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On February 17, 2010, in Hormones, MEDICAL FACTS, by Dr. Tuchinsky

The question many women ask themselves is whether taking oral contraceptives for a number of years can alter their bodies and affect their wellbeing  In many ways, oral contraceptives are one of the best inventions that medical science gave to a modern  woman.  Not only they prevent pregnancy and make sex more enjoyable, but they even provide many health benefits from improving acne to decreasing risk of ovarian cancer. However, nothing is perfect and the list of their side effects unfortunately is just as long.

Can your birth pill make you tired?  There are quite a few risks to increased estrogen and progesterone, blood clots being the most ominous one, but in this post I want to focus on one important aspect of their influence on the body that only recently has become recognized and the one that is directly linked to fatigue. If you are taking birth control pills and feel tired, non-motivated and less interested in sex than you used to be, you might be experiencing a lack of testosterone.

Testosterone is not just a male hormone. Historically, testosterone was considered a purely male hormone, and it was thought that bringing down its level in women could only mean a good thing (since testosterone is responsible for hairy legs and acne). However, the research in the last decade helped us understand that testosterone plays just as important role in women’s well being. Even in small amount it affects such important attributes as energy, drive, motivation, ambition, athleticism and sexual libido.

What happens to your hormones when you take birth control? Oral contraceptives decrease testosterone production by ovaries via hypothalamic-pituitary axis suppression. However, probably even more significant is that over period of time, oral contraceptives induce production of a special protein (called serum hormone binding protein or SHBG) that binds testosterone and inactivates it.. Recent studies proved that women who take birth control have significantly increased levels of SHBG and decreased levels of free testosterone. This is actually the basis behind using birth control as treatment for acne (testosterone is implicated in causing acne, particularly during puberty)

Tip: if you want to have your testosterone level checked, make sure you ask for free testosterone and not total. Also, be aware that many physicians are still reluctant to order testosterone in women and many labs only have reference range of males, as there is still some controversy about what the optimal female levels are.

Is it reversible?  It appears that the answer to this burning question is “no” but there is some controversy as to how long it might take for the hormone levels to return to normal, and in some people a mild degree of change may be permanent.

Not all birth control has been created equal.  Some women appear to tolerate this birth control effect better than others, and it probably has to do with the initial level of testosterone you have, and how many sensitive is your body to testosterone effects (genetically predetermined). Some pills are less anti-androgenic (meaning anti-testosterone) than others. One of the recently synthesized progesterone analogs called drospirenone (which is contained in popular contraceptives Yasmin and Yaz) is particularly vicious in robbing your body of testosterone effects. While these drugs may be a good choice for women with excess of testosterone, they can be really detrimental to those with normal or already low levels. Also, typically younger women tolerate birth control better than women in the 30s because testosterone naturally begins to decline at this age.

What to do next? In short, if you are taking birth control pills (whether you started them just recently or have been on them for years), they might be linked to your chronic fatigue.  On other hand it is just one of many possible explanations. Do not jump to conclusions without talking to your physician first or rush to take yourself off your birth control without having a good alternative plan of contraception- after all pregnancy can make you much more tired than you are now! Sometimes switching to a different brand may be enough. Here is a link to the androgenic strength of different contraceptives (remember the least anti-androgenic will leave you with more testosterone).

IMPORTANT: Read my recent post on DHEA for some eye opening information related to female hormones!


  1. […] higher than women. I have already touched on testosterone deficiency in women in the post about birth control, and  now I would like to focus on testosterone deficiency in men. On one hand testosterone is […]

  2. tamara says:

    tell me how the pill is benaficial it has completely ruined my life.ever since i took it i have had cronic fatigue dizzieness blury vision heavieness in the arms and legs and foggy vision whats so great about i havent been able to work for 2 years i want answers

  3. Brooke says:

    Can’t agree with you more. The pill really has messed me up, and my doctor never though of it as the cause of my chronic fatigue, “lactose intolerance”, mood swings and constant hungriness, therefore suggesting I had chronic fatigue syndrome and there was nothing I could do. Missing 2 days a week from school, I was unsatisfied and began researching, Only till months later it hit me that it might be the pill. I took a month off, and I felt like am entirely different person.

  4. Brittany says:

    I just started taking yaz birth control and i am hungery all the time and also just want to lay on the couch..NO ENERGY at all….This is how I felt when i was pregnant….this is a recipe for gaining weight which i am not intrested in at all… is the very last day i take this crazy pill!!

