Q: I've been taking an oral contraceptive for about a year, and I think it's destroyed my sex drive. Help! What other options are out there?
A: As wonderful as the Pill is -- it's more than 99 percent effective when taken correctly, curbs or eliminates PMS, and reduces the risk of ovarian cancer -- it can lower your libido. The same hormones in birth-control pills that prevent pregnancy (estrogen and progestin) also reduce testosterone production, and testosterone is one of your body's surefire ingredients for a mind-blowingly good time. And the Pill's hormones increase production of SHBG, the sex hormone-binding globulin, which, in turn, can reduce circulating levels of testosterone even more. All this can lead to fizzle instead of sizzle in the bedroom for some (but not all) women. Happily, there are solutions, short of becoming celibate. Here are four options -- talk to your doctor to see if any of them might be right for you.
1. NuvaRing. This small, flexible prescription contraceptive ring contains slow-release hormones that are more likely to keep your testosterone levels normal. You insert the plastic ring into your vagina in front of the cervix. Leave it in place for three weeks, remove it, have a period, then insert a new one.
2. Hormone-free IUD. Your doctor inserts this T-shaped IUD, or intrauterine device, into your uterus, where it blocks sperm from reaching the fallopian tubes. It's effective for up to ten years, and because there are no hormones involved, you can breastfeed. The downside: Some women develop heavier periods and anemia.
3. Mirena IUD. This IUD releases a low dose of progestin to thin the uterine lining. The progestin is low enough that it doesn't spike testosterone-dampening SHBG, but it's a high enough dose to minimize menstrual bleeding. In fact, up to 20 percent of women using Mirena will cease to have menstrual periods.
4. Essure. A soft, flexible insert made of metal and fiber, Essure is a noninvasive alternative to tubal ligation and vasectomy. Your doctor inserts the device into your fallopian tubes through the vagina and uterus. It works with your body over the course of three months to create a natural barrier (aka scar tissue) that prevents the egg and sperm from meeting (it doesn't affect your menstrual cycle). The procedure is not reversible, however, so you need to be sure you don't want more children.
Plus: Read more about birth control in Parenting.com's health guide.