New YorkThe relationship between birth control pills and libido has been complicated from the beginning. The pill is known to have revolutionized sex, but for some women, the combination of hormones that prevent pregnancy also reduces sexual desire. “Oral contraceptive pills can cause very significant sexual dysfunction,” says Andrew Goldstein, MD, a gynecologist and former president of the International Society for the Study of Women's Sexual Health.
A decade ago, a group of researchers analyzed 36 studies on the side effects of combined hormonal birth control pills — those containing estrogen and progestin — and found that 15% of 13,700 women who participated in the studies had decreased sexual desire during pregnancy. Treatment time. But since then, only a few studies have analyzed the causes, and no consensus has yet been reached due to the variety of versions of pills containing different doses of hormones.
Now, birth control pills are known to lower testosterone levels, which researchers believe is the main link to sex drive. However, low libido is not recognized on birth control pills, and many doctors or gynecologists don't realize that it can be a problem as well, Goldstein warns. That's why, when women tell health professionals about it, they often tell them that “it can't be due to the pill.”
Excitement and fun
Loss of sexual desire has many manifestations, according to Loren Streicher, a professor of obstetrics and gynecology at Northwestern University. According to anecdotal accounts, the researcher noted that some women notice changes in sexual desire within weeks of starting to take birth control pills, while studies reveal that other women take months or years to notice these changes. In addition, Streicher notes that for some, it begins with a loss of spontaneous desire for sex and then progresses to a lack of arousal to stimuli.
In a 2016 study, 340 women were randomly assigned to either the pill or a placebo for three months to measure its effect on sexual function. The researchers measured levels of certain hormones in the blood and used a survey to determine the number of sexual encounters participants had had, as well as whether factors such as desire, arousal, orgasm, pleasure, and enjoyment had changed. The study revealed that it negatively affects desire, excitement, and pleasure. Birth control pills have also been linked to decreased lubrication, which can make intercourse painful, and this can affect libido.
Method of change
Genetic differences mean that some women need more free testosterone than others to activate their hormone receptors, so low testosterone has a noticeable effect. “Understanding who is more sensitive and who can develop harmful side effects is something that has not been done yet,” explains Carolyn Morrow, a professor at Johns Hopkins University School of Public Health. He adds that it's difficult to directly link biological markers, such as testosterone levels, to sexual function, which can be affected by stress, relationship dynamics or other circumstances.
For the subset of women who have had these negative experiences with birth control pills, the effects are reversible. The first step is often to explore other contraceptive options, especially non-hormonal ones, such as the IUD. Women who experience a decrease in libido may regain libido almost immediately. “When women stop taking the pill, within weeks they say they are much better,” Streicher says. Over time, they also re-lubricate. “It's very rare for a doctor who treats complex patients to say, 'I'll treat you,'” he adds. But when it comes to the pill's effects on sex drive, she says it can help.
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