I went on the contraceptive pill when I was 17 without knowing much about what it would do to my body. I’d see my friends pull out the plastic packets during lunch breaks and tell me they were taking it either because they had acne or were having sex (sometimes both). So when I got my first serious boyfriend, the obvious thing to do was to make an appointment with my GP and ask about going on the pill myself.
I was at a pretty formative stage in my life when I made this doctor’s appointment. I was studying for my A-levels at the time. Shortly after, I moved out of my hometown to go to university, where I balanced an entirely new social life and sex life with my studies. It was during this time that a few things changed physically: I began dealing with anxiety on a regular basis, I developed IBS, I put on some weight and my skin completely cleared up. There’s no way to tell if these things happened because I went on the contraceptive pill or simply because I was a teenage girl coming out the other side of puberty. But in the six years since then I have spent a lot of time wondering what I’d be like as a person had I not spent my late teenage years and early 20s taking hormonal contraception. And so, after being advised by my GP to switch to the progesterone-only pill due to concerns about migraines I’ve been having, I decided now was as good a time as any to take a break from it completely.
The nurse I spoke to during my most recent pill check informed me that there are few risks to being on the pill for an extended period of time and that it was unlikely that coming off the pill would benefit my long-term fertility or impact the potential of long-term health issues. However, as long as I used other forms of protection, there was no harm in coming off it if that was something I wanted to do — I could stop taking my pill that same day. Another factor in my decision was that I’ve been reading for the past few years about the seismic impact the pill can have on people who take it. When I was first prescribed the pill at age 17, my doctor warned me about the very low risk of serious health issues like blood clots and cervical cancer, and talk among my friends in my teenage years informed me that taking the pill might lead to weight gain (although there isn’t enough evidence to suggest this is accurate).What I didn’t know at the time was that the synthetic hormones used in the pill could potentially alter my sex drive, mood and even the function of my brain.
In the six years since I started taking hormonal contraception, I have spent a lot of time wondering what I'd be like as a person had I not spent my late teenage years and early 20s on it.
Sarah E. Hill, PhD, is a research psychologist specializing in women’s health, whose book How The Pill Changes Everything: Your Brain On Birth Control explores the impact of hormonal contraception on the brain and the body. "I think that we need to take it very seriously, the idea that the way we're regulating fertility for women is by changing their hormones, because our hormones are a lot more than something that affects our period," she says.
Dr. Hill assures me that a lot of the social media content I have been seeing around the pill recently is potentially alarmist, making huge claims about the pill that don’t have any scientific backing. For example, one TikTok showing a clip from a podcast saw the host claim that your body thinks it’s pregnant when you’re on the pill, going as far as to say that "maybe trying to meet a life partner when you’re drugged is not a good idea."
"There's some wisdom with being cautious and in questioning introducing novel things into our bodies," Dr. Hill tells Refinery29. Her research interrogates why so many people are encouraged to take the pill without adequate knowledge of its potential side effects. However, she stresses that the pill impacts everyone differently and broad statements like the one made in the above TikTok video are not accurate.
There are 23 different formulations of the pill in the U.K., which is one of the reasons it impacts people differently, although this also comes down to individual hormone levels. "Some women’s normal hormones are so different to the level to what they are taking in the pill, which can make them particularly susceptible to the effects of those hormones and they can really feel a difference," explains Sarah Welsh, a gynecologist based in the U.K. and cofounder of the sexual wellness brand HANX. For other women, the level of hormones in the pill might not differ too much from their normal level, so they’re not as affected by taking it.
When I stopped taking the pill in October, I wanted to keep a close eye on how it affected my body so I downloaded the period tracking app Clue, which allows you to log daily habits, emotions, and track your physical health. I also kept a diary of any unusual or recurring symptoms. Of course, the effects of the pill and coming off it are highly individual and it’s difficult to know whether some of the things I was tracking were really impacted by coming off hormonal contraception or were circumstantial, particularly because a doctor wasn’t monitoring my symptoms. However, these are some of the changes I’ve noticed since I came off the pill three months ago.
I have always had a very high sex drive but it has definitely increased since I stopped taking the pill. According to Dr. Welsh, this is very common and some research indicates that it’s because the pill lowers your body’s natural levels of testosterone. "Some women really do feel the difference with their libido when they come off the pill, whether it increases or decreases," she says, explaining that it’s totally dependent on an individual’s natural hormone levels.
It's difficult to tell whether the increase in my libido is because of circumstantial factors or hormonal changes in my body. However, my libido has been consistently higher than normal in the entire three months since I stopped taking the pill.
The biggest immediate change when I stopped taking the pill was that I experienced the biggest breakout I’ve had since I was at school. I struggled with mild acne when I was a teenager and it cleared up a lot when I went on the pill, but I was never sure if these two things were related.
