21st March 2022

A science story: My experience on the combined pill

In this new series, our writers share personal encounters and explain the science behind them. This week, we hear from one writer’s experience with the contraceptive pill.
A science story: My experience on the combined pill
Reproductive health supplies coalition @ unsplash

Like many other girls my age, I was prescribed the pill by my doctor after complaining about bad acne and painful periods. In the eyes of a teenager the pill appeared magical –  clearer skin, no period pains – even bigger boobs! With over 100 million women worldwide taking the combined oral contraceptive pill, it felt like a safe bet. Yet the last four years have taught me that there is a great difference between the ‘magical pill’ I was told I was being prescribed and its reality.

How does the pill work?

The combined pill contains synthetic versions of two hormones – oestrogen and progesterone. The hormones work to prevent the release of the egg into the fallopian tube for fertilisation. Pregnancy is also prevented by the thinning of the womb’s mucus lining and thickening of the fallopian tubes. The artificial oestrogen and progesterone in the pill prevent ovulation by inhibiting the production of these naturally occurring hormones in the ovaries.

Can the pill cause changes in mental health?

Whilst it is impossible to say definitively that the pill causes anxiety or depression, many women notice these problems arising and it is important to address this. During my second year of being on the pill I started to notice some deeper issues forming – the most important being a change in my mental health. This was the first time I had struggled with an issue like this. I was experiencing intense mood swings, a general lower mood and significantly higher levels of anxiety. I would feel tearful without understanding why and avoid conversations that would cause me social anxiety, even with my friends.

When trying to understand why I felt this way, I discovered the hormones within the pill interact with specific receptors in the brain involved in emotional control. Depressive symptoms are among the most common reasons why women discontinue this form of contraception. A woman’s brain is said to finish maturation by the age of 21, which is highly concerning as the pill is prescribed so heavily to teenagers. It has been shown that there is an 80% increased risk of depression if you take the pill between the ages of 15-19 years. This is a shockingly high number yet the pill is still heavily prescribed by doctors to teenagers.

Whilst most women choose to take the pill for contraceptive reasons, many decide to go on it due to hormonal issues such as acne or painful periods. In these circumstances, the pill acts like a ‘band aid’, covering the deeper undiagnosed issue that the individual is experiencing. Many women have reported that since coming off the pill they have been diagnosed with hormone-related conditions, such as polycystic ovarian syndrome (PCOS). However, it is important to say that some of these cases are women with short-term ‘pill induced’ PCOS as opposed to ‘true’ PCOS. Women with PCOS have small cysts covering their ovaries which can later lead to fertility issues and there is currently no cure. It is therefore of paramount importance to be diagnosed so that preventative steps can be taken.

The issue with prescribing the pill so heavily to teenagers is that the common symptoms of PCOS are virtually identical to changes during puberty, such as acne and oily skin. Therefore, it can be incredibly difficult to decipher whether there is a deeper health issue that needs to be treated. And, if the individual experienced acne before the pill, it is very common for that acne to reappear once the pill is stopped. So when a doctor prescribes the pill to “treat” the acne the patient is experiencing, this could be causing long-term damage.

Finding the right birth control

It is vital to address the fact that one method of birth control will not work for everyone. Plenty of people love the pill and suffer from minimal side effects. For many of my friends, the pill has helped to improve the low mood commonly experienced during their PMS. This has led to overall improved mental health. That being said, it is not uncommon for people taking this contraception to experience some uncomfortable side effects. Either way, it is important to be fully informed so that you can make the best decision for you and your body.

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