Can Birth Control Pills Cause Low Libido?

The pill lowers testosterone and raises a binding protein that leaves less testosterone available, which could dampen desire in women who are sensitive to that shift. Research has not settled how strongly that shift drives desire.

Why could the pill affect desire?

Your ovaries make small amounts of testosterone along with estrogen and progesterone. Combined pills pause ovulation, so your body makes less of its own estrogen, progesterone and testosterone. At the same time the pill raises SHBG, short for sex hormone-binding globulin, a blood protein that holds onto testosterone and leaves less free testosterone available to tissues. A 2013 meta-analysis of 42 studies in 1,495 healthy women found lower total and free testosterone and higher SHBG during combined pill use, and the authors said what this shift means for daily life remains to be clarified.

A 2019 review of hormonal contraception and sexual function described the same hormone drop and suggested desire could also reflect lower estradiol and progesterone and a smaller neural response to erotic cues. The same review stressed that study results conflict, so additional research is needed to sort out cause.

How common is a drop in libido?

In research summarized in a clinician-reviewed Clue article, more than 6 in 10 pill users reported no change in libido, more than 2 in 10 reported an increase, and about 1 in 10 reported a decrease. Those numbers describe groups of users.

Desire moves for many reasons. A Columbia Nursing review estimated sexual difficulty affects 27 percent to 70 percent of women worldwide and noted no guidelines call for checking sexual function before or after starting the pill. Stress, sleep, relationship satisfaction, relief from pregnancy worry, and relief from painful or heavy periods can raise or lower desire during the same months you start the pill.

What if you think the pill lowered your libido?

Track timing for one or two cycles. Note when you started the pill, when desire changed, and what else changed with stress, sleep, mood, bleeding, pain and relationship satisfaction. Bring that record to your clinician and ask whether a pause or switch fits your history. A 2019 review lists options clinicians consider when pill-related sexual difficulty is suspected, such as copper IUD, levonorgestrel IUS (hormonal IUD), etonogestrel implant or vaginal ring.

Blood levels returned to baseline after stopping in a small prospective study in women with polycystic ovary syndrome (PCOS). That study measured androgens and SHBG, not how fast desire returns, so it does not set a timeline for libido. If you switch methods, keep tracking desire, bleeding and mood for the next few cycles and compare with your earlier notes at follow-up.