Do Contraceptives Affect Libido?
When it comes to choosing a contraceptive, one of the most common yet least talked-about concerns is libido. Does the pill lower sex drive? What about the implant or IUD? The truth is, the relationship between hormonal contraception and libido is complex, and experiences can vary wildly from one woman to another.
In this post, we break down what the research says — and what you can expect from different contraceptive options.
Combined Oral Contraceptives (The Pill)
These contain estrogen (usually ethinylestradiol) and a progestin. While they’re highly effective and convenient, they can impact libido in a few ways:
They suppress ovarian testosterone production.
They increase sex hormone-binding globulin (SHBG), which binds testosterone and reduces the “free” form available for libido.
What the research says:
15–30% of users report lower libido.
Progestin type matters:
Pills with androgenic progestins (like levonorgestrel) are more likely to worsen libido.
Those with anti-androgenic progestins (like drospirenone or nomegestrol) may improve acne but could also reduce libido due to testosterone suppression.
Some users find libido improves, thanks to reduced anxiety about pregnancy or better cycle control.
Cochrane Review (2013): Found no consistent pattern, highlighting wide individual differences.
Progestin-Only Pills (POPs)
POPs don’t contain estrogen and are usually better tolerated from a mood perspective, but they may still cause irregular bleeding, which can affect sexual desire.
Less likely to raise SHBG = less testosterone suppression.
Research is limited, but most data suggest a neutral to mildly negative impact on libido.
Implants & Injections (e.g., Nexplanon, Depo-Provera)
These deliver a high dose of progestin continuously, strongly suppressing ovulation.
Estrogen levels drop, which can lead to vaginal dryness, painful sex, and lower libido.
Depo-Provera has the most consistent reports of negative effects on libido.
Hormonal IUDs (e.g., Mirena, Kyleena)
These release levonorgestrel locally in the uterus, with only minimal systemic absorption.
Do not significantly suppress estrogen or testosterone.
Most studies and anecdotal reports suggest little to no effect on libido — some users even report an improvement in sexual well-being due to lighter, less painful periods.
Non-Hormonal Options (e.g., Copper IUD, condoms)
These have no effect on hormone levels, so they don’t affect libido.
A great option for those highly sensitive to hormonal shifts.
Final Thoughts
There’s no one-size-fits-all answer when it comes to how contraception affects libido. Your experience may depend on:
Your hormone sensitivity
Your baseline testosterone levels
How you feel emotionally about your contraception
Your relationship context and life stressors
If your current contraception is affecting your desire, it’s worth discussing with a GP or women’s health specialist — there may be an alternative that better suits your body and lifestyle.