Can Birth Control Pills Lower Your Sex Drive?What Studies Found

If your desire has faded and you’re on the pill, it’s a fair question whether the two are connected. The research gives a mixed but fairly reassuring answer.

What a review of 36 studies found

A 2013 review pooled 36 studies with 13,673 women.¹ Among the 8,422 pill users:

Effect on desire	Share of pill users
Increase	About 22% (1,826 women)1
No change	About 64% (5,358 women)1
Decrease	About 15% (1,238 women)1

Pills with 20 to 35 micrograms of estrogen made no clear difference; desire dropped only with the lowest 15-microgram pills.¹ Most studies saw free testosterone fall and its binding protein rise on the pill, though that didn’t translate into lower desire for most women.¹

What a placebo trial found

In a Swedish trial, 340 women aged 18 to 35 took a common pill (levonorgestrel with 30 micrograms of estrogen) or a placebo for three months, without knowing which.²

• Overall sexual function and the number of satisfying sexual episodes were similar in both groups.²
• Desire, arousal and pleasure scores dropped slightly on the pill.²
• Distress about sex didn’t differ.²

What it means for you

A 2012 review summed it up: most women are unaffected, a small share notice less desire, a small share more, and the topic is under-studied.³ Both trials were in younger women, so they say little about the pill in your 40s.

If desire has dropped since starting a pill:

• Note the timing. Did it change with the pill, a new dose, or something else, such as stress, sleep or a new medicine?
• Ask about a different formulation or a non-hormonal method.¹³ Don’t stop without a backup plan. See do you still need birth control in perimenopause?
• Look at the whole picture. See antidepressants and sexual side effects and responsive desire.

Try: “My desire dropped noticeably after I started this pill a year ago. Could it be the pill, and what are my options for switching?”

Down There, Decoded covers this in Chapter 9, “Where Did My Desire Go?,” in a section called “What Gets in the Way.” Its Down-There Log keeps dates next to changes, so you can see whether a dip in desire lines up with a new pill, dose or medicine. See the book.