For most women, hormonal birth control does not noticeably change sexual desire. Some report a dip; others notice an increase. The experience depends on the person, the method and what else is happening in her life.
Online forums are full of stories about the pill making someone’s libido disappear. Lavanya Kiran offers a more measured answer: “It can, but it does not for most women.”
There is a biological reason the pill might affect desire. It suppresses ovarian activity, reducing the ovaries’ production of hormones, including testosterone. The estrogen in combined pills also prompts the liver to produce more sex hormone-binding globulin, or SHBG, a protein that binds to testosterone and leaves less of it freely available.
For some women, those changes may contribute to lower desire or vaginal dryness, Kiran says. But a change in hormone levels does not automatically translate into a change in someone’s sex life.
“Many women show a clear drop in free testosterone, yet report no loss of sexual interest,” she says. “Desire depends on much more than one hormone.”
The research reflects that complexity. According to Onlymyhealth, a 2024 review in Sexual Medicine Reviews found that combined pills lower free testosterone, but whether those changes affect sexual function, including desire, remains unclear.
The review suggested that pills with antiandrogenic effects, which counter the action of hormones such as testosterone, may negatively affect arousal, lubrication and orgasm. Its authors cautioned that a shortage of placebo-controlled trials makes firm conclusions difficult. A separate 2023 review of 45 papers in Gazeta Médica also found that effects on libido vary by contraceptive method.
Those differences matter. Hormonal IUDs act primarily within the uterus, Kiran says, while copper IUDs and condoms contain no hormones.
If your desire dips after starting the pill, Kiran suggests allowing time to adjust: Some side effects settle within about three months. But a change that bothers you is worth discussing with your doctor, who can help you consider another formulation or method.
Kiran says desire often returns to its previous level within weeks to months after stopping or switching. If you want to make a change, speak with your doctor about a transition that maintains contraceptive protection.
The pill can affect libido. It just does not affect everyone’s libido the same way—and your experience deserves attention, even if it is not the most common one.