The Guide to Getting It On (127 page)

Plan B emergency contraception is available over-the-counter in the United States. If you don’t see it, be sure to ask. If you can’t find it, visit
www.PlanBOneStep.com
.

The copper IUD is another form of emergency contraception that has been approved by the FDA. The IUD either prevents conception or disrupts it, depending on when it is inserted. It does not need to be taken out, and can provide several years of continuous and highly effective birth control.

Male Condoms

For an extensive discussion about male condoms, please see Chapter 22:
Condoms—For the Ride of Your Life
.

A Very Special Thanks to Angela Hoffman, birth control and sex education expert, for help above and beyond the call of duty with this chapter. Collossal amounts of gratitude & thanks to Cynthia Graham and one of her partners in condom research crime, Bill Yarber. A big nod of appreciation to James Trussell.

CHAPTER

59

The Pill & Your Sex Drive

“
I have noticed a big decrease in my sex drive since I started taking the pill. I used to have the biggest libido and wanted to have sex at least once a day but now it just takes a lot more for me to be in the mood. I am not just randomly horny anymore and I used to be all the time. I have less sex on the pill.”
female age 20

“After a not-so-great experience with the first brand I tried, I have switched to a low-dose birth-control pill. I like it. I have no side effects at all. My sex drive is most certainly back, which is great!”
female age 19

“I used the pill and saw no effect on my sex drive whatsoever. However, my twin sister took the pill and saw a marked decrease in her sex drive. It just goes to show that everyone reacts differently—even identical twins.”
female age 21

Little research has been done on the impact that birth control pills have on a woman’s sex drive and mood. The perception is that women are pretty hormonal to begin with–what’s the big deal with topping off the tank?

This chapter looks at what we do and don’t know about birth control pills and your sex drive. It also includes a list of questions you might ask yourself before using hormonal birth control. That way, you can have something to refer back to after you’ve been on the pill for a couple of months.

Fortunately, there are many different formulas of birth-control pills. So if one isn’t working well for you, you can easily try others. Also, a long term study that has followed thousands of women who took the pill for at least four years has found that forty years later, the women who had taken the pill are actually living longer than women who didn’t take the pill.

NOTE:
It used to be that the only hormonal method of birth control was the pill. But different delivery systems have emerged, including the Nuva-Ring, the Minera IUD, the patch, the Implanon implant, and the Depo shot. For simplicity’s sake, this chapter will refer to all of these as “the pill,” unless otherwise specified.

Less Than 5% or More Than 25%?

“We used to use condoms until six months ago when I started taking the pill. I love the pill! I have noticed no change in my desire for sex since starting it. I was incredibly horny before the pill, and am still incredibly horny now!”
female age 19

“I took the pill for five months but stopped because it gave me horrible side effects (no sex drive although I was a newlywed, depression, paranoia, panic attacks, weight gain, and heart burn). Now that I’m off hormones my sex drive is a whole lot better.”
female 21

A recent study suggests that sexual side effects occur in approximately 25% of the women who try the pill. Still, healthcare providers are often quoted as saying that less than 5% of women stop taking the pill due to sexual side effects. Why the fivefold disparity?

Until recently, the few studies that did inquire about sexual side effects tended to be studies of women who had been taking the pill for five years or more. But we now know that women who experience a drop in sexual desire often stop taking the pill within the first year. So most women who did experience sexual side effects would not be represented in a study of women who had been taking it for five years.

Other problems in getting consistent results have to do with the kind of questionnaires that are used (do they actually measure what the study says it is measuring?), the quality of the study design, the length of the study, and how the woman’s testosterone level and other androgens are measured.

It’s easy to manipulate just a few of these variables to get the results you are looking. Unfortunately, most of the studies have been funded by the drug companies who make the pills and who stand to benefit from the results.

Are Women Too Suggestible to Deserve Adequate Warnings?

“This is the third brand I have been on. The first was a three-month kind, which left me spotting for weeks, made me frustrated and took away my sex drive. The second made me very depressed with a sex drive that rose and fell like crazy. This third one has leveled out my emotions and might be making my sex drive a little stronger than before.”
female age 20

“My doctor never told me that I could have any of those side effects. Sure, I was expecting weight gain and such, but not depression and NO sex drive.”
female age 21

As long as healthcare providers are convinced that less than 5% of women who take the pill have undesired sexual side effects, they don’t necessarily give warnings about possible sexual side effects. And some healthcare providers feel that to give a warning would plant the idea in a woman’s mind. The trouble is, any warning can become a self-fulfilling prophecy. So why warn any patient about anything?

