What Is the Pill Doing to Your Libido?

pill is bad for libido Doctors, please stop prescribing the birth control pill willy-nilly to teenage girls. It is only a band-aid solution for symptoms like acne and PCOS, and it does nothing to correct underlying hormone balance.

Never mind the hair loss, depression, and weight gain from hormonal birth control. There is something else of great importance for young women: the pill reduces libido, possibly forever.

This ‘forever’ part is very worrying, especially when we are talking about teenage girls. Researcher Dr. Irwin Goldstein puts it this way:

When [women] stopped taking the pill, we fully expected their sexual function to recover. But we weren’t seeing that.

Dr. Goldstein’s research showed that even brief Pill use (few months) can cause a permanent abnormal elevation of a protein called SHBG (sex hormone binding globulin), which affects testosterone levels.

If a girl starts the Pill at 15, will she ever—in her lifetime?— know what it’s like to have a normal libido? Should we not care about the lost libido of young women?

Expert quotes reassuring us that this pill-libido effect is a myth. I would love to believe that, and yet, I see the problem again and again with my patients. I speak with young women who suffer their low libido quietly. They have been told that it “could not be the Pill,”  so they silently blame themselves instead. It makes me sad. Women should not have to put up with it. I believe that all women—even young womenhave the right to a libido.

I hope that there are some of you Pill-takers out there who have not had your libido squashed. If so, then I look forward to hearing from you in the comments section. I WANT to be convinced that the problem is not as bad as I think it is.

Here are a few non-pill solutions below. I will go into more detail about treatment in coming posts.

Natural treatment for period problems

Heavy periods. Anti-inflammatories like turmeric and ibuprofen can reduce menstrual flow by half. Please see my Heavy Periods post.

Period pain. Stop eating inflammatory foods like sugar and milk products, and take the natural muscle relaxant magnesium.

Acne. Again, stop eating sugar and milk. Talk to a doctor about a zinc supplement. Please read my acne post.

PMS. See my PMS post.

Non-hormonal birth control

The best contraceptive methods are condoms, Fertility Awareness Method, and the copper IUD.

Condoms are fantastic birth control, and they also protect against disease. For added security, please learn to recognize your ‘egg-white fertile vaginal mucus’. Fertile mucus occurs for just a few days per month, and when you see it, that is just the time when you don’t want a broken condom. You should abstain completely for those few days.

28 thoughts on “What Is the Pill Doing to Your Libido?”

  1. Hi Lara!

    I only recently stumbled upon your blog and started educating myself about my health and body. I’m 26 years old and on the pill since about 20 with a lot of breaks and just now I realize how lucky I must have been, because I didn’t notice much of a libido going on before it, but when I’m on the pill, I could have sex for days! My poor boyfriends… My overall mood definitely improved (although that could just be the change to a better environment, better job, being in tune with myself, etc.) and I lost a lot of weight easily once I put my mind to it (and kept it for 2 years now without a fuss). Also, my breasts got bigger and my asymmetry lessened, which is also a plus. For reference, the progestin in my pill is drospirenone.

    With all of that said, I’m really concerned with the long term effects of not being able to ovulate properly and produce the hormones I need for having been born with ovaries. I probably couldn’t even before going on the pill because I starved myself religiously right at the start of my puberty and probably caused an insulin-resistant PCOS (to be determined with tests). I’ve always had really fragile nerves, terrible mood swings and heavy depressive episodes, which I really hope naturally produced progesterone could lessen.

    I love love love the care you put into what you write and just wanted to say thank you! I’m definitely reading your book on periods next!

  2. Hello Lara, I want to firstly say how thankful I am to you for all this info that you provide us with, which conventional doctors just ignore. Thank you for listening, most of all. (That is the first wrong thing that most conventional doctors do. That’s why it takes so much time for anecdotal “facts” to reach research.)

    I have been having (severe) PMDD symptoms for several years now. At some point (management of stress, I think), it settled on lasting a week (3 days prior and 4 days into my period), though still as severe (if not even more) in its intensity. It stayed that way for years. Then I had to take the emergency contraception pill (Levonorgestrel 1,5mg) and in two months’ time my PMDD doubled in length (it became 2 weeks). That was more than 1,5 year ago and it has not gone back to being one week (it actually became even longer, but I believe that to be the cumulative effect of Seroquel/quetiapine which I started taking a bit later – I am weaning off of it and I am hoping that the effect on the menstrual cycle (and everything cycle-related) of atypical antipsychotics at least is reversible).

