Why I Would Never Go Back On The Oral Contraceptive Pill
When I was 16, I started taking the oral contraceptive pill (the pill). It wasn’t an informed decision I made after weighing up the pros and cons of my options, it kind of just happened. I was late to get my period, my friends were all on it, so it seemed like the obvious choice. At the time, I didn’t think twice about the risks or side effects. I just knew I didn’t want acne, I didn’t want a period each month, and I definitely didn’t want to get pregnant. I asked my doctor, he said yes and there I remained for over a decade.
It wasn’t until I started taking control of my health and learning about hormones that I began to question whether the pill was still the right for me. I decided to experiment with coming off, thinking my body would regulate itself but it didn’t. After three years I still didn’t have a regular menstrual cycle. It was a journey that made me reflect deeply on my experience with the pill, the healthcare system and the importance of informed decision-making when it comes to contraception and health.
In this post, I’ll share my personal story alongside a balanced look at the pros and cons of the pill. My goal isn’t to tell you what to do but encourage you to reflect on your own journey.
Understanding the Pill: Synthetic Hormones and Withdrawal Bleeds
One thing I wish I’d known earlier is that the bleed you experience on the pill is a withdrawal bleed, not a true period. When you take the pill you are taking synthetic hormones (not natural), during your placebo (sugar pill) week, these hormones drop resulting in a withdrawal bleed.
Natural menstrual cycles are driven by your body’s own hormones, you experience a natural ebb and flow of your menstrual cycle. Where as the pill suppresses ovulation entirely, which means you’re essentially putting your hormones on pause.
Forms Of The Pill
The pill comes in several different forms:
The combined oral contraception pill containing both synthetic estrogen and progestin;
Progestin-only pill (or mini pill) containing synthetic progestin; and
The bioidentical estrogen pill containing estradoil.
The combined pill is the most common and has several forms within it differing in dosage and additional hormones/ingredients, for example, there are anti-androgen dominant combined pills to reduce acne and symptoms caused by PCOS. This pill can also be used as an ‘extended cycle pill’ when the pill continuously (i.e. not placebo/sugar pills are taken) to have fewer periods per year. Examples of brands include Ava, Yasmin, Yas, Levlen ED.
The progestin-only pill is often used for women who can’t tolerate synthetic estrogen, and during postpartum and perimenopause. Examples of brands include Noriday and Cerelle.
Bioidentical estrogen pills contain estradoil, the same type of estrogen produced in the ovaries. These are a gentler option for women sensitive to synthetic estrogen or experience side effects from other pills. Common brands include Zoely and Qlaira.
The Pros of the Oral Contraceptive Pill
There is no denying that the pill has been a game-changer for women. For me, it delivered exactly what I wanted, no acne, no periods, and no unplanned pregnancies. But beyond these, the pill has had a profound impact in society:
Empowering Women: The pill has enabled women to take control of their reproductive health, allowing them to pursue education, careers, and personal goals without the constant worry of unplanned pregnancies. It’s played a significant role in keeping women in the workforce longer and providing more options in life.
Effective Contraception: The pill is over 99% effective at preventing pregnancy when taken correctly, providing peace of mind for women.
Predictability and Planning: The withdrawal bleed is predictable, lighter, less painful and can be skipped if wanted.
Improved Skin Health: The pill can help clear up hormonal acne by regulating androgen levels which typically causes a breakout.
Other Health Benefits: Further research is required but some studies suggest the pill may reduce the risk of ovarian and endometrial cancers, as well as reduce symptoms associated with conditions like endometriosis.
The Cons of the Oral Contraceptive Pill
With every decision, comes a trade off. My main gripe once I came off the pill was the lack of education around risks and side effects. There are several impacts on hormones, mood, and a women’s long-term health:
Hormonal Imbalance: The pill works by suppressing natural hormones, which can lead to imbalances when you come off it if other issues have been masked while taking the pill.
Mood Changes: Many women report mood swings, anxiety, or depression while on the pill. The pill interacts with the brain, not just the ovaries, and when you remove the natural hormonal rhythm, the brains emotional regulation can shift too.
Weight Fluctuations: Some women gain weight on the pill, while others struggle to lose it. Sometimes this is initial water retention and other times it’s due to changes in appetite or muscle mass.
Reduced Libido: The pill can also lower sex drive, a side effect that’s rarely discussed because it is such a taboo topic but can have a significant impact on relationships.
Interference With Nutrient Absorption: The pill can reduce levels or availability of B vitamins, magnesium, zinc, vitamin C and fat soluble vitamins through liver metabolism, gut enzyme changes and mineral shifts. This can be problematic for women who do not have a balanced diet.
Cardiovascular Risks: Combined pills can increase the risk of blood clots, stroke, and heart attack. The risk is higher in pills with a higher dose of estrogen, and in women who smoke, are over 35, or have underlying health conditions. While absolute risk is low, screening and choosing the lowest-risk pill is important.
Impact on Developing Brain: The teenage brain is a developing brain, particularly in the areas responsible for decision making, emotional regulation and reward processing. Introducing synthetic hormones could subtly influence neurotransmitter systems which may affect mood, stress and risk taking behaviour. This is an active area of research.
Other Forms Of Contraception
I stayed on the pill for so long for convenience and because I didn’t know much about other options. But there are several other options outside of the pill, including:
Intrauterine device (IUD) like the Mirena or copper IUD
Implant
Injection
Condoms
Cervical cap
Spermicides
Fertility awareness method
A Balanced Perspective
The oral contraceptive pill is a powerful tool, but it’s not one-size-fits-all. What’s most important is that you feel empowered to make choices that are right for you.
I’d encourage you to reflect on your own experience with the oral contraceptive pill:
What were you told when you first went on the pill?
What do you understand about it now?
Have you noticed any changes in your body, mood, or cycle while on or off the pill?
Is it time to reevaluate your choice and explore alternatives?
These are big questions, but they’re worth asking as your health is your own, and you deserve to feel confident in the choices you make.
With love and balance, my Friends x
Disclaimer: This blog post is not medical advice. If you’re considering starting, stopping, or changing your contraception, please consult a healthcare professional to discuss what’s best for your individual needs.
