Birth Control Pills And Sex Drive

by Christiane Northrup, M.D.

Sex & Sexuality

Like most OB/GYNs, I’ve prescribed my share of birth control pills, even though I’ve long argued that there are safer alternatives that are just as effective when used conscientiously. As long as you don’t mind putting your ovaries on “automatic pilot” and ignoring your fertility, there’s nothing that comes close to the pill for sheer convenience. That’s why oral contraceptives (OCs), which ushered in the sexual revolution in the 1960s, are now used by more than 100 million women worldwide, many of whom love them and do well on it. But like most magic bullets, the pill definitely has a downside. And a very significant downside is, ironically, the fact that the pill can significantly lower sex drive!

Recent research published in the January 2006 issue of the Journal of Sexual Medicine found that birth control pills significantly decrease circulating levels of testosterone, a hormone that is strongly associated with optimal sexual functioning. The result is diminished sexual interest, sexual arousal, initiation of sexual activity, and also sexual enjoyment. Since I’ve seen this for years in many (but not all) patients on the pill, I was very happy to learn of this new research, which confirms that the pill’s effect on libido is “not all in a woman’s head!”

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Birth control pills are comprised of potent synthetic estrogens (for example, ethinyl estradiol) and synthetic progestins (for example, norethindrone) that diminish the levels of follicle stimulating hormones (FSH) and luteinizing hormone (LH), two pituitary hormones. This results in the metabolic suppression of ovarian function, including both the suppression of ovulation and testosterone production!

In addition, OCs also cause a marked increase in the production of sex hormone binding globulin (SHBG) in the liver. (This is the main binding protein for sex steroids.) The higher the SHBG levels, the more hormones are “bound” and unavailable for biologic effects on tissues. In the recent study on the pill’s effect on testosterone, researchers found that SHBG levels were four times higher in pill users than in those who had never used the pill. This means that although a woman taking OCs produces testosterone in her body, it’s unavailable for normal uses such as stimulating her sex drive.

Even more worrisome is that SHBG levels remained elevated in women for at least six months after they stopped taking the pill, after which the study was concluded. No one knows how long this effect lasts, but researchers are concerned that prolonged exposure to synthetic hormones induces gene-imprinted and increased gene expression of SHBG in the liver in some women who have used the pill.

Dr. Claudia Panzer, an endocrinologist in Denver, Colorado and the lead author of the study, was quoted in a press release issued on January 3, 2006. She said, “It is important for physicians prescribing oral contraceptives to point out to their patients potential sexual side effects, such as decreased desire and arousal, decreased lubrication, and also increased sexual pain. Also if women present these complaints, it is crucial to recognize the link between sexual dysfunction and the oral contraceptive, and not to attribute these complaints solely to psychological causes.” (For more information, contact Blackwell Publishing.) I certainly agree with Dr. Panzer!

Spiritual and Holistic Options

Of course there are many causes of decreased sex drive. From what I’ve seen, the most common for women in their childbearing years is lack of sleep! Couples need to make time for each other, too. That’s why I love the new country music song by Reba McIntyre called “Love Needs a Holiday,” about a couple who takes a weekend away to rediscover each other. To listen to a clip, please visit the Reba McIntyre Official Web site. Here are tips for putting some sizzle in your sex life—whether you’re on the pill or not.

  1. If you’re on the pill, it agrees with you, and you like it, I recommend you stay with it. Just be sure to take a good multivitamin/mineral, rich in the B vitamins. The hormones in the pill change a large number of metabolic functions in your body, including putting increased pressure on the liver to metabolize those synthetic hormones. When you take a good multivitamin/mineral regularly, you provide your body with the materials it needs to do its job well!
  2. If you’re on the pill and you’re worried about whether to continue with it, I recommend you stop taking it. But be sure you’re willing to “make friends with your fertility” and know exactly how to prevent or achieve pregnancy at will.
  3. Use your brain to turn yourself on! The brain is the biggest sex organ in the body. Newer research on sex drive and menopause has found that the most important factor in ensuring an optimal sex drive is the ability to turn yourself on with your own thoughts. This includes deciding to feel sexy. That’s right. When a woman knows how to use her own mind to arouse herself, she is far more apt to have a satisfying sex life—with herself or with a partner.
    Let me suggest an exercise I learned from Laura Bushnell, author of the delightful book Life Magic: The Renowned Psychic Healer Shares Her 7 Keys to Finding Your Power and Living Your Purpose (Miramax-Weinstein, 2005). Imagine that there is a giant mirror over your head that broadcasts how you feel to the world. Write the following on that mirror in red lipstick: “I am an irresistibly sexy woman. I am magnetically attractive to pleasure now!” Visualize that mirror over your head wherever you go. The more you practice this, the more sexually fulfilling your life will become.
    Consider reading novels or renting movies that contain sexual content to help you get in the mood. For movies, I recommend Two Moon Junction, Dangerous Beauty, and Delta of Venus. For books, you can’t beat Valley of the Horses by Jean Auel or Outlander by Diana Gabaldon. Of course Kathleen Woodiwiss writes some good steamy romance novels too, just not as sophisticated.
  4. Plan for pleasure. Most people operate under the erroneous belief that sex is supposed to be spontaneous, and that there is something wrong with your sex life if you plan for it. Nothing could be farther from the truth! If you want to have a good sex life, you have to pay attention to it. What we pay attention to expands. That means making time for arousal and sex, even if it means jotting it in your Day Timer! (By the way, that includes making time for self-pleasuring, too!)
  5. Take advantage of your natural sexual cycles. The menstrual cycle is designed so that your libido peaks during two phases: the three-day period surrounding ovulation, and, ironically, just before the onset of menses—proof to me that sex is about far more than just procreation. It’s also re-creation in the finest sense of the word. During ovulation, the body produces more testosterone, which increases sex drive, and it produces potent pheromones that waft into the air and make you more sexually attractive to others. To read further research on pheromones, please visit the Athena Institute or Love Scent. (Hint: You can also help nature along with some purchased pheromones!)
    But you don’t need to ovulate to experience sexual arousal. As I said before, your brain is set up to do a fine job of this for a lifetime—long after you’ve stopped ovulating.
  6. Give yourself a “tune and a lube.” There are times in every woman’s life (for example, after childbirth, after chemotherapy or illness, or during menopause) when vaginal dryness can decrease sexual pleasure. For many women, all that is necessary to slide through these dry spells is a little lubrication.
    For some women, non-hormonal lubrication is not enough. They require the effect of estrogen, which thickens the vaginal and outer urethral tissues as well as the covering of the clitoris—that lovely little organ that has 8,000 nerve endings and whose sole purpose is for pleasure. All that is necessary is a dab of estrogen cream (available by prescription) on the clitoris and/or in the vagina daily for a week, then twice per week thereafter. There is no substantial increase in blood levels of estrogen when you use the cream this way. I recommend you use the lowest dose necessary (the amount of cream needed is about the size of a penny). It takes a week or two to estrogenize vaginal and clitoral tissue, so you have to use it daily. But after that twice a week is all that’s necessary. Regular vaginal stimulation, in and of itself, also helps keep vaginal tissue resilient.
    Some women will want to use systemic hormone replacement because in some (not all) it can help sex drive. If so, use bioidentical hormones and consult my book The Wisdom of Menopause for more information!

