</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. nmcasado91@gmail.com." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=de+Alarc%C3%B3n+R&cauthor_id=31242625" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Rubén de Alarcón">Rubén de Alarcón</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. ruperghost@gmail.com." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=de+la+Iglesia-Larrad+JI&cauthor_id=31242625" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Javier I de la Iglesia-Larrad">Javier I de la Iglesia-Larrad</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. javidelaiglesia.jdli@gmail.com." href="#full-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Bote-Bonaechea+B&cauthor_id=31242625" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Berta Bote-Bonaechea">Berta Bote-Bonaechea</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. bertabot@yahoo.es." href="#full-view-affiliation-4" ref="linksrc=author_aff"> 4 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Montejo+%C3%81L&cauthor_id=31242625" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Ángel L Montejo">Ángel L Montejo</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. amontejo@usal.es." href="#full-view-affiliation-5" ref="linksrc=author_aff"> 5 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Nursing School E.U.E.F., University of Salamanca, Av. Donantes de Sangre SN 37007 Salamanca, Spain. amontejo@usal.es." href="#full-view-affiliation-6" ref="linksrc=author_aff"> 6 </a></sup></span> </div> </div> </div> <div class="short-article-details"> Affiliations <button class="more-details" id="toggle-authors" data-alt-text="Collapse" aria-controls="expanded-authors" aria-expanded="false" data-pinger-ignore data-fetch-url="/31242625/long-authors/" data-id-prefix=""> <span class="title"> Expand </span> </button> </div> <div class="extended-article-details" id="expanded-authors" aria-hidden="true"> <div class="expanded-authors" id="full-view-expanded-authors"> <div class="affiliations"> <h3 class="title"> Affiliations </h3> <ul class="item-list"> <li data-affiliation-id="full-view-affiliation-1" id="full-view-affiliation-1" ><sup class="key">1</sup> Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. nmcasado91@gmail.com.</li> <li data-affiliation-id="full-view-affiliation-2" id="full-view-affiliation-2" ><sup class="key">2</sup> Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. ruperghost@gmail.com.</li> <li data-affiliation-id="full-view-affiliation-3" id="full-view-affiliation-3" ><sup class="key">3</sup> Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. javidelaiglesia.jdli@gmail.com.</li> <li data-affiliation-id="full-view-affiliation-4" id="full-view-affiliation-4" ><sup class="key">4</sup> Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. bertabot@yahoo.es.</li> <li data-affiliation-id="full-view-affiliation-5" id="full-view-affiliation-5" ><sup class="key">5</sup> Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. amontejo@usal.es.</li> <li data-affiliation-id="full-view-affiliation-6" id="full-view-affiliation-6" ><sup class="key">6</sup> Nursing School E.U.E.F., University of Salamanca, Av. Donantes de Sangre SN 37007 Salamanca, Spain. amontejo@usal.es.</li> </ul> </div> </div> </div> <ul class="identifiers" id="full-view-identifiers"> <li> <span class="identifier pubmed"> <span class="id-label"> PMID: </span> <strong class="current-id" title="PubMed ID">31242625</strong> </span> </li> <li> <span class="identifier pmc"> <span class="id-label"> PMCID: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=PMC6617135&id_type=PMC" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6617135/" data-ga-category="full_text" data-ga-action="PMCID" > PMC6617135 </a> </span> </li> <li> <span class="identifier doi"> <span class="id-label"> DOI: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=10.3390/jcm8060908&id_type=DOI" href="https://doi.org/10.3390/jcm8060908" data-ga-category="full_text" data-ga-action="DOI" > 10.3390/jcm8060908 </a> </span> </li> </ul> <div class="in-clipboard-label " hidden> Item in Clipboard </div> </div> <div class="short-view" id="short-view-heading"> <div class="publication-type" >Review</div> <h1 class="heading-title"> Hormonal Contraceptives, Female Sexual Dysfunction, and Managing Strategies: A Review </h1> <div class="short-citation"> <span class="authors-list"> <span class="authors-list-item "><span class="full-name">Nerea M Casado-Espada</span><span class="citation-separator"> et al.