Is the pill killing your sex drive?

Like most medications, the birth control pill comes with a few side effects. Most of them are mild and similar to the symptoms you may have right before your period—like nausea, bloating, breast tenderness, and mood swings. Thankfully, these side effects often go away after a few months. But some pill users feel that the pill also causes them to lose interest in sex and that this doesn’t go away, or even gets worse, with extended use.

Decades of research do not support this claim. Studies on thousands of women suggest that most don’t notice a decrease in libido from using the pill, and the most recent research finds that relationship issues may be behind any post-pill dip in desire. After all, most people go on hormonal methods like the pill, patch, ring, or shot once they enter into a long-term monogamous relationship—and people in long-term monogamous relationships tend to have less sex than they did in their early days together.

Still, you are the only one who lives in your body and the only one who can possibly know if you feel different since you started using a hormonal birth control method—so always trust your instincts. If you think your birth control might be affecting your sex drive, here are a few things to consider before you decide to part ways with your method.

Research says it’s probably not the birth control

The idea that the pill causes libido to drop has been around for almost as long as the pill itself. Some coverage of the subject even offers a biological explanation based on the fact that the pill reduces the amount of testosterone women produce. (Yes, even though we think of testosterone as the male sex hormone, females make it too and it is instrumental in their sex drives as well.) The theory is that the decrease in testosterone, which is similar to what happens after menopause, causes a decrease in desire.

While this seems to make sense, the research doesn’t back up the idea of the pill as a crusher of sex drives. A review of 36 studies conducted between 1978 and 2011 found that only 15% of women felt lower libido when they went on the pill. Another 22% said they felt no change, and 62% actually said they felt an increase in sex drive since going on the pill.

The most recent research on this topic used a tool called the Sexual Desire Inventory on over 900 women and men in heterosexual relationships of various lengths. The tool questioned participants about both their desire for sex with their partner and their desire for masturbation when they were alone. The results initially suggested that women on non-hormonal contraceptives had higher desire on their own, while women on the pill had higher desire with their partner, but these correlations went away when the researchers adjusted for age of the women and length of their relationships.

The researchers say this suggests that the differences are more about relationships and less about birth control. Dr. Kristen Mark, the lead author on the study said in a statement: “Sometimes women are looking for something to explain changes in their sexual desire, which is not fixed throughout her life. The message that hormonal pills decrease desire is really prevalent….[But] our findings are clear: the pill doesn’t kill desire. This research helps to bust those myths and hopefully eventually get rid of this common cultural script in our society.”

But you may have to troubleshoot

If you’re taking hormonal birth control or thinking about starting, it should be reassuring to know that generations of women have road tested the pill and found that it is not a libido killer. Of course, if you are on a hormonal method now and finding yourself less interested in sex—or if you have a partner in that situation—mountains of research mean next to nothing. Luckily, we have some suggestions for troubleshooting—and hopefully getting your mojo back.

1. Rethink your definition of desire. We often think of desire as a rousing in our loins that should come out of nowhere and be so urgent that we need to rip off our partner’s clothes. Right. This. Second. This kind of “spontaneous desire,” as researchers call it, does exist and can be great, but many people (women in particular) are more likely to experience “responsive desire,” a stirring of sexiness in reaction to something you see, hear, or experience. There is nothing wrong with responsive desire—it’s not a lesser type of desire—it just requires some, ahem, stimulus to get you going.

2. Just do it. Next time you’re worrying about your libido, try forgetting about whether you’re turned on right this second. Start kissing your partner or watching a sexy movie and see what happens. We’re not suggesting doing anything you don’t want to do, and if a few minutes in you’re still not feeling it, stop. But you may find that responsive desire kicks in faster than you’d think.

3. Talk to your partner. If you’re feeling less in the mood lately, it might be tempting to keep it to yourself so that you don’t hurt your partner’s feelings, but this isn’t the best idea. Find a gentle way to tell your partner you’re in a slump, and see if you can find a way out together. Think back to a time when sex was great and try to recreate the magic, or brainstorm new ideas. The conversation alone may be a turn-on.

4. Consider medical issues. There are medications (such as anti-seizure meds and anti-depressants) that are known to cause a decrease in libido. Medical issues like diabetes, high blood pressure, and even high cholesterol can also interfere with sex drive. If you have any medical issues that you know about, or if it’s been awhile since your last check-up, make an appointment and talk to a health care provider about any possible culprits other than your birth control.

5. Get in touch with your emotions. It can be hard to get in the mood if you’re overwhelmed with stress, secretly angry with your partner, or suffering from anxiety and/or depression. Self-esteem or body image issues can also play tricks on your desire. Do a mental health check and be honest with yourself about whether it could be time to see a therapist or counselor to talk about your lack of desire and any underlying issues that might be at play. You could also engage in some self-care by getting a massage, reading a good book, or going out for a night with friends.

6. Don’t forget the simple things. Here’s an easy one: The pill can lead to vaginal dryness, which can in turn lead to pain during sex—and pain during sex can make more sex seem less appealing. Fortunately, if dryness is the issue, lube can help!

7. Consider switching methods. The bottom line is that you know your body best. If you don’t like your birth control method for any reason, you should change it, regardless of what the research says. If your sex drive feels different to you, ask your health care provider first about switching to a different hormonal method or even just a different formulation of the pill, which can have a big impact on side effects. If that doesn’t help, a non-hormonal method may be the best option for you.

Birth control is important for anyone who doesn’t want to get pregnant, but it shouldn’t prevent pregnancy by killing your sex drive. You can find a perfect balance between method and libido—you may just have to troubleshoot a bit.