The Clitoral Shrinkage Study: How Hormonal Contraceptives Affect Sexual Function | Ep. 472

Key Topics Covered:

• The Clitoral Shrinkage Study: Understanding the impact of hormonal contraceptives on sexual organs and function.
• Hormonal contraceptives and their effect on testosterone levels and sexual sensation.
• Why all women on hormonal contraceptives experience hormonal changes, particularly a reduction in testosterone.
• Changes in libido and sexual function tied to contraceptive use.
• The importance of education and open discussion about contraceptive side effects and their impact on sexual health.

Key Moments (Timestamps & Detailed Summaries)

Introduction to the Episode & Sponsor ( 00:00 – 01:30 )

Lisa introduces the episode and mentions the sponsor, the Fertility Awareness Mastery (FAM) Mentorship Program. She explains that FAM is designed for women’s health professionals who want to integrate fertility awareness into their practices by using menstrual cycle charting as a diagnostic tool. She mentions that enrollment is open once per year, and provides a link to join the waiting list.

Introduction to the Topic: Clitoral Shrinkage Study ( 01:30 – 05:00 )

Lisa transitions into the main topic: a controversial study on how hormonal contraceptives (such as birth control pills and NuvaRing) affect sexual function and clitoral size. She introduces the study, acknowledging that it has received some criticism due to its smaller sample size but emphasizes its relevance to the discussion on hormonal birth control and sexual health.

Overview of the Study Methodology ( 05:00 – 09:00 )

Lisa discusses the methodology behind the study, conducted in 2013-2014, which involved 40 women who were not using hormonal contraceptives at the time. These women were screened for their clitoral anatomy and sexual function (through questionnaires) before being placed on hormonal birth control (either Yasmin or NuvaRing). After six months, the same tests were repeated to see what physical changes occurred. This section sets the foundation for understanding the research process and how the study was structured.

Results of the Study: Clitoral Shrinkage ( 09:00 – 14:00 )

Lisa dives into the main findings of the study: the women who used hormonal contraceptives for six months experienced a reduction in clitoral volume, with the average reduction being 20–23%. She explains how this reduction was measured and why this is significant, noting that this finding might surprise many women, as this aspect of contraceptive side effects is often overlooked.

Why Does This Happen? Hormonal Impact on Testosterone and SHBG ( 14:00 – 18:30 )

In this segment, Lisa explains the biological mechanisms at play. She discusses how hormonal contraceptives lower testosterone levels in women and increase the production of SHBG (Sex Hormone Binding Globulin). SHBG binds to testosterone, rendering it unavailable to the body. This process leads to decreased testosterone levels in all women using hormonal birth control, contributing to changes in sexual function and sensation.

Impact on Sexual Function: Libido, Orgasm Frequency, and Pain ( 18:30 – 23:00 )

Lisa elaborates on the effects hormonal contraceptives can have on libido and sexual function. She references the study’s findings that women on hormonal contraceptives experienced reduced libido, fewer orgasms, and increased pain with intercourse. She discusses how these effects can be linked to the reduction in testosterone levels and the thinning of vulvar tissues, which can decrease sexual sensation.

Pushback on Discussing Negative Effects of the Pill ( 23:00 – 27:00 )

Lisa addresses the common criticism she receives when sharing this type of research. She reflects on the pushback that often arises when discussing the negative effects of the pill, particularly concerns about scaring women away from using birth control. Lisa argues that withholding information about the risks of contraceptives does a disservice to women, as they have the right to make informed decisions about their health.

Personal Reflection: The Importance of Knowing the Facts ( 27:00 – 30:00 )

Lisa shares her thoughts on the importance of knowing the full truth about hormonal contraceptives, especially for women who may be considering them or currently using them. She emphasizes the need for women to understand the physical consequences of these drugs, even if they may be hard to hear. This section provides a more personal perspective on why these studies matter and why open discussions are essential.

Are These Effects Permanent? ( 30:00 – 34:00 )

Lisa clarifies that the effects observed in the study, such as clitoral shrinkage, are not necessarily permanent. She points out that most of these changes are reversible once women stop using hormonal contraceptives, but it’s important to understand that these physical changes can happen. She also addresses the psychological aspect of women potentially not realizing the changes in their bodies until they come off the pill.

Beyond Reproductive Health: The Larger Impact of Hormonal Contraceptives ( 34:00 – 38:00 )

Lisa explains that hormonal contraceptives have an effect that extends beyond just preventing pregnancy; they alter women’s entire hormonal profile. She discusses the importance of recognizing that hormonal contraceptives suppress the body’s natural reproductive processes, which affects more than just fertility. This segment also touches on how the menstrual cycle and hormonal health are integral to overall well-being.

Comparison with Male Contraceptive Study ( 38:00 – 40:00 )

Lisa compares the findings from the male contraceptive study shared in a previous episode. She highlights how, unlike women who experience reduced libido on hormonal contraceptives, men in the male contraceptive study reported increased libido. This comparison serves to highlight the gender disparity in how hormonal contraceptives affect sexual function.

Sample Size Criticism: Why It’s Still Relevant ( 40:00 – 45:00 )

Lisa discusses the critique of the study due to its small sample size of just 40 women. She acknowledges the concern but argues that the pill has been studied extensively for over 60 years, and this study is part of a broader body of research. She points out that while one study on its own may not draw broad conclusions, when combined with numerous other studies, the findings are compelling and contribute to the growing body of evidence about the side effects of hormonal contraceptives.

Conclusion: The Need for More Research and Open Dialogue ( 45:00 – 50:00 )

Lisa wraps up the episode by reinforcing the importance of continuing the conversation about the side effects of hormonal contraceptives. She emphasizes that while these effects may be difficult to talk about, they are real and need to be acknowledged so women can make fully informed choices about their health. She encourages listeners to seek out more information and stay educated about the options available to them.

Closing & Call to Action ( 50:00 – 51:30 )

Lisa closes the episode with a reminder about the Fertility Awareness Mastery Mentorship Program and encourages listeners to visit the website for more information. She also reminds them to share the episode, subscribe to the podcast, and leave any questions or feedback in the comments.