The Pills Effect on Our Sexual Health

Fifty years ago, the birth control pill gave women a freedom that previously eluded them: Women could engage in romantic or recreational sex without fear of unwanted pregnancy.

Many women would agree that this was a life-changing development, aligned with the women’s movement and a gift that allowed women to have children when they wanted to, and, yes, have sex when they wanted to, too.

It was anticipated that this freedom would come with a side effect filled with irony, but a study has recently been released by the Journal of Sexual Medicine that connects serious declines in sex drive with hormonal birth control.

This is not really news to many professionals in the field of sexual dysfunction.

Dr. Bat Sheva Marcus, clinical director of the Medical Center for Female Sexuality in New York, has a great deal to say about this.  After eleven years of providing medical treatment to women with different kinds of sexual dysfunction, she has case after case where this has proven to be true.

“All hormones are suspect,” Dr. Marcus declares.  She estimates the pill is a contributing factor in 60 percent of the women she treats for low libido.

Why does this happen?

The problem is multifaceted:

1. The pill can inhibit the production of the hormone testosterone. Though testosterone is typically associated with men, women also produce testosterone which contributes to her hormonal make-up in partnership with estrogen and progesterone.   Though it’s a small amount, it appears this testosterone is critical to a woman’s libido.

2. The birth control pill also may make what little testosterone is in a woman’s body unavailable to the rest of the body. It significantly raises the level of SHBG, the sex hormone-binding globulin protein.  This protein binds to testosterone isolating it and preventing it from playing a role in the body’s normal functioning.

3. The synthetic estrogens in the pill can inhibit a woman from continuing to produce her own natural estrodial. The ultimate result is reduced or skewed hormones in women. This can result in lowered sex drive, vaginal dryness, pain and general reduction in pleasurable sensations. “I feel like I have a slip-cover on my body” is the way one women described this condition to Dr. Marcus.

Watch:  Dr. Alan Altman on Safe Estrogen Treatments

For women approaching peri-menopause or menopause, these symptoms may sound familiar. Testosterone levels decline in menopausal women and incidental side effects include hair thinning and loss of sex drive.  Is this beginning to make sense?

Being in practice for eleven years has given Dr. Marcus the opportunity to see the impact of birth control pills in other areas of sexual dysfunction besides low libido.  Several women have come to the Center complaining about painful intercourse that seemed to coincide with their taking the pill for birth control.

Dr. Marcus has two recent cases where a woman came to the Center severe vaginal pain.  These two women had remarkably similar paths. In both cases vaginal pain started between three and six months after starting a new form of birth control pill. In both cases the patients suspected a relationship between the birth control pill and their pain, and both were told by their gynecologist that the two were not connected and recommended they stay on the pill.

Each patient steadily got worse for several years and underwent treatment after treatment until each found her way to our Center. They both needed to get off the offending drugs and then do some rehabilitation to address the physical and emotional remnants of the pill on their sex lives. Both have opted for different forms of birth control and no longer need any treatment for pain.

When considering the connection between the pill and your sex life and the role of hormones in a woman’s sexual health, there is a lot of reliable research.  The question that remains is: birth control!  For some women hormonal birth control does not seem to be a problem and does not impact on their sexual functioning. For many women, though, it does. In those cases, finding a successful way to have both effective birth control and normal sexual functioning is an important quest.


Watch the genConnect “No Strings Attached” Event. genConnect experts Dr. Marianne Brandon and Dr. Alan Altman tackle casual relationships and whether we were really born to be monogamous. For more details, contact

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Category: Intimacy, Relationships

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About Bat Sheva Marcus, LMSW, MPH, PhD: Dr. Bat Sheva Marcus, a sexual dysfunction specialist, has dedicated her life to making sure every woman she meets is satisfied with her sex life. As clinical director for The Medical Center for Female Sexuality [...]
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