  5. Jessica says:

    To Brittany’s post…..I myself have been struggling with chronic fatigue, no motivation, have completely lost my sex drive, which really sucks and it wasn’t till reading this forum that it dawned on me it’s probably my birth control. My husband and i aren’t ready for another baby right now so that’s why I’m determined on taking BC, but I am completely not the person I used to be. I’m a mother of two and that naturally will wear you out amongst work, and kids sports, and home responsibilities, but not like this. Your post is older, so if you’ve discovered any fixes yet or tried something different that’s working, please let me know. And anybody else’s input would be great too.

    Thank you!!! Very tired Wife and Mother

  6. nicole says:

    So glad I found this! Thought I was crazy when I have been feeling less motivated and exausted.
    My Dr put me on avaine aka aleese oral conceptive to regulate my cycle which is on and off for the longest. I started the pill the begining of Dec this year and my cycle came the 20th and still going….(grr) so despite the 3 months my Dr recommends to regulate I would stay loyal to it however I hate taking pills at a 13 I started having migraines every day. They subsided at 17 however learned to hate taking pills unless I’m near death (no offense to anyone). After this 28 day pack is finished I am DONE. If I still am irregular I will call my Dr after the holidays and get an appointment.

  7. Jennifer says:

    I’ve been taking Ortho Tri-Cyclen Lo for 3 months, finally called it quits 10 days ago as I finished the pack. This pill has been nothing but a nightmare! I’m tired ALL the time, even after 8-9 hours of sleep. No energy throughout the day, I’m walking around in the haze, in complete zombie mode. Not to mention I have no motivation to do anything, all I wanna do is lay around and sleep. Sex drive is completely gone. I’m also experiencing dry eyes. Ugh! It has been 10 days, and I haven’t notice any difference, I really hope this won’t last forever because it is definitely causing me to be depressed almost everyday. This really blows!!! I wish I knew this was a bad choice in the beginning, guess I had to learn it the hard way. *sigh*

    Anyone out there knows how long it will take for this nightmare to end? Please share! I am slowly going insane. :(

  8. MI-MI says:


  9. Savanna says:

    I’m on Lutera I’ve never had any issues with my sex drive but I do feel less modivated then usual

  10. Cresia says:

    I started seasonique two weeks ago and I am so tired! I haven’t felt like this since I was pregnant! I have two children and I need my energy, wo b12, I am too tired to function. I’m thinking of trying depo. For some reason my doc suggested it. She stated some weight gain may be associated with deposit so I declined. But now I would rather have the weight gain than the
    M constant fatigue.

  11. Admin says:

    Cresia, I’m sorry to hear how tired you are. I can imagine what it’s like when you have two kids to take care of. Make sure you get plenty of good quality sleep and get yourself checked out for any medical problems. But if birth control is really the issue, then it’s certainly worth going with a different kind. Good luck and hope you feel better!

  12. Nicole says:

    Jennifer- Ive been on ortho tri-cyclen for a long time and was so tired, irregular periods and terrible cramps. I just got Mirena put in and so far I love it! I’m not tired and donot lay around in bed all day! I reccomend you look into getting it.

  13. Tracey says:

    I have been on the pill (Minerva) for almost 9 years now, and I only recently realized that I have been taking a headache tablet almost daily, since I have been on my pill. I feel constantly tired, and have more than enough sleep and eat really well. I have heavy periods and lots of pain around this time, and have also noticed some hair loss, mood swings as well as a loss of sex drive. Is it good to change pills over time, or go completely off of it. I often feel lazy and demotivated because of my lack of energy from tiredness. How can I overcome this?

  14. Irina says:

    Tracy, you should probably first of all to get some lab work done to make sure there is no other explanation for your symptoms (such as anemia or thyroid problems). If everything is normal and you do feel that your problems are related to the pill, then its best to stop for a few months and use alternative protection, and see if your symptoms get better. Stopping completely will also give a chance for your SBHG levels to return to normal faster. Once you’re back to normal, you can discuss with your MD a different brand – maybe lower dose of hormones, etc.

  15. Karen says:

    I just started my nuva ring on an off again..i get sick taking pills but lately i been noticing im tired a lot, no energy what so everr, gain weight an hungry for no reason at all..i feel like im preggo an hate the feeling, when im not.oh the headaches too. I feel like i change into a person im not. I feel depressed campare to 3months ago. Now it all makes alot sense. Ieven went an brought erengy pills

  16. Shirly says:


    I went off the pill a year ago due to low libido, pigmentation, and bloating. (I didnt know the pill was the cause of this, I just assumed and took a chance) I noticed the following things since being off the pill (yazmin):

    Loss of appetite
    Loss of weight (but excessive)
    Massive amounts of energy!
    Increased sex drive
    Healthy digestive system
    No period
    Chest & back acne
    Loss of hair
    Skin greyness

    This took 4 months to reach its peak.

