The contraceptive pill is great. It’s free, easy to take, and doesn’t involve inserting foreign objects into your uterus or arm, or having to faff about with condoms every time you want to have sex. It’s the ultimate form of female sexual liberation, allowing us control and agency over our own bodies, meaning we can have sex whenever we want, however much we want, without having to worry about getting knocked up. It can also help women who suffer from acne, heavy periods and endometriosis. It’s so great that roughly half of women of reproductive age are taking hormonal contraception. But one thing a lot of us don’t fully take into consideration as a factor in our choice of whether to go on the pill or not, or whether to continue taking it, is the effects it can have on our mental health. How liberating can hormonal contraception really be when it’s affecting so many women’s mental health and relationships?
When I decided to go on the pill I saw it as something that could only be positive. And for the most part, it’s been just that. The days of heavy, often unbearable periods are gone, now they only last a few days, I barely feel a thing, and no longer have to worry about leaking through a tampon and a pad during the night. I don’t have to worry about remembering condoms every time, or that the pull-out method is going to go wrong and I’m going to end up pregnant. But it’s not all been happy days. It took me quite a few months after I started taking the pill to realise that I wasn’t feeling myself anymore. I don’t laugh as much as I used to, I feel antisocial, avoid talking to people too much, and prefer to spend a lot of time alone. I realised that I’ve become more and more distant from my friends, isolating myself, feeling out of touch, and when I thought back to when I started feeling like this, I realised it coincided with around the time that I started taking the pill.
Depression, anxiety and mental health issues more generally in women are commonly linked to hormonal contraception. It’s written in tiny writing on the information leaflet inside my pill packets – but there’s actually relatively little understanding of or attention drawn to the relationship between contraception and mental health, so it’s often not really something we take into account when we’re thinking about going on the pill. Even if we do recognise that it’s a potential side effect, we prioritise our desire not to have babies, or our desire to make protective sex hassle-free, and neglect the fact that it might not be something our bodies agree with. Part of my motive for going on the pill was less about me, and more about being able to reassure my sexual partner that we could do it without a condom and not have to worry about any malfunctions or pulling out too late.
And when it comes to the issue of sexual liberation, the contraceptive pill may not be as liberating as it seems. We may be going on the pill so that we can have as much care-free sex as we want, but the pill might actually be stopping us from doing just that. A lot of women on hormonal contraception experience a decrease in libido, while the mental health issues mentioned above in themselves can lead to a decreased desire to have sex. So not only could the pill be putting a strain on our friendships, but also on our sexual relationships. In the grand scheme of things, a low sex drive can seem relatively insignificant, so the issue is subordinated in favour of our desire not to have babies – though if we’re not having sex, we won’t be having babies anyway. It’s easy to brush off a lack of libido, particularly as women are often generally, and wrongly, perceived to have lower sex drive than men, but the female libido in general needs to be taken more seriously. By ignoring the changes in our bodies and not voicing our concerns, we’re reinforcing this idea that the female libido doesn’t really matter. There also seems to be a lack of understanding on men’s part about the implications of hormonal contraception for women – they see it as something that simply stops us getting pregnant and means that we can have sex without condoms, which seems great, but don’t necessarily understand the side effects, meaning they aren’t always empathetic towards their partners when it comes to them not getting the urge to have sex.
While we certainly shouldn’t dismiss the pill as an option for controlling our bodies and choices, as well as a way with dealing with other health issues, there should be more of a conversation around the way it can affect our mental health and put a strain on our friendships and sexual relationships. Maybe it’s the lesser of two evils, but the challenge of finding something that’s convenient but also that works for our bodies will continue until the link between contraception and the issues of female mental health and libido is taken more seriously.