- Dr. Felice Gersh told INSIDER that hormonal birth control can cause a decline in your sex drive.
- Each birth control method can affect your sex drive in different ways.
- Using a non-hormonal birth control method, like condoms, is the only way to guarantee that your sex drive won’t be affected.
Many people complain that their birth control is "killing their sex drive." But, it can be difficult to know if this is really the case. To get answers, INSIDER talked to Felice Gersh, MD, the founder and medical director at Integrative Medical Group of Irvine.
Birth control pills may decrease a person’s sex drive.
By increasing the production of globulin, birth control pills can decrease a woman’s sensitivity to sexual stimulus which in turn makes them less likely to want to have sex, according to Dr. Gersh.
"Birth control pills increase the liver's production of sex hormone-binding globulin, which literally binds up testosterone — effectively lowering the levels reaching the tissues," Dr. Gersh explained. "Lower testosterone gives lowered sex drive and can lessen the sensitivity in the clitoris and surrounding [vaginal] structures."
Additionally, synthetic hormones in the pill make cervical mucus thicker and decrease "the fluid coming through the vaginal wall." Between the thicker cervical mucus and the decrease in the fluid, "all can serve to make the vagina drier and less receptive to penile penetration," said Dr. Gersh.
It's worth noting that not all experts are in agreement on birth control's effects and Dr. Jessica Atrio, a board-certified obstetrician-gynecologist at Montefiore and Albert Einstein School of Medicine, previously told INSIDER that more research is needed and that there is no definitive link between hormonal birth control and sex drive.
Not all birth control methods operate in the same way.
It’s possible that hormonal IUDs can also decrease your sex drive, but the evidence is not as conclusive as it is with the birth control pill.
Dr. Gersh says that “there are no definitive studies on this "but notes that levonorgestrel — of a class of medications called progestins — would theoretically have less of an effect on your sex drive. This is because “certain progestins, like levonorgestrel, have more androgenic features" meaning that they aren't decreasing your testosterone.
IUDs do not have the estrogen-mimicking hormones that the pill does, so they don’t trigger the liver to produce the testosterone-binding globulin.
Without birth control, your body naturally ovulates once a month, which is when your sex drive is at its highest. This is purely evolutionary — a higher sex-drive when you’re most fertile yields the best results for procreation.
IUDs suppress "ovulation for most women in the first year of use," according to the cycle-tracking product, Ava. Thus, with no ovulation, there is no naturally occurring increase in sex drive.
Therefore, despite containing testosterone-like hormones, progestin-based birth control like IUDs can be just as debilitating to your sex drive as the pill.
But all birth control affects your "hormonal rhythms."
When you go on any form of birth control, Dr. Gersh describes how your "normal hormonal rhythms" stop, which reduces the function of your hormone receptors, thus "lowering the response to what [little] testosterone there is."
Not only that, but birth control can alter your mood at best and trigger depression at worst. These two things can then have an impact on your sex drive.
Non-hormonal birth control methods affect your sex drive in a different way.
When it comes to birth control methods that likely won’t affect your sex drive, Dr. Gersh lists copper IUDs, condoms, and the rhythm method. However, each comes with a different set of caveats.
"The copper IUD has no hormones in it, so theoretically it should not have any impact on sexual desire, but it's not tested," Dr. Gersh explained. "It is also possible that the copper IUD can alter sensations due to its inflammatory nature."
She also cautions against the rhythm method as a form of birth control if you have an irregular period.
Condoms and diaphragms might be the best options if you want a birth control that won’t affect your sex drive. However, as Planned Parenthood points out, condoms and diaphragms are only 85% and 88% effective, respectively.
"Sadly, anything that alters a woman's natural hormones will impact sex in some way," Dr. Gersh said.
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