The Contraceptive Pill Explained

I’ve been taking the contraceptive pill for the nearly four years, so I’ve had my fair share of experience with it. The phrase ‘the things you love the most will hurt you the most,’ comes to mind, since despite the issues I’ve had with this form of contraception, I also know I couldn’t be without it. And on the surface, the pill does appear to be a ‘wonder drug’. A way to regulate your menstrual cycle, reduce hellish period pains and have sex without fear of pregnancy? Sign me up.

So, how does the pill work? Hormonal contraception, which includes everything from pills to implants, works by controlling the hormones involved in the menstrual cycle. This works by using synthetic versions of female hormones, oestrogen and progesterone. Mid-cycle, your oestrogen levels typically peak, triggering the release of Follicle Stimulating Hormone (FSH), and Luteinising Hormone (LH) from your pituitary glands. This then allows eggs to mature, and be released from the ovaries. The synthetic hormones ultimately prevent this from happening, reducing your chance of pregnancy. The combined pill uses a combination of oestrogen and progesterone, while the mini pill just uses progesterone, but both have similar effects.

It was only after the best part of a year had gone by that I realised the pill might not be everything I’d hoped it would be…

Sounds great right? And it would be, if it wasn’t for all the other issues associated with the contraceptive pill. With side effects ranging from nausea, headaches, weight gain, decreased libido, and the risk of thrombosis, it has become common knowledge that taking the pill isn’t all fun and games. While the ‘serious’ risks, namely the possibility of a blood clot, are monitored closely- nurses are likely to change your pill or take you off it all together if you report and increase in headaches or migraines-others are not.

When I first began taking the pill, a version called Microgynon 30, I thought it would solve all my problems. And to begin with, it did! My skin cleared up, my periods were much less painful and, despite many other people’s experiences, I had no issues with weight-gain. It was only after the best part of a year had gone by that I realised the pill might not be everything I’d hoped it would be. Like many others, I have found the pill to have detrimental effects on my mental health. Personally, my main issue with the damn thing was how little control it let me have over my emotions. Low mood and periods of anxiety became a common occurrence. Think severe PMS, but all the time. However, just like the side effects of various medicines can vary person to person, assorted combinations of hormones in versions of the contraceptive pill also affect individuals differently. So, eventually thinking that enough was enough, I changed the pill I was taking, with (so far) positive results.

 If this teaches us anything, it’s that while we know the basic science of how the pill works, we have very little idea of how it will affect individuals…

Many people encounter mental health problems when taking the pill, and currently we just have to assume what it all comes down to is again, hormones. Just as synthetic hormones have the power to affect your menstrual cycle, they can also have serious implications on your mood. And I say assume, because presently there isn’t much definitive research to explain these side effects. Perhaps because it is so difficult to quantitatively evaluate an individual’s mental health that depression and anxiety aren’t even listed as official side effects on the NHS website. Or perhaps it’s due to mental health stigma that they are not properly acknowledged. Instead, they are referred to as ‘mood swings’, which I personally consider to be a gross understatement. I strongly believe there is enough anecdotal evidence out there to seriously recognise the effects contraception can have on the mind.

Unfortunately, there just aren’t that many other options out there at the moment. Other forms of contraception can still alter hormones in ways that you can’t really predict or prepare for. Fear of finding out how my body and mind would react to other contraceptives led me to dealing with the side effects of a certain combined pill for far too long, but changing my prescription taught me that I should have taken them seriously far sooner.  If this teaches us anything, it’s that while we know the basic science of how the pill works, we have very little idea of how it will affect individuals. More than anything, it’s important to listen to your body, and consult your doctor if you have any concerns.