Sex Points by Dr. Bat Sheva Marcus

Author:Dr. Bat Sheva Marcus [SHEVA MARCUS, DR. BAT]
Language: eng
Format: epub, pdf
Publisher: Hachette Books
Published: 2021-03-09T00:00:00+00:00

Hormonal Birth Control

Whether you are using Depo-Provera, patches, or pills, hormones in birth control are systemic—which means that they are intended to affect your hormones throughout your body. Hormonal birth control methods are incredibly effective and often women find they can connect more to their sex drive once they are no longer worried about getting pregnant. But many women also experience negative effects that hinder their sex drive. Many patients tell me, “I feel like I have a slipcover on my body.”

Here’s how the hormones in your body usually work: As your period and the bleeding ends, FSH (follicle-stimulating hormone) and LH (luteinizing hormone) rise, signaling that the oocyte (egg) is ready to be ejected from the ovary. Meanwhile, estradiol, one form of estrogen, is starting to climb as well. A few days later, FSH and LH spike, and this triggers the release of a mature oocyte. Levels of progesterone and estrogen rise for the next two weeks and signal the body to prepare the uterine lining for implantation of an embryo. If no implantation occurs, both estrogen and progesterone levels drop sharply, triggering your next period. If fertilization and implantation do occur, your estrogen and progesterone stay high, in the best of cases, throughout pregnancy, suppressing the spikes of FSH and LH that drive ovulation.

So now, think about it. If you wanted to stop the rise of FSH and LH to stop an egg from being ejected into a fallopian tube and from there into your uterus, you would raise the progesterone and estrogen and that should do the trick. That’s exactly what birth control pills do. They come in many formulations, some with more progesterone and some with more estrogen, but in every case, they are intended to raise progesterone and estrogen to stop the spikes of FSH and LH. That’s why some people say that the pill is “tricking the body into thinking it’s pregnant.” That’s not entirely true, but it is true enough. The bleeding that happens because you have discontinued the progesterone and estrogen, looks like a period, but it is not really a period because you have actually interrupted the regular ebb and flow of your hormones. Basically, when you are on the pill you are mimicking being pregnant for three weeks and then you have one week of not being pregnant and you bleed as a result.

Now, why are birth control pills problematic for your sex drive? Many forms of hormonal birth control have a secondary effect of lowering your production of natural estrogen as well as testosterone, both of which you really do need to have a sex drive. And to add to the puzzle, most of them also raise your SHBG (sex hormone–binding globulin). As mentioned earlier, SHBGs are proteins in your bloodstream that attach themselves to any testosterone floating around and make them nonusable in your body. So if you have a limited amount of testosterone but a high level of SHBG, your body is not going to have any testosterone to use.

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