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contraceptives and sexual function | Image Courtesy of Reproductive Health Supplies Coalition via Unsplash
Contraceptives & Sexual Function | Image Courtesy of Reproductive Health Supplies Coalition via Unsplash

Contraceptives and Sexual Function Considered

As pelvic floor physical therapists, we work with a lot of women who have some type of female sexual dysfunction, whether it may be pain with initial penetration, pain with deep thrusting/deep penetration, pain with orgasms, or decreased sexual arousal, desire, libido. Unfortunately, about 30-50% of women may suffer from these symptoms.

We often see women with sexual impairments have the following conditions/scenarios:

  • Postpartum (regardless of delivery)
  • Vaginismus (involuntary spasms of the pelvic floor muscles)
  • Post-menopausal
  • Vulvodynia
  • Skin inflammatory conditions such as lichen sclerosus

As you can imagine, any of these conditions listed above, or just experiencing pain with any type of sexual activity can be debilitating and impair our quality of life. To quote,

Female sexual dysfunction is associated with physiological, psychological, social, interpersonal, medical and cultural factors,”

(Gȕrbȕz, et al 2020). 

Common Types of Contraceptives

Lately, there has been more research linking the relationship between contraceptive use and possibly increased sexual dysfunction. But before we dive into sexual dysfunction topics, let’s go over common contraceptive types.

There are hormonal contraceptives (oral contraceptives, Mirena, etonogestrel implant, ring, “Depo” injections) and non-hormonal contraceptives (such as copper IUD, silver IUD).

Based on the research, hormonal contraceptives have a higher risk of negative sexual functioning compared to non-hormonal methods. This is likely due to ovarian suppression, decreased estrogen, increased androgen metabolism that results in increased SHBG levels which then leads to decreased free testosterone and androgen levels. Due to the hormonal changes in the tissue, this can lead to other conditions that increase the risk of sexual dysfunction and pelvic pain. 

Conditions Associated With Oral Contraceptives and Sexual Function

A systematic review (Champaneria, 2016) found articles that discovered:Oral Contraceptives & Sexual Function | Image Courtesy of Reproductive Health Supplies Coalition via Unsplash

  • Those with dyspareunia (pain with sexual intercourse) has a positive association with either current or past use of oral contraceptives
  • Significantly increased risk of vulvar vestibulitis in women currently on oral contraceptives (as you can imagine, can affect our sexual function!)
  • Significant relationship between interstitial cystitis/painful bladder syndrome and oral contraceptive use (we also know that women with painful bladder syndrome often experience pain with sex as well)

Libido, Sexual Desire, Lubrication & Pain

One study compared the test scores of The Female Sexual Function Index (FSFI) among different groups of those who took contraceptives and those who did not. The FSFI asks questions on sexual desire, arousal, lubrication, orgasms, overall sexual satisfaction/partner satisfaction, and vaginal penetration.

The authors of the study found that those who were taking contraceptives were significantly more likely to report pain, decreased desire, and issues with lubrication. However, they did not find a significant difference between groups on the arousal, orgasm and satisfaction topics. Among the groups, those using condoms showed the most positive scores of female sexual functioning on most topics. 

One qualitative study involved having deeper conversations with women who believe they have negative effects specifically from hormonal contraceptives. Many women who ceased hormonal contraceptives for whatever reason (forgot to get a new prescription filled, postpartum, etc.) noticed a drastic difference in sexual functioning when they stopped taking it.

A common complaint among these women was significantly decreased desire. This inspired some women to either stop contraceptives altogether or find alternate non-hormonal contraceptives. Some women spoke up about how arousal and lubrication had decreased dramatically when on contraceptives and noticed a vast improvement as soon as they stopped the contraceptive method. Women who had menstrual dysfunction, irregular bleeding, or excessive bleeding also noticed decreased arousal but felt it was worth it for the stability of their cycle and other painful symptoms.  


Contraceptive use can affect our sexual functioning in areas of libido, sexual desire, lubrication, and pain. In addition, there are some pelvic conditions that are associated with oral contraceptives such as vulvar vestibulitis and painful bladder syndrome. There are pros and cons to any type of medication, including birth control options. Someone with menstrual pain, irregular periods or excessive bleeding, or feeling that her moods are not stabilized, may find that contraceptives outweigh the risks of the sexual side effects.