</span></span> </span> <span class="citation-journal"> J Clin Med<span class="citation-separator">.</span> </span> <span class="date"> <time class="citation-year" datetime="2019">2019</time><span class="citation-separator">.</span> </span> </div> <div class="more-article-details-section with-display-settings"> <button class="more-article-details" id="toggle-article-details" data-alt-text="Hide details" ref="linksrc=toggle_article_details" aria-controls="full-article-details" aria-expanded="false" data-fetch-url="/31242625/long-authors/" data-id-prefix=""> 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dropdown-block"><button id="short-view-journal-trigger" class="journal-actions-trigger trigger" ref="linksrc=journal_actions_btn" title="Journal of clinical medicine" tabindex="0" aria-controls="short-view-journal" aria-expanded="false" aria-label="Toggle dropdown menu for journal Journal of clinical medicine" data-pinger-ignore> J Clin Med </button><div id="short-view-journal" class="journal-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for journal Journal of clinical medicine"><div class="title">Actions</div><div class="content"><ul class="journal-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22J+Clin+Med%22%5Bjour%5D&sort=date&sort_order=desc" data-href="/?term=%22J+Clin+Med%22%5Bjour%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_journal_name_link&journal_abbrev=J Clin Med" data-ga-category="search" data-ga-action="journal_link" data-ga-label="J Clin Med"> Search in PubMed </a></li><li><a class="search-in-nlm-catalog-link dropdown-block-link" ref ="linksrc=search_in_nlm_catalog_link" href="https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Clin+Med%22%5BTitle+Abbreviation%5D" data-ga-category="search_catalog" data-ga-action="journal_link" data-ga-label="J Clin Med"> Search in NLM Catalog </a></li><li><a class="add-to-search-link dropdown-block-link" ref ="linksrc=add_to_search_link" role="button" data-search-term='"J Clin Med"[jour]' data-ga-category="search" data-ga-action="add_to_search" data-ga-label='"J Clin Med"[jour]' href="#"> Add to Search </a></li></ul></div></div></div><span class="period">. </span><span class="cit">2019 Jun 25;8(6):908.</span> </div> <span class="citation-doi"> doi: 10.3390/jcm8060908. </span> </div> <div class="expanded-authors" id="short-view-expanded-authors"> <div class="authors"> <h3 class="title"> Authors </h3> <div class="authors-list"> <span class="authors-list-item "><a class="full-name" href="/?term=Casado-Espada+NM&cauthor_id=31242625" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Nerea M Casado-Espada">Nerea M Casado-Espada</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. nmcasado91@gmail.com." href="#short-view-affiliation-1" ref="linksrc=author_aff"> 1 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=de+Alarc%C3%B3n+R&cauthor_id=31242625" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Rubén de Alarcón">Rubén de Alarcón</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. ruperghost@gmail.com." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=de+la+Iglesia-Larrad+JI&cauthor_id=31242625" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Javier I de la Iglesia-Larrad">Javier I de la Iglesia-Larrad</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. javidelaiglesia.jdli@gmail.com." href="#short-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Bote-Bonaechea+B&cauthor_id=31242625" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Berta Bote-Bonaechea">Berta Bote-Bonaechea</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. bertabot@yahoo.es." href="#short-view-affiliation-4" ref="linksrc=author_aff"> 4 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Montejo+%C3%81L&cauthor_id=31242625" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Ángel L Montejo">Ángel L Montejo</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. amontejo@usal.es." href="#short-view-affiliation-5" ref="linksrc=author_aff"> 5 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Nursing School E.U.E.F., University of Salamanca, Av. Donantes de Sangre SN 37007 Salamanca, Spain. amontejo@usal.es." href="#short-view-affiliation-6" ref="linksrc=author_aff"> 6 </a></sup></span> </div> </div> <div class="affiliations"> <h3 class="title"> Affiliations </h3> <ul class="item-list"> <li data-affiliation-id="short-view-affiliation-1" id="short-view-affiliation-1" ><sup class="key">1</sup> Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. nmcasado91@gmail.com.