    Anecdotally, I have known of people that have taken contractive pills and had their PMDD worsened or even triggered (as in, they started exhibiting symptoms of it for the first time in their life) because of it. An example that comes to mind is Laura Murphy, PMDD awareness advocate and education activist, who took a contraceptive pill for 21 days when she was 17 and she was never the same again (she had to undergo THBSO some 20 years later to finally get rid of her PMDD) – her story, including this fact, is on many websites e.g. https://www.rcog.org.uk/en/blog/pmdd-awareness-month-2018/.

    I am worried that my PMDD will never go back to being “only” (hah, it was already hell!) one week.
    (I want to get my B6 tested, because I read somewhere -not sure if perhaps it was on your blog or your book “Period Repair Manual”- that contraceptive pills can cause deficiency of vitamin B6. Maybe it’s a defeciency that cannot be treated without supplements. My last hope. One day, one pill, to change my life forever??)

    I am worried that PMDD sufferers are given contraceptives (they are considered among the first line treatment options for PMDD as you probably know) by medical providers, who are not aware and cannot (or will not??!) inform their patients about the possibility of permanent side effects (either of libido like you talk about, or of PMDD or of anything really).

    I am even more worried that a young girl/AFAB individual of 17 years old, who was healthy and happy up till then, will end up having reduced (or absent) libido forever or will have to enter premature menopause through surgery to get rid of the hell that 21 pills released on their life.

    Thank you. Please keep us informed. <3

  3. I was started on birth control at age 15 due to acne and cramps. My libido has definitely been squashed and my partners over my lifetime have all wondered what is wrong with me. Well I have always wondered the same things but I was always told it had nothing to do with birth control. It’s very disheartening. Do you have any solutions for low libido? I mean I literally could care less about sex. I have to tell myself to do it. It’s so sad and unhealthy.

  4. So I know this post is years old. I’m hoping there’s been an update on how to help. I went off of hormonal birth control methods about 6 years ago. I knew they could suppress libido and I was hoping for a fix. I’ve had a copper IUD for about 4.5 years of that 6. My libido is still dead. I originally started bcp when I was 15, because my mom had PCOS before menopause and they were worried my ovaries were already showing signs of cysts from their shape. I used various versions of bcp for 15 years before coming off. I’ve never had a normal libido, only tiny sparks of interest when in a brand new relationship. As soon as the relationship settled, it would disappear. I can respond if my husband initiates, but I’m completely uninterested in initiation myself.
    So far as I can tell I do ovulate, but I also have symptoms of insulin resistance so I’m planning on addressing it with magnesium and cutting fructose. I’m quite overweight and only just starting to exercise, pay attention to my diet, and try to address it. I figure if I’m trying to help my body heal, adding something to help resurrect my dead libido would be a good idea.
    I hope you see this comment and can make a suggestion. Regardless, thank you for this blog, and all the knowledge you’ve already shared. I’ll be getting your book as soon as I can afford it!

  5. Hi Lara,

    I was on the pill sporadically (sometimes a few months, longest was a couple of years) when I was 18, 20, 25 & 28. I always went off it due to fluid retention, depression and ALWAYS loss of libido. It would return within days of stopping the pill. I will never ever take bcp ever again nor will I ever let my daughter go on it. There are so many other options out there for contraception. I am 35 now. Thank you for your period revolutionary work.

  6. Hi Lara, I was on the pill for 5 years, stopped end of 2015. I have had the opposite effect. I have a bizarrely high libido, and in the last year it’s gone a bit wild! My partner can’t keep up! At first I thought “GREAT!” but now i’m thinking perhaps this is a sign of something not quite right. I could easily have sex 3-5 times a day if I had the time! Just wanted to know your thoughts 🙂

    • You mean your libido increased when you came off the pill? Yes, that can happen. It’s the surge in both estrogen and androgens (male hormones).

  7. Hi there Dr. Briden; thank you for this wonderful post regarding the importance of SHBG. I am a 42 year old woman who was on ortho-tricyclen for 25 years, 7 of which spironolactone was added. For the past three years, I have been struggling with extreme hormonal imbalance. I tried going back on the pill, which created further problems, including extreme anxiety, hot flashes, 20 lbs of weight gain and other serious mental issues) I was also a vegan for three years, thinking that an exclusive plant based diet would increase my health. I have had several tests which point to high SHBG (undetectable total and free testosterone, low DHEA-S, low estradiol symptoms, and very high morning cortisol). I have now been off the pill for almost two months, and have been introducing many meats into my body and am feeling much better, though still not great. Do you have any advice to lower SHBG further? Would the addition of micronized DHEA be beneficial? I am begging for your help, please. Thank you!

