WHY ARE SO MANY WOMEN QUITTING BIRTH CONTROL?

Last November, my sister got married. It was the most beautiful day, full of love and flowers and joy. It was also the day I realized I needed to dump my birth control. After five years with an IUD, I had restarted the pill about four months before the wedding. My gynecologist had assured me that any physical changes from the different hormones would be minimal. She said that at most, I might gain three pounds, and that it would largely be due to an increased appetite. Tell me why, then, my maid-of-honor dress—which fit perfectly and comfortably in August—left bruises on my collarbones because the straps had become too tight?

If you compare a picture from the late-summer bridal shower to one from the wedding, the change in my cleavage is simply obscene. I hadn’t adjusted my diet or workouts in that window; the only variable was my contraception. WTAF? According to Tiffany Pham, a Texas-based ob-gyn and medical adviser at Flo Health, a women’s health app, I’m far from alone in my agita. She says that at least 30 percent of women taking oral contraceptives report some form of negative symptoms. This leaves about 70 percent feeling fine on the pill, but still, one third of users having issues isn’t something to ignore. “We typically see skin changes, weight gain, mood swings or irritability, more anxiety, headaches, and sexual effects such as decreased libido and vaginal dryness,” Pham says.

Of course, none of this is new. Women have experienced the pill’s unpleasant side effects for 64 years, to be exact. The difference is that today, they’re done tolerating them. National statistics are scarce, but Pham and Sarah Hill, PhD, a psychologist and author of This Is Your Brain on Birth Control, have both noticed increased interest in non-hormonal forms of birth control over the past few years. On Google Trends, the search term “side effects of stopping the pill after prolonged use” saw an increase of 350 percent in the past year. And when theSkimm polled its Instagram followers in the fall of 2023, 32 percent said they had recently stopped taking the birth control pill.

“I see this more with younger millennials or Gen Z users—there’s a shift toward natural products or more naturalism in the things that they’re using, including hormone-free contraceptives,” Pham says. There is a hormone-free birth control option that’s long-term and reversible: the copper IUD. But the word natural really points to old-school methods of tracking your fertility via your basal body temperature or counting your cycle (or, ya know, pulling out). The CDC says these can have an up to 23 percent chance of failing, compared to the pill’s 7 percent failure rate. And, unfortunately, natural fertility-tracking methods are the ones that many influencers are pushing on social media. Searching “birth control” on YouTube sends you to an endless scroll of videos with millions of views—many of which a 2023 study found to be “primarily about the discontinuation of hormonal birth control” and “may provide inaccurate sexual health information.” #Gettingoffbirthcontrol has been viewed more than 24 million times on TikTok.

There’s actually been a lack of research and innovation with birth control in general, says Jolene Brighten, an endocrinologist, sexologist, and author of Is This Normal? “Women live in their bodies. They know their bodies. And yet medicine is waiting for a research study before believing your experience in your body.” Hill concurs: “For a very long time, nobody has put any effort into looking for alternatives for us. Everybody assumed that the issue was solved because we got the pill.” Plus, birth control is still seen as a woman’s responsibility. There’s been an increase in vasectomy consultations since the fall of Roe v. Wade, yes, but the numbers are pretty small—and, keep in mind, vasectomies are reversible in most cases and do almost nothing to the male body’s hormones.

That’s why this growing trend of women sharing quitting stories on social media is a double-edged sword. We need to bring the lack of research to light—but we don’t want to drive anyone away from birth control when they might desperately need it. “A lot of people who advocate against birth control are like, ‘It’s poison,’” Brighten says. “But they don’t understand the privilege of the situation they’re in. Maybe they’re not being sexually abused at home. Maybe they’re not houseless. They just don’t realize how much privilege they have to be able to say no to using hormonal birth control.” I know how lucky I am to be a somewhat financially stable white woman in New York City. I have access to luxuries that many other women do not—including access to every form of contraception and safe abortions.

It’s deeply ironic that this exodus comes in the wake of Roe’s fall. But, to uncover one silver lining: “There’s an increased demand for education, for content that allows you to be more informed about the decisions you’re making about your body,” Pham says. And it’s actually one of the most powerful tools women can use in maintaining their bodily control. “I’m hoping this starts to put pressure on both science and medicine to create alternative products,” Hill says. “Women are realizing how low our standards are. We would not have these low standards with anything else.”

So, for the next stop on my birth control journey: I went off the pill. Maybe my weight fluctuations would’ve worked themselves out, but I do know that my bras started fitting me again within a few weeks. And now, for the first time in eight years, I’m letting my body do whatever it wants to do without hormonal contraception. It may be “natural,” but I can’t say I’m enjoying it. My period is heavy and makes me want to cry—a lot—and I’m still anxious as ever. Plus, not being in a relationship, condoms feel like my only option for protection. And the fear of rejection from asking a new or casual partner to use one? That’s a whole other can of worms.

But when I asked my gynecologist about trying Nexplanon, an estrogen-free contraceptive in the form of a matchstick-size arm implant, she said it would take three to six months to get—“because of insurance.” There’s also a brand-new, FDA-approved over-the-counter, progestin-only pill, the Opill, hitting pharmacy shelves soon. Once again, though, it’s not a perfect solution. “You have a very narrow window—you can’t miss that pill,” Brighten explains. “If you miss it by a few hours, you should really abstain from sex for a couple of days.” Not only that, but since a doctor didn’t prescribe it to you, there’s no support if anything goes astray. “I’m glad it’s going to be available, but I don’t know what sort of safeguards are around it,” Hill says. “You can just pick it up, and nobody knows that you’re starting it.”

So for now, I’m waiting—and watching. Will the rise in women quitting birth control lead to a rise in unplanned pregnancies—all in a post-Roe world? The jury’s still out.

2024-03-14T15:18:24Z dg43tfdfdgfd