If women know from the start that there can be problems, but thatthere are as many types of pills as there are lipstick and nail-polish colors, they might be more willing to make adjustments. With the help of an astute healthcare provider, a woman might find another pill or a different delivery system such as the NuvaRing or IUD that could work really well for her.

So What’s Going On?

“No change whatsoever... Still horny as a dog.”
female age 21

“The pill has totally suppressed my sex drive. I have hardly any desire.”
female age 22

“
I definitely enjoy sex way more knowing that I won’t get pregnant if the condom breaks or slips off.”
female age 24

One of the big crazes in drug research has been to find a pill for women who have low sexual desire, as if low sexual desire is usually a medical problem. Researchers had hoped that the answer would be Viagra, but it didn’t work. It seems that women’s sexual interest isn’t suddenly switched on by a pill that creates the girl-version of a boner.

Since Viagra was a bust, researchers started focusing on testosterone. While testosterone tends to be associated with male arousal, having a small amount of it pulsing in a woman’s veins is often necessary before she will look at a guy and think sexy things.

The reason for discussing this is because birth-control pills lower the amount of testosterone in most women. In other words, if there were a direct connection between lowered testosterone and sex drive, the pill might be a train wreck for a lot of women.

To confuse matters totally, the sexual desire of some women has either gone up or remained constant even though the pill caused their testosterone level to go down substantially. Other women’s sexual desire has hit the skids with only a small drop in testosterone. So at this time, it’s simply not possible to look at the testosterone level of a woman and predict whether she’s having sexual problems or not.

In trying to make sense of all of this, a theory has emerged that each woman has a threshold of testosterone that is necessary for her to experience her normal sex drive. This threshold can be different for different women, and it could be that a woman won’t start to experience sexual problems until her testosterone falls below her threshold.

This might explain why one woman can handle a big drop in testosterone with no adverse effects, while another woman might want to curl up with a book instead of her lover after only a small drop in testosterone.

There is also an idea that some women’s sexuality is more testosterone dependent–like the male sex drive might be–while other women’s sexuality depends more on relationships. So the pill-related drop in testosterone might be more of a turn-off for women whose sexuality is testosterone-driven.

Another interesting finding about testosterone is that even when women report a drop in desire, they usually don’t experience a decrease in sexual satisfaction when they do have sex. That’s because testosterone only impacts the desire to have sex, but not the ability to enjoy sex once the physical part of it begins. They just don’t want to have sex very often.

Expectations & Our Own Sex Survey

Another factor that might influence a woman’s sexual desire while taking the pill might have to do with her expectations about sex. Researchers found that women reported fewer concerns about the pill in a country where they didn’t expect to enjoy sex as much as women in other countries. However, in our online sex survey, the percent of women reporting sexual side effects from taking hormonal methods of birth control has been more than 35%. While there is nothing scientific about Internet surveys, we were surprised by the high number of sex-related complaints. (On the other hand, this leaves 65% who had no complaints about the pill, with some saying they believe their sex drive is even higher now that they are taking it.)

The women who take our sex survey tend to be in the 18- to 28-year age range, with most reporting that they enjoy sex and are sexually active. Perhaps the women who go to
www.GoofyFootPress.com
expect more from sex than other women. Maybe they find the pill’s sexual side effects to be less tolerable than women who aren’t quite as amped about sex to begin with.

The Importance of Smell

If you are a woman, does the way your partner smells register in a sexual way? Do you cherish wearing a lover’s shirt that has his scent all over it?

Research is showing that a woman’s ability to smell a guy’s pheromones, can be inversely impacted by the pill. If smell is an important turn-on for a woman and the pill is impacting her ability to sense her partner’s smell, then this might contribute to her negative feelings about the pill. On the other hand, if there were something about a man’s pheromones that’s a turn-off, it could be that a pill-related decrease in her sniffer’s pheromone detector might make sex with him feel better.

Pill Related Benefits

So far, this discussion has explained why taking the pill might lower your sex drive, but it doesn’t explain why it might help increase it.