Oral Contraceptives May Inhibit Women’s Sexual Desire

Source: Simone Van Der Koelen/Unsplash

A large portion of women in the U.S. take oral contraceptive pills to prevent pregnancy and manage menstruation. New research by Handy and colleagues (2023) published in The Journal of Sexual Medicine suggests that some types of oral contraceptives inhibit women’s feelings of sexual desire as well as their physiological arousal responses. The authors hypothesized that women taking antiandrogenic oral contraceptive pills (which reduce testosterone) would be most likely to experience decreased sexual desire and inhibition of physiological sexual arousal responses.

Methodology

Sexually active women between the ages of 18 and 35 were recruited via online advertisements as well as through the participant pool at a large university in Texas. Of the 130 women who participated in this study, 59 had never used hormonal contraceptives, 50 were taking androgentic oral contraceptives and 21 were taking antiandrogenic oral contraceptives (all women taking oral contraceptives were taking the pills for at least three months). Most of the women in the sample identified as heterosexual and White. The women watched erotic videos and the researchers measured vaginal blood flow, lubrication, as well as self-reported vaginal dryness, bleeding, and pain associated with sexual activity.

Results

The researchers found evidence of sexual arousal disorders in 33 percent of the women taking antiandrogenic oral contraceptives and 24 percent of the women taking androgenic oral contraceptives, as compared with only 8 percent of the women in the control condition. While all three groups of women showed increases in blood flow during the erotic videos, women not taking any hormonal contraceptives showed the strongest increases in vaginal blood flow. Women taking antiandrogenic contraceptives were most likely to show reduced blood flow as well as lubrication versus women in the other two conditions. Women in the androgenic contraceptive condition were more likely to report bleeding during intercourse.

Conclusions and Implications

The authors concluded that oral contraceptives impair women’s sexual desire and physiological arousal responses. Women in the control condition experienced the strongest physiological responses to the erotic stimuli and were the least likely to report difficulties with their usual sexual activities. Women taking antiandrogenic birth control pills were most likely to report symptoms consistent with sexual arousal disorder, which the authors believed was driven by a lack of vaginal lubrication. The authors recommend that women discuss the different types of oral contraceptives with their doctors and consider a pill that allows more testosterone, which may be necessary to maintain healthy vaginal tissue.

The authors acknowledge that sexual desire as measured in the laboratory may not equate with sexual desire in more natural settings. It is also possible that women with concerns about their level of sexual desire may have been more likely to volunteer for the current research project. However, the authors conclude that all types of hormonal oral contraceptives may impair women’s sexual desire and physiological arousal responses.