The Contraceptive Pill: At What Cost?

For decades, the contraceptive pill has been hailed a revolutionary medical advancement, offering women unprecedented control over their bodies and their future. However, beneath the surface lies a more complex story – one that is often untold. For many young women, the pill comes at a cost they were never willing to pay, at times leaving them grappling with side effects that remain largely unexplored. Unfortunately, these struggles are frequently downplayed or dismissed, leaving many to wonder: at what cost?

Types of Contraceptive Pill and Reasons for taking it

The two main contraceptive pills are the combined pill and the progesterone-only pill (POP). The combined pill contains both oestrogen and progesterone, whereas the progesterone-only pill, as the name suggests, contains only progesterone.

There are further types within each pill, but the most common contains 21 active pills and 7 inactive ones in a pack. One pill must be taken daily and during the last 7 pills, bleeding should occur, emulating a period.

According to a 2019 study by the UN, a staggering “300 million women worldwide” are on hormonal contraceptives and many of these individuals use hormonal birth control for its primary use, contraception. However, others take hormonal birth control to manage long-term medical conditions, including heavy or painful periods, endometriosis, PCOS and menopause symptoms - to name a few.

The Good

Before diving into all things pessimistic, it is important to acknowledge the positives that arise from taking the pill. Not only does research suggest a reduced risk of uterine cancer, but studies have also shown that the pill can lower the risk of ovarian cancer by 27% and colon cancer by 18%. Furthermore, strong epidemiologic evidence supports a remarkable 50% reduction in the risk of endometrial cancer. Additionally, women with conditions such as endometriosis or PCOS often benefit from the pill as it can help alleviate symptoms like heavy bleeding, acne, irregular cycles.

And undoubtedly, the greatest benefit of them all is the obvious increased autonomy women have over their own bodies, allowing them to make a decision that is becoming easier and easier due to increased accessibility of the pill. This freedom empowers women to plan their futures, whether this includes focussing on their careers, education or personal goals.

The Bad

According to the NHS, common side effects of the combined pill include:

• Bleeding between periods

• High blood pressure

• Headaches

• Nausea

• Dizziness

• Abdominal cramping

• Breast tenderness

Oftentimes, seeing these effects listed methodically and in a very matter-of-fact way diminishes just how debilitating they truly are. Imagine going about your daily life with crippling nausea every morning, headaches throughout the day and cramping, deterring you from doing things you would normally enjoy. For many young girls, these experiences are intensified by the societal stigma around discussing such symptoms. They are often told that talking about their discomfort is taboo, leaving them to silently endure their pain while being expected to carry on as if nothing is wrong.

And The Ugly

The pill has long been known to increase the risk of blood clots, affecting approximately 10 in 10,000 people annually, according to the Centres for Disease Control and Prevention (CDC). In addition, research shows a slight elevation in the risk of breast and cervical cancer among pill users. However, the NHS website assures women that their risk of breast and cervical cancer returns to normal ‘10 years’ after discontinuing the pill, which, evidently, is extremely reassuring.

A UCLA-led study found that hormonal contraceptive users "processed stress differently at the molecular and psychological level" which can result in a more negative psychological response compared to non-users, supporting the observation that changes in mood and depressive symptoms are among the most commonly cited reasons for discontinuing oral contraceptives. Not only this, but past research indicates that the pill may increase a woman’s risk of chronically elevated inflammation, which carries the long-term risk of developing illnesses such as cancer, cardiovascular disease, and autoimmune disorders.

However, this remains understudied and unclear, a prevalent pattern found in discussions of women’s health. This lack of clarity highlights a broader issue in women’s health, where crucial research is often insufficient, which is saddening as it is paramount for both women and doctors to be able to make informed decisions when dealing with medication that could change a person’s life. This gap is one that needs to urgently be addressed - for a safer future for women and young girls.

Sources:

UCLA Health Study

National Library of Medicine – Oral Contraceptive Pills

Cancer Research UK – Does the contraceptive pill increase risk of cancer?

National Library of Medicine – Hormonal contraception and mood disorders