For Great Sex, IUDs Beat the Pill |
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American women who use contraception prefer the Pill over IUDs.
Studies show the Pill can cause reduced arousal, pelvic or vaginal pain, and less sexual satisfaction.
Individuals who experience sex problems that appear Pill-related might want to consider switching methods.
There are several good reasons why women might prefer the Pill over an IUD, but satisfying sex is not one of them.
Among sexually active women who use contraception, 21 percent take birth control pills, while far fewer—13 percent—rely on intrauterine devices (IUDs). The Pill and IUDs both offer advantages and disadvantages. Women can assess which of the dozen methods is best for them by talking with family planning counselors at Planned Parenthood and other contraception providers.
But those interested in satisfying sex are more likely to enjoy it if they choose an IUD over the Pill. Recently, a rigorous Brazilian study shows that, compared with IUD users, women taking the Pill report reduced arousal (p < 0.05), more sexual pain (p < 0.05), more anxiety and depression (p < 0.03), and less sexual satisfaction (p < 0.05).
Does the Pill Have a Dirty Little Secret?
Some studies show no connection between the Pill and women’s sex problems. But the Brazilian finding is not an outlier. Other studies have corroborated the Pill’s association with a wide array of sex problems:
Polish researchers surveyed 495 women, of whom 237 used the Pill, with the rest relying on other methods. Among users of methods other than the Pill, 14 percent reported sex problems. Among Pill users, the proportion was considerably higher, 22 percent.
Women’s health specialists from around the U.S. reviewed the research linking the Pill to sexual side effects. Their conclusion: Birth control pills “have a negative effect on sexual arousal, lubrication, and orgasm, and appear to be associated with vaginal pain during sex. Sexual side effects are a strong predictor of oral contraceptive discontinuation.” In other words, Pill-related sex problems are a major reason why women stop using birth control pills.
Why Would Birth Control Pills Cause Sex Problems?
Birth control pills contain one or two female sex hormones, estrogen and/or progestin. The monthly hormonal changes of the menstrual cycle alter many women’s moods and how they experience sex. It’s reasonable to believe that the hormone(s) in the Pill might do the same.
Compared with 30 years ago, today’s birth control pills contain lower doses of hormones. But even at low doses, available research shows that Pill might still cause sex problems. Pill-related sex problems typically begin a few weeks to a few months after starting them.
Assess your situation. Do you think you’re having more sexual issues since you started taking birth control pills? Top sexual side effects include: reduced arousal, reduced vaginal self-lubrication, pelvic or vaginal pain, and less sexual satisfaction. In addition, many Pill users report increased anxiety and depression that might also interfere with sex.
Consult the physician who prescribed you the Pill. Discuss your experience. Ask what the clinician knows about Pill-related sex problems. You might bring along a copy of this post.
Consider switching to another method. You might switch temporarily to see if you enjoy sex more using another method. If so, you can consider making the change permanent. The Brazilian study shows that IUDs are less likely than the Pill to cause sex problems. In addition, diaphragms, condoms, and ovulation-detection approaches are unlikely to cause sex problems.
Involve your partner. If your partner is a woman, she'll probably sympathize with your situation. But if you're with a man, he might not. Ask him to read this post. The two of you might try condoms. If he thinks they reduce pleasure, ask him to read my previous post about condoms.
The Fundamentals of Sex
Take our Sexual Satisfaction Test
Find a sex therapist near me
The Guttmacher Institute. May 2021. "Fact Sheet: Contraceptive Use in the United States by Method."
Casey, PM et al. “Impact of Contraception on Female Sexual Function,” Journal of Women’s Health (Larchmt) (2017) 26:207. doi: 10.1089/jwh.2015.5703.
Dea, CA et al. “Sexual Function, Quality of Life, Anxiety, and Depression in Women of Reproductive Age Using Hormonal, Nonhormonal, and No Contraceptive Methods,” Journal of Sexual Medicine (2024) 21:683. doi: 10.1093/jsxmed/qdae060.
Krapf, JH and A Goldstein. “Combined Estrogen-Progestin Oral Contraceptives and Female Sexuality: An Updated Review,” Sexual Medicine Review (2024) 12:307. doi: 10.1093/sxmrev/qeae011.
Nowosielski, K. “Do Oral Combined Contraceptive Pills Modify Body Image and Sexual Function?” Reproductive Biology and Endocrinology (2022) 20:94. doi: 10.1186/s12958-022-00968-5.
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