Can contraceptive alter the course of your life?

Dr Sarah E. Hill thinks so.

Before we get into it, here’s a 20% discount on paid subscriptions for a whole year.

Less than $1 per piece of writing. Alright, let’s get into it.

When I was at the beginning of grade ten, fifteen years old, I was prescribed the contraceptive pill by my doctor. YAZ, her name was (yes, they give many of the pills different female names). At the time I was experiencing heavy periods ranging from seven to ten days long. I had become anaemic due to the excessive bleeding.

I wouldn’t have sex for the first time for another five years. I was not taking birth control for it’s titled purpose, I was taking a contraceptive daily to manage the intensity and length of my period. Nothing else was explored.

Six months later, I found myself crying every single day. My mood swings were debilitating. I was calling in sick to work, crying at school and I gained ten kilos and two breast cup sizes in the first sixty days. At the time, it was easy to attribute these shifts to pubescent bodily changes, pressure and stress I put on myself at school. I was a straight-A student who worked a minimum of fifteen hours per week. When I broke down and sobbed in the driveway one day at the end of year ten, I told my mum I needed to see a psychologist because I was having dark thoughts. She said no.

“You need to go off the pill first.”

At the time, I remember thinking she was a mental health denier, not really looking to help me. Looking back now, I’m so glad this was the first thing we decided to do.

Within weeks, I was my happy self again. I wanted to go to school again. I liked my time at work. I wanted to do everything that I thought was breaking me.

For the next three years I continued to suffer through my periods and retained my mental health. Panadol and night time pads all day were preferable to the self-harming cycle my mind had been playing on loop.

Fast forward to the end of my first year of university, I went to the doctor on campus to ask what contraceptives I could go on. I still hadn’t made my sexual debut, but I wanted to. I firmly believed I needed a plan.

“Let’s just prescribe a different pill. It’ll help with the pimples anyway.”

I hadn’t mentioned my skin. I had just asked for information. Suddenly there was a script in my hand and an open door leading me out. Estelle was the next pill of choice.

“Wait three months to see if the side effects level out.”

Great. Wade through at least three months of bad mental health to see if it goes away, levels out, wanes, eases, feels normal enough that you no longer believe yourself and your ability to identify what’s wrong, etc.

I spent the next five years on this pill. I have no idea how it impacted my relationship with my partner, the sex we did and didn’t have and the emotional and stress responses I had to incredibly traumatic work I undertook while in the legal profession. At the end of my three year relationship, when I was 23, with a dead sex drive and nothing to lose, I moved to the Implanon bar.

Photo by Reproductive Health Supplies Coalition on Unsplash

The pill works by attempting to imitate the second half of a menstrual cycle, where progesterone is dominant. The core ingredient of the pill is artificial progesterone (called progestin) which shuts down the signals that develop an egg. This means that we also don’t produce oestrogen while on the pill, which is the core hormone of the first half of our cycle (the one that makes us feel HORNY, HOT and ENERGISED). While we do have a synthetic form of oestrogen in our pill - there’s still a distinct gap.

The Implanon, contrastingly, is a thin rod that is inserted into your upper arm. It works by releasing a slow, steady dose of progestin (that synthetic version of progesterone) into the body over three years. This prevents the release of an egg and thickens the mucus in the cervix which stops sperm from reaching the egg if it happened to bypass the first barrier.

To me, only one hormone coursing through my body sounded better. I didn’t understand much about contraceptives, but I knew it was also the most effective, at 99.7% baby-proof. Plus I didn’t have to set an alarm to remember to take my egg eliminator. For the first six months of the implanon - I didn’t bleed. For the next 18 months, I got my period in a one week on, one week off roster like a FIFO worker on a terrible contract with their own uterus. At the end of last month, I had my doctor take it out of my arm after being denied the first three times I asked (they put me on the pill at the same time as bar to ‘shock my body’ into remembering it had the bar inserted - great! double hormones!!!! It didn’t work at all and I cried all the time for the last year!!!).

I feel I’ve been through a birth control war. I don’t know who I am without these chemicals. The day after the Implanon was removed, I put myself straight back on the pill. As I felt the onset of sore boobs, intense hunger, mood swings and a previously high libido that I can now only describe as shot dead on sight, I started to question my own sanity. Am I making this all up? Am I being a baby? Am I complaining excessively about the invention that changed the lives of women everywhere?

Last week, I again picked up my slow-reading of Dr Sarah E. Hill’s book, Your Brain on Birth Control: How the Pill Changes Everything. As of this week, I stopped taking it. I don’t know what I am going to do next, but I know it’s not this.

Despite my clear bias, let me say that I don’t think the pill is evil and I do think contraceptive is vital. Choice is freedom, and the pill gave simplicity and power to women. I have many friends who love it, who find it to be a mood stabiliser and not a detriment to their health. The pill is a powerful tool of choice, and in a post-Roe world where people who can become pregnant have less reproductive freedoms than in decades past, birth control is a powerful tool. It is a feminist weapon we must fight to protect and must deploy when needed. My concern is not the existence of the pill, but our lack of knowledge around it.

