Can oral contraceptives cause sexual dysfunction?
The birth control pill is one of the simplest and most readily available forms of contraception. Used by more than 10 million women in the US, oral contraceptives are used to prevent pregnancy, stabilize unpredictable cycles, and even to aid in the treatment of acne. However, research indicates that the birth control pill can have numerous negative effects on our health. Long associated with problems such as blot clots and risk of breast cancer, newer studies suggest that it could also affect our sex hormone binding globulin (SHBG) levels.
What is SHBG?
You’re probably wondering what on earth SHBG might be, and you certainly wouldn’t be alone in asking the question. Sex hormone binding globulin is the protein that binds the testosterone women produce rendering it less available. When estrogen is being added to the body via the oral contraceptive pill, it increases the amount of SHBG produced. When bound to SHBG, sex hormones become inactive and are no longer biologically available.
When more SHBG is present, less ‘free’ testosterone is available for our bodies to use. Testosterone is important in women for bone density, fat distribution, sexual desire and arousal, energy levels, and mood regulation. As we have discussed in previous blogs, testosterone (or any other hormone) imbalance can have damaging effects on the female body.
Research has shown that even after patients have stopped taking the contraceptive pill, elevated SHBG levels did not appear to decrease to the levels seen in women who have never taken it. As a result of the prolonged elevation in SHBG levels, users of the birth control pill could find themselves at risk of various long-standing health problems, with sexual dysfunction at the top of the list.
What is sexual dysfunction?
You may now be wondering what might constitute sexual dysfunction. This isn’t about having the odd day when you don’t feel like having sex; it relates to persistent and recurrent problems with libido, sexual response, orgasm, and sadly, in many cases, pain. This can be distressing for both sexual partners and may have an emotional impact as well as a physical one.
A report entitled, ‘Impact of Oral Contraceptives on Sex Hormone Binding Globulin and Androgen Levels: A Retrospective Study in Women with Sexual Dysfunction’, published in The Journal of Sexual Medicine, concluded that SHBG values were four times higher for pill users than for those who had never taken it. And while SHBG values dropped when the use of the contraceptive pill was stopped, it did not subsequently fall to match the level recorded in ‘never-users’.
One of the authors of this report, Dr. Claudia Panzer, said that: “It is important for physicians prescribing oral contraceptives to point out to their patient’s potential sexual side effects, such as decreased desire, arousal, decreased lubrication and increased sexual pain. Also in women present with these complaints, it is crucial to recognize the link between sexual dysfunction and the oral contraceptive and not to attribute these complaints solely to psychological causes.”
Fellow author, Dr. Andre Guay, said that: “For years we have known that a subset of women using oral contraceptive agents suffer from decreased sex drive.”
How can I redress the balance?
If you’re currently taking oral contraceptives, it’s wise to keep going with them until you have consulted your primary care practitioner. However, if you have experienced any form of sexual dysfunction, mood swings, or weight gain, it is certainly worth finding out if these symptoms are related to your contraceptive pill. Having your SHBG levels tested is wise as this will allow you to measure levels in your blood which can be beneficial in diagnosing various conditions that may be affecting you. There are various other forms of birth control if you’re experiencing adverse effects, and your integrative medicine provider will be able to advise you on how to address any hormone imbalance you may be experiencing.