Are you choosing TV over sex? This and other culprits that might be killing your libido

Does being on the pill decrease your libido? The question is a source of ongoing debate on the internet and, to some degree, in science. Depending on the study, the type of oral contraception and the person, the answer might be yes or it might be no. 

Anecdotal accounts given by women online reveal widespread concern about the pill's potential negative side effects, including its impact on sex drive. A decrease in the pill's popularity suggests that these stories may be having an impact. Many women I know have chosen to go a different route with their contraception. 

Yet, according to a systematic review of scientific research, only about 15 per cent of women on the pill actually experience a decrease in sexual desire.

"For most people on an estrogen-containing birth control pill, there's very little impact on sex and sexuality," says Dr. Jen Gunter, an obstetrician and gynecologist well known for busting sexual and reproductive health myths. She's the author of The Vagina Bible and the host of CBC Gem's new show Jensplaining. 

Gunter believes that while it may be easier to home in on one easy-to-change cause for a low sex drive, the problem may actually be much more complex. 

"If you're tired, if you're stressed, if you're feeling unwell, if you have a medical condition that's untreated — all of those things are also going to affect not only how your body performs, but maybe how you feel like performing or what energy you have to give to things," says Gunter. 

She cites sleep hygiene, relationship dynamics, communication and societal expectations as other contributing factors.

And while you may not want to consider how all the different aspects of your health and lifestyle are impacting your sex life, research shows that for women in relationships, context has more of an impact on sexual desire than contraception. 

The role of health and medication

The first thing you might consider when there's something out of whack with your sex drive is whether it's an actual health issue.  

Gunter says diabetes (with poorly controlled blood sugar), pelvic disorders, sleep apnea and autoimmune disease are just a few of the conditions that can impact sexual desire. She also says some blood pressure medication and antidepressants can have an impact, while depression or dealing with fertility issues, can affect desire from a psychological perspective.

If you do think birth control, for example, is playing a role in your decreased sex drive, Gunter says to consider whether it's something that's come out of the blue, whether it could be cumulative from birth control or if it could be related to multiple factors. 

Then, she says, consult with a doctor to test whether going off the pill makes a difference for you libido-wise. A physician can help you figure out alternative contraception options and track whether your sex drive actually improves — and it might not be as straightforward as you think. For some women, the potential side effects of a non-hormonal form of birth control, like the copper IUD (think heavier periods and more cramping), might impact their sex drive more than an oral contraceptive ever did. 

"Too often, when women have been asking the questions, doctors poo-poo the risks, and these other forces overemphasize the risks, and then everybody forgets about the benefits," says Gunter, referring to online sources that discount the pill without looking at what the research really shows. 

It's why Gunter encourages women to find a doctor they trust and who is open to discussing all of their options and concerns.

"Only you can weigh your personal risk/benefit ratio … but you can't possibly even decide what your personal risk/benefit ratio is if all the information you have is contaminated."

Live to work or work to live?

It likely comes as no surprise that, beyond medical concerns, things like working too much, spending too much time on social media, and excessive stress or alcohol consumption can cut into the time (and quality) of the sex you're having. 

"If you actually look at how people live their lives, they're not living their lives like sex is the most important thing," says Gunter. "If you're spending four hours binging a show on Netflix ... and then you wonder why you're not having sex, well, there was four hours you could have been having tantric foreplay."

In pointing out the disconnect between how important we claim sex is and our actual behaviour, Gunter likes to reference James Gleick's 1999 book Faster: The Acceleration of Just About Everything, in which the author compares the average amount of time Americans spend having sex per day to filling out government paperwork. Both clock in at roughly four minutes.  

By compartmentalizing your sex drive and sexual health from your other lifestyle choices, you may actually be denying yourself the satisfaction you seek. 

So, if you want to be having more sex, Gunter suggests analyzing how you're spending your time, considering what types of things make you want to have sex and tracking how many of those things you're actually doing. 

Relationship dynamics

"At the beginning of a relationship, we all do things that put sex front and centre," says Gunter. 

When patients come to her with concerns about libido, she'll ask about whether or not they're setting aside time for romance and having fun together — beyond just watching TV. 

"We have this false idea that sex is easy and it should just happen," says Gunter, adding that people often expect that a relationship to always be like it was early on. In reality, things are likely to change when you've been with a partner for a long time.  

"If I'm not spending any time on meal prep, I shouldn't be surprised that I'm not having any homemade food," she says.

Of course, the problem may go beyond not spending adequate quality time together. "It's a lot easier to blame other things than to than to say, 'Well, maybe we're not having sex because I actually don't like you."

Tell them what you want, what you really, really want

Even when we love our partners, we're not always on the same page about sexual desires. 

"We have this myth in our society that every single day everybody's thinking about sex, and they want to have sex three times a day, every day," says Gunter, referring to the way culture can shape our idea of how much sex is "normal." (Studies suggest this number hovers at just over once per week for Canadians between the ages of 46 and 60, as well as Americans 18 and over.) 

The better norm to form, says Gunter, is being honest about what you actually want and enjoy.

"Having open communication with your partner is one of the most important things," she says, though she acknowledges that "it's easier for people to have sex than to talk about sex." 

If communication and low libido are things you struggle with, you may want to check out resources like sexandu.ca or try these strategies for talking to your partner about better sex. 

Sex therapists can also help you figure out when and why your sex drive issues arose and how to address them, says Gunter. One approach they might suggest is mindfulness. In Jensplaining, Gunter addresses some of the myths we've been sold about sex and speaks with Dr. Lori Brotto, a professor of obstetrics and gynecology at The University of British Columbia and a Canada Research Chair in women's sexual health. Grotto's research has shown that mindfulness-based cognitive therapy can help women increase their sexual interest. 

The concept serves as a reminder that in our busy lives, having more sex may require slowing down.

"Most people wish they were having more sex, but a lot of people aren't really willing to put this time and effort into it," says Gunter. "If it matters to you, you have to prioritize it."

Eva Voinigescu is a freelance journalist and producer. She writes about health and science, careers, and culture.