Ask the Doctors: Libido and Hormonal Birth Control

I’m interested to know if there is any research you guys know about on libido and hormonal birth control. I don’t have a very big libido and I find that when I’m on birth control I have none. Which I guess does the job regarding birth control but kind of defeats the purpose. I don’t remember ever reading about that as a side effect but from asking around, people do recognize the phenomenon.

Thank you for taking the time to answer my question
–Desire-Challenged

The hormonal birth control pill and other hormonal methods of contraception can indeed affect women’s libido. There’s even some research I recently read about (did not see the original) that suggest it might lower the libido of male partners!

Here’s a TIME article which describes one of the most significant recent studies. It notes that there is only an association, rather than a proven cause-and-effect relationship; as one of the interviewees notes, there may be something about those women who choose hormonal birth control (such as greater longevity of relationship) that is also associated with lower libido. (Libido tends to go down in longer-term relationships; as couples increase in comfort with each other, the spark of newness that tends to raise libido in recently-connected couples may wane. That might be enough to explain the finding about men I mentioned above.) Note, too, that the European study described here looked at female medical students; these women may not be precisely comparable to other women in the general population.

Some researchers, by the way, think this effect might be especially pronounced in the case of certain synthetic hormones. Here’s a WebMD article about one study that might point in this direction.

But what’s a woman to do?

First: Speak to your healthcare provider, and make sure when you do that s/he sounds like s/he cares about your experience and your concerns about sexuality. Some docs are simply better about this than others, and you deserve an MD who will address your sexuality-based questions with knowledge and compassion. This might involve looking for a new provider. (The book Health Care Without Shame addresses this issue from the point of view of one of the top sexuality-informed docs in the business.) It’s possible that trying a different formulation of the Pill (or other hormonal delivery method) will make a difference for you, if you haven’t explored that possibility.

Second: You might consider switching to a non-hormonal method, like condoms and spermicidal lubricant, to see whether this affects your experience of desire. If you do this, you may need to wait a few months for the effects of the hormonal birth control to fade, so be patient for a little while longer. Hormonal birth control does affect many of us powerfully, and the physical changes may take some time to resolve.

Finally: Sex therapist JoAnn Loulan notes that it is not necessary to have the fires of libido stoked high to have a satisfying sex life: One must simply be willing to have sexual experiences with one’s partner. Of course, this way of looking at it requires a pretty good relationship in the first place, with a substantial degree of comfort in communicating about sex and intimacy. If you feel you have this with your partner now, it might be worth a try to pick out a day or a few per week and make that “erotic potential” time; you won’t always wind up having intercourse or even making love some other way, necessarily, but commit to a time when you hang out without other distractions, cuddle, kiss, touch, do massage, bathe together — anything that might light the spark and make both of you feel physically desired and cared for. Many people never prioritize this, and as relationships go on, they can suffer from its lack.

If there are elements in your life that get in the way of this — too much stress in your life to relax (like those female med students?), too little comfort communicating with your partner about sex — and the possibility arises that it isn’t specifically your libido that is the issue, hormonal contraception or no hormonal contraception.


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Dr. Carol Queen

Carol Queen has a PhD in sexology; she calls herself a "cultural sexologist" because her earlier academic degree is in sociology: while she addresses individual issues and couple's sexual concerns, her overarching interest is in cultural issues (gender, shame, access to education, etc.). Queen has worked at Good Vibrations, the woman-founded sexuality company based in San Francisco that turned 35 years old in 2012, since 1990. Her current position is Staff Sexologist and Good Vibrations Historian; her roles include representing the company to the press and the public; overseeing educational programming for staff and others; and scripting/hosting a line of sex education videos, the Pleasure-Ed series, for GV’s sister company Good Releasing. She also curates the company's Antique Vibrator Museum. She is also the founding director of the Center for Sex & Culture, a non-profit sex ed and arts center San Francisco, and is a frequent lecturer at colleges, universities, and community-based organizations. Her dozen books include a Lambda Literary Award winner, PoMoSexuals, and Real Live Nude Girl: Chronicles of Sex-Positive Culture, which are used as texts in some college classes. She blogs at the Good Vibes Magazine and at SFGate's City Brights bloggers page and contributes to the Boston Dig. For more about her at carolqueen.com.

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