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"I have turned into someone I don’t recognise, someone who falls into fits of rage over the slightest things, who is so irritable and self-centred," 29-year-old fitness instructor Jess tells Refinery29. "I had the contraceptive implant [which releases progesterone and is fitted under the upper arm] fitted April last year and since then, I have completely changed."
In the six months following the implantation, Jess experienced psychological symptoms like mood swings, depression and low self-esteem, which had a significant effect on her relationship. "Before I had the implant [my husband and I] hardly ever fought, but ever since I’ve had it, I have gotten mad at him over the tiniest things. It’s always a huge overreaction too. I’ll scream at him for not doing the dishes. I’m just tired and bloated and angry literally all the time," she explains.
"I feel like I’m going crazy and I shouldn't be so mad at him but I can’t control it." Jess is now waiting to have her implant removed, which she hopes will improve her relationship with both herself and her husband. "To put it bluntly, I’ve been a nightmare since I got the implant. My husband wants me to have it taken out because it makes me so miserable, and I want it gone because I’m making him miserable too."
Jess is not alone. Many women report changing their contraception to better their relationships.
Dr Becky Mawson, clinical lead at contraception review platform The Lowdown, tells Refinery29 that although long-acting contraception is becoming more and more popular, around one in four people have their LARC (long-acting reversible contraception) removed early due to side effects, including women whose relationships have suffered as a result.
"Some side effects of hormonal contraception are obvious, like spotting or irregular bleeding, while other side effects can be slower to emerge and are the ones which often cause issues in relationships," explains Mawson, adding that common complaints include loss of sex drive, mood swings and vaginal dryness.
"These can happen with certain synthetic progestins, which are found in the implant, injection and hormonal coil and can really take a toll on your relationship. These side effects, if unaddressed, can cause problems with intimacy and communication, and even result in relationship breakdowns. I often hear from people who have these side effects and it leads to relationship issues and breakups."
A recent survey of 500 British women, shared in a Stowe Family Law press release, echoes Mawson's findings. The survey revealed that 73% of women have experienced effects like mood swings, depression, anxiety and a loss of sex drive when taking hormonal contraception. Of those women, 89% said their relationship was strained by those effects and 64% of women said mood swings caused by hormonal birth control brought on arguments and communication problems with their partners. Like Jess, a whopping 65% said they had to come off their contraception to help their relationship issues.
Twenty-six-year-old schoolteacher Charlie says she knows "all too well" the feeling of hormones taking over a relationship. Charlie has been with her boyfriend for seven years and says they rarely argued before she had the hormonal intrauterine device (IUD) fitted. "After, though, I would fight with him over basically anything."
I didn't notice any changes in my body but my brain was a mess. I'd wake up angry and upset without a reason for it.
Like Jess, Charlie struggled with mood swings and low self-esteem, which had a knock-on effect on her relationship. "I didn’t notice any changes in my body but my brain was a mess. I’d wake up angry and upset without a reason for it," she explains. "You can imagine how a person who thinks of themselves like that for no reason [can impact the state of] a relationship."
Since having the coil (IUD) removed and going back to condoms, Charlie says she and her boyfriend have managed to get back on track. "I got the coil taken out to save myself and my relationship. The way it changed me wasn’t good for either of us," she explains.
Hormonal contraception is notorious for giving women a hard time psychologically. Symptoms like depression and mood swings are commonly cited by women who are on LARC such as variations of the contraceptive pill, implant, injection or hormonal coil. Though these side effects are well understood, they’re often framed as a small price for women to pay in exchange for relieving the worry of unwanted pregnancy. This attitude, however, fails to recognise the severity of these symptoms in real-world situations.
Relate counsellor and sex therapist Tamara Hoyton tells Refinery29 that she sees a lot of patients who are struggling with the side effects of contraception, like depression and mood swings, which have a profound effect on their romantic relationships.
"Experiencing depression and mood swings will impact your relationship with yourself," she says. "If you're struggling with mood swings [while in a relationship], you may hear yourself saying things that you might not be terribly proud of later. That can impact on your self-esteem first of all, but it also impacts your whole relationship as it affects the sense of trust." This sense of unpredictability can make everyone in the relationship feel wobbly.
