Many credit the sexual revolution of the 1960s to countercultural movements like “free love.” Yet a far more concrete catalyst was the advent of reliable hormonal contraception. The pill, introduced in the early 1960s, allowed women to separate sex from procreation. As one commentator put it,
“With the Pill came what we now call the sexual revolution. Women could, for the first time in history, be like men, and enjoy sex for its own sake.” (Goodreads)
Birth control enabled a shift in sexual norms. Freed from the constant fear of unintended pregnancy, women gained agency over their sexuality. The racial, political, and legal battles over access to contraception (e.g. Eisenstadt v. Baird in 1972, which gave unmarried people the right to use contraceptives) also formed the legal framework for the revolution. (Wikipedia)
But as contraception evolved, so did awareness of its potential for effects on sexual function–both good and bad. Many women report libido or arousal changes after starting hormonal contraception — a complex phenomenon rooted in biology, psychology, and method choice.
How Hormonal Methods Can Influence Sexual Function
Estrogen, Androgens, and SHBG
Combined hormonal contraception (pills, patch, ring) typically includes estrogen that increases sex hormone-binding globulin (SHBG) in the liver, which binds free testosterone and reduces its activity. (PMC) Because androgens like testosterone play a key role in arousal and libido, lowering their free form can blunt sexual desire. (MDPI)
The Ring vs. The Patch: A Surprising Study
In a randomized trial, Gracia and colleagues studied first-time users of the contraceptive ring vs. the patch among women who previously used oral contraceptives. (PubMed) After three months:
-
Women switching to the vaginal ring had slight declines in sexual function scores (arousal, lubrication, pain) (mean FSFI score change −0.74). (PubMed)
-
Women switching to the patch saw a small improvement (mean change +0.32). (PubMed)
-
The declines noted with the ring were modest and may not always be clinically significant. (PubMed)
This suggests that the delivery method of estrogen and progestin (vaginal vs transdermal) may influence how the body and sexual system adjust.
Conflicting Evidence & Multifactorial Effects
Other studies paint a more nuanced picture. Hormonal contraceptive use has been associated with sexual side effects — including decreased desire, changes in arousal, or more pain — but results vary by population, formulation, and individual sensitivity. (ScienceDirect) Some formulations with lower estrogen doses or more androgenic progestins may mitigate these effects. (PMC)
Moreover, sexual satisfaction is more than just hormones. Emotional connection, mood, stress, body image, and relationship dynamics also heavily influence libido. (MDPI)
The Takeaway: Method Matters — and So Does Communication
Contraceptive choice doesn’t just affect pregnancy prevention; it can influence your sexual experiences. A method that works well in one dimension might have side effects in another. If you notice diminished desire, lubrication changes, or discomfort, don’t silently suffer — talk with your gynecologist. Adjustments might include:
-
Understanding sexual function, talk to us about what is healthy, ? do you masturbate
-
Know what your hormone levels are doing, including SHBG
-
Considering switching from ring to patch or pill, contraceptive effectiveness will not be affected, they all work!
-
Choosing a lower-dose estrogen or a different progestin
-
Exploring contraceptive methods with less hormonal impact (e.g. IUDs, implants)
-
Considering interventions to support libido (sexual therapy, hormone therapy if indicated)
In the end, just as the sexual revolution was about giving women freedom of choice, modern contraceptive decisions should include choice about sexual satisfaction, not just fertility.
