The Pill and Sex Drive

This post is more of a PSA (public service announcement) rather what I usually do here.

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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 

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14 Comments on “The Pill and Sex Drive

  1. We used the pill for years. What changed my perspective was a small book by Randy Alcorn named “Does the Birth Control Pill Cause Abortions?”. We were happy to stop using the pill because some of its metabolic side effects, but that book made an argument too compelling for me to ignore.
    Nathan N. recently posted…Seasonal VisionsMy Profile

    • I have done a lot of research on the various pills. Some do destroy fertilised eggs, but some do not. Alcorn did a good job with the information available when he wrote the book, but he has not updated it with newer information from better studies. There are solid, pro-life doctors who are convinced some pills do not prevent fertilisation.
      Not really trying to argue this, I don’t think anyone should use the pill, but I always want to put the facts out for people.
      Paul Byerly recently posted…Friday Flashback: Who put that in my Bible?My Profile

      • Good points. The technical nature of the topic (I am not a doctor or chemist) and the margin of unknown risk made it simpler for us to use a different, non-chemical method.
        Nathan N. recently posted…Seasonal VisionsMy Profile

        • There is a lot of conflicting information out there. Many folks see preventing implantation as a good thing, because it is one more way to prevent pregnancy, so the companies are happy to make the claim based on a theoretical possibility.
          Not enough care about this to get funding for the kind of studies needed to settle this. Still, there are a few studies that help, if you dig for them.
          Paul Byerly recently posted…Lust is a ChoiceMy Profile

  2. I took a low-estrogen pill for four years between child #2 and child#3, then again for probably ten years after #3, all at my husband’s request because by his reasoning it “was easier” (for him) than me using a diaphragm (which had been completely successful for several years). Looking back, I could say using the pill greatly lessened my libido. I’m sure the fact that I used it under coercion didn’t help any. I also believe the pill is what contributed to my going through menopause at an early age. Have you seen any studies on that? Also, as mentioned in the previous comment, a lot of pills are abortifacient, not preventing pregnancy but preventing the implantation of a fertilized egg, i.e. abortion. I am sorry I ever let myself be pushed into using the pill as a form of contraception when there are other viable and reliable avenues.

  3. The abortion issue is the main reason we didn’t use birth control while we were having kids, and after 5 beautiful kids in 7 years, my husband volunteered to be ‘fixed’. However, birth control came into our lives for a different reason altogether. For 3 years after our last child, I experienced heavy, heavy periods and extreme pms (so much so, that for two weeks of every month, life was pretty much miserable). My doctor suggested continual birth control (something she’d tried for years herself) and my husband and I spent time thinking what it would mean. Our decision for birth control changed our lives incredibly. I no longer have the unexplained loss of control feeling (ask my husband, I’m usually a very even-keeled person). And, our sex life has gone through the roof, better than ever, and always on the table (we average 3-5 times a week, sometimes more). We’ve never been happier or satisfied, both of us- the rate of orgasm for me has increased dramatically where it was non-existent before.
    My husband is just as enthusiastic about it as I am.

    I know every woman and situation is different, but for us, birth control is a blessing.

    • My wife had very heavy periods and worsening of PMS. Not a fun thing! I know heavy periods can be so bad they threaten a woman’s health or even her life. They certainly interferer with life… and normal sexuality. The pill usually is very effective at reducing bleeding, or eliminating it when used as you did. I think it is more hit and miss on the PMS, glad it worked for you.
      I see this kind of pill use as medical, not contraceptive. There should be no ovulation with this type of use, so the fear of destroying a fertilised egg is not there. If someone was not convinced of that, they could use some other form of contraception for conscience sake.
      Glad to hear your sex life has gotten so good. I doubt the pill caused that – rather it treated the symptoms messing with your sex life. A stronger drive is common nearing menopause – perhaps you had that but could not enjoy it because of the hormonal issues.
      Paul Byerly recently posted…Friday Flashback: Who put that in my Bible?My Profile

  4. I had two false pregnancy whilst on the pill. Both lasting several months (the first was 6 months and the second 3 months) With the first I had a scan about 4 months in that showed no pregnancy or signs that I had ever been pregnant. Both stopped with in a month of me stopping the pill and the second one started about 2 months after I re started the pill.

  5. I’ve been debating forms of contraception for months now. I know I don’t want the pill (beyond it’s side-effects, I am not good at regular timing of medication), and I tried the IUD approach with horrible side effects. We haven’t decided to be done with kids, but as the baby reaches 1yo and my husband is still working on his doctorate degree, now is just not the time. Also natural family planning has failed us as here I am with three kids in the span of planning for one!
    I’m totally at a loss and my doctor keeps pushing the pill as “it’s not as bad as you (I) say.” What is out there that doesn’t have these sexual side effects?! I’m already struggling to be “into” it.

    • There are no great options right now. A couple of things for men that look very good are working through the system, but it will be years down the road.
      Spermicides are one option, if they do not irritate either of you. The success rate is lower than for the pill or the IUD.
      We used FAM with condoms or spermicide during the fertile time. If your cycle is fairly stable and you use birth control a few days either side of when it should be necessary, it is as effective as using birth control all the time, but you use it for no more than a third of each cycle.
      We have an article on contraception over on The Marriage bed –
      Paul Byerly recently posted…Lust is a ChoiceMy Profile

  6. I am only birth control due irregular periods. I wss bleeding for about two weeks wit a lot of clots during my period about a year ago. Test were ran everything came back fine. So the doctor put me on birth control to regulate my cycles. I didn’t get on birth control for a contraceptive. I honestly wish I did not have to take it.

    • As with any drug the question is which is worse – the drug and it’s side effects, or the condition it treats. For some women it is a life or sanity saver!
      Paul Byerly recently posted…Lust is a ChoiceMy Profile

  7. BC is such a hard issue. I used oral bc for 10+ years. I started as a teenager bc of rare & irregular periods. My doctor prescribed without much investigation & it did “fix” the problem. However, I so wish I had had Godly, knowledgable people in my life who would have spoken truth to me about the other side of the issue. I stopped taking them about a year ago because after my own research into the matter I was concerned about the abortion aspect. I had been in the church all my life but had never considered that! What’s funny is that my husband are enjoying a rebirth of our sex life, so to speak. It has taken a full year for things to get straightened out (I blame that on the amount if time I took them) but the benefits are amazing. I know I will certainly be more outspoken in advising my daughter when the time comes for her to choose an appropriate family planning method.

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