  8. Hi Lara,

    Great post – I have had high levels of SHBG for a number of years, even after going off OCPs. Are there ways to lower you SHBG levels?

    • are you vegetarian? That’s a common reason for high SHBG. The next thing to consider is a possible low level of the adrenal hormone DHEAS (which causes high SHBG)

    • Hi Kathryn, By libido, do you mean 1) the spark of interest, or 2) the ability to respond and orgasm?
      Estradiol pessaries should help with the second part– the ability to respond. The spark of interest depends more on thyroid and androgens such as DHEA-S. Have you been tested for those?

  9. I know this is a very old post but do you have any suggestions for lowering extremely high SHBG? I was on the pill for 14 years (off now for 7) and on my last bloods test SHBG was through the roof. I obviously have no sex drive 🙁

  10. I turned 39 this year and have had no libido since 27 due to bcp. I’ve been to many dr.s, no help found. I take diff forms of testosterone boosters and they work for 1 or 2 days and never work again. Something seems to stop working chemically. No dr knows enough about the issue. .

    • Are you saying that you stopped the Pill, but your libido did not return? I’m afraid that does happen sometimes because the Pill can permanently (maybe) elevate sex hormone binding globulin (SHBG) which binds and inactivates testosterone. You can ask your doctor to test SHBG with a blood test. If that is normal, then test for the adrenal hormone DHEA to see if it is too low. You might also consider thyroid (because under-active thyroid causes low libido.
      Finally, estrogen is important for libido so it’s important to ovulate regularly (because that’s how you make estrogen).

      • Correct, never returned. Ok, I will try again and specify those test you recommend. It’s very frustrating to do because dr.s don’t know alot about the issue and apparently each has a different idea of what normal range is and what specifically should be tested. I have also seen a endocrinologists. I do appreciate at least speaking to something that is familiar with the issue and acknowledges the effects of bcp, so thank you.

  11. Thanks so much for your insightful posts, Lara, and I couldn’t agree more about how unnecessary the pill is and how we are led to believe it’s harmless for young women to be on it for years. Anecdotally, I’m one of the lucky ones who sees an immediate return of libido as soon as stopping the pill (I’ve been on numerous brands, but rarely could stay on it for longer than a few months to a year as I noticed the immediate changes to my mood, weight and libido).

  12. This has been a very interesting read, I have been on the pill since I was 18. I am 27 and recently decided to come off the pill completely to purge my body of unnatural processes. This year has been a journey for me already, I had a bad case of adrenal fatigue and 6 months later am only now just getting my energy levels back. During this time I went on a health kick to do whatever I could to get better and get my energy back, I decided to reduce/cut out food my body is sensitive to and has a hard time breaking down, so wheat, refined sugar, dairy and processed food. As an unknown-to-me added benefit, my skin definitely improved and those areas where I’ve always had a little bit of weight slimmed down. I had been told being on the pill would slow the recovery of my hormones coming back into balance and doctors had told me not to come off pill. Which made me start to think what I am doing to my body? I have only been off the pill one month and have had hair loss, oily skin, and muscle pain. I had attributed some of these to coming off the pill but didn’t know for sure. I have also often commented to my friends about having a low libido, and only clued in recently that it could be because of the pill, which is actually quite sad to hear that this is a common occurrence, one I wish I had known years ago! I have my fingers crossed that it returns and I no longer have to be jealous of my friends sex drives. On that note, Lara you will be happy to hear one of my good friends has been on the pill for a similar length of time and she has no such problems with her libido, so it is very much each to their own and this is just how my body reacts. Thanks for your article

    • Thanks for your comment Em, and for sharing the story of your friend. I am always happy to hear of women who feel well on the Pill.
      Hair loss and oily skin are common symptoms transitioning off the Pill, but they are temporary, and should settle after a few months.

  13. Do you have any advise to prevent weight gain when stopping the birth control pill? I have seen many posts and forums where women gained weight when they stopped the pill but no advise on how to prevent it or balance hormones to loose it. Do you have any advise to prevent weight gain when stopping the pill or to lessen the weight gain?

    Do you have advise for preventing a hair shed/loss when stopping birth control pills? Or any thing that will slow the shed/loss down or lessen the amount that sheds?