I have learnt more from 100 pages of this book (which you can buy here - I know it’s Amazon but I haven’t found it anywhere in Australia) than I have in my 25 years of existence. This book is not about changing your mind, but making informed choices about your own body. Information is power.

One of the more fascinating elements of Dr Hill’s book is the way the pill impacts our choice of mate. In an interview with The Guardian when asked about this data, she said:

“Oestrogen is known to nudge women’s preferences when it comes to their romantic partners to favour qualities that are associated with masculinity and higher testosterone: square-cut jaws, broad shoulders and brow ridges, for example. But research suggests pill-taking women – in their state of artificial progesterone dominance and lacking a cyclical oestrogen urge – seem to prefer the faces of men who are less masculine. The implication is that if a woman chooses her partner when she’s on the pill and then goes off it – it might lead to relationship dissatisfaction because she no longer finds herself as attracted to the person. It is a possibility that women should at least keep in mind.”

There is an entire chapter dedicated to this phenomenon, and the different traits and characteristics that become prominent in pill-taking versus non-pill taking women. One study reported a pattern that women who chose their partners while on the pill were significantly less likely to divorce than women who chose their partners when they were off this contraceptive. The reason for this contradiction? Women on the pill were more inclined to choose partners based on financial stability and intelligence, as opposed to blatant sexual attraction. While the data isn’t conclusive, it is mind-boggling that these patterns in studies have emerged (and that we don’t widely hear about them!!).

The pill also impacts our stress response, this is another pillar of Dr Hill’s text. Research shows us that the typical human stress response is a release of the hormone we know as cortisol (anyone else triggered by that word because Tik Tok won’t stop spreading misinformation around it?). Well, data suggests that pill-taking women have a diminished or completely absent cortisol response. What happens as a result of this muted hormonal function? It impacts our ability to process negative emotion. Women who take the pill indicate the same stress response as those diagnosed with Post Traumatic Stress Disorder, according to Dr Hill:

“For almost three decades now, researchers have been documenting that women on the birth control lack the cortisol response to stress. Pill-taking women exhibit higher than average levels of total cortisol, high levels of corticosteroid binding globulins (CBGs), and dysregulated responses to exogenously administered cortisol. 

This is significant because these patterns are typically only observed when the body becomes so overwhelmed with cortisol signaling that it has no choice but to shut the signal down altogether. For example, this type of pattern is often observed in children who have been abused or abandoned and those with a joint diagnosis of PTSD and major depressive disorder.

We should all be alarmed by the fact that the stress hormone profiles of women who are on the birth control pill look more like those belonging to trauma victims than they do like those belonging to otherwise healthy young women.”

For myself and many of my friends, and millions of girls around the world who were prescribed the contraceptive pill before we were sexually active, research indicates that contraceptive use during puberty and adolescence resulted in a blunted stress response and changes to the brain structure related specifically to memory and emotional processing. When we talk about mood-related mental illness in women using oral contraceptive, this may just be the tip of the iceberg. A study in Denmark found that pill-taking women were more likely to be prescribed use of antidepressants and a first diagnosis of depression than non-pill taking women. The rates were higher among young people - girls aged 15-19 had almost double the suicide risk than that of non-pill taking adolescents.

This week’s piece may sound like one big ad for this book, and I’d say it sort of is. But more than this, it’s a promotion to actually consider how your birth control may be impacting you and whether you’ve been blaming yourself. I’ve been a professional gaslighter of my own mental health for a long time now, and it’s been through understanding my hormones, my cycle and myself by extension that I now want to shift my approach.

It may be my own echo chamber, but it feels like Generation Z is overwhelmingly in agreement: the current contraceptive landscape isn’t working. We are talking about it more than ever, looking at non-hormonal options in higher rates and believing ourselves when we say something is wrong. Our mum’s and sisters paved the way. We are no longer willing to put something into our bodies that we don’t understand the consequences of. We want to prevent pregnancy, but we also want options and to not be expected to live with pain.

In a post-Covid world where young people are having less sex than previous generations (article coming on this soon), more purposeful intimacy and advocating for better control of our health and our bodies - are we breaking up with the pill?

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Please leave your contraceptive experiences in the comments if you feel comfortable. I am a firm believer that a robust comments section can truly MAKE a piece of writing. Go for gold.

To end on a higher note, incase you missed it on my personal Instagram stories, HIGHLY recommend the Stardust app for everyone looking for a privacy first, women founded menstrual tracking app. It has witchy vibes and incredible mood, behaviour, stress and discharge logging options. It logs the moon and sends you hilarious notifications every day. They should give me equity in the business due to my excessive marketing of them. I also noted this morning that if you connect with 7 friends on the app it gives you a year of premium for free #HACK.

Anyways, this was a free piece for everyone this week but most of my weekly pieces are paid. If you got something out of this - there’s a special offer $10 off for a year ($40 - which is 20% off and equates to less than $1 per opinion piece).

Click here to access it.

Have a great week queens,

H.