Birth Control and Sex Drive Explained

When women taking the pill or another form of hormonal birth control notice a bit of chill sneak into a once sizzling sex life, it’s normal to wonder if their birth control is to blame. If you find yourself less interested in sex should you switch to a different pregnancy prevention plan?  We turned to Cristin Hackel, MSN, WHNP, a Nurse Practitioner at Nurx, for answers, and . . .she doesn’t have simple ones, but she does have helpful advice to share.

Does birth control affect libido?

It’s complicated. “Libido is such a complex thing, especially for women, and a change in your sex drive is rarely caused by a single factor,” says Hackel. There’s no conclusive research proving that birth control pills increase or decrease the female sex drive. Many women who aren’t on hormonal birth control experience increased sexual urges around ovulation (which makes sense from an evolutionary, keep-the-species-going perspective), and you won’t experience that on the pill since you’re not ovulating. On the other hand, you don’t need a peer-reviewed study to tell you that heavy, painful periods are a mood-killer, and birth control makes periods lighter and less painful, so that should be a net gain for your sex life.

You may have heard that being on the pill lowers your sex drive because it decreases your body’s natural levels of testosterone, but Cristin says that any difference you notice probably isn’t caused by that. “Most studies show that testosterone doesn’t play a definitive role in women’s sex drive, and show that when you give women testosterone it has no effect.”

One caveat to this: There are studies that show that the birth control shot can cause depression in some women, which can lower libido. That said, many women on the shot are turned on by not having to think about birth control more than once every three months — just avoid the birth control shot if you have a history of depression.

How can you tell if the pill is hurting your sex drive?

“If you have a distinct noticeable difference in your libido within the first few months of taking a new birth control — you have the same partner and nothing else has changed and your sex drive has completely plummeted — then you should definitely look into switching methods,” says Hackel. 

But if your birth control prescription isn’t new, and your libido has decreased over time, it’s likely that other factors are responsible for your missing mojo — like stress, relationship issues, or another prescription medication (certain antidepressants are known to dampen sex drive). “It’s pretty natural for your sex drive to decline somewhat with age, and with longer relationships, or after pregnancy, and with parenting and all of life’s changes,” says Hackel. “But most people don’t want to think that it’s because they’re tired or stressed or their relationship isn’t great.” In some cases a woman hopes that switching birth control methods will be a quick fix, when in fact revving up her lagging libido requires a more nuanced strategy of reducing stress and improving communication or connection with her partner. 

What should you tell your provider if you want to switch?

“You know your body the best, so if you feel that your pill has changed your sex drive or caused any unwanted side effects — acne, weight gain, anything — there’s no harm in switching prescriptions and trying something different,” says Hackel. It could be that you feel better on a pill with a different type of progestin or level of estrogen. “In the US there are more than ten types of progestin used in combination birth control pills, so trying a pill with a different type of progestin could help.”

You might want to try a formula with a higher or lower dose of estrogen, if your provider determines it’s a safe choice for you. “Estrogen helps with lubrication and the thickness of the vaginal walls, so pills containing estrogen can sometimes improve sex for women transitioning to menopause,” says Hackel.

The Bottom Line

Don’t expect that going off of birth control or switching to a different formula will crank up your sex life to scorching if the other necessary elements aren’t there. But listen to your body! If you suspect that your birth control is bringing you down, don’t hesitate to talk to your healthcare provider about trying something different. “There’s no harm in switching birth control methods as long as a provider confirms it’s a safe choice for you,” says Hackel. “Just commit to giving it a three-month trial, because it can take that long for your body to adjust to the new formula.” 

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