Birth control is one of the most common prescription medications people take, but it still comes with questions: What side effects will I experience? Will I gain weight? Will it affect my sex drive? 

The short answer is: it depends. Everyone is different, and birth control is not one-size-fits-all. For some, it may have no effect at all. For others, it can increase or decrease their desire for sex.

Nebraska Medicine OB-GYN Marcela Pineda, MD, explains how different types of birth control can impact libido, and why sex drive is about more than just hormones. 

Not all birth control is the same

“Not all birth control is created equally,” says Dr. Pineda. “When we’re talking about birth control pills, we usually mean combined oral contraceptives – the ones that contain both estrogen and a synthetic form of progestin.”

Progestin-only birth control, such as the “mini pill,” some IUDs and injections usually doesn’t impact sex drive. 

“In theory, progestin shouldn’t lower libido,” says Dr. Pineda. “Some women may be more sensitive or notice changes. If that happens, we can always try something else.”

Estrogen-containing birth control, like the pill, patch or ring, can sometimes have a greater effect. However, that doesn’t mean everyone will have the same experience. Birth control is highly personal, and what works well for one person may not for another.

Peace of mind

While hormones play an important role in sex drive, birth control also provides peace of mind that can improve libido.

“One benefit of birth control is the safety of not having an undesired pregnancy,” explains Dr. Pineda. “That can actually help some people feel more relaxed and open to intimacy. When you’re not worried about getting pregnant, it can improve your sex life.”

More than hormones

Sex drive isn’t just about hormones.

“There’s so much more to our sex drive than just hormonal factors,” says Dr. Pineda. “There’s our relationship status, how we feel with our partner and what’s going on in our lives. Anxiety, depression, sleep disturbances and even the phase of our menstrual cycle can all play a role.” 

As far as why some women are impacted and others aren’t, Dr. Pineda compares it to taste preference: “Why do some people like chocolate and others don’t? We’re complex human beings – not just guided by hormones. It depends on our circumstances, how we feel about ourselves and sometimes how kind our mind is to us.”

This is also something Dr. Pineda sees in patients going through perimenopause. 

“Some women may no longer feel attractive, no matter what their partner tells them. There are days we feel more confident and like we own the world, and days we don’t. That’s normal.”

Practicing mindfulness

Daily stress can also interfere with intimacy.

“Our lives are busier than ever, and it’s easy to get distracted by anxiety or what’s going on in the world,” says Dr. Pineda.

She recommends practicing mindfulness during sex. 

“It’s about clearing our minds from external factors, being present, not thinking about groceries, kids or chores. There’s nothing sexy about that. Instead, we need to change into the role of being with our partner, not the different hats we wear every day.”

When to talk to your doctor

Some side effects may improve over time, but not always.

“If you have bothersome symptoms like vaginal dryness, that’s not going to get better, and it’s time to switch methods,” says Dr. Pineda. “If you notice a slight decrease in libido that doesn’t improve after a few months, let’s look at other options.”

The good news is, you don’t have to figure it out alone.

“Even if you’re not ready to switch or you just have questions, please reach out,” Dr. Pinedasays. “Our job is to find the birth control that’s right for you, makes you feel comfortable and helps you achieve your goals.”

Birth control can impact sex drive, but it’s only part of the story. Hormones, mental health, relationships, stress and self-confidence all work together. If you notice changes in your libido after starting birth control, don’t hesitate to talk to your health care provider. Together, you can find the right method that works for your body and your life.