By Michelle Harthoorn
Perhaps, you, the person reading this, are one of those lucky humans whose body loses blood once a month in order to prepare itself for conception. If you are like me and the idea of getting pregnant does not sound appealing to you, despite being sexually active, you have possibly experimented with one or multiple types of birth control.
For example, here in The Netherlands it only takes one trip to the doctor’s office and ten or so euros to get your hands on one version of oral contraceptive pills, for there are many, all containing different combinations and amounts of hormones. Easy access to birth control has been a massive influence on the empowerment of women and others with a uterus, as well as on their position in society, for it allows them to take control of their fertility and sexuality. Even though having access to the pill can feel Utopic, considering how it can be used to improve people’s lives, as feminists we should remain critical of the pill and not close our eyes for its unwanted, possibly harmful effects
According to a study by the CBS from 2013 (see the graph), the pill is the most commonly used type of birth control among women aged 18 to 45 in The Netherlands. The study also shows that in 2013, 6 in 10 women from the age of 18 to 25 were on the pill, which indicates its popularity among young women in particular.
I was one of those women. For multiple reasons (like being in a steady relationship, no longer having to rely on condoms or the occasional morning after pill and having friends who recommend it) I wanted to test how the pill works for me. Only after quitting the pill, I decided to educate myself on what exactly the pill does to someone’s body. To do this, I read How the Pill Changes Everything (2019) by dr. Sarah E. Hill. In this book, Hill not only provides the reader with background information on what hormones are and why human females menstruate, but also how the pill affects your brain and, therefore, basically your experience of life.
In a TED Talk she gave about the topic, called ‘The surprising link between women’s brains and the birth control pill’ (2019), Hill mentions that the sex hormones in the pill not only change processes in the brain that are related to sexuality, like sexual desire and attraction, but also to other processes, like one’s stress response, which is linked to issues surrounding anxiety and depression. If you want to get a little taste of what Hill discusses in her book, I recommend listening to this talk.
As Hill describes in her book, hormones affect innumerable processes in your body. For example, when it is time to go to bed at the end of the day, hormones make sure that your body prepares itself for a good night’s sleep. If you take the pill, the hormones in the pill not only target the reason why you take them (whether this is to protect yourself against an unwanted pregnancy, regulate, delay or skip your menstruation, treat acne or ease menstruation and/ or PMS symptoms), but they have an influence on all those other processes as well. This is why there are so many side effects to the pill, like experiencing headaches, nausea, depressive moods or changes in one’s libido and having an increased chance of getting thrombosis and breast cancer. Because you get the full package of effects when you take the pill, this form of birth control is like a scale with desirable effects on the one side and unwanted effects on the other. Is gaining the desirable effects worth also experiencing the unwanted effects? This scale is very personal, since one individual might find being able to regulate your cycle a pro, while another may prefer maintaining one’s natural cycle. It is up to the pill taker to decide what the pros and cons are and which part of the scale weighs the most.
Hill is very transparent when it comes to the limited knowledge that is available about the pill. She explains that, due to a lack of research on the topic, not all theories that she mentions can be backed up by science. An entire section in her book is dedicated to this problem. What it comes down to is that performing research on women takes more time and costs more money than doing research on men, for men do not have menstrual cycles that might change the test results. Since academic researchers are, like many of us, tied to the capitalist system and have to publish many research papers in order to make a living, studies that require female test subjects, like studies on the pill, are pushed to the side because of a lack of time or money. The theories that Hill mentions that can, however, be backed up by science (like hormones in the pill altering parts of a pill taker’s sexuality and disabling them to be able to appropriately respond to stress) sound quite drastic to me, which raises the question whether it actually is a good thing that hormonal birth control is prescribed so easily.
For instance, before prescribing me the pill my doctor only asked me whether my family has a history of thrombosis. She did not ask me about my mood in general or whether I have a history with mental health problems, which resulted in me quitting the pill for mental health reasons after three months of taking it. Even though you should be able to trust your doctor as a patient, if I myself had been more educated on the workings of the pill, I think I could have received a prescription for birth control that fits much better with me as an individual. Therefore I was glad to read that, at least in the Netherlands, guidelines from the NGH (Nederlands Huisartsen Genootschap) for doctors have been altered to include more awareness about and attention for the psychological consequences of the pill.
As an alternative to the pill, my doctor recommended a hormonal IUD to me, which supposedly would have less of a negative impact on my mental health. She explained that a small amount of hormones is released from the IUD throughout the day, in contrast to undergoing a hormonal peak once a day when you take the pill. Additionally, the type of hormones that the IUD releases also differs from the hormones in the pill. What exactly an IUD does and the effects it could have on my body, however, I do not yet know. At least for now, I do not feel ready to start experimenting with hormonal contraceptives again. Therefore, I have returned to reliable, old fashioned condoms. Since sustainability can be applied to every aspect of your life, even your sex life, the condoms that I use are vegan, so they do not contain the casein, a derivative from milk, that may be present in non-vegan condoms.
I will leave it up to you whether the mass prescription of hormonal birth control, despite so many unresolved questions being attached to it, is either a good thing or alarming. Instead, I want to give you my learn-from-my-mistakes kind of advice. Of course, there is nothing wrong with experimenting with different forms of birth control. In fact, I recommend trying out different methods to see what suits you the best. In addition to the pill, you can also look into a contraceptive patch or implant, a vaginal ring, a hormonal or copper IUD, a diaphragm and spermicide and of course condoms. Each option has its own qualities, so there is probably one that matches your preferences the best. If you understand Dutch, you can use the tool by Rutgers that can help you decide which form of birth control suits your preferences the best at http://www.anticonceptievoorjou.nl. And while you are doing research, you might as well figure out whether your insurance company pays for your method of contraception or not at http://www.zorgwijzer.nl/vergoeding/anticonceptie/. But, when you are experimenting with birth control, I strongly advise you to thoroughly do your own research before trying one of the options, especially when it comes to hormonal birth control. Even though it is impossible to tell what effect one type of birth control will have on you exactly, understand what it does to your body if you decide to use it and determine whether its effects would work in your advantage or disadvantage.
Michelle Harthoorn studied Arts and Culture at Radboud University, Nijmegen.
‘Gebruik pil daalt, spiraaltje wint terrein.’ CBS, 18 June 2014, http://www.cbs.nl/nl-nl/nieuws/2014/25/gebruik-pil-daalt-spiraaltje-wint-terrein. Accessed on 16 Apr. 2020.
Hill, Sarah E. How The Pill Changes Everything. Orion Publishing Group Ltd, 2019.
‘The surprising link between women’s brains and the birth control pill | Sarah E. Hill | TEDxVienna.’