I am 22 and I have been taking birth control pills (Tri-Levlen 28) for four years. Is it possible that the pill can affect a women's sex drive? I do not get as excited or even want sex as often as I did a few years ago. I am starting to feel that there is something wrong.

--Tavia

Birth control pills can decrease sex drive. Most of the time, however, there are many other factors that contribute to a lower sex drive -- stress, poor body image, financial worries, relationship difficulties. Life in the 90s is difficult, and at 22 I imagine you are just graduating from college and about to really be out on your own for the first time; such changes are stressful, and sex drive is one of the first things to succumb to stress.

Of all the types of birth control pills, however, triphasic pills, like the Tri-Levlen you are on, have a lesser impact on sex drive. In fact, in one recent study of college women, triphasic pills were associated with an increased sex drive!

As this is bothering you, I'd suggest you see your doctor. Medical conditions like thyroid disease or depression can lower sex drive. Conditions like infections or endometriosis that cause sex to be uncomfortable can, obviously, make you not want to have sex. Also examine your relationships and life in general for clues. If nothing else is found, you might consider a change of pill or using another form of contraception.