4 surprising physical & mental side effects of birth control

mental side effects of birth control
Photo: Liza Summer

I was the last in my group of friends to have sex. As my friends began to couple up, most of them started taking birth control, almost as a rite of passage. I remember them discussing how the pill made their breasts bigger and their acne go away—so when I had my first real boyfriend, going on the pill seemed like a no-brainer.

At that time, the only adverse effect of birth control my doctor mentioned was that I could get blood clots if I were a heavy smoker. Other than that, the doctor told me there were no long-term adverse effects, so I stayed on the pill pretty consistently for the next 10 years without much thought.

It wasn’t until the last few years that I began to learn more about how birth control may have impacted parts of my life beyond just having clearer skin and bigger boobs. If, like me, you’ve taken birth control on auto-pilot for many years, it may be time to explore some of the other ways birth control can impact your life and well-being that your doctor likely did not share at the start. 

Here are four physical and mental side effects of birth control to consider:

Side effect #1: Decreased interest in sex

The great irony is that the pill you are taking to enjoy sex without the threat of pregnancy may lead to less interest in sex. When pregnancy is possible, we are more in tune with sexually relevant stimuli than when it is not. Research shows that at specific parts of the cycle (before and during ovulation), women are more likely to put effort into their appearance, have a richer fantasy life, and generally be more sexually excited

Birth control puts women in a perpetual non-ovulatory (i.e., non-thirsty) phase, instead of naturally cycling. This is because birth control tricks your body into thinking you’re pregnant all the time (to prevent pregnancy), but the result can be a lower sex drive for those on the pill. 

Side effect #2: Shifts in attraction

Is it possible that we date different people depending on our contraceptive choices? Research points to yes. As mentioned above, birth control shifts our arousal and, on some level, takes our focus away from attraction and sex. One study found that women who chose their partner while on the pill were likely to be happy with their partner’s finances and intelligence. However, respondents who were not on the pill expressed higher attraction to their partner and rated their partner’s body as sexier. 

An interesting way to understand the effect of birth control on attraction is to examine how relationships shift when partnered women who were previously on the pill go off it. Research shows that going off the pill improves women’s sexual relationships only if their partner is rated as empirically attractive! This makes sense because being on the pill can shift our focus away from sexuality.

By taking off the pill-glazed glasses, we are better able to assess our partner’s appearance. If our partner is attractive, we may enjoy exploring the sexual relationship with them even more. However, if they are not, we are less satisfied, perhaps because we become more aware of their appearance. 

Side effect #3: Mood changes

Among the most significant mental side effects of birth control are its impact mood regulation. Research from Denmark shows that women were 50% more likely to be diagnosed with depression in the six months after starting birth control than women not on birth control. This spike is highest for women aged 15-19, often when girls start taking the pill. The same Danish study  found that, tragically, women on birth control were three times more likely to commit suicide than folks not on the pill.

Correlation isn’t causation, and there may be other factors that make women who are on the pill more likely to have mood issues. However, it seems that, at least for some women, birth control can shift their mood—likely due to the changes in hormonal levels that the pill creates in the body.

Side effect #4: Impaired stress response

Whether a bear jumps out at you or you see your ex walking down the street with a new partner, it is natural to experience a stress response. Stress is typically expressed in the body through the release of cortisol. Fascinating new research shows that folks on the pill experience stress in their bodies (i.e., would say that they feel stressed out) but do not experience cortisol-related release. 

Although this might appear to be a good thing, having a balance of stress hormones is healthy. If you experience too much stress, you may become overwhelmed and unhappy, but if you experience too small a stress response, you may feel bored, sad, or disinterested in life. Put simply, science shows that this shift in cortisol over time can lead women on the pill to experience biological markers of chronic stress, some that may even last after they go off the pill.

Understanding the physical and mental side effects of birth control and making informed choices

There is no question that the creation of birth control was brilliant, giving us important options when it comes to our sexual health. For some, the relief of not worrying about pregnancy may make them more excited about having sex, less stressed, more into their partner, and therefore happier. In that case, being on the pill is certainly the move.

The issue is that we deserve to make informed decisions about the drugs we take. Doctors need to start disclosing how birth control can impact our day-to-day experience, and not just the most extreme side effects. For years, women’s health has been deprioritized, and women’s complaints have not been taken seriously, especially with issues related to mood or sexuality. Knowledge is power. To grow as a society, we need to become more informed about the physical and mental side effects of birth control so that we can make the right choices about which contraceptive will work best for us.

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