    I lost too much weight but in all honesty I liked it, and maybe took it too far with excersizing so got way too skinny. I ate SOOOO much, more than I ever did. In fact, I never watched what I ate even though I lost my appetite. I no longer had food on my brain 24/7. I didnt get my period which was a HUGE concern so my Gynae put me back on the pill – YAZ to protect my uturus. It took 4 months for the side effects to get into full swing.

    I have since:

    Picked up 4 kilo’s and counting
    Hungry all the time
    Suffer from constipation
    Heavy legs
    No sex drive
    Chronic Fatigue
    No motivation!
    Healthy hair
    Glowing skin

    I have taken the time to research the side effects of the pill, using myself as a guinny pig. Its quite a thing us woman do to our bodies to prevent us from concieving. There are too many pro’s and cons.

  17. Kacey says:

    Just wondering if you can provide any peer-reviewed journal article research to support this? I feel like I’m banging my head against a wall trying to show my doctors why I’m not going back on the pill and why I stopped it to help with my fatigue.

  18. Dr. Tuchinsky says:

    Kacey, here are some links for the articles about birth control. Why would your doctors force you to be on the pill? Sounds like it should be your personal decision…

  19. EB says:

    wow ! stopped taking the pill and I am woman reborn. I feel better all around- I am more efficient at work, I am certainly not nearly as emotional. Why do we do this to ourselves??????

  20. Anonymous says:

    Its been hardly 7 days on the pill and already im forever tired and want to sleep all the time.

  21. kaylyn Shaw says:

    I’m tired by the time I get hone now I take naps . Like I hardly been on it for three days and I’ve been like this .any thoughts why?

  22. Quinn says:

    This is exactly the opposite for me. Have just stopped the pill and am feeling far more tired. I was on various brands mostly to control my hormones (PCOS problem)for about 20 years. At 50 it was recommended I stop the pill (the last type being Yaz). Seems my body needed the pill as opposed to others, and I am also scared that this will mean scalp hairloss and other vile PCOS symptoms. There are hardly any remedies except for perhaps HRT but since I only stopped taking Yaz 2 weeks ago, the dreaded effects may still take a while.

  23. Lesli says:

    I’ve been on bc for about seven months and the only reason I take it is cause I get cysts and it worked for a little while but then I got another cyst again so they had to up it. Now I feel so tired that it’s messing with my epilepsy. I’ve been hungry, Moody among other things.Honestly I would rather have cysts than feel like this I’m so tired I am fighting to type this cause I’m so tired. This is my first week on the upped ugh I didn’t feel this way on my last one, so I don’t know what to do. Smh

  24. Mariana says:

    Ive been on bc for about a week. It makes me sooooo tired, not sleepy, but tired. I just want to lay down and not move at all because I feel I have no energy in my body. I also feel hunger all the time. It makes me nauseous in the mornings.Ugh, I really didn’t think it would affect me this much.

  25. josephine says:

    hi. my gyne also put me on hormone pill becoz of irregular menstruation. but after started the pill i feel like that im the laziest person ever. always wanting to sleep and always feel tired. i also had mild muscle. pains on my legs, sneezing all the time and always feeling hungry, some mild headaches and abdominal crampings on and off. sometimes i think that im pregnant. but after reading these comments i know its my pill that has something to do.

  26. Jen says:

    I feel very moody and lethargic on the pill.

    Has anyone successfully used the diaphragm instead to prevent fertilization? There is a new one called the caya.

  27. Holly says:

    Could progesterone only oral contraceptives cause the extreme tiredness? Northindrone, I believe?

  28. Maribel says:

    I just started my bc pills 4 days ago and I’m super tired, lazy, no motivation, hungry all the time. Before taking bc I had tons of energy!!!

  29. Sharmz says:

    Wow. I’ve been going a bit crazy taking Yasmin. I took one pill more than 12 hours late so started the second pack without a break as instructed. As a result I haven’t fad a period as the second pack hasn’t finished but . I have nausea and am really tired all the time just like in early pregnancy, I was so worried I did two tests and luckily they were negative. I already have 3 children hence why on the pill, but after this pack I’m not continuing because I always need a nap and can’t be bothered to do anything which is having a negative impact on my kids. Damn you Yasmin!

