What Women Want and Need to Know About Hormonal Birth Control

Did your doctor explain the potential side effects when you started taking the pill? I recently attended a showing of The Business of Birth Control, a documentary following the history and business of oral contraceptives in light of the feminist movement that changed women’s health forever. In the film, parents, women, and healthcare professionals all expressed concern over the lack of informed consent regarding hormonal birth control. What does this mean?


A lot of women, like myself, began a sometimes decade-long journey of birth control for a slew of reasons, from painful periods to “promiscuity”. Many share a similar confession from this journey: I wish I would’ve known how birth control would end up affecting my life.


Today, more women fulfill leadership roles in the healthcare industry, and an increasing number of women are practicing medicine (59% of OB GYNs are now female). More than ever, there is a nuanced discussion of the results of the supposedly innocent— and possibly even glorified— birth control pill. Here are some key takeaways from this growing discussion.



Every Woman’s Right to Her Sexual Health

First, let me make it clear: The concern isn’t birth control itself. Every woman deserves access to sexual health options that work for her, which very well may include the pill. What we must address is the lack of informed consent women are receiving when it comes to hormonal contraceptives given to women so readily, and the consequences of leaving young women unaware of other birth control options today.


In this article, we’ll explore informed consent, plus:


  • Pros, cons, and side effects of the pill

  • Non-hormonal birth control options

  • The importance of women’s sexual and fertility wellness choices today


Browse more Fempower Health resources on birth control, fertility, and hormones.


Birth Control Side Effects

Birth control started with a turbulent history, where women living in poverty were included in the pill’s clinical trials without being made aware of potential side effects. Today, its side effects are still under-discussed, and many experts in the industry agree we need to change this.


Whether you have personal experience or simply know a woman on birth control, here are some of the side effects.


Migraines

The pill and other forms of hormonal birth control that release estrogen can sometimes cause migraine headaches, or make them worse in people with chronic migraines.


Acne

Some women experience acne with the hormonal changes of birth control pills. Conversely, some women start taking birth control as a form of acne treatment. For example, Yaz (a birth control brand commonly known for severe side effects) was originally acne and PMS treatment. Different types of birth control affect women in different ways.


Emotional Side Effects

It’s normal for women to experience emotional cycles through their menstrual phases. During our fertile phase and ovulation, it’s normal for women to feel more energized, social, and sexually excited. Several days before a period, we may feel lethargic, moody, and solitary. Why? Different hormones rise and fall through each phase.


When taking hormonal birth control, many women notice a “blunted” cycle. Some experience uncontrollable emotions:


  • Weepiness

  • Depression

  • Anger/rage

  • Anxiety

  • Compulsive behavior


Informing women about the potential emotional side effects of birth control can allow them to observe any major changes in their mood. If mood swings or negative emotions affect a woman’s life, birth control might not be her preferred option.


Sexual Side Effects

As much as hormones affect mood, they can also affect sex drive and attraction. The libido can change upon taking hormonal birth control. Some women notice a dramatic decrease or increase in sexual desire. This can also interrupt one’s lifestyle, especially in romantic relationships.


Changes in Partner Preferences

Because birth control changes a woman’s natural hormones throughout her cycle, her pheromones, arousal levels, and even preferences in intimate partners become altered. Yep, it’s real: women sometimes grow unattracted to their partners. This phenomenon has been demonstrated and is being further explored.


There are countless reports of women who entered relationships while they were taking birth control and then found they became uninterested in their partners upon coming off of it. Additionally, the opposite scenario can also happen.


Menstrual Side Effects

Sometimes, a woman comes off of birth control once she wants to try to conceive. Some women struggle to get back to their normal cycle months after stopping the pill. Generally, about 80% of women take three months to return to the normal menstrual cycle, and many can conceive within one year of quitting birth control.


