More than just hormones — it touches intimacy, communication, emotional connection, and long-term dreams.

When couples talk about birth control, they usually focus on practicalities (avoiding pregnancy) or physical side effects (weight gain, headaches, libido shifts). But in marriage counseling, I see something deeper:

Birth control doesn’t just affect your body —
it affects the relationship dynamic, your connection, your sexual rhythm, and your shared vision for the future.

Understanding this can help couples reduce resentment and make healthier, more conscious decisions together.

1. Hormonal Changes Can Affect Libido and Emotional Connection

This is one of the most searched-for concerns online.

Many women report changes after starting hormonal birth control, including:

• lower libido

• less sensitivity or desire

• mood swings or irritability

• feeling “flat” or disconnected

• reduced emotional engagement

For men, this often feels confusing or personal:

“She’s not interested in me anymore — did I do something wrong?”

When in reality, it may be physiological, not relational.

Why this matters:
Sexual intimacy is often a barometer of the emotional climate in the marriage. If libido changes dramatically, couples may misinterpret it as rejection, disinterest, or relationship problems — when it’s really biology.

What helps:
Open dialogue, reassurance, and exploring non-hormonal methods together can prevent unnecessary emotional distance.

2. Birth Control Can Change How Safe or Connected Sex Feels

Many couples report:

• less spontaneity

• feeling pressured about frequency

• anxiety about “what if the method fails”

• resentment if one partner is carrying all the responsibility

When one spouse feels more “invested” in preventing pregnancy, the other may feel disengaged or overly dependent on the other’s efforts.

Couples function best when they’re collaborating, not relying on one partner to shoulder the entire burden.

3. Disagreements About Having Kids Can Strain the Marriage

This is by far the biggest relationship issue tied to birth control — even more than physical side effects.

Common conflicts include:

• One partner wants another baby; the other doesn’t

• One spouse feels “done,” while the other feels “not yet”

• Fear of pregnancy after a traumatic birth

• Timing disagreements: “Not now” vs. “Why keep waiting?”

• One spouse secretly stops or continues birth control

These issues touch core emotional needs:

• security

• identity

• lifestyle

• financial stress

• fear of losing freedom

• fear of regret later

Without structured, safe conversations, couples end up avoiding the topic — which builds resentment and fear.

4. Birth Control Can Create Power Struggles

When one person controls the contraception, the other may feel:

• powerless

• unheard

• pressured

• anxious

• resentful

This is NOT about blame — it’s about shared decision-making.

If birth control becomes a battleground, it’s usually a sign that communication—not commitment—is the real issue.

5. Past Trauma or Fertility Anxiety Can Surface

For some:

• a previous miscarriage

• financial instability

• postpartum depression

• complicated pregnancies

• infertility struggles

…can make conversations about birth control emotionally loaded.

Partners often assume the other is “overreacting,” when in reality, they’re reacting from pain.

This is where structured processes (like Imago dialogue or the 5-step method) help couples speak and listen with empathy rather than fear.

6. When Birth Control Impacts Intimacy, It’s Not a Sign Your Relationship Is Failing

This is the reassurance most couples are searching for.

Changes in desire, attraction, or emotional closeness can feel terrifying, but they often have a simple explanation:

• hormones

• physiology

• anxiety

• fear of another baby

• communication breakdown

Addressing birth control together can often improve your relationship dramatically.

What Couples Can Do (From a Marriage Counselor’s Perspective)

✔ Create safety for honest conversations

Use “I feel…” and “What I’m needing is…” instead of blame.

✔ Discuss ALL family-planning decisions as a team

No secret choices. No pressure. Real transparency.

✔ If libido or mood changes are drastic, consider exploring other methods

A non-hormonal option may dramatically shift the emotional tone.

✔ Get support if conversations feel stuck

A structured approach (like Imago) helps you understand one another without triggering defensiveness.

FAQ: What People Search Before Coming Into Therapy

1. Can birth control ruin a relationship?

The misunderstandings that arise can cause resentment. Healthy communication prevents this.

2. Can birth control change who you’re attracted to?

Some research suggests hormonal changes may affect attraction cues. It doesn’t mean you chose the wrong partner — it just means hormones influence perception.

3. Why has my libido changed since starting birth control?

Hormones can affect desire. It’s not your fault, and it’s not your spouse’s fault.

4. What if we disagree about having another child?

This is a relational issue, not a birth-control issue. A structured dialogue process can help you hear each other clearly.

5. Should couples make birth-control decisions together?

Absolutely. Shared decision-making builds trust, safety, and intimacy.

Sources

1. Sanders, S., et al. (2018). Effects of hormonal contraceptives on sexual desire. Journal of Sexual Medicine.
2. American College of Obstetricians and Gynecologists (ACOG). Birth Control FAQ.
3. Imago Relationships International. Communication and emotional safety in intimate partnerships.
4. Contraceptive Technology, 21st ed. Impact of family planning on couple dynamics.
5. Planned Parenthood Research Papers. Contraception and emotional wellbeing.