It is crucial that you find a gynecologist that you trust, and someone you can speak freely about your overall concerns, values to find the best option for you! Regardless of contraceptive use, if you are having any symptoms of painful sex, painful orgasm, vulvar pain, we can help! Contact us here.

Contraceptives & Sexual Function | Image Courtesy of Reproductive Health Supplies Coalition via Unsplash


Champaneria R, D’Andrea RM, Latthe PM. Hormonal contraception and pelvic floor function: a systematic review. Int Urogynecol J 2016;27:709-722.

Gȕrbȕz T, Gȕngör ND, Okcu NT& Yurci, A. Effects of contraception methods on female sexual function and quality of life.J Surg Med 2020;4(12):1231-1235. 

Malmborg A, Brynte L, Falk G et al. Sexual function changes attributed to hormonal contraception use-qualitative study of women experiencing negative effects. 

Moreira, et al. Sexual function and metabolic/hormonal changes in women using long-term hormonal and non-hormonal contraceptives: a pilot study. BMC Women’s Health 2020;20:240. 

More Great Products We Love

Damiva Mae | Vaginal Moisturizer

Who gets vaginal dryness?

Women can have vaginal dryness for a variety of reasons and at any age. Dryness is most common after menopause due to the loss of hormones such as estrogen and progesterone.

Vaginal dryness occurs due to hormonal changes after menstruation, pregnancy, breast feeding, peri-menopause and menopause. It can also occur as a side-effect of taking certain medications, such as birth control, acne meds, antidepressants, antihistamines and fertility treatments.

  • Mae is a 100% natural, body-friendly vaginal suppository used to moisturize the vagina from the inside.
  • Mae is made for women experiencing vaginal dryness and designed for long-term usage.
  • Each package of Mae comes with 10 individually wrapped suppositories.

Is Mae natural?

Mae's all-natural formulation contains no water or alcohol, both of which dehydrate the delicate mucous membrane of the vagina over time. Instead, Mae contains emollient plant butters for silky lubrication. As Mae has no water, there is no need to add harmful chemical preservatives. Mae has a shelf-life of 5 years based on extensive laboratory studies.

damiva mae cleo

Is Mae safe to use with condoms?

Mae is not safe with latex condoms. Non-latex condoms are available at your local drugstore.

How long do I need to use Mae?

Mae takes a few weeks for most women to obtain results. However Mae’s all natural composition makes it suitable for long-term use.

Is Mae tested on animals?

No. Mae is vegan and cruelty-free certified by Leaping Bunny and PETA.

Does Mae have any preservatives?

No, Mae does not have any chemical preservatives.

We named our heroine product Mae because of all the Maes who inspire us such as Mae Jameson and Mae West. We especially love Mae West’s cheeky humor! Did you know that she was arrested for writing a Broadway play, Sex, in 1927? We salute all the Maes in our lives.

Click here and use code FEMINAPT to get 10% off your own supply of Mae and start enjoying sex again!

What Our Patients Have to Say


Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

Testimonial by Jackie W.

I was in multiple car accidents a decade ago, and I have been to many physical therapists through the years without success. They found the root of my lower back pain problems and after nearly a decade of barely being able to walk I finally can again without pain. They are also the best pelvic floor pts and the only ones who found the connection between my pelvic floor and lower back problems. If you need help with physical pain, they are your answer.

-- Jackie W., 1/19/17 via Yelp!

Testimonial by M.M.

My husband and I were married for 5 years and unable to have intercourse, but I never knew why. After numerous awful experiences at doctor’s offices (where many doctors told me I “just needed to relax”), a surgery that didn’t fix the problem, and a year of owning dilators that didn’t get me anywhere, someone finally referred me to Heather for Physical Therapy. I finally had answers and information from someone who knew exactly what I was dealing with!

Read more: Testimonial by M.M.

Testimonial by T.C.

While pregnant with my twins, Heather took care with keeping me on my feet and pain free. She saved my back, my sanity and the holidays! I would recommend her to every “mom” looking to stay on her feet during pregnancy and post-partum.

-- T.C.

Testimonial by T.C.

While pregnant with my twins, Heather took care with keeping me on my feet and pain free. She saved my back, my sanity and the holidays! I would recommend her to every “mom” looking to stay on her feet during pregnancy and post-partum.

-- T.C.

Testimonial by A.W., age 32

I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

-- A.W., age 32
(completed Post-partum Renewal Program using the InTone biofeedback/stim unit)

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