I was a freshman in college when I began taking birth control pills. At the start, the prescription was just for treating acne, but when I lost my virginity not too long afterward, it took on a new purpose.
This was a year of intense experiences—my first serious relationship, many all-nighters spent writing papers and studying for tests, extracurricular activities, all of the partying, losing my religion (not the song), my first time living away from home for an extended period of time, etc.
So when I sensed an uptick in my obsessive thinking, I couldn’t say for sure whether the new little bundle of hormones I was swallowing daily at noon had anything to do with it.
For many women, however, the connection between hormonal contraception and side effects is clear. When the changes are only taking place in your mind, pinpointing their cause can be a slippery affair, and depending on how subtle these changes are, they can be easier to shrug off. It’s much more difficult to ignore migraines, periods that last for weeks, and life-threatening blood clots.
Undoubtedly, birth control pills and other hormonal contraceptives—such as injections, skin patches, transdermal gels, vaginal rings, intrauterine systems, and implantable rods—have provided women with something invaluable: safe, effective means for managing their reproductive health. But for many women, these forms of contraception have come at a price.
The Side Effects We Experience Vs. the Side Effects Our Doctors Warn Us About
If you’re a woman who uses hormonal contraception—or even if you aren’t—you’re probably familiar with the disconnect between what doctors tell women about the potential for side effects and what you’ve heard from other women or experienced yourself.
It’s likely for this reason that a Danish study published last year citing a correlation between hormonal contraceptives and depression has received so much attention. It’s a comfort to many women to learn that scientific findings are beginning to corroborate their sense that introducing artificial hormones into their bodies changes them in some troubling ways.
Unwavering faith in the absolute harmlessness of hormonal birth control options is probably not helped by their shady past, either. As Broadly reported last year in “The Racist and Sexist History of Keeping Birth Control Side Effects Secret,” the pill’s trial run involved covert or coerced testing on poor, uneducated Puerto Rican women; on female medical students who were threatened with expulsion if they didn’t comply with the study; and on women locked up in mental institutions.
(Apparently, the same folks who’d tested a pill containing 10 times the amount of hormones needed to prevent pregnancy on the Puerto Rican women had originally looked into hormonal birth control for men, but the symptoms—like shrinking testicles—were considered to be too much of an impingement on their quality of life.)
Of course, any responsible discussion of hormonal birth control must also discuss the profound ways it has helped people. According to health services researcher Aaron E. Carroll, over the past decade, the American public has seen record lows in teenage pregnancies and abortion, a shift Carroll says most researchers attribute largely to the increased availability of contraception.
Carroll points out in The New York Times that the Danish study linking hormonal birth control and depression, though expansive, has its holes. But even with the holes, it’s a move in the right direction—toward demanding more complete information about something that affects a great number of women.
As National Women’s Health Network executive director Cindy Pearson tells Broadly, “This information shouldn’t be hidden from women for the fear that they will make a wrong decision down the line. Trust women to make good decisions when they have good information.”
For the sake of good information, here are the stories I got after reaching asking women I knew about their own experiences with side effects from hormonal contraceptives.
“I was going sh*t crazy.”
“I was on hormonal birth control since I was about 16/17?? I got off of it when I was 29. That’s almost ten years. Before I moved to Spain I was always on a low contraceptive. I was sh*t about taking them so some days I would miss and double up or even triple up…shame on me. Then I moved to Spain about six years ago. You can get birth control over the counter, no prescription and no consultation with a doctor.
“I started taking this, it was ok, but had some side effects. I can’t remember the name but no sex drive, dry down there, patchy dry skin. I switched birth control a few years later, still horrible at taking it but realized how it was [affecting me]. I normally don’t notice these things with my body but I was literally going…sh*t crazy, so depressed and same symptoms as before.
“I finally made the switch to a non hormonal copper IUD. It was realllly painful but worth it. My periods are heavier and I have cramps (before because of the hormones my periods were light and never cramps). I feel a lot better mentally, not dry… More of a sex drive, no weight gain. I don’t like the idea of having something inside of me but I’ll take it over hormones.” —Julie
“I have to suffer for the rest of my life because I did this.”
“The Essure permanent birth control I do not recommend. I have to suffer for the rest of my life because I did this. The only way I can fix this is paying $7500 for the [inserts] to be removed… I have a swollen cervix, the [nickel] that the [inserts] are made from I’m allergic to.
“I turn 30 in September and I’m having [symptoms] of menopause because of the birth control… My insurance will only cover a hysterectomy.” —Christina
“I was completely panicked.”
“I’ve been on and off pills since I was 15, but about 3 years ago I went on them again after a few years off. I’ve had migraines since i was 12, so I didn’t think much of it when I started having relatively frequent headaches. I also developed vulvodynia, which is basically painful sex. I had no idea that birth control pills could cause this, so I was completely panicked over it.
“My doctor never mentioned it either, so I was prescribed multiple creams, antidepressants, and even physical therapy, all for my broken vagina. When I finally went off the pills, mostly because I just felt moody all the time, my symptoms immediately went away. No more migraines, and sex was no longer painful.