</li> <li data-affiliation-id="short-view-affiliation-2" id="short-view-affiliation-2" ><sup class="key">2</sup> Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. ruperghost@gmail.com.</li> <li data-affiliation-id="short-view-affiliation-3" id="short-view-affiliation-3" ><sup class="key">3</sup> Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. javidelaiglesia.jdli@gmail.com.</li> <li data-affiliation-id="short-view-affiliation-4" id="short-view-affiliation-4" ><sup class="key">4</sup> Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. bertabot@yahoo.es.</li> <li data-affiliation-id="short-view-affiliation-5" id="short-view-affiliation-5" ><sup class="key">5</sup> Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain. amontejo@usal.es.</li> <li data-affiliation-id="short-view-affiliation-6" id="short-view-affiliation-6" ><sup class="key">6</sup> Nursing School E.U.E.F., University of Salamanca, Av. Donantes de Sangre SN 37007 Salamanca, Spain. amontejo@usal.es.</li> </ul> </div> </div> <ul class="identifiers" id="short-view-identifiers"> <li> <span class="identifier pubmed"> <span class="id-label"> PMID: </span> <strong class="current-id" title="PubMed ID">31242625</strong> </span> </li> <li> <span class="identifier pmc"> <span class="id-label"> PMCID: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=PMC6617135&id_type=PMC" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6617135/" data-ga-category="full_text" data-ga-action="PMCID" > PMC6617135 </a> </span> </li> <li> <span class="identifier doi"> <span class="id-label"> DOI: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=10.3390/jcm8060908&id_type=DOI" href="https://doi.org/10.3390/jcm8060908" data-ga-category="full_text" data-ga-action="DOI" > 10.3390/jcm8060908 </a> </span> </li> </ul> <div class="in-clipboard-label " hidden> Item in Clipboard </div> </div> </div> </header> <div class="actions-buttons inline"><div class="inner-wrap"><button class="full-text-links-button full-text-links-dialog-trigger" title="Open dialog with full text links" ref="linksrc=full_text_links"> Full text links </button><button class="citation-button citation-dialog-trigger" aria-label="Open dialog with citation text in different styles" data-ga-category="save_share" data-ga-action="cite" data-ga-label="open" data-all-citations-url="/31242625/citations/" data-citation-style="nlm" data-pubmed-format-link="/31242625/export/"><span class="button-label">Cite</span></button><button class="more-actions-button more-actions-dialog-trigger" title="Open dialog with more actions to take" ref="linksrc=more_actions_btn"></button><div class="display-options" data-format-key="format" data-default-format-value="abstract" data-current-format-value="abstract" role="region"><button class="trigger usa-button" title="Change format" data-ga-category="display_options" data-ga-action="display_options_dialog"><span class="button-label">Display options</span></button><div class="dropdown" hidden><div class="title"> Display options </div><div class="content"><div class="format-container"><span class="option-label"> Format </span><select name="format" data-initial-value="abstract" aria-label="Display format" id="inline-actions-display-format"><option value="abstract">Abstract</option><option value="pubmed">PubMed</option><option value="pmid">PMID</option></select></div></div></div></div></div></div> <div class="abstract" id="abstract"> <h2 class="title"> Abstract </h2> <div class="abstract-content selected" id="eng-abstract"> <p> In recent decades, hormonal contraceptives (HC) has made a difference in the control of female fertility, taking an unequivocal role in improving contraceptive efficacy. Some side effects of hormonal treatments have been carefully studied. However, the influence of these drugs on female sexual functioning is not so clear, although variations in the plasma levels of sexual hormones could be associated with sexual dysfunction. Permanent hormonal modifications, during menopause or caused by some endocrine pathologies, could be directly related to sexual dysfunction in some cases but not in all of them. HC use seems to be responsible for a decrease of circulating androgen, estradiol, and progesterone levels, as well as for the inhibition of oxytocin functioning. Hormonal contraceptive use could alter women's pair-bonding behavior, reduce neural response to the expectation of erotic stimuli, and increase sexual jealousy. There are contradictory results from different studies regarding the association between sexual dysfunction and hormonal contraceptives, so it could