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Is Hormonal Birth Control Actually The Worst?

Depression, weight gain, loss of libido, NBD!

woman standing against a wall

In the 1960s, hormonal birth control was introduced in the United States when Enovid landed on the scene. Women’s lives drastically changed, and a new industry was born. All of a sudden, women found themselves inundated with a variety of options—and those options have only increased throughout the years. Hormonal birth control is now widely used (67 percent of American women use some form of it) in a variety of forms: pills, patches, implants, and other devices. Lots of research has gone into creating innovative devices for women to prevent pregnancy, but there’s been a woeful lack of long-term studies looking at the effects of hormonal birth control on the women who use it. The few studies that are available tend to investigate the link between hormonal birth control and cancer, and not much else. That’s surprising, until you consider the long history of the medical establishment ignoring issues related to women and people of color.

Until a study came out with findings that were hard to ignore: the University of Copenhagen’s study on birth control use concluded that women who are on hormonal birth control are also more likely to be struggling with near-crippling depression. As the Guardian explained:

Researchers found that women taking the combined oral contraceptive were 23% more likely to be diagnosed with depression and those using progestin-only pills (also known as “the mini-pill”) were 34% more likely. Teens were at the greatest risk of depression, with an 80% increase when taking the combined pill, and that risk is two-fold with the progestin-only pill. In addition, other hormone-based methods commonly offered to women seeking an alternative to the pill – such as the hormonal IUS/coil, the patch and the ring – were shown to increase depression at a rate much higher than either kind of oral contraceptives.

Like a lot of women, I’ve had less-than-ideal experiences with hormonal birth control. I started taking the pill in college, and my biggest side effect was steady weight gain (about 15 pounds per year). That steady weight gain led me to obesity, and I really struggled to take the weight off. In fact, it wasn’t until I went off hormonal birth control that I was able to see significant weight loss. During my years on the pill, I also suffered from a few bouts of depression, but I’m unclear about whether my birth control use contributed to it.

Others have had drastic experiences with the pill, like one APW staffer who suffered for years:

I got put on birth control when I was a teenager, because I had irregular periods. I think doctors now know better than to do this, but since the medical system often ignores women’s issues, who knows. In retrospect, going on the pill also kicked off my first full-blown depressive episode. I stayed on the pill (often just to keep my cycles regular, which I now know isn’t something you even need to do), for the next decade-plus. For most of that decade I also battled severe depression, which medication was only half able to manage. Oh, right, and I thought I had no libido. I’d been off the pill awhile when I got pregnant, and slipped into severe partum depression. The doctors asked me if birth control pills had ever made me depressed, since that was a leading risk factor for partum depression. It was the first time anyone had ever asked me that question. I was thirty-two. I was livid.”

Another staffer notes that hormonal birth control gave her intense mood swings, no matter the type she was on:

”I went on birth control for six years, starting when I was sixteen, and still viscerally remember the emotional highs and lows that followed. I didn’t experience depression, but I had terrible mood swings (when pressed, my partner said it was like living with a “perpetual rage monster”). I switched from Yasmin (pill) to Nuvaring halfway through high school, and then went off altogether after college when my insurance disappeared. It wasn’t until I tried going back on it a few years ago that I made the connection. I got an IUD and immediately felt like I had been thrown onto a hormonal Tilt-A-Whirl. I think I lasted three months before demanding they take it out. The thing that kills me is that I was taught to use two forms of birth control always, and have always used condoms pretty strictly while sexually active. So all that torture was more or less for about 2 percent more security.”

While it’s great that the medical community is researching the link between hormonal birth control and depression, I’m left wondering what took them so long. For decades, women have reported mood swings, depression, and other mental health issues while on birth control. The Guardian piece notes that one of the top reasons women report discontinuing use of birth control is mood changes. So clearly this has been a huge problem for a large number of women for possibly decades, but it wasn’t deemed important enough to conduct a large-scale, long-term study of this magnitude until now? Or maybe it was, but not to… men:

As soon as this research dropped, the experts lined up to deliver their usual mix of gaslighting and paternalistic platitudes. We’re told not to be alarmed, concerned, or deterred from continuing to use our hormonal contraceptives, mostly by men who have never and will never take them themselves (partly because the long-term, large-scale study undertaken by WHO on the “acceptability” of the male pill revealed it would negatively impact their emotional wellbeing).

So, why is it that we’re not supposed to take this study seriously? Considering that women are fertile just six days per menstrual cycle and men are fertile every single day, that the burden of avoiding unwanted pregnancy falls to us, regardless of the burden that might have on our health and wellbeing, is nothing short of sexism.

I’ve had many conversations with friends, or participated in comment sections on the web, that are filled with women recounting their horror stories about using hormonal birth control. I’ve heard so many stories, each one eerily familiar, as these women describe mood swings, loss of libido, depression, weight gain, and more. I know so many Black women who suffer from endometriosis, uterine fibroids, or have needed hysterectomies—and many of those women have openly questioned if their years of birth control use contributed to their illnesses and medical conditions. But without more large-scale studies, it’s possible we’ll never be able to answer those questions.

APW readers: tell us about your experience with hormonal birth control. What forms of birth control have you tried, or are considering? Do the results of this study make you look at hormonal birth control differently?

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