We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful sexual health situations that inevitably crop up when you’re getting down? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. This week’s topic: Does being on the pill lower your libido — and what can you do about it?
Q: I went on the pill a few months ago because I’m not ready to have a baby yet, but I love having sex. But ever since I went on birth control, I've felt way less into sex , and it’s putting strain on my relationship with my boyfriend. My ob/gyn never warned me that this could happen. What’s going on? What should I do to get my libido back?
A: First, let me commend you for taking charge of your reproductive health by seeking protection against pregnancy. Oral contraception, commonly known as the pill, is actually a class of medication unto itself, with significant variation within the available offerings. Because of this variation, you can experience a number of different side effects on hormonal birth control — including lowered desire, regardless of whether your doctor mentioned it or not (which s/he should have).
If you look up “lowered libido + pill” or any related search terms on the Internet, you will find a ton of content about this disorder, including some pretty intense statistics about Female Sexual Dysfunction, or FSD. In fact, a recent well-reviewed article on the subject says that an estimated 40 percent of women have FSD. The most common description of FSD is low desire, which might make you think: if nearly half of the female-bodied world is being diagnosed with low libido, maybe we should redefine the bar of “average” libido. (Because 40 percent sounds pretty damn average to me.)
Still, lowered sex drive appears to be a real side effect of being on the pill, so first, let’s learn why this happens — and then we can get into how you can work to get your libido back to the levels you’re used to.
How Does the Pill Work, Again?
Before you can figure out how the pill may be affecting you, it’s good to understand how it works. So first things first — what’s actually in the pill? It’s actually pretty simple: Oral contraceptives can be made of two hormones: estrogen and progestin. Some pills have both, and some have only progestin. Additionally, different pills have different levels of these hormones.
Your body makes both these hormones naturally on its own, but the pill contains synthetic versions that alter your body’s normal levels for the purpose of making you not get pregnant. Specifically, both of these hormones block your body from ovulating, which is when your ovaries release a mature egg that is ready for fertilization, allowing it to travel through your fallopian tubes and meet any sperm that may be hanging around. Progestin additionally makes the mucus around your cervix thicker and stickier, which makes it more difficult for sperm to get up there to meet your egg.
The pill has been approved since 1960 and is currently used by four out of five women in America because it works. If you take the pill every day as directed, it’s extremely effective in tiny-child-creation prevention — 99.7 percent with perfect use and 92 percent with typical use, because we’re human and sometimes forget to take a pill here or there. Overall, it’s a really good option for people who are having sex but don’t want to get pregnant.
Oral contraceptives help protect you against pregnancy, but NOT sexually transmitted infections (STIs). Barrier protection methods, more commonly known as condoms, protect you from STIs as well as pregnancy. Research indicates that if you combine the pill with male (or as I like to call them, external) condoms, they are 99.99 percent effective with perfect use, or 98.8 percent with typical use. So I say: the more the merrier!
The Most Common Side Effects of the Pill
The pill can have some intense and nasty side effects. Commonly listed side effects include changes to your menstrual cycle, including it going away (this isn’t dangerous, although some women like getting the blood each month for various reasons...it shows us visual proof that we’re not pregnant, makes us feel more connected to the moon, whatever), nausea, changes in mood, depression, migraines, weight fluctuation, and tender breasts. More intense and medically dangerous side effects can include blood clots, heart attacks, high blood pressure, or stroke — but don’t worry, these are extremely rare and are even less likely to occur with the progestin-only pills.
What About Lowered Libido?
While it’s not listed as a side effect on oral contraceptive packages in the United States (ugh), another side effect of the pill can be changes to your sex drive. This reaction has been found in a number of research studies, which have reported that a subset of women on the pill complain of losing their libido. It’s rather difficult to find statistics on this side effect, but prevalence is often cited by doctors to be in the 10 to 40 percent range, with most coming down on the higher end of that spectrum. (Which is quite significant not to list as a side effect, if you ask me.)
