05.17.10

Is the Pill Killing Your Sex Drive?

A new study shows the strongest evidence yet for what some women have always suspected—those little tablets have been hijacking their libidos for years. By Joyce Tang.

This month, as women around the world cheered the 50th anniversary of the birth control pill, they also got some unsettling news: Those pills are likely driving some women’s sex drives toward extinction. A few days before the pill reached its golden anniversary, a study published in the Journal of Sexual Medicine presented the most convincing evidence so far for what some women have suspected for a while—that the pill, while a miracle drug for some, is a sex-drive neutralizer for others.

It’s old news to Sarah Redman, 32, from Santa Clara, California. Redman doesn’t take prescription drugs. She even avoids Advil. But for some reason, she “blindly took the pill for so long without questioning it.” And because she’d started on the pill when she was 14 years old, Redman had no point of comparison to know what her sex drive would be like without it. For nearly her entire adult life, her libido was virtually nonexistent. At one point, she stopped taking the pill—why bother when she “never wanted to have sex anyway?”—and her sex drive increased, but she didn’t make the connection. Then, right before her honeymoon, a three-week jaunt across Europe, Redman decided to go back on the pill to regulate her period.

“Where my sex drive was zero to 60, it flatlined.”

“It was our honeymoon, and I had no sex drive,” Redman says. It was at that moment that she realized that the pill was the culprit. “We only had sex once” during the entire three weeks, she says. “But at least it was in Paris.” When she returned from Europe, she emptied her bag and threw out every pack of birth control she had—nearly a year’s worth. Other women have found themselves doing the same.

Culling from the largest sample population to date—more than 1,000 women—the study’s researchers from the University Hospital Heidelberg in Germany found that some women using hormonal birth control, most often oral contraceptives, experienced lower sexual desire and arousal than those using a nonhormonal method or no birth control at all. The study isolated the influence of hormones on sexual desire and arousal from factors such as stress or relationship status, which are known to affect sexual functioning. To be sure, birth control affects individual women differently—some women get randier when they’re on it. But for those whose sex drive falls off a cliff, it can be a depressing and baffling experience.

Julie Sibert, who was on the pill for most of the seven years she was married to her first husband, was uninterested in sex from virtually day one of her marriage, which was also when she began taking the pill. She and her husband had agreed to abstain from sex with each other until they were married. As soon as it was time, however, Sibert found that suddenly, she couldn’t be less interested.

“I recognized that we should be having sex, because we were married. I just didn’t have that internal desire to initiate...to respond when he initiated,” Sibert says. “For the sake of our marriage, I would do it more out of obligation than genuine interest.” Sibert simply came to the conclusion that “this is just how married life is,” a conclusion she now calls a “myth.”

Though Sibert experienced feelings of dullness and numbness toward sex, she could still achieve orgasm, something that eludes 10 to 15 percent of women. But “even knowing the feeling of orgasm was not a powerful enough incentive to overcome the effects of the pill on my body,” she says.

When Sibert went off the pill so she and her then-husband could try to have a baby, she noticed a significant difference in her sex drive, but simply attributed it to her desire to start a family. “I wasn’t connecting the dots,” she says of her failure to seek help or try other options. And soon after they had a baby, Sibert was back on the pill. To her, it was the easiest and most effective method of birth control.

The pill works by raising levels of the sex hormone-binding globulin protein, which binds to testosterone, making it unavailable to the rest of the body. Reduced testosterone in women can cut down on masculine features such as hair growth, acne (a common reason teenage girls get on the pill), and sex drive.

Dr. Bat Sheva Marcus, clinical director for The Medical Center for Female Sexuality, asserts that “all hormones are suspect,” and estimates the pill is a contributing factor in 60 percent of the women she treats for sexual dysfunction. “I think there’s a very direct link between hormones and sexual dysfunction,” she says.

Redman and Sibert are far from alone. In clinical studies supporting FDA approval of Yaz, one of the top-selling oral contraceptives worldwide, 5 percent of trial participants reported (PDF) decreased libido, compared with 1 percent in the placebo group. Those numbers are consistent with studies of other oral contraceptives.

For three tortuous years Denise Davila, a 31-year-old New Yorker, made her way through pill after pill, from Seasonale to Loestrin to Yaz, only to deal with weight gain, cramps, mood swings, migraines, and a flagging sex drive. Like Redman, Davila avoids antibiotics or even over-the-counter products when she’s sick, and had steered clear of the pill until her late 20s. Wanting more of a back-up plan to condoms, her usual method of protection, Davila finally decided to give the pill a try.

After the low-hormone option turned out not to be strong enough, Davila’s doctor put her on Yaz, which many attest to being one of the worst-offending pills because it is highly anti-androgenic. “My sex drive took a nosedive,” she says. “Where my sex drive was zero to 60, it flatlined.” The effect was so drastic that Davila says she stopped having sex immediately. After nearly three years, Yaz was the “nail in the coffin” for her, and she abandoned her quest to find the perfect pill. She’s back to using condoms, and never even considered methods that don’t affect hormone levels, such as the copper IUD. “I just don’t like the idea of messing with my body or putting something into my body,” Davila says.

With so many variables, women often don’t make the connection between their dwindling interest in sex and their choice of contraceptive. Redman shrugged off her disinterest, thinking it was due to stress from her job. And Davila made the connection only when she started frequenting online message boards. Their apathy toward sex extended to their efforts to fix it. “You almost accept it,” Davila says.

Vanessa Cullins, an OB/GYN and vice-president for medical affairs at Planned Parenthood, cautions women against assuming their lowered sex drive is caused by the pill. “Hormonal contraceptives are very effective in terms of preventing pregnancy,” she says, and at a 95 percent success rate (PDF), the pill ranks among the top five most efficacious contraceptives. Additionally, no study to date has confirmed or refuted a direct cause and effect relationship between the pill and decreased libido.

Despite the murky connection between the pill and women’s sex drive, many wish they had been aware or forewarned of its possible negative effects. “My doctor didn’t volunteer that information,” Sibert says. In hindsight, she says she probably wouldn’t have chosen the method had she known.

It wasn’t until Sibert went off the pill after she and her first husband divorced that she suspected her low libido might have to do with the pill. Though she wasn’t sexually active, she began noticing men, and that dull, numb sensation went away. When Sibert remarried, she swore off oral contraceptives altogether.

“My sex life now,” she says, “is fabulous.”