Can the pill affect orgasms?

Dear Curious, 

For many people assigned female at birth, achieving the sought-after pelvic pyrotechnics associated with an orgasm is difficult  from time to time regardless of whether they take the birth control pill. The ability to reach orgasm is complex and is impacted by a multitude of mental, emotional, and physical factors. One of these factors may include the birth control pill, also referred to as an oral contraceptive (OC). Just as OC methods vary, so do individual experiences with them, as you’ve seen with your friends. For some, the hormones in OCs that are used to prevent pregnancy can also influence sex drive, lubrication, and ability to orgasm. Given that there could be many variables at play, it might be good to do a bit of self-exploration to learn more about how get the motor going. If that doesn't kickstart the way to climax, it could be helpful to talk with a health care provider about potential causes and the best treatment options to help reach the “Big O.”

So, what impacts someone’s ability to experience an orgasm? Orgasms result from a combination of physical and psychological triggers. If you have a safety lock on either one of those for any reason, an orgasm may not be as easy to achieve. Some of these factors include any type of abuse, traumatic experience, depression, anxiety, stress from a partner, and certain medications. It doesn’t help that trouble reaching orgasm can cause emotional stress, which in turn can affect one’s ability to achieve an orgasm. All that said, trouble experiencing orgasms is actually quite common. Nearly one third of people that identify as women between ages 18 to 49 report problems with sexual arousal, pleasure, and orgasm. When the trouble to achieve an orgasm is ongoing, it may be what’s called female sexual dysfunction (FSD). The good news is that there are treatment options ranging from cognitive behavioral techniques (methods to relax and reduce anxiety) to stimulating creams and medication adjustments (more on that in a bit). Again, a health care provider can provide guidance about which treatment option would work best for each person.

Back to your original question about the effects of birth control pills on orgasms. There are many types of birth control that vary in how you take it, such as orally via a pill, and differ in whether or not they contain hormones. Birth control pills with hormones may contain the hormone progestin only (these are known as minipills) or a combination of the hormones estrogen and progestin (known as combination pills). Hormone dosage may vary based on the brand and on what a health care provider prescribes. You might be wondering, why do birth control pills contain hormones anyhow? In short, the hormones in both types of OCs trick the body into thinking it’s pregnant so that it doesn't release an egg. When taken correctly, this leaves no egg to be fertilized, hence, no possibility for pregnancy. However, because sexual urges, responses, and emotions for all people are strongly correlated with the levels of hormones in the body, some may experience sexual side effects. In one study, half of the participants were taking OCs and the other using a non-hormonal method, those taking OCs reported less arousal, decreased lubrication, and fewer orgasms. However, research studies haven’t definitively shown a relationship between OC use and the ability to orgasm.

With all of this in mind, what can you do if you’re having trouble? 

• Try experimenting with yourself. Learn what lights your fire by giving masturbation a go. Getting to know yourself better may also help you communicate what you need to a partner.  
• Be your own sexual advocate. If climax remains elusive, a health care provider may be able to help you navigate various treatment options. If they don't ask about your sexual health, you may want to bring it up during your visit. After completing an evaluation, the health care provider may recommend that you try a different type of OC or may refer you to other specialists, such as a psychologist or sex therapist. 
• Change the focus. While orgasm can be an enjoyable experience, it doesn’t need to be the sole focus of sex. It could be an opportunity to spend time on sexual activities that aren’t focused on orgasm and learn other ways to enjoy the body sexually.  

While many folks assigned female at birth have trouble easily climaxing at times, all isn’t lost. Hopefully, with practice, experimentation, and the help of health care professionals, anyone experiencing difficulty will master reaching the "Big O" instead of a "Big Uh-Oh." Good luck!