An ‘atomic bomb’ of hormones: Are women ditching the pill for good?

The pill has given women reproductive freedoms since the ’60s, but some women are deciding to hit pause on hormonal contraceptives altogether.

In a dark period for reproductive rights globally, stopping may seem like a step back for feminism. But in conversation with women ditching it for good, they explain why they’re avoiding the pill like it’s going out of fashion. And maybe it is.

Kirsty Smith, Functional Medicine Health Coach and Founder of Natural Rays, said: “As somebody that was taking hormonal birth control for over 10 years, I personally don’t think that we know enough about how hormonal birth control works. I know I certainly didn’t.”

And with a decrease of 1.3 million in contraceptive pills dispensed in 2022/2023 compared to 2014/2015, there are signs that women may be opting out.

Abbie, 24, who founded the self-discovery podcast ‘It’s all well and good with Abbie Nesbitt’, stopped taking hormonal contraceptives around two years ago. She said: “I thought I knew myself, but then I came off contraception and I felt more in tune with my body, more in tune with my mind.

“I feel more in touch with my womanhood and what it is to me to be a woman. I felt like I was missing that when I was on contraception and everything was just put on hold.”

Abbie Nesbitt talks about why she came off of the pill

Dr Sarah E Hill on the pill

With two types of contraceptive pill available on the market: the combined pill and the progesteron-only pill, both containing hormones, the American Psychological Association (APA) points out that there is the general worry that hormonal contraceptives were developed before scientists truly understood the role of hormones in the body and the brain.

Caitlin Taylor, PhD, a senior scientist at the University of California, Santa Barbara (UCSB) told the APA: “As a global population we’ve been taking this pill as a natural experiment, as we’ve been simultaneously discovering that the impact of estrogen and progesterone is way beyond just pregnancy.”

In Dr Sarah E Hill’s book ‘How the Pill Changes Everything’, which covers the impact of hormonal birth control on women, she highlights that the pill is not a "magic bullet" of targeted hormones.

Dr Hill, who is an associate professor of psychology, said: “No matter where you administer the hormones, they all end up in the same place. And that place is everywhere.”

As a result of these unpredictable hormones, women face the likes of: spotting, clotting, weight gain, high blood pressure, headaches, and increased cancer risks. All of which are listed in the fine print of that tiny folded up piece of paper stuffed behind pill packets.

But that’s not all. There are also mental side effects of taking the pill, which are often spoken about a lot less. One study found that in the first two years of oral contraception use there was a 71% higher risk of developing depression compared with people who had never taken the pill. And there were even links to an increased lifetime risk of depression and major depressive disorders.

But how could a small pill cause so much hormonal havoc?

In one analogy from Dr Hill’s book she says that taking the pill is “sort of like dropping an atomic bomb on your house to blow out a candle. Dropping a bomb on a house will blow out a candle. It’s just that the effects are nonspecific”.

So, are women being given the contraceptive pill as a supposed ‘magic bullet’ to pregnancy prevention, without much consideration for what else it might be working its magic on?

“We definitely need more research around the impact it has on mental health. A lot of us are pretty much growing up on hormonal birth control and there becomes a point where we feel like we don’t really know ourselves,” said Kirsty, who has over 9k followers on Instagram.

“And a lot of women say to me that they just feel really flat, they don’t feel any particular highs or lows.”

It's sort of like dropping an atomic bomb on your house to blow out a candle.

Dropping a bomb on a house will blow out a candle. It’s just that the effects are nonspecific.

- Dr Sarah E Hill -

Lauren, 24, who has taken both combined and progesteron-only pills in the past, and is no longer on the pill, said: “I think the NHS tries to push the contraceptive pill onto people in order to prevent pregnancy. I completely understand why, but there are other methods of preventing pregnancy without causing mental side effects and increasing risks of cancers.

“Women deserve to have all the facts and all the options available to them before making a decision.”

With that in mind, women are turning their backs on contraception and are instead favouring the empowerment of their hormonal health.

Enna, 27, who has previously been on Levest and Cerelle, noticed that after coming off of the pill her side effects of mood fluctuations, increased anxiety, and low libido decreased. “I wanted to regain control over my body. And I did,” says Enna.

“I feel that a lot of women when they go to their doctor and say the pill is impacting my mental health or I’m feeling low, it’s often like well, you can have an antidepressant as opposed to linking the correlation with the type of pill they've been taking.

“I don’t think it’s talked about enough, and I do feel that women’s experiences when they’re on it are definitely disregarded,” says Kirsty.

For women who started the pill in their early teens, coming off of the pill can mean learning who they really are. And with research linking the use of oral contraceptives between the ages of 16 to 19 to the development of major depressive disorders in the early 20s, it begs the question of whether GPs are too quick to provide young girls with the contraceptive pill.

“It is handed out very quickly. It feels as freely given as giving someone two paracetamols if they’ve got a sore head.

“You need to be going out and doing your own personal research before you make this huge, potentially life-changing decision,” says Abbie.

Despite the obvious hormonal implications, there is also a massive amount of misinformation online that can impact the decision to come off the pill. And in a study that looked at TikTok as a source of health information and misinformation for young women, it found that 1 in 5 TikTok videos are likely to contain misinformation.

“A lot of young girls are doing their research by going straight onto TikTok, but as a viewer you don’t know how trustworthy that information is,” Abbie says. And this can cause risks of pregnancy for women.

Then promoted as safe alternatives online, ‘natural birth control’ such as FDA approved apps like Natural Cycles track fertility levels via temperature - but ‘none are officially recommended by the NHS’.

Lauren said: “It is becoming hugely popular which is great, but if it’s not taught correctly you still are hugely at risk of pregnancy.”

Lead researcher Dr Rosie McNee told the BBC: "Something that really needs scrutiny is the surge in the use of ehealth, including fertility apps and period trackers.

"The market has exploded. There are hundreds of them and some are more reliable than others. Plus you don't need a prescription, and so you may not get all the information you need."

However, some women don’t even have the option of stopping hormonal contraceptives. In fact, GPs are very quick to offer hormonal contraceptives to help treat anything from acne and painful periods to endometriosis and PCOS. And most of the time, they are the only offer on the table.

Rebecca, 24, who has tried several combined pills including Rigevidon, Qlaira and Yasmin to combat heavy and painful periods, is now on the depo injection. This is a contraceptive injection containing the hormone progestogen.

She said: “I have the injection once every 12 weeks, and I have been on it for 8 months now. I started taking it because I’ve been on about 6 different contraceptive pills and none of them were working.

“So I have to ask why? And is it doing my body any good being on all these different pills.”

Fertility expert Natalie Crawford MD on the effects of the pill and the stigma

Is there a solution to our hormonal conundrum?

Acting as a plaster for many female health issues, the pill and other hormonal contraceptives are a readily available solution to women and girls.

Which is why Kirsty believes more needs to be done. “Personally, I don’t think that there are enough open conversations about the full impact of these medications that they are on, and often women are on them for long periods of time,” she said.

“There’s not enough studies for the wider impact for longer term use.”

Abbie Nesbitt on what the solution is moving forward