If these kinds of feelings are dominating a relationship, Hoyton says it’s unsurprising that many women would want to remove the source – in this case, their contraception.
However, contraceptive side effects in themselves aren’t solely to blame. Many women surveyed by Stowe Family Law pointed out that, often, the men they were with lacked empathy towards how hormonal contraception was affecting them and knew little about it. In the same research, nearly a quarter of women said their partner does not understand the physical and emotional struggles caused by their hormones.
Hoyton notes that because of this, as well as the lack of a 'male pill', a lot of women are not only burdened with the task of choosing and sorting out contraception in their relationship but also face the side effects alone.
"It’s important for a long-term partner to be involved in talking about contraceptive options so women don't automatically assume all the responsibility for it," she says. "Contraception is something that affects each party in the relationship's health, and that can feel like a big responsibility. It’s nice to have your partner help and share some of that weight."
Being forced or pressured to change contraceptives by a partner is a form of abuse. In some cases, partners are not always looking out for you. They might insist on changing contraceptives to be in charge and take control.
TAMARA HOYTON, COUNSELLOR AND SEX THERAPIST
That said, all current LARC is for women and it’s ultimately a woman's decision what goes inside her body, particularly when some contraceptives are so invasive. When it is not her decision, more sinister intentions around contraception can come into play.
Twenty-five-year-old childcare worker Sophie* says she came off the combined pill after being pressured by her boyfriend. "I put a lot of weight on [within the first three months of taking it] and he admitted he didn’t feel as attracted to me now I was fatter. It was hard to shift the weight and I read that my pill might be causing it. I told him, hoping he’d lay off [me about] my weight, but he wanted me to come off [the pill] altogether," she tells Refinery29.
Sophie couldn’t get an appointment to discuss contraception alternatives with her doctor "for a long while". While she was waiting, she started to struggle with other side effects. These were made worse by her boyfriend's attitude to the uncontrollable changes in her body.
"My mood was low and I basically didn’t think about sex for weeks. Me and my friends [who are also taking the combined pill] joke that [the pill] only works as a contraceptive because it puts you off sex entirely," she explains. "Maybe I didn’t want to have sex because my boyfriend was being mean or maybe it really was the pill. Whichever it was, I felt fat with no desire and he started to openly talk about not knowing why he was with me."
Sophie says this change in her partner’s feelings towards her had her "on the phone daily" trying to move her appointment forwards. She came off the combined pill and had the implant fitted a few weeks ago, and hopes it will help her relationship.
Hoyton says that discussing contraceptive choices in a relationship is important but warns that some complaints and demands about contraception can be a sign of coercive control.
"Being forced or pressured to change contraceptives by a partner is a form of abuse. In some cases, partners are not always looking out for you. They might insist on changing contraceptives to be in charge and take control," she explains.
As naturally social creatures, our relationships are important to our quality of life. It makes sense to want to abandon contraception with side effects that threaten this. If your pill, implant or other contraceptive is wreaking havoc on your mental health and damaging your relationships, it’s okay to switch options.
Dr Mawson agrees. "I absolutely support women stopping LARC sooner if they are having side effects, which affect their relationships. There are so many options available and each contraception is different, with separate sets of side effects, so it’s worth trying different things [to see what works for you]."
It can be hard to determine whether your relationship is being affected by your contraception’s side effects or whether something darker is at play – particularly if a partner is pressuring you. If a partner complains about your contraception’s side effects, they may be genuinely concerned for you, but Hoyton says to pay close attention to the language being used.
"It’s a warning sign if it’s for selfish or superficial reasons like your weight, the potential of losing your sex drive or him not wanting to use condoms," Hoyton emphasises. "In these cases, this person is making the impact of your contraception about them, not about you or both of you as a couple."
*Name changed to protect identity
This article contains general information, and should not be understood as medical advice. Each individual's circumstances are different and should be discussed with a medical practitioner.