Does the pill decrease a woman's sex drive?

Madeleine M. Castellanos, MD
Ask many women and they will tell you that after going on the pill, they noticed a drop in sexual desire, a decrease in their ability to lubricate, and an overall decrease in sexual pleasure. The pill can also decrease a woman's frequency of sexual fantasies and curtail their sexual arousal. Although oral contraceptives, as well as vaginal rings, work by way of synthetic estrogens, it is actually their effect on a woman's testosterone that causes these sexual side effects.

It is worthwhile speaking to your doctor about different alternatives if you find that you are experiencing these side effects after using oral contraceptives, or a vaginal ring-type contraception. If you find that your birth control pill is affecting your sexual desire, it does not necessarily mean you should stop taking the pill. Instead, changing the type of pill you use may relieve some of these side effects.  Some women find that triphasic birth control pills (different amounts of hormones every week) have less impact on their sex drive than monophasic pills (same amount of hormones each dose). Other women find that they experience these effects regardless of what type of pill they use. Keep in mind that all hormonal methods of birth control can result in these sexual side effects. If you and your doctor decide to discontinue the use of the birth control pill, remember that you will need to use another form of contraception when engaging in sexual intercourse if you want to prevent pregnancy. Some non-hormonal options to consider are condoms or diaphragms.

Most women will find the birth control pill will decrease their sex drive over time, especially in perimenopause. Remember why teens like the pill, lighter periods and less acne! The clearer skin occurs on the pill largely because it inhibits testosterone so much. But testosterone drives libido in all of us.

Pill forms of hormones, as found in most birth control pills, go from stomach to liver when absorbed- and trigger the liver to make more proteins that bind up your circulating testosterone!

In perimenopause women often struggle with libido for many reasons including stress, boredom in relationship, less lubrication, and dropping testosterone levels already - so being on the pill may add to that list of factors. Contrary, if fear of pregnancy curtails your libido- then being on the pill may help!

There are many forms of birth control pill formulations. Some pills are really more anti- testosterone than others.  The newer pills that contain Drospirenone are the most anti-testosterone, great for acne and PMS- but you may want to avoid if trying to improve libido [Like Yaz or Yasmin]. 

While other pills that contain Norethindrone may be the least anti-testosterone pills we can choose from, and a better choice if you need the pill but want to encourage a better libido. For women in their 40's who need/want the pill, I usually suggest the Loestrin variety which contains norethindrone. 

Talk to your GYN practitioner to discuss what may be best for you if you need contraception and you have Libido concerns for sure. You can certainly consider good nutrition, exercise, stress reduction and mind body techniques to improve your libido even if you are on the pill~! We offer many suggestions at


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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.