be firmly said that additional research is needed. When contraceptive-related female sexual dysfunction is suspected, the recommended therapy is the discontinuation of contraceptives with consideration of an alternative method, such as levonorgestrel-releasing intrauterine systems, copper intrauterine contraceptives, etonogestrel implants, the permanent sterilization of either partner (when future fertility is not desired), or a contraceptive ring. </p> </div> <p> <strong class="sub-title"> Keywords: </strong> depot medroxyprogesterone acetate; desire; female sexual dysfunction; hormonal contraceptive; libido; orgasm; sex life; vaginal ring. </p> </div> <p class="disclaimer" id="disclaimer"> <a href="/disclaimer/" target="_blank" data-ga-category="literature_resources" data-ga-action="disclaimer_link" data-ga-label="under_abstract">PubMed Disclaimer</a> </p> <div class="conflict-of-interest" id="conflict-of-interest"> <h2 class="title"> Conflict of interest statement </h2> <div class="statement"> <p xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:p1="http://pubmed.gov/pub-one">AL Montejo has received consultancy fees or honoraria/research grants in the last five years from Boehringer Ingelheim, Forum Pharmaceuticals, Rovi, Servier, Lundbeck, Otsuka, Janssen Cilag, Pfizer, Roche, Instituto de Salud Carlos III and Junta de Castilla y León. Berta Bote has received fees to give lectures from Lundbeck and Janssen. Nerea M. Casado-Espada has received an economic award from Janssen in an oral communication contest. None of the other authors declare any conflict of interest.</p> </div> </div> <div class="figures" id="figures"> <h2 class="title"> Figures </h2> <div class="figures-list" id="slides-container" itemscope itemtype="http://schema.org/ImageGallery"> <figure class="figure-item " itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="0" data-label-slug="figure-1"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fdc/6617135/f58d1669d0f8/jcm-08-00908-g001.jpg" itemprop="contentUrl" aria-describedby="figure-caption-0" role="button" data-image-width="797" data-image-height="446" data-image-alt="Figure 1" data-pmc-id="PMC6617135" data-figure-id="jcm-08-00908-f001"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-0" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fdc/6617135/46f3c1eb71f1/jcm-08-00908-g001.gif" alt="Figure 1" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="797"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="446"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> Figure 1 </p> </strong> <div class="figure-caption-contents"><p> PRISMA flow diagram. (Preferred Reporting… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> Figure 1 </p> </strong> <div class="figure-caption-contents"><p> PRISMA flow diagram. (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). </p></div> </div> <figcaption id="figure-caption-0" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> Figure 1 </strong> <div class="figure-caption-contents">PRISMA flow diagram. (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).</div> </figcaption> </figure> <figure class="figure-item " itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="1" data-label-slug="figure-2"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fdc/6617135/726dbf76748f/jcm-08-00908-g002.jpg" itemprop="contentUrl" aria-describedby="figure-caption-1" role="button" data-image-width="723" data-image-height="199" data-image-alt="Figure 2" data-pmc-id="PMC6617135" data-figure-id="jcm-08-00908-f002"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-1" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fdc/6617135/83ecb9f68ea3/jcm-08-00908-g002.gif" alt="Figure 2" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="723"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="199"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> Figure 2 </p> </strong> <div class="figure-caption-contents"><p> Types of estrogens used in… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> Figure 2 </p> </strong> <div class="figure-caption-contents"><p> Types of estrogens used in combined oral contraceptives (COCs). </p></div> </div> <figcaption id="figure-caption-1" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> Figure 2 </strong> <div class="figure-caption-contents">Types of estrogens used in combined oral contraceptives (COCs).