  30. Macy says:

    I recently started back taking Azurette and it has me very moody, I’m always tired,I keep having crazy dreams, and sex drive has disappeared. Hopefully all of this will go away

  31. Meagan says:

    I’ve been on birth control for over 2 months now. I feel like my body has no energy…even lifting up my arms seems like a lot of work. I just want my energy and happiness back. These pills have changed me.. my body no longer feels like my body. I want to stop but if I do than what?? I’m 18 and I don’t want to get pregnant
    I feel trapped. But I think im going to finish this pack and be done… it’s a really hard decision. Is there a better way? Please please let me know if you know something better.

  32. valerie mcgriff says:

    Was on depo bc shot. Had very heavy bleeding & huge blood clotting. Changed my bc to pills & I’m always tired! Taking a nap everyday is not me at all. Today I took my last pill! I hope to feel better soon.

  33. valerie says:

    Can anyone suggest anything for heavy periods without taking birth control?

  34. amber lennon says:

    From age 18-26, I was on Ortho tri cyclen. Then, I went off the pill for nearly 10 years. 2 kids later, I wanted to go back on the pill to help regulate my period. I went back on Ortho tri cyclen because I never had a problem before.
    NOW, I have dizziness, vertigo, fogginess, blurred eyesight, anxiety, my arms and legs feel heavy and weak. I feel like I need a nap every day even if I slept a full 8 hours. It’s hard to concentrate and sometimes it’s hard to speak well…even typing this is taking a lot of concentration.
    I am done. I will take 8 days of heavy bleeding over this any day.

    I’m glad I found this forum. It makes me feel a little less insane.

  35. Courtney says:

    I started taking elinest two weeks ago. Since I have been taking all I do is sleep on and off all day. Haven’t had 8 hour straight sleep in two weeks. My body feels weak.

  36. Irina says:

    I highly recommend salivary testing for all sex hormones (testosterone, DHEA, estradiol, progesterone). You can order these tests online on your own if your doctor doesn’t know about them. However, these tests are expensive, and if you can’t afford them, you can still do the blood test, which is not as reliable but it’s better than nothing. Every time we mess with our hormones, we can create a major shift in our body.

  37. Tara says:

    I’m so glad I’m not the only one who feels like this, I’m 20 years old and started taking the pill 18 months ago when I started seeing my boyfriend. I’m now on my 4th pill (yasmin) as the previous 3 didn’t agree with me… I’ve been on it 4 months now and didn’t feel that bad, but then the week I had as a break between pack 3 and 4 I was on antibiotics for a skin infection, and antibiotics block the hormones as I was warned by the nurse to be careful, and I felt great, I had energy, I lost weight, went to the gym, was happy. It’s now been two weeks into the 4th pack and I’m constantly tired,.I’m moody, the weights creeping back on despite healthy eating and all I want to do is sleep.
    I.have a nurses appointment next week as last time I had a high blood pressure, May just consider coming of the pill completely, my boyfriend and I always use condoms as well, and I’m fed up of feeling like this… Any advice?

  38. Emily says:

    I have been on the pill for years, cilest for my skin and birth control, then Yasmin short while before my baby and most recently microlite. I got blood test which told me thyroid is normal and all else well. I’m functioning but during the day I’m tired in stages and at its worst completely slumped, I decided to come off the pill over a week ago, my question is if anyone could answer does it take long for your body to loose the effect of tiredness which I really feel is linked to the pill. I did have a c section but that was 20 months ago. I also got allergy test done two weeks ago which covered a lot intolerance to casein and eat more greens. Wish there was more medically available to explain that yes pill makes you tired

  39. Dr. Tuchinsky says:

    Emily, if your tiredness is due to lowered testosterone due to increased serum binding globulin level, then it may take as long as six month for the symptoms to resolve. Meanwhile, you may consider getting your natural hormone levels tested and if there is a defiiciney than maybe replacing them with biodientical hormones can make you feel better.

  40. I'jose says:

    I thought I was alone in this, ever since I inserted my IUD, I have never been the same. The fatigue is so severe I feel am not going to make it to the next day. I have numbness on the right side of my body, sometimes I feel something is wrong with my eyes, all the pregnancy symptoms I had when I had my kids are all coming back. My doctor said there is nothing wrong with me but I know I have a lot going on inside my body. I’m scared to get the IUD out because I don’t want to get pregnant again, This is really insane.