Following this initial breakout, my skin went back to normal pretty quickly, apart from the odd spot or two the week before my period. Dr. Welsh tells me that the acne I experienced in the first month after coming off the pill was probably my body’s reaction to the withdrawal of the synthetic hormones that it had been used to while I was on the pill.
I had never had sex before I started taking the contraceptive pill and I’ve always struggled with a mild form of vaginismus, which means penetrative sex can sometimes be painful for me. Although I’ve learned to manage it as I’ve gotten older, it does still affect me from time to time. I was curious to learn whether the hormones in the pill played any part in this.
My experience of penetrative sex hasn’t really changed since I stopped taking the pill. The main difference in my sex life is that I’m not used to using condoms on a regular basis, apart from with new partners who haven’t been tested for STIs. Because of this, I’ve started carrying condoms in my purse.
As much as I was trying to be safe, I did forget to use a condom at one point shortly after coming off the pill. I took the morning after pill a few hours after having sex, which I was slightly nervous about as it was the first time I’d ever taken it. However, I had no symptoms other than a very light period exactly one week later. Dr. Welsh tells me that because the morning after pill contains a synthetic version of the hormone progesterone (which works to stop ovulation before it happens), this could have had an impact on some of the things I’m tracking.
Digestion, bloating and IBS
I developed IBS very shortly after I started taking the pill when I was 17 and have experienced bloating and stomach cramps on a regular basis since then. Neither of these has totally gone away since I came off the pill, although I have experienced less bloating than usual in the two weeks after my period ends and much worse bloating during my period and the week before it.
"Your bowels are really close to where your uterus is," says Dr. Welsh, explaining that it’s normal for the menstrual cycle to affect digestion, especially when the uterus is contracting during periods.
I used to take the pill continuously with no breaks, in order to avoid periods altogether. My GP told me this was totally safe to do and it was one of the main benefits of being on the pill for me. I had my withdrawal bleed a couple of days after I stopped taking the pill. Dr. Welsh explains that this isn’t the same thing as a normal period: "During the withdrawal bleed, you shed the lining of your womb but because you haven’t ovulated while you’ve been taking the pill, no eggs are released, which is what usually happens during your period." This bleed was very light and lasted only a few days.
"Once you stop taking the synthetic hormones that are in the combined pill, your normal hormonal function starts kicking in," says Dr. Welsh. For some, this begins immediately and their menstrual cycle will return to normal very quickly, whereas for others it can take a few months. This is usually dependent on factors that regularly impact the menstrual cycle, like weight, stress, and diet. If it does take longer for your period to return after you come off the pill, this isn’t necessarily something to worry about, especially because the hormones in the pill won’t linger in your body at all once you stop taking it, according to Dr. Welsh.
My first real period came exactly one month after I stopped taking the pill and it was much heavier than any period I’ve ever had. I also struggled with period pains almost the entire time I was on my period, which lasted around five days. This experience has been pretty consistent in the three periods I’ve had since coming off the pill. According to Dr. Welsh, my periods might be heavy and painful because my body is readjusting, or this might simply be what my natural cycle is like now. Most people’s cycles change as they get older, so there’s a high likelihood that mine changed while I was on the pill.
It’s also worth noting that the period I had a few weeks after taking the morning after pill was extremely painful and heavy, and I felt nauseous and had very painful cramps, even vomiting a couple of times, in the week leading up to it. "A lot of people say that they get a more painful, heavier period after taking the morning after pill," Dr. Welsh explains. "It is very common and it's because your hormones are readjusting the balance after you have taken synthetic hormones."
How I feel after three months off hormonal contraception
The impact on my body of coming off the pill was perhaps smaller than I anticipated, as my mood, energy, stress, and weight have all been more or less the same as when I was taking the pill. However, Dr. Welsh and Dr. Hill agree that both my body and brain might need a few more months to fully adjust, even though my menstrual cycle seems to be back to normal.
I’d like to stay off hormonal contraception for a few more months at least, but I definitely see myself going back on the contraceptive pill (the progesterone-only pill on my doctor’s advice) this year. This is mainly because I prefer the pill over condoms as a method of contraception. I’d also rather not have periods if I can avoid them — buying pads and tampons is expensive! The differences I’ve felt so far aren’t significant enough to negate these factors.
However, during the past three months I have felt more in touch with my body and better able to understand my experiences and feelings, both physical and mental. Recognizing what my body wants and needs and how that relates to my hormones has undoubtedly been the biggest benefit of life without hormonal contraception (especially when PMS is the perfect excuse for 10 hours of sleep and chocolate for breakfast).