One of the greatest paradoxes about birth control is that, while it may make sex seem more available to women, it can tank women’s libidos, making them feel less in the mood.
For many women, hormonal birth control might be the main culprit in their lowered sex drive. This could have something to do with the fact that hormonal birth control suppresses testosterone levels in women, the hormone that is responsible for sexual arousal in women (as well as men). Lowered levels of testosterone might not only negatively affect a woman’s sex drive, but also her sexual satisfaction. Low testosterone is also linked with vaginal dryness, which makes sex less enjoyable—even painful—for many women. Therefore women on the birth control pill may have a more difficult time “getting in the mood,” or experiencing arousal and orgasm.
There’s also the matter of depression and anxiety—both of which can be symptoms of hormonal birth control use. For many struggling with depression, the condition may go hand-in-hand with a loss of libido or disinterest in sex. Low testosterone is associated with depression in women (and men), and as we’ve already discussed, low testosterone may cause decreased sex drive. Further compounding the issue, the antidepressant medications often used to treat depression and anxiety are also known for their libido-lowering effects.
Birth control may also cause physical changes to the clitoris, labia, vaginal opening, and vulva. In one clinical study, birth control (both oral contraceptives and the vaginal ring) was actually shown to shrink the size of a woman’s clitoris. Another study found that oral contraceptives also thinned the tissue of both the labia minora and the vaginal introitus, and changed the vascularization of the vulvar tissue. These changes can make sex less desirable, less pleasurable, and more painful for women.
For more on libido and birth control, see the articles below.