The posited reason for this change in some women is as follows: female sexual response is in part connected to androgens, which are male sex hormones (think testosterone). Yes, female bodies make them too — just in different levels than males. The presence of androgens is linked to female libido, particularly in regards to the blood flow that makes your sexy parts sensitive and ready to go — and also increases the intensity of orgasm.
So what happens with your sexy-making androgen levels when you’re on the pill? Some oral contraceptives mess with your body’s natural androgen production while they’re hindering your ovaries from doing their normal job of helping you make babies. Pills that contain estrogen vanquish your androgen stash even further, leaving you with less of the desire-boosting hormone available to your body — and potentially minimizing the intensity of your orgasm.
Why Doesn’t Everyone's Sex Drive Get Messed Up on the Pill?
The jury is still out on why the pill doesn’t mess with the libido levels of all women. Common theories include that the feeling of sexual freedom without the threat or worry of conception is so sexy that it can override the feelings you may be getting from low androgen levels. Also, new romance can be so exciting that it can distract you from lower-than-usual levels of sexual feelings (this is non-scientifically called the honeymoon period). Finally, people have different levels of hormones both throughout their lives and at different times during their lives, and androgens are no exception — so the pill can affect you differently, depending on who you are and what stage of life you’re in.
What Can You Do About It?
If not-sexy is the way you’re feeling while you’re on the pill, don’t worry — there are a bunch of things you can do to increase your sex drive.
Change Your Pill
Some pill options have been found to lower libido more than others. Since all oral contraceptives on the market are basically equally effective in preventing pregnancy, selecting the right pill for you really comes down to what side effects you personally get from each pill, and which you want to tolerate. For instance, some research indicates that pills that have less of the weight gain and mood swing effects are more likely to mess with your desire. Talk to your gynecologist about the side effects you’re having and consider transitioning to another pill option.
Stop Taking the Pill
You can either stop taking the pill forever, or you can just put the process on hold for a few months until your body gets back to its normal hormone levels. Getting all the synthetic hormones out of your system — a three to six month break is recommended — will allow you to check out how you feel without them. If you go this purge route, remember to supplement with another contraceptive option so you don’t get pregnant. If you are still feeling not as sexual as you want to, there could be other factors at play, such as depression, anxiety, or stress. The good news is that other contraceptive options haven’t been found to have the same libido-decreasing side effects, so you may want to check out getting an IUD or relying on condoms.
Talk to Your Doctor About Taking Androgens
While giving androgens to women with low sexual drive isn’t FDA approved yet, it’s being used experimentally to do just that. Talk to your doctor about the possibility of going on an androgen to help boost your libido.
Communicate With Your Partner
You probably know this already, but it really bears saying explicitly: It’s important to talk to your partner about the way you’re feeling always, but particularly if something’s changing within you that is impacting your relationship. Think about things your partner can do to make you feel sexier or more turned on. The research shows that feelings and circumstances can override hormonal deficiencies and keep your sex drive high. And as I love to say...communication is the best lubrication!
Talk to a Professional
There is a whole industry of counselors and therapists who specialize in problems related to sexual function, sexuality, and relationships. These trained professionals can help you figure out ways to talk to your partner and can also help you learn about your own desire so that you can extend it within yourself. Some of these counselors also offer education about ways to optimize your body’s sexual response.
The Bottom Line
Oral contraception is a very powerful drug — one with many pros and some cons, and just one offering in our growing pregnancy prevention toolbox. If it works for you and makes you feel great and in charge and safe, then it’s a great option! But if the side effects of the synthetic hormones are getting you down in any way — whether it be lowered libido or any of the other side effects listed above — you may want to talk to your doctor about switching to a different option, such as something with lower or no hormones. Bedsider has an exceptional interface where you can learn about all the contraceptive options available to you.
Images: UCI UC Irvine/Flickr; Getty; Giphy