Birth control isn't just an effective method for preventing pregnancy, it's an extremely popular one. According to a 2015 report from the CDC, 99 percent of women who have ever had sexual intercourse have used contraception. While "contraception" could mean anything from condoms to oral birth control and IUDs, hormonal forms of contraception tend to come with some not-so-pleasant side effects.
While side effects vary from person to person—and some women are lucky enough to show none at all—common complaints include nausea, headaches, and spotting between periods. And while it's not as commonly reported, loss of sex drive is a big one, too. To get to the bottom of why this happens and find out what we can do about it, we chatted with OB/GYN and Tia CMO Dr. Stephanie McClellan. Here's what she had to say.
Meet the Expert
Stephanie McClellan MD is a board-certified OB/GYN with 30+ years of experience founding and managing best-in-class integrative women's care practices. She's the Chief Medical Officer at Tia.
Birth Control Can Impact Sex Drive
According to Dr. McClellan, birth control—especially oral birth control—can have a significant impact on sex drive. So, no, it's not in your head. "The progestins used in oral contraceptive pills, the patch, implant contraception, and injections are likely the cause of altered libido," she explains. In one study comparing women using copper IUDs to women using hormonal contraception, they found women using the vaginal ring, implants, and injections were more likely to report diminished libido. McClellan says, "What's interesting in these findings is all three methods sustain a steady release of hormones into the body with very little day-to-day fluctuation."
That said, it's important to consider the specific progestin in the birth control pill a woman is using. "The so-called new progestins—desogestrel, gestodedne, and norgestimate—are intrinsically less androgenic, as reflected in increased sex hormone binding globulin levels and reduced available testosterone levels." Essentially, if your oral contraceptive contains one of the "newer" progestins, it could be correlated with a lower sex drive.
But Not for Everyone
While there's no question birth control does negatively impact sex drive in some women, it doesn't impact sex drive in all women—or even most women. According to a 2013 review, 85% of oral contraceptive users reported an increase or no change in sex drive, while 15% reported a decrease. "As mentioned earlier, it is possible that OCPs containing the progestins listed above may be more impactful—especially when coupled with the low doses of estrogen currently used in birth control pills," says McClellan.
Here's Your Action Plan
If your sex drive is low, there are things you can do. Having a low sex drive isn't fun for anyone, but before blaming your birth control it may be worth it to examine other possible causes. These could include lifestyle habits (drinking too much is a big one), or exhaustion.
If you believe your low sex drive is the result of birth control, worry not: You have options! "Consider another method of contraception including copper or hormonal IUDs, or changing the specific OCP you're using," McClellan says. "I have on occasion suggested my patient use her OCP vaginally, versus swallowing it and have had some anecdotal success with that." If you had no idea that your birth control could be inserted vaginally, trust us—we're just as shocked as you are. "Yes, the pill is equally effective if you place it in the vagina." McClellan confirms.
If you're struggling with low sex drive and are looking for a solution, it's probably worth it to take a closer look at your lifestyle choices to make sure those aren't the culprit first, and then have a chat with your OB/GYN. While birth control isn't perfect, we're lucky to have a lot of options these days. So be your own advocate and find one that's the right fit for you.
Daniels K, Daugherty J, Jones J, Mosher W. Current contraceptive use and variation by selected characteristics among women aged 15-44: United States, 2011-2013. Natl Health Stat Report. 2015;(86):1-14.
Boozalis A, Tutlam NT, Chrisman Robbins C, Peipert JF. Sexual desire and hormonal contraception. Obstet Gynecol. 2016;127(3):563-572. doi:10.1097/AOG.0000000000001286
Pastor Z, Holla K, Chmel R. The influence of combined oral contraceptives on female sexual desire: a systematic review. Eur J Contracept Reprod Health Care. 2013;18(1):27-43. doi:10.3109/13625187.2012.728643