Is the Pill Killing Your Sex Drive?

If the pill was an advertisement, it’d be a billboard for female sexual empowerment. Since its introduction, hormonal birth control pills have enabled women with the freedom to enjoy sex on their terms, with a less than 1% risk of unplanned pregnancy (find out the chances of falling pregnant on the pill).

Sex life aside, birth control pills release synthetic hormones that provide women with the sexual health support they need to regulate their menstrual cycle and ease symptoms of polycystic ovary syndrome (PCOS), endometriosis, and other menstrual conditions. It truly is a magic pill; a girl’s medicinal best friend.

But like all medications, the pill comes with its fair share of potential side effects. So, if you’re one of 500-million women with a never-ending supply of birth control pills and a low libido, you wouldn’t be alone in wondering if hormonal pills decrease desire or affect sex drive in any way.

Before you start self-diagnosing a female sexual dysfunction, here’s everything you need to know about how hormonal contraceptives can affect your sex drive and sexual functioning. 

First, a refresher on how hormonal contraception works

Hormonal contraception refers to birth control methods containing synthetic forms of hormones that mimic the naturally-occurring hormones in a woman’s body.

The two types of hormonal birth control are combination birth control and progestin only birth control.

Combination hormonal birth control contains synthetic estrogen and a type of progestin. They prevent pregnancy by stopping an egg from being released by the ovaries, and thickening the cervical mucus to make it hard for sperm to implant in the womb.

Combined hormonal contraceptives are available as a combined pill that’s taken daily at the same time, and a vaginal ring that’s inserted into the vagina to provide three weeks of pregnancy protection.

Progestin only birth control contains progestin only (no surprises here), and provides an option for women who cannot use birth control with estrogen for whatever reason. Progestogen only methods prevent pregnancy by thickening the cervical mucus and stopping ovulation.

Progestin only birth control is available as progestin only pills (aka the mini pill) that are taken daily at the same time, and hormonal IUD (intrauterine devices) that are inserted into the uterus for up to several years of pregnancy prevention.

In short, no matter what hormonal birth control method is used, all hormonal contraception users will experience a subtle release of estrogen and/or progestin that prevents sperm joining with an egg for fertilisation. If fertilisation doesn’t occur, there’s no chance of a pregnancy occurring.

Learn more about how hormonal birth control works.

What is libido?

Libido is your sexual desire or appetite.

Commonly referred to as your sex drive, a healthy libido can provide benefits of less stress, better mental health, healthy relationships, boosted confidence, greater self esteem, better sleep, and motivation to exercise more frequently.

When a person experiences a low libido, they have less desire to engage in sexual activity, which is completely healthy at times. At the opposite end of the spectrum, when a person experiences a higher sex drive, they have an increased desire to engage in sexual activity and tend to seek it out with a partner or solo through masturbation. Again, it’s completely healthy to experience bouts of high libido.

When an overly high libido becomes too hard to control or interferes with quality of life, it can be a sign of a hormonal imbalance or neurological disorder. The opposing extreme of persistently low or non-existent libido can be an indication of a condition known as hypoactive sexual desire disorder.

How does libido work?

Testosterone and estrogen are the sex hormones responsible for the biological urge for sex, and regulation of sexual desire. When on the verge of sex, the body undergoes a series of physical changes in what’s known as the stage of arousal.

If you have a vulva, arousal manifests physically as an increase in vaginal fluid and a sudden rush of blood that causes swelling of the clitoris and labia. Your friends with a penis will experience an erection.

Every person’s libido is unique to them. You may notice you have a reduced sex drive in comparison to your partner, and that’s completely fine. It is common for some people to have a higher desire or more spontaneous desire for sex, and your desire for sex may fluctuate throughout life stages, or with different partners.

For example: you may feel a higher desire for sex with a long-term relationship partner who you’ve spent time building trust and connection, rather than with women or men partnered through dating apps (who, let’s be honest, can sometimes kill desire when you realise their profile doesn’t match up).

Female sex drive can be influenced by many factors, including:

Psychological factors

• Stress

• Mental health issues, such as depression or anxiety (P.S. here are some tips on how to prevent an anxiety attack)

• Personality

• Age

• Relationship status

• Lifestyle

• Mood

• Past experiences, such as sexual abuse or trauma

• Body image and self-esteem

Sex hormones

• Estrogen (one of the female hormones)

• Testosterone levels (lower testosterone levels can lower sex drive) 

Medical and health conditions

• Illness

• Fatigue

• Medication

• Sexual disorders

Other factors

• Loneliness

• Relationship issues

• Feeling stagnant in long term monogamous relationships

• Intimacy issues

• Sexuality (sometimes people fall into heterosexual relationships before realising they’re not interested in the opposite gender)

How do hormonal contraceptives affect libido?

Female reproductive health is governed by many hormones, including estrogen, progesterone, and androgens. One of the most well known androgens is testosterone. Despite being labelled as a ‘male hormone’, testosterone exists in small amounts in the female body and plays a key role in female sexual function and sex drive.

The pill is a hormonal birth control method that decreases the production of androgen hormones, thus potentially causing decreased libido. Oral contraceptives also increase the production of sex hormone binding globulin (SHBG) in the liver. SHBG binds to testosterone and stops it from circulating throughout the body, causing the decrease of a woman’s sex drive.

Recent research on the link between birth control methods and libido

Using a tool called the Sexual Desire Inventory, 900 male and female participants in heterosexual relationships were questioned about both their desire for sex with their partner and their desire for masturbation when they were alone.

The findings revealed a significant difference in the way birth control influenced sexual desire of women alone and in their relationships. Most women using non-hormonal birth control reported higher sex drive on their own, and oral contraceptive users reported higher desire with their partner.

What types of hormonal birth control can affect your sex drive?

Some forms of hormonal birth control have a greater effect on sex drive than others. The mini pill is a progestin only pill that doesn’t affect androgen levels, so it’s less likely to cause low libido in comparison to combination birth control. Both hormonal and non-hormonal IUD are less likely to impact sexual desire since they don’t cause the liver to produce higher levels of sex hormone binding globulin (SHBG).

If you want to safeguard your sex life, barrier methods like condoms are the only form of birth control that won’t influence a change to your sex drive. Non hormonal contraceptives, like the copper IUD, will be less likely to impact your libido when compared to hormonal methods.

How to increase sex drive when using birth control pills

Oral contraceptive users concerned about changes to hormone levels causing low libido or impaired sexual function should know there are several ways that may help hormones return to normal levels, including:

• Switching to a different oral contraceptive or form of hormonal birth control (perhaps lower dose combined pills)
• Starting birth control of the non-hormonal variety, like a copper IUD
• Taking antidepressant or anti-anxiety medications (always talk with your doctor prior)

Hormonal changes aside, there are many factors that can impact sex drive, including painful sex experiences (check out common reasons your vagina could be sore after sex) or personal distress as a result of past trauma.

Identifying the root cause of decreased libido can be challenging. Consulting with a doctor or sex therapist will help to determine the cause and find the right sexual medicine for your situation.

Talk with one of our Aussie-based doctors to discuss your birth control options or any women’s sexual health issues you’re experiencing.