    • Most women lose weight when they stop the Pill. Yes, some women gain, but that is far less common, in my experience.

      The hair loss is another story. Even though many Pills cause hair loss, stopping them can also trigger hair loss. That is because hair is sensitive to any rapid change in hormones. What I advise patients is take some time before stopping the Pill to identify and treat any other issues that might worsen hair loss (such as thyroid or iron deficiency). If you haven’t already seen it, then please read my hair loss post.

      • I have read your hair loss post. I do not have any symptoms of any other issues. Doctors here in the US wont test for anything unless you have symptoms. I have only been on the pill for just over a year. I had a hair shed when I started the pill, but it feels like my hair is still slowly shedding and thinning. When a hair shed is triggered by stopping the pill, is the hair loss from it temporary or permanent?

  14. Do you have any advise for stopping the pill with the least amount of side effects? I have been to womens blogs and forums and they all say that they got hair loss, weight gain, mood swings. etc when stopping the pill. They dont post anything that will help with the side effects. They also dont come back and repost to tell if they lost the weight or the hair loss stopped or hair grew back. I wish they would post and tell their progress. My husband is the only one who knows I am on the pill. My mother doesnt know I am on the pill and I see her every day since we live on the same street. I want to avoid any side effects she would notice like bloating, weight gain or hair loss. I have only been on the pill about a year and my hair is thinning. It feels thinner and I notice more hair coming out in my brush every morning. I am afraid of hair loss and weight gain when I stop the pill. Do you have any advise for any thing that will lessen or let me get the least amount of side effects when stopping the pill? Or can you direct me to any website that may help.

  15. Hello!
    I also just stumbled upon your blog. Yes nuvaring zapped my libido away. I have been off of nuvaring birth control for going on 3 months after almost seven years. My libido came back almost with avengence! Unfortunately, so did my acne.And I have been on a tea detox for the last few days trying to stay away from sugar and milk so the acne goes away. Overall I am glad to finally be off birth control and really getting to know my body and my cycles. I will never go on birth control again. I actually felt like l was MORE attracted to my husband after I got off of it. It was like coming out of a fog.
    Thanks for the information.

  16. I am now losing my hair after going off the pill. I am devastated that after promising myself I would never allow a doctor to hurt my body again with medication, this has happened to me. I was fine on my original pill Ortho Novum 777.. but after being put on it at age 17 for acne that responded to nothing else – I was on it for 20 years, with doctors saying (when I asked about being on the pill long term) that it was completely safe. I went off at 37. I got extremely sick with pain all over my body that nothing stopped. I didn’t realize it was from going off the pill until I got put back on it 3 years later and the pain stopped right away. Then I was scared to go off it. In the meantime my untreated thyroid issue was finally treated and many of my problems went away.. but I was still scared to death to go off the pill. This time they put me on LoEstrine. About 3 or 4 months after going on it I had chronic vaginitis…and was told it wasn’t from the pill. However, I NEVER had anything like this before and I knew it had to be linked. I also had zero sex drive. The chronic vaginitis made sex extremely painful on top of having no drive. I am finally off the pill. Over 50% of my hair has fallen out. I no longer have a painful sex problem and libido is better.. not great but better. How can I really know though when I have been on the pill most of my life? I’ve been lied to repeatedly about the safety of the pill. I believe I got my thyroid issues from long term use of the pill as no one in my family has this issue.

  17. HI there, I have just stumbled across your blog and enjoying the learning so far. I have been on the pill since around the age of 15 and I am now 27 and seeing a naturopath with the main aim to get my libido and sex drive back. I just don’t want sex and your line “silently blame themselves” hits so close to home for me. I do blame myself for no libido and my partner of 8 years probably does too because he doesn’t know anything about female hormones etc. tonight I only mentioned to him that the pill isn’t actually causing “normal processes” in your body. I do want to come off the pill pand try another contraceptive so hopefully with some more reading and talking with my naturopath I can make some informed decisions. Currently we are working on improving a low thyroid and adrenal glads, high iron and low vitamin D along with cleaning up my digestive system. So it’s step by step at the moment but my gut feeling is that the pill isn’t doing me much good other than not becoming a mother! Thanks

    • Thank you for sharing your story Lauren. The Pill crushes libido.

      The worrying evidence (discussed in the blog post) is that libido suppression may continue for some time after the Pill is stopped. The good news is that some women report that their libido returns fairly quickly – within a few months. I hope that you are one of those lucky ones.


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