Contraception, also known as birth control, is the use of medications, devices, or surgery to prevent pregnancy. Some examples of contraception are condoms, birth control pills, diaphragms, hormonal vaginal rings, intrauterine devices (IUDs), contraceptive implants, birth control patches, spermicide products, contraceptive injections, and surgical sterilization (i.e., vasectomies for people with penises or tubal ligations for people with vulvas).

In many instances, birth control may contribute positively to a person’s sexual health by reducing any anxiety they may have about unintended pregnancy. Nevertheless, research shows that there may also be some negative sexual side effects associated with different forms of contraception. The following are some ways in which birth control may affect a person’s sexual health.

Changes in libido

Some, but not all, individuals who are using a hormonal form of birth control may experience a decrease in their sex drive or libido. This is because hormonal forms of birth control prevent surges in the body’s hormone levels that affect desire and sex drive. Additionally, these forms of birth control can decrease a person’s sex drive by increasing the synthesis of testosterone-binding globulin in the liver, leading to less active testosterone available in the body. Testosterone is an important hormone for libido, so lower levels of testosterone could plausibly lead to a reduced sex drive.

Importantly, not all individuals who are using hormonal contraception experience a decrease in their libido. In fact, some experience an increase in their sex drive. This could be due to them having less anxiety about unplanned pregnancy, feeling more confident or better prepared for sex, or having improved symptoms from conditions like polycystic ovary syndrome (PCOS) or endometriosis while on birth control.

Changes in the genitourinary system

Hormonal birth control may also cause changes in a person’s genitourinary system. In some individuals, hormonal birth control may cause vaginal dryness, a decrease in vaginal lubrication, and atrophic changes in the vaginal and vulvar tissues. These changes may make sex less comfortable or even painful. Again, not all forms of birth control affect individuals in the same way, so not everyone will experience these changes.

Possible vaginal irritation

A few forms of birth control such as condoms or spermicide products may cause vaginal irritation. The vaginal flora is a sensitive, self-regulating environment, and introducing new substances such as spermicide or the lubricants that are frequently used on condoms can cause itching or irritation. In fact, some condoms are coated in a lubricant that contains spermicide, so it may be a good idea to switch the type of condom you are using if you are experiencing vaginal irritation.

Reduced anxiety and increased confidence

The effects of contraception on sexual health are not always negative, and some individuals report feeling less anxious and more confident during their sexual experiences knowing that they are less likely to become pregnant unintentionally. This increased confidence and reduced anxiety may facilitate increased sexual desire, arousal, and satisfaction for some individuals. There are many different forms of contraception, so if one does not work well for an individual, it is worthwhile to experiment with other types of birth control.

References:

• Caruso, S., Palermo, G., Caruso, G., & Rapisarda, A.M.C. (2022). How Does Contraceptive Use Affect Women's Sexuality? A Novel Look at Sexual Acceptability. Journal of clinical medicine, 11(3), 810. https://doi.org/10.3390/jcm11030810
  
  
• Higgins, J.A., & Smith, N.K. (2016). The Sexual Acceptability of Contraception: Reviewing the Literature and Building a New Concept. Journal of sex research, 53(4-5), 417–456. https://doi.org/10.1080/00224499.2015.1134425