Question 78
Doctor N,
I am 29 years old, no kids or husband, and feel my sex drive is slowly but surely going away. What should I do? I feel tired most days with an accompanying little headache and am always sleepy and fatigued. There are no hot flashes, though! I have tried every multi-vitamin there is, but no help. I recently bought a box of Extroven but, when reading the label, it said not to take if you are taking birth control pills. I have been taking Ortho Novum 7-7-7 for ten years. What are the effects of taking this vitamin while taking birth control? What is my problem? Am I going through the "change"? I just want to feel normal and healthy again.
Sincerely,
Tired
Reply:
I am sorry that you are having this problem. I assume that you have not had a hysterectomy or any other pelvic surgery and you are not taking any anti depressants as you have not said anything about this and both would have affects in this area.
Testosterone is the hormone most closely associated with libido. Oral contraceptives influence the liver to increase its production of sex hormone binding globulin (SHGB) which binds to the testosterone the ovary produces and as there is less "free testosterone" available libido can be affected. In addition, in some women oral contraceptives also may lower the amount of testosterone the ovary produces further complicating the problem.
In any event, oral contraceptives are recognized as being capable of lowering libido. Your options to regain your libido assuming your problem is due to the mechanism above are (1) stop the oral contraceptives and use an alternate method of contraception and see if your libido returns to its previous state, or (2) try adding some testosterone preferably by transdermal gel and see if this of help.
Alternatively, you could try monthly injections of 50 mg of depo testosterone.
I do not think that Estroven will be of any value for you. It is not a vitamin and it is marketed as an alternative to hormone replacement therapy and I do not think it is effective for this either. If the packaging information advises you not to take it with oral contraceptives then I would not do it.
Discuss these issues with your doctor and let me know how you do.
Dr N