</div> </figcaption> </figure> <figure class="figure-item " itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="2" data-label-slug="figure-3"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fdc/6617135/0b1c28f01c8f/jcm-08-00908-g003.jpg" itemprop="contentUrl" aria-describedby="figure-caption-2" role="button" data-image-width="747" data-image-height="424" data-image-alt="Figure 3" data-pmc-id="PMC6617135" data-figure-id="jcm-08-00908-f003"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-2" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fdc/6617135/59b389518935/jcm-08-00908-g003.gif" alt="Figure 3" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="747"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="424"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> Figure 3 </p> </strong> <div class="figure-caption-contents"><p> Management strategies for hormonal contraceptive… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> Figure 3 </p> </strong> <div class="figure-caption-contents"><p> Management strategies for hormonal contraceptive (HC)-related sexual dysfunction. </p></div> </div> <figcaption id="figure-caption-2" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> Figure 3 </strong> <div class="figure-caption-contents">Management strategies for hormonal contraceptive (HC)-related sexual dysfunction.</div> </figcaption> </figure> </div>  <div class="pswp figures-dialog" id="figures-dialog" tabindex="-1" role="dialog" aria-hidden="true" data-image-gallery-uid="article-figures" aria-label="Figures Dialog">  <div class="pswp__bg"></div>  <div class="pswp__scroll-wrap">  <div class="pswp__container"> <div class="pswp__item"></div> <div class="pswp__item"></div> <div class="pswp__item"></div> </div>  <div 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Med. 2012;9:2213–2223. doi: 10.1111/j.1743-6109.2012.02848.x. - <a class="reference-link" href="https://doi.org/10.1111/j.1743-6109.2012.02848.x" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="10.1111/j.1743-6109.2012.02848.x" > DOI </a> - <a class="reference-link" href="/22788250/" ref="linksrc=references_link&ordinalpos=2" data-ga-category="reference" data-ga-action="22788250" > PubMed </a> </li> </ol> </li> <li> <ol class="references-and-notes-list"> <li class="skip-numbering" value="1"> Casey P.M., MacLaughlin K.L., Faubion S.S. Impact of Contraception on Female Sexual Function. J. Women’s Heal. 2017;26:207–213. doi: 10.1089/jwh.2015.5703. - <a class="reference-link" href="https://doi.org/10.1089/jwh.2015.5703" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="10.1089/jwh.2015.5703" > DOI </a> - <a class="reference-link" href="/27622561/" ref="linksrc=references_link&ordinalpos=2" data-ga-category="reference" data-ga-action="27622561" > PubMed </a> </li> </ol> </li> <li> <ol class="references-and-notes-list"> <li class="skip-numbering" value="1"> Champaneria R., D’Andrea R.M., Latthe P.M. Hormonal contraception and pelvic floor function: a systematic review. Int. Urogynecol. J. 2016;27:709–722. doi: 10.1007/s00192-015-2833-3. - <a class="reference-link" href="https://doi.org/10.1007/s00192-015-2833-3" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="10.1007/s00192-015-2833-3" > DOI </a> - <a class="reference-link" href="/26407563/" ref="linksrc=references_link&ordinalpos=2" data-ga-category="reference" data-ga-action="26407563" > PubMed </a> </li> </ol> </li> <li> <ol class="references-and-notes-list"> <li class="skip-numbering" value="1"> Egarter C., Frey Tirri B., Bitzer J., Kaminskyy V., Oddens B.J., Prilepskaya V., Yeshaya A., Marintcheva-Petrova M., Weyers S. Women’s perceptions and reasons for choosing the pill, patch, or ring in the CHOICE study: A cross-sectional survey of contraceptive method selection after counseling. BMC Womens. Health. 2013;13:1. doi: 10.1186/1472-6874-13-9. - <a class="reference-link" href="https://doi.org/10.1186/1472-6874-13-9" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="10.1186/1472-6874-13-9" > DOI </a> - <a class="reference-link" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC3605181/" ref="linksrc=references_link&ordinalpos=2" data-ga-category="reference" data-ga-action="PMC3605181" > PMC </a> - <a class="reference-link" href="/23448283/" ref="linksrc=references_link&ordinalpos=3" data-ga-category="reference" data-ga-action="23448283" > PubMed </a> </li> </ol> </li> <li> <ol class="references-and-notes-list"> <li class="skip-numbering" value="1"> Baird D.T., Castelo-Branco C., Collins J., Evers J.L.H., Glasier A., La Vecchia C., Leridon H., Mishell D.R., Wellings K., Arisi E., et al. Female contraception over 40. Hum. Reprod. 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