Some worry that infertility is a result of prolonged birth control use. But other links have been found to play a bigger role. For example, if a woman was on birth control for many years and then has difficulty conceiving, it may be due to common infertility factors like age, genetics, or underlying conditions.


Medical Risks

There is varying information on an increased risk of medical conditions from the ongoing use of synthetic estrogen and/or progesterone.


These include:


  • Blood clots

  • Heart attack

  • Cancer (breast, liver, or cervical)

  • Stroke or death (rare cases)


These concerning side effects are a risk to women who have pre-existing conditions. Combination pills (estrogen and progestin) can increase the risk of blood clots, so some women are prescribed minipills (just progestin).


Take charge of your reproductive health and become an expert on your cycle with some of the resources on our Menstrual Cycle page.


So… is Birth Control Bad for You?

The question isn’t whether or not birth control is “bad”. The biggest thing women must ask themselves is: which birth control is my best option?


From medications to food and vitamins, the body responds to meet our needs when we ingest something. As with any medication or drug, side effects are possible at any time. Some women experience mild or unnoticeable side effects on the pill, while others may find them unbearable or life-altering.


Bottom line: any woman who’s wary of the side effects of birth control deserves the same level of guidance and reproductive awareness as the one whose best option is the pill. It’s about finding what’s best for you.


Non-Hormonal Birth Control Options

What can women do if they talk with their doctor and conclude that hormonal birth control isn’t what they need? Several options don’t require hormonal treatment.


Fertility Awareness and Natural Family Planning

Whether or not you’re planning to get pregnant, knowing your cycle is one of the most empowering things you can do for your sexual health as a woman. When you know how your body works and can track your fertility, you can base reproductive decisions around that, and stop living in fear about when you can or can’t get pregnant.


Barrier Method

A popular form of non-hormonal birth control is the barrier method— something that blocks sperm from entering the uterus. Think condoms.


Aside from condoms, other barriers can be:


  • Spermicide

  • Phexxi

  • Diaphragm

  • Cervical cap

  • Sponge


When used correctly, male condoms are 98% effective at preventing unwanted pregnancy.


Surgery

Not everyone can afford surgery. Many couples want to wait to have kids, but surgical sterilization can be permanent. In women, this surgery is tubal ligation or “getting your tubes tied”. In males, it’s a vasectomy.


Pull-Out Method

Risky, but some women who know how to accurately track their cycle can effectively use the “pull out” method to avoid pregnancy. On fertile days, abstaining from intercourse or enjoying other sexual acts aside from penetration are natural ways of birth control (but it’s not always effective).


Want to hear about a type of on-demand, non-hormonal birth control? Listen to the Fempower Health episode interviewing the founder of Phexxi, a women’s contraceptive gel.


Birth Control and Informed Consent

A lot of information gets lost with a lack of informed consent. In the medical system today, women not only experience a downplay of symptoms and side effects— all too often, but reproductive concerns are also dismissed.


On top of that, only about 41% of women start using the pill for contraceptive purposes. Others get put on the pill for things like:


  • Painful periods

  • Underlying hormonal imbalances

  • Irregular menstrual cycles

  • Unaware of effective contraceptive alternatives

  • Intense PMS symptoms

  • Societal pressure to take the pill in adolescence or young adulthood


Birth control is a $30 billion industry, where women and doctors alike have reported that it’s a given among a majority of medical professionals: go on birth control; you’ll be fine and free to live as you please.


But for the women who aren’t fine, who don’t feel free, or who aren’t satisfied remaining unaware of other resources to help them manage their own sexual health, the pill isn’t as reasonable of a solution as it’s prescribed to be.


From OB-GYN to researcher to parent, we must advocate more realistic alternatives. Families have also requested black-box warnings and clearer labels highlighting side effects. To learn more about the need for informed consent with hormonal birth control, view The Business of Birth Control.


Learn more about your menstrual cycle, including perspectives on birth control in the menstrual health Spotify podcast playlist.

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