If low libido (sex drive) puts a damper on your romantic evenings, you are not alone. It is estimated that 40% of women experience some form of sexual dysfunction, with low libido being the most common, and the reason could be "the pill".
Originally Posted February 2017
Updated February 2019
While there are many causes of low libido, including stress and relationship problems, hormone imbalances caused by oral contraceptives is one that is often overlooked. Even though this is thought to affect only a small percentage of women on “the pill” (5-10%), it translates into a staggering number when you consider that roughly 80% of women born after 1945 have taken birth control at some point in their lives. Clearly, this is an issue that needs more recognition.
More Than Just Speculation
It is well known that “the pill” can cause weight gain, mood swings, and other symptoms associated with hormonal imbalances. So why are the side effects related to sexual dysfunction less known? It may be that some physicians downplay reports of low sex drive in female patients because women generally have less desire for sex than males (due in part to lower testosterone levels). However in 2006, a study confirmed that women taking an oral contraceptive had significantly lower sexual desire than those taking a placebo. Last year, another study published in the European Journal of Contraception and Reproductive Health Care provided additional evidence. The study, which surveyed 3,740 Swedish females between the ages of twenty-two and twenty-eight, found that those taking hormonal birth control were twice as likely to report decreased sexual desire than those using non-hormonal methods. It was also noted that this was a major predictive factor for wanting to discontinue or change the medication.
How “The Pill” Kills Sex Drive
Oral contraceptives have been linked not only to low libido, but also to decreased sexual enjoyment and lubrication. This is due to a decrease in the production of androgens in the ovaries as a result of “the pill.” Androgens, such as testosterone, play a crucial role in experiencing pleasure during intercourse (yes, women have testosterone too!). The changes in the protein called Sex Hormone Binding Globulin (SHBG) also helps explain the mechanism of action behind this unpleasant side effect. Oral contraceptives increase SHBG, which binds testosterone and prevents it from being effectively used by the body. High SHBG has been directly linked to lower testosterone levels and low libido. Unfortunately, it appears that hormonal birth control can suppress hormone levels long term – even years after the medication has been discontinued. Thankfully, there are some things you can do to rebalance hormones and boost libido.
Although it may be an uncomfortable subject to approach with your doctor, it is a conversation worth having. Sexual dysfunction can be a major source of psychological and relational stress, and can prevent you from experiencing the many physical and emotional benefits of a healthy sex life. A few of the medical approaches available to help remedy this problem are:
- A trial of a different brand of birth control (different amounts of hormones)
- Switching to a non-hormonal form of birth control (ie. condoms, diaphragms, etc.)
- Testosterone supplementation (bio-identical hormone replacement)
- Vasodilator medications, such as Viagra® (yes, they can be used in women also!)
Dietary Aphrodisiacs & Other Natural Approaches
If you are looking for a more natural approach, there are various nutrients, amino acids, specific foods, essential oils, and herbs that may help boost sexual desire. These work by various mechanisms such as either 1) providing the building blocks for sex hormone and neurotransmitter synthesis, 2) increasing blood flow – throughout the body or specifically to the genital area, 3) increasing lubrication, or 4) contributing to an overall feeling of well-being. General malaise, headaches, etc. can interfere with sexual desire. A few of these natural solutions include:
- Eat MORE of these foods: figs, bananas, avocados, watermelon, brazil nuts, almonds, dark chocolate, and tiger nuts
- And MORE of these: foods rich in vitamin C, iron, and collagen
- Eat LESS of these foods: fried foods, trans fats, conventional dairy, sugar, caffeine, alcohol, factory-farmed meats, processed foods (especially microwave popcorn, due to chemicals in the bag that disrupt hormones) – learn more about how diet affects the libido here.
- Stay hydrated by drinking plenty of water throughout the day
- Try an herbal remedy such as ashwagandha, panax ginseng, or maca
- Get your iron levels checked – choose a chelated form if supplementation is needed
- Diffuse essential oils such as cinnamon, ylang, jasmine, rose, sandalwood
As you can see, there are many options for addressing sexual dysfunction, including those cases brought on by taking oral contraceptives. Other medications, such as antidepressants, are also known to decrease libido – get a list of medications that lower libido here. Don’t let sneaky side effects be the reason for a disappointing date night. Instead, let this be a good reminder to have this conversation with your doctor, especially if you feel that a medication may be to blame. You (and your partner) will thank us! And as always, do not change your medications or supplements without talking to a healthcare professional first.
1. Agota Malmborg et al. “Hormonal contraception and sexual desire: A questionnaire-based study of young Swedish women.”The European Journal of Contraception & Reproductive Health Care. Volume 21, 2016 – Issue 2.
2. WH Staff. “Birth Control and the Female Libido.” Women’s Health.
3. 34MS Staff. “Birth Control and Loss of Libido.” 34 Menopause Symptoms
4. Montgomery, Keith A. “Sexual desire disorders.” Psychiatry (Edgmont (Pa. : Township)) vol. 5,6 (2008): 50-5.
5. Lara J. Burrows, MD, MSc, Maureen Basha, PhD, Andrew T. Goldstein, MD. “The Effects of Hormonal Contraceptives on Female Sexuality: A Review.” Journal of Sexual Medicine. September 2012 Volume 9, Issue 9, Pages 2213–2223.
6. Annie Price, CHHC. “How to Increase Libido the Natural Way.” Dr. Axe.