“I also got the implant for a month but had migraines literally every day and was so insanely moody and honestly mean to everyone that I had it taken out. I didn’t even recognize myself. So, now I am hormone free and much happier.” —Rachel
“You cry from all the guilt.”
“In order of peskiest side effect:
3. Short temper
“Even on a low dosage of the pill I spot like the whole week about the 2nd or 3rd week in but my periods have been way light (about 2 days). I kind of hate it all. Also, I have more zits on low dose than I did on regular. But I don’t feel so insane. It’s sort of like knowing that your filter is down but you get angry and impatient regardless. And then you cry from all the guilt the next day!” —Amy
“I started having three-week-long periods.”
“6 weeks after having [my second child] I started birth control again and from the first pack, I was having two-week-long periods. Then I started having three-week-long periods. Obviously this was super annoying and inconvenient, affecting my sex life, etc. My doctor is about 45 minutes away and the thought of schlepping two kids two and under all the way out there and dealing with them during the appt was just overwhelming.
“Finally [my husband] pretty much forced me to go in case something was horribly wrong. I switched birth control because my doctor thought I just needed different hormone levels and he couldn’t find anything wrong internally (after an ultrasound). Anyway, this is my second month on the new pills and I’m still having two-week-long periods and don’t know when I’m going to find the time to go back.
“Luckily, my doctor is super chill and he told me to text him if the problem continued but it’s just super annoying to be dealing with this plus still adjusting to two kids and dealing with normal life stresses. Not to mention the fact that the BC I’m on now is the same I had been on for over 5 years before having [my first child], and I literally never had any issues, so I’m worried this is just my life now.” —Brittney
“I was having dreams of committing suicide.”
“My gynecologist recommended I get the Mirena IUD because I’d had debilitating cramps for years. The first day of each period, I would sweat profusely, tremble, become dizzy, and sometimes pass out. Twice I fainted on public transportation on the way to my office. The cramps were so insufferable that I sometimes had to take the day or morning off work because I couldn’t do anything except lie in bed with a heating pad.
“My gynecologist thought the IUD would be a great option because, over time, it eliminates most period symptoms entirely. Although I had terrible cramps the first six weeks after I had the IUD implanted, a month of oral birth control on top of the IUD solved that problem, and thereafter my periods pretty quickly lessened in length and pain.
“Six months after I had the IUD put in, I had almost no period at all, and I hadn’t experienced cramps or dizziness for the past four months. I noticed that I had started to feel anxious on a fairly regular basis, but I called my gynecologist and she said it was unlikely the IUD caused the anxiety because it was localized to my uterine lining (versus other birth control that diffused throughout the bloodstream).
“The anxiety continued, however, and after eight months with the IUD, it was so bad that I made an appointment with my gynecologist. I did not want my terrible periods to return, and additionally, I had noticed a significant increase in my sexual drive since implanting the IUD, which I didn’t want to lose. When my gynecologist again said it was unlikely the IUD was what was causing the uptick in anxiety, I didn’t press the issue further; I began searching for a therapist instead.
“I’d had the IUD for almost a year when one night I experienced a sudden, jabbing pain on one side of my lower abdomen. I thought it might be my appendix bursting. The next day I saw my gynecologist, who ran an intravaginal scan thinking I may have had a cyst burst. In fact, the pain had come from my body trying to expel the IUD. It was now no longer properly in place and had to be removed immediately.
“Two weeks after remov[al of] the IUD, my anxiety almost completely disappeared. So marked were the changes that my boyfriend commented that it was as if I was a different person. I asked my gynecologist if the IUD could have been causing the heightened anxiety. She told me again it was unlikely, but each woman reacts differently to each form and formula of birth control, so it was possible.
“I don’t blame her for my experience. She gave me her professional opinion based on what should have occurred, to the best of her knowledge. It’s also widely stated in the materials about birth control and IUDs in particular that every woman is different and there’s no way to know for sure what each woman’s experience will be.
“After three months of no birth control, I decided to try the NuvaRing. I hadn’t been having painful periods, but I was nervous they’d soon return. I tried to give the NuvaRing three months so that my body could get used to it, but after two months, I was having dreams of committing suicide, so I removed it. Given the urgency of the situation, I was glad that I could remove it myself and not have to make an appointment.
“I had the option to try hormonal birth control, which I had used in high school and college without issues, but I was so nervous about the potential side effects that I chose not to. Perhaps my body has changed significantly since that time. I’d rather use nothing than risk another period of extreme anxiety or suicidal thoughts.
“I am a firm believer in the positive benefits of birth control for pregnancy prevention and period regulation. Some of my friends have also used it to clear their skin. In fact, I know many more women who have had no issues whatsoever with birth control than I know women who have had problems from using it.
“The challenging thing is that it’s impossible to know ahead of taking birth control what your experience is going to be like. I wouldn’t go back on it, but I also wouldn’t discourage other women from trying it. What I would advise is that anyone who experiences upsetting or alarming emotions stop using the birth control at the first signs of a problem. I wouldn’t wait around to see if your emotions even out. There’s no sense in putting yourself through distress that could be avoided.” —Elizabeth
Some quotes have been edited.