When it comes to sex—or anything else—each of us is unique. What works for one woman won’t work for another. And that includes the birth control pill. One thing I’m absolutely clear on, having spent a lifetime of study in this area, is that we are sexual beings by nature. Our sexuality is part of our spirituality. Allowing the life force from our sexuality to course through us is one of the most sublime experiences we are capable of in a human body. So take my advice. Embrace this aspect of your body and enjoy this part of your life in your own unique way!

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Christiane Northrup, M.D.

Christiane Northrup, M.D.

Christiane Northrup, M.D., is a visionary pioneer and a leading authority in the field of women’s health and wellness. Recognizing the unity of body, mind, and spirit, she empowers women to trust their inner wisdom, their connection with Source, and their ability to truly flourish.


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  1. Elektra G.
    6 years ago

    Yes, this is horrible. When is it going to end? I wish women were more assertive and worked harder on their education on the matters of being a woman. I’ve had so many friends’ friends who had their first baby, a C-section, for not particular reason. Women are being disempowered, for doctors tell them: “You can not know how to give birth. We studied a quarter of our lives, you have no other choice than listen to us..” They take all the power away this way, and women doubt their own inborn potential. (I can rant on and on on all the areas of the industry that are also associated with taking the power away from women!) The women were young, healthy, gorgeous. After the C-section their babies landed in Intensive Care, and the young mothers could not even walk normally from all the pain. So the first weeks of motherhood, that were supposed to be magical and inspiring, have turned out to be pure hell, and also spent in the hospital. And what for???
    When i approach those women telling them how natural birth CAN be, they all do not believe it, for the memories of tortures endured are forever engraved into their minds and bodies. Their sex life is also gone. Their relationships suffer. Their immune system weakens tremendously (most suffer chronically from colds). Their pelvic muscles are in such a bad shape, that they get desperate. And the doctors??? The doctors tell them:” Learn to live with it…”
    Elena Tonnetti has told me once: “What those doctors do, is in fact Mutilation of Women.”
    And i agree…
    Speaking of your Women’s Bodies, Women’s Wisdom book. Few years ago, after discovering belly dance, my body suddenly REFUSED to be on anti-conception. Every time i would bring the pill to my mouth, my hand will literally push it away!!! I was terrified to quit… Doctors, books, you name it: all were telling me doom stories. To name a few: “You will get an AWFUL skin, you don’t want that, do yo?” “Your period will need AT LEAST a year to stabilize!” “You will get pregnant right away!” “If you get pregnant, your child will suffer from all the hormonal build up in your system.” “Natural birth-control is the worste!” And so on, and so forth…
    Guess what? I got angry…. And: QUIT AT ONCE!
    …. My period was immediately perfect 28 cycle. Always with the New Moon.
    …. My skin became more glowing!
    …. My sex life became wonderous!!! I suddenly was more inspired, so to speak.
    …. I felt more feminine, more powerful, more connected to nature and my body thanked me in many many ways for my courage and bravery!
    ….. Men started reacted to me on the streets in this aweseom animalistic enchanted way! haha!

    THANK YOU!!!!

    I once recommended your book to a girl who was suffering from very painful ovulation. They told her to learn to live with it. I do not know the medical term for it, but the egg went not where it should.

    I asked her whether she had problems with expressing her creativity. She said: “Yes.” (We are talking about a young, gorgeous young women of nearly 20 here!)

    Recommended her your book.

    And guess what??? She CURED after reading it!!! HA!!!
    Her life improved, and improved, and improved!

    Knowledge is Power, ladies!!!!

    Educate yourself!!! :)

    Sorry for this long message… But i hope this will inspire others.

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