Is a loss of sexual desire connected to taking the birth control pill? The answer to this question was central in the mind of researchers from the Ohio State University Medical Center when they examined more than 25 years' worth of studies that looked at the relationship between oral contraceptives and libido. Their conclusion? If your sex drive is sputtering, you may want to take a closer look at other factors in your life rather than blaming the pill. The review of past research, conducted by Ohio State's Dr. Jonathan Schaffir, appears in the Journal of Sex & Marital Therapy. Schaffir says the issue of lost libido has its roots in early formulations of the pill, which often contained high levels of estrogens and progestins, causing women to become bloated, feel breast tenderness or experience nausea. "These side effects could easily have caused women to feel extremely uncomfortable, translating into decreased libido," said Schaffir. "Also much less was known about the human sexual response at that time, which could have led to information based on opinion and not on fact."
In his assessment of the published information, Schaffir looked for whether certain types of hormonal contraception - or certain segments of the population - are more prone to changes in libido. He noted that some women do experience a change in libido while taking oral contraceptives, but he could find no predictable patterns for this in the literature.
Schaffir also looked at whether androgens (male sex hormones) might be a factor in diminished libido. "It was shown that the birth control pill decreased the concentration of free androgens, including testosterone, but that doesn't necessarily translate to a loss of libido. Chemical changes occurred, but they did not apparently impact sexual behavior for the vast majority of women," he said.
The review found that only a small minority of oral contraceptive users experienced a negative effect on sexuality. Additionally, Schaffir said he found no reliable predictor of a negative effect in those who experienced such side effects. "Studies showed that it was a problem for a small number of women using birth control pills to experience decreased libido, but it didn't happen predictably in any specific sub-population, or with any particular type of hormonal contraception. In fact, changes in sexual desire could as likely represent a combination of biological, psychological and social phenomena as any hormonal effect."
Schaffir said the review should reassure both patients and doctors that oral contraceptives are a safe form of contraception. "Don't let such fear factor into your decision of whether to take hormonal birth control pills," said Schaffir. Instead, he suggested women with decreased libido look to all areas of their lives to identify potential problems; such as other medications and supplements, stress and potential psychological issues.
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Source: Ohio State University Medical Center
