Birth control may affect long-term relationships

Ian Kerner, a sexuality counselor and New York Times best-selling author, blogs about sex weekly on The Chart. Read more from him on his website, GoodInBed.

A recent study shows that women with lower testosterone levels - typically caused by the use of hormone-based oral contraceptives like the pill - are more attracted to men who also have low testosterone levels.

Previous studies have shown that the less testosterone a man has, the less likely he is to cheat, the more supportive he is, and the better he is at providing for his family. Sounds good, right?

Not quite. Previous studies have also shown that most women are historically more sexually attracted to higher testosterone levels. And the mothers in the study who eventually went off birth control post-wedding reported less sexual contentment than other women; they found their husbands less attractive and less sexually exciting once they went off the pill.

Dr. Craig Roberts of Stirling University questioned more than 2,500 women from around the world for his research. Did their taste in men shift? Or did their birth control have a “love-potion” type of effect?

When a woman uses hormonal birth control containing estrogen, she decreases her levels of available testosterone. And while women have much less testosterone in their systems than men - women’s bodies contain about 10% the amount of testosterone men do - what they do have helps fuel sexual desire, fantasy and the ability to become naturally lubricated in response to arousal.

So it makes sense that when a woman’s testosterone levels are diminished even further by something like the pill, she might be left feeling blasé about sex: hence her potential attraction to a low-testosterone male.

So it may not be as much the issue of going off birth control as it going on it in the first place. Sexual health expert Dr. Madeleine Castellanos cautions women to think carefully about their choice of contraceptive: "Some of these side effects are so serious that I now urge young women to consider just using condoms and leaving the birth control pills behind."

In addition to libido-shifts, some women who go on hormonal birth control experience pain during intercourse due to irritation of the tissues surrounding the opening of the vagina. In many cases, this is because she is unable to become physically aroused. And those who don’t deal with the issue may actually go on to develop vestibulodynia - a chronic and significant pain surrounding the opening of the vagina and the area of the perineum.

But for those who don’t want to give up the pill, there are women who find that triphasic birth control pills (different amounts of hormones every week) have less of an impact on their sex drive than monophasic pills (same amount of hormones each dose). Of course, hormones affect every woman differently, and there’s no guarantee that a triphasic pill will make much of a difference for you.

So it’s important for a woman to do her due diligence and weigh the pros and cons of various birth control options before settling on one. And know that the changes to a woman’s testosterone level (potentially diminished when she goes on, and then increased when she goes off) could alter her libido and create gaps with that of her partner’s.

Dr. Roberts says women who met their partner while taking hormonal birth control should consider switching to another method several months in advance of tying the knot in order to assess whether their feelings for their partner will change or stay the same.

But before you or your partner do anything of the sort, just make sure you have alternative contraception in place - there’s nothing like a sudden unintended pregnancy to put a damper on one’s sex life.

And for those women who do choose to stay on the pill, the study offers a silver lining: the women on the pill were happier overall in their relationships and more likely to stay together than their non-pill-taking counterparts. The benefits of the non-sexual aspects of the relationship outweighed any sexual downsides.

So perhaps it’s better to be evenly matched at the low-testosterone end of the spectrum (with a man who is more likely to be faithful) than potentially mismatched.