  41. Em says:

    Hello everyone i thought im alone but good thing i found this site, please help me! Im 30yrs old mother of 2 girls, Been on orth-tri-cyclen lo for 7yrs. Then March 2015 stopped since i realized i gained 25lbs weight after the baby and the pills,but since im scared to get pregnant… and May 2015,i went back again and started Yasmin, i thought everything was fine, i finished 1 pack ( i lost 2 lbs)? and almost done with second pack ( i gained 2 lbs again )it just happend 2 weeks ago i started having ” shortness of breath” pimples break out, lost weight and gained again and every 5pm i started feeling sleepy and yes like sleepy that cant be controlled, and im always feeling tired, all i want to do is just sleep! I dont know if this is sign of pregnancy? Or yasmin is not for me? Please help me

  42. Rachel says:

    I just started taking the pill and have been feeling sicks, extremely tired, slow. I am currently at work and i just want to sleep! I have 2 babies and right now we just can’t do baby #3 so i have to deal with it, but it is ridiculous to feel the way i do. I don’t want to walk, nothing, all i want to do is sleep. Also, since i started i feel bloated and i have been getting air in my tummy! Lawd, this is horrible!!

  43. Becca says:

    Bc pills can block absorption of vitamins and minerals especially b vitamins which are the happy energy vitamins. Not all bc pills lower your sex drive. Try a version of Mircette for example. The hormones in this do nit effect testosterone levels. I take Azurette and have no side effects other than some fatigue. I just purchased some quality b12 drops to fix that.

  44. Becca says:

    Different hormones do different things. I have endometriosis so I take low dose pills with little estrogen and the progestin called deconogestrel because for me it works and makes me feel good most of the time. Do some research and also talk to your doctors. Everyone is different and what is great for one person might be bad for the other.

  45. rogue says:

    I’ve been struggling with this for years and only realized recently that the pill is the cause. I ran out of the pill had some trouble with getting a refill before getting in the see my doctor. I went without for almost 5 days but I felt like a different person. the exhausted me was gone, I’d been feeling like this for so long that it was almost normal even though I knew it wasn’t but I didn’t know why til this happened. When I told my gyno about the pills causing my fatigue she basically made me feel like I was crazy. told me that she’d never heard of such a thing and that maybe I was suffering from depression. Now I know there are tons of women like me who’ve experienced the same. I’m just trying to figure out what to do since I have endometriosis and this is how they treat that. I’ve been on the low dose miracett for yrs and even that causes fatigue. My doc, I don’t think, is gonna be much help to me because she acts like it’s a wonder pill and cures everthing and does not believe that it is the source of my problems. now I’m trying to decide if I want to be in excuitating pain for almost 2 weeks out of the month and not be able to do my job (might be do-able if I didn’t have to work to survive) or do I want to be a zombie for the rest of my life and continue to gain more and more weight (ive put on 60lbs since this all started 5 years ago).

  46. Keisha says:

    Hey all… I just started taking the pills this is my 4th day and im on Tri-Previtem since i started taking them i been always tired falling asleep even at school and i take it at 8pm every night never miss one yet but also been nauseous and not eating a lot very tired get home and around 4 i fall asleep and feel very weak cant get up even if someone tries waking me up… Ill be waking up by myself at almost 7 with my eyes hurting and burning because im still tired ill take the pill at 8 get a good sleep (8 hours plus) but still tired in the morning and i feel really down and not motivated for nothing if anyone thinks i should stop or switch it please let me know it will help is my first time taking them thanks I’ll appreciate it God bless💖

  47. Dr. Tuchinsky says:

    Keisha, it usually takes about a week for the hormones to adjust. If you are not feeling better by then it probably means that this isn’t the right pill for you. Talk to your doctor about changing to a different one that has different strength of estrogen and progesterone or consider using a different method of birth control.

  48. Tee says:

    I have been taking orthocyclen for seven months for hormonal acne. It has helped some and I am scared to stop because my acne symptoms ca be very severe. I am a very athletic person. I eat extremely healthy; however, I am hungry all of the time, I have gained weight, and most of all I am extremely fatigued. I did not know why until I decided to research and see if the bc pills could be the cause. I can not continue with this fatigue. My energy is so depleted that I have trouble working out which is something I love. I am absolutely tired at work and I feel like I need a nap everyday. The headaches are terrible. What would be a better treatment for hormonal cystic acne other than these bc pills that are making me crazy? Please help.

  49. Dr. Tuchinsky says:

    Trootoolife, cystic acne can be also be treated with a low dose oral antibiotic such as minocycline. There is also Accutane but it would require non-hormonal contraception because it is highly teratogenic (may cause genetic defects in a fetus). You should also make sure the fatigue is not due to some other cause, such as anemia, vitamin deficiency or low thyroid.

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