The Pill and Sex Drive
This post is more of a PSA (public service announcement) rather what I usually do here.
Rumours about birth control pills limiting or killing a woman’s sex drive have been around for decades. Those who are invested in the pill for financial or social reasons have done all they can to claim it is not so. They are starting to sound like cigarette companies back in the 60’s saying “there is no proof” and “it’s all in their minds”. Several studies * have shown clear correlation, and by eliminating other possible causes, the cause and effect looks solid. Placebo controlled tests have shown the same thing – women taking real pills reported more sexual problems than those taking a placebo.
Sexual side effects of the pill include loss of sex drive, difficulty getting aroused, and difficulty reaching orgasm or weaker orgasms. Less lubrication and more pain are also reported. Some women do not seem to have a problem, but many (most?) do. All forms of hormonal contraception can cause problems, but those not swallowed seem to be less of damaging to sexuality.
Much of this is explained by the hormonal consequences of taking the pill. Among other things, the pill increases the levels of sex hormone binding globulin (SHBG), a protein that binds with testosterone. This leaves the women with less “free testosterone” – the form that does things in the body. Women on the pill have four times the levels of SHBG found in women who have never taken the pill, and show a corresponding drop in free testosterone. ** Lower free testosterone levels have been shown to reduce the frequency of sexual thoughts, and how often a woman feels aroused.
One big concern is the fact SHGB levels do not return to normal when pill use it stopped. They do go down, and free testosterone goes up, but after six months many women still show at least twice normal levels of SHGB. Some small studies have suggested how fast levels go down varies from woman to woman. I can find no good long-term studies on this. Studies have also hinted the amount of estrogen in a pill is a factor – the less estrogen, the less SHBG increases and the faster it drops when the pill is discontinued.
Will going off the pill jump-start your sex drive? Maybe. There are many factors involved. A growing body of anecdotal evidence says most women will see sexual benefits from not taking the pill. Of course, that leaves you having to find another form of birth control.
~ Paul – I’m XY, and I’m fixed!
* For example: Prevalence of Sexual Dysfunction and Impact of Contraception in Female German Medical Students The Journal of Sexual Medicine, May 2010
** Oral contraceptive pill may prevent more than pregnancy
The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysis Human Reproductive Update. Jan 2014