For someone who still has the libido of a raging teenager, it’s hard to remember a time when I didn’t feel like jumping into bed.
But then I remember back to when I was 17 — a literal teen who’d just lost her virginity to the British boyfriend she was madly in love with — and felt nothing.
I’d just gone on the contraceptive pill because YOU WILL GET PREGNANT AND DIE otherwise.
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I thought I was so cool. So grown-up. I was finally an adult. Driving around in my car, going to uni and having sex.
Except I no longer left like it. After years of confusing sensations down there, my actual drive was gone and I just felt tired all-the-time. (God, the adult life of a 17-year-old was HARD).
Fast forward 16 years and thank goodness a lot has changed including my Pill, because in my quest for clear skin and a happy hormonal balance, I have tried them all and discovered what works for me.
So now I have to ask, was my teenage brain jumping to conclusions, or can hormonal contraception actually kill your vibe?
I went straight to the expert, Dr Kirsty Wallace-Hor, a Kin Fertility GP, for the answers.
Can the Pill affect libido?
“There is some pretty compelling evidence that hormonal contraception does impact on libido but there's not a huge amount, which isn't super surprising given how women's health in general tends to be a bit neglected in the medical field,” Dr Wallace-Hor said.
“It's important to note that most people on hormonal methods don't experience any issues with libido but there have been trials which show that if you get hormonal contraceptive users and compare them to non-hormonal contraceptive users, they do tend to report higher levels of issues with libido.”
Why might hormonal contraceptives impact libido?
“There is a logic behind why it might impact on libido,” said Dr Wallace-Hor. “For example, with the combined pill, we know that it reduces the level of free (unattached) testosterone in our body and also increases something called sex hormone binding globulin, which also reduces the level of free testosterone in the body and we know that testosterone — and other male sex hormones — do impact with libido. So we know that there is a link but it's not fully understood.
“Another proposed mechanism behind it is that the forms of contraception that stop or inhibit ovulation, or the release of an egg, might also be responsible for that kind of effect on libido. Just because stereotypically there's a kind of thinking that around the time of ovulation, you do tend to be a little bit more interested in having sex — which from an evolutionary perspective makes total sense. And so if you lose that and you don’t get those normal fluctuations in sexual desire, that’s why it might be noticeable as well.”
What do you hear from your patients?
“I do get to this question [whether hormonal contraceptives can affect libido] from a lot with people,” Dr Wallace-Hor said, “because I routinely ask about side effects, specifically with libido.”
“It's interesting how commonly people will respond with, ‘Yes, actually, now that you mention it, I have had issues with that’. And people going, ‘Is this normal? Is this related to my Pill? What can I do about it? Are there better Pills that I could be taking?’. Those are the sorts of questions I get.”
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Could the Pill potentially impact on libido change over time?
“We know that issues around libido are normally multifactorial,” explained Dr Wallace-Hor. “So I do get some people going, ‘Look, I took the Pill and immediately noticed this difference, can we please try something else?’ and I'm totally up for doing that.
“But then sometimes I'll get people, after having been on the Pill or another contraceptive method for a few years, and they’ve been like, ‘Look, I’ve just kind of been noticing this’. And I'll often say, ‘Oh, look, you know, it could well be your contraception contributing to it, but what else is going on, what's your relationship like, are you taking any other medications that might be contributing to it’ and that sort of thing.”
How do you treat your patients?
“Firstly, I acknowledge that what they're feeling is legitimate,” Dr Wallace-Hor said. “Because I think a lot of people get dismissed about these things from people going, ‘Oh no, there's not a huge amount of evidence for it, don't worry about it, it's just you’. That sort of thing.
“I normally then say, ‘Look, there's not a lot of evidence that changing to another particular Pill will help, however, I do find that trying different Pills can just be a bit of trial and error with people’. Like, people respond to different hormones, or the slightly different hormonal combinations in the Pills slightly differently. So often what I’ll say is, ‘Look, what else are you using the Pill for?’ For example, it could be for acne or excess hair growth? Perhaps there is another pill that they could try to see if it suits them better, or they could even try a low-dose version of their current Pill to see if that makes a difference simply because less hormones normally means less side-effects.”
What else can people do to boost their libido?
“I think it's important to recognize that it's normal for your libido to fluctuate throughout your cycle and throughout your life, and that can be for many reasons,” said Dr Wallace-Hor, pointing to the use of particular medications such as antidepressants.
“We know they can impact on libido, in fact, we use those medications to help with premature ejaculation and things like that, so we definitely know that that's a side effect of those medications so sometimes we can review those sorts of things.
“But also just maintaining a healthy lifestyle we know helps. So eating healthily, being active, and reducing stress.
“I often get people to engage in other forms of intimacy as well, because I just find that when we're really, really busy, we forget to do the little things like hugging, kissing and touching, and having that little bit of incidental physical contact can help spark things a little bit.
“Also particularly with women, the only time they might be getting touched is when their partner is wanting to have sex. So if you're having these moments of touching, where it's not that expectation of, ‘Now I've got to think about whether or not I'm even in the mood for this’, it just takes the pressure off as well.
“I also find that having date nights and actually allocating time for sex is a good idea, as well as encouraging communication between partners about what their feelings are, and definitely no TV in the bedroom.”
When should people seek help?
“If people are having issues or it’s impacting on their relationship or just in terms of their quality of life in general because not everyone is coupled, I would encourage them to see their GP. Because there are things like medication that could be contributing to a low libido, or there could be health conditions that could be contributing, like thyroid disorders, anemia, those sorts of things like that. And, if needed, they might be referred on to someone who could help as well.”
Image: Getty + Mamamia.
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