Hormones & Cycles

Why more and more women are ditching the pill

The world's most popular method of birth control turned 60 this week. Time to take a closer at the current trend against hormonal contraception.

You’ve probably noticed it too: More and more reports of happy women who have stopped taking the pill may pile up in your timeline or the topic just seems to appear more frequently in your circle of friends and in the media that you regularly consume. Flowery phrases such as "finally feeling yourself again" or "experiencing your cycle" are coming up. There is also talk about how intensively these women now perceive ovulation and that possible hellish menstrual pains are always made up for by the constant explosion of feelings and the generally better condition.

The current trend against hormonal birth control

Different reports from different countries around the globe actually also all point to this development. For example: according to a survey, more than half of sexually active American women currently use no birth control method, and of the ones who do, 36 percent say they would prefer a non-hormonal method.

If you yourself have been taking the pill for many years, stories like this will naturally make you think. Should you perhaps rethink your daily use of medication even though you feel fine with it? The argument that often follows this question is: But how do you actually really know that you are well? Isn't it possible that you have simply got so used to the pill and its effects that you no longer notice its negative sides? The answer is: It is!

Many describe being on the pill feels like there are neither highs nor lows. And even though the drug was celebrated in the 1960s as a liberation and sexual revolution, associating the pill with self-determination could be seen as rather questionable. After all, most women know far too little about the proven side effects apart from thromboses or the loss of libido, listlessness or depression- to name only a few. As various studies have shown, combined oral contraceptives can influence general well-being in healthy women even far beyond the mentioned side effects and in a way justify the statement that consumers lead somewhat of a chemically manipulated life.

So logically, it’s easy to understand why many women choose to turn to alternative methods when it comes to contraception. For example, so called fertility awareness methods such as temperature or hormone tracking are growing more and more popular. It has to be noted though, that these methods require a thorough understanding of your own body and leave little to no space for mistakes.

The other side of the coin

A possible explanation for the current trend against hormonal contraception could be found in the length of the birth control pills' existence: The pill was introduced 60 years ago- which means that among young women there is almost nobody left who has experienced the time of natural fertility themselves. Our mothers would still know families with eight children, for example - and thus know that it is important to control their fertility. But young women today are growing up in a world where most families only have one or two children and may confuse this privileged world with the "normal state". This can sometimes also lead to being less careful when choosing contraceptive methods.

For many gynecologists, consultation about hormone free alternatives to the pill have long been added to their everyday practice lives. By them it’s then explained that hormones are not fundamentally bad- and simply safe. The argumentation is here, that young women are extremely fertile and if they don't want to experience the morning-after pill as a permanent solution, they’ll have to consider what they want: If not hormones, all that is often left is the copper IUD. A condom works as well of course, but when it comes to young women's fertility, condom contraception is often seen as bad and unsafe. According to advice centres, the condom actually has a Pearl Index of 2 to 12, which means that if it is used for 12 months, two to twelve women out of every 100 women will become pregnant unintentionally. It has to be noted though that with condoms, this is often due to incorrect use.

So out of a gynecologists perspective, one could argue that a hormone-free contraception isn’t necessarily better for every patient. If you take the pill, after all you are in a hormonal steady state. In general, we know what the pill does - it suppresses cycle-dependent hormonal fluctuations, both positive and negative. This may be great for one woman because her libido returns, but it may be less so for another woman who suffers from severe PMS after stopping the pill.

It’s all about education

What’s most important, is that women must be encouraged more to do what is good for them and should be able to decide alone about their fertility and all possibilities should be open to them. In order to do this though, even young girls should be given detailed advice about how their cycles work and how the pill works and what its possible effects can be when it is prescribed to them- which is often not the case and can be seen as rather irresponsible.

It is frightening how little information gynaecologists seem to obtain from their patients and how poorly they inform them. Even though according to case law in some countries, information should be given with particular care. But the opposite seems to be the case: Inadequate or incorrect advice can ultimately even lead to a treatment error and serious damage to health. However, this circumstance is difficult to prove if there were no witnesses and doctors are not obliged to keep a record of the consultation. Up to now, many countries are still lacking a guideline from gynaecological professional associations that tells doctors what questions they should ask during a contraceptive consultation and what information they should pass on.

The eternal fuss with male contraception

Research is still underway on the pill for men. But just like the birth control pill for women, the pill for men would be a hormone bomb. So the legitimate question on both sides would be: Do I want this?

But as latest research shows, there is a possibility for a hormone free contraceptive method for men which just recently has been successfully tested: The so called Vasal gel, works by blocking the sperm duct for, well- sperm. Experts doubt, however, that the product will be ready for the market, as it would have to be injected into the spermatic duct and the target group, heterosexual men, have already proven to be demanding when it comes to contraceptives in the past. An even bigger problem in the further development of the gel is the financing though. Large pharmaceutical companies are not interested in the gel, because they make much more turnover with monthly pill packs than with an injection which is necessary every 10 years. It is therefore questionable whether the product can only be brought to market by non-profit organizations.

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