by Sarah Doyel
In September 2016, I wrote a breakup letter and posted it on my blog. Before you get concerned about the fact that I shared such an intimate letter in a public space, I wasn’t breaking up with a person. I was breaking up with my birth control.
After roughly nine years of taking the Pill — Ocella, to be specific, which is the generic version of Yaz — I finally stopped. My relationship with my birth control far outlived any other relationship I’d had, and something about the decision felt momentous. I needed to make an official goodbye to the little purple packets that had accompanied me through nearly a decade of my relatively short life.
I find it difficult to pinpoint the exact moment I decided to stop taking the Pill. I had gone vegan in March 2016, earlier that year, and in the process started to question everything that I put in my body. I felt as though I’d suddenly removed a blindfold that I didn’t even realize was there in the first place. Starved for information, I began educating myself on the many industries that dictate what we consume, from food to cosmetics to household products to medication. What I discovered often surprised me, so I started to wonder about the medication I’d been taking every day at 10pm since I was fifteen years old.
Even before this process, I’d felt uneasy for some time about having been on the Pill for so long. It seemed odd that none of my doctors ever asked me about it, even though I dutifully listed Ocella on every new patient registration form I filled out. On the rare occasion that I brought up my birth control at a gynecological appointment, the doctor would tell me that staying on the Pill actually reduces the risk of certain cancers. Then she’d remind me to stand up and stretch on long-haul flights to reduce the risk of blood clots, smile reassuringly, and the conversation was effectively over. This happened with several different gynecologists, enough that I eventually just stopped asking. Their responses made me feel silly for asking, and conclude that their lack of engagement with me on the topic must mean that there was nothing more to discuss.
Until, that is, I started doing my research.
Before I go any further, it’s crucial for me to be clear: the Pill is widely accepted as a safe and effective method of birth control. As the article linked above explains, many physicians state that the Pill has either no net effect on cancer risk or actually reduces overall risk. In fact, studies have shown little to no significant difference in mortality rates between those who take oral contraceptives and those who have never used them, whereas maternal mortality rates and other pregnancy-associated health risks continue to rise in the United States. All this is to say that I am not telling you that you shouldn’t take the Pill. What I am saying, however, is that I wish I’d been given more information before taking that first prescription to the pharmacy ten years ago.
More specifically, I wish my doctor had talked to me about the relationship between hormonal birth control and mental health. A recent study made waves across the Internet and medical community with its findings that hormonal birth control may raise the relative risk of depression, but it’s common sense that a medication that modifies one’s hormones can also affect one’s mood.
As a teenager, I struggled with undiagnosed depression and anxiety. I never talked to anyone about it because I didn’t have the vocabulary, didn’t recognize that my feelings had names, let alone a diagnostic code. The year before I started taking the Pill, I cried for nearly the entirety of my birthday. I didn’t know why, and I couldn’t explain it. I would get a stomachache on the way to school every morning, not realizing this was a symptom of unchecked anxiety. Put simply, my mental health was not great, and I wish my doctor had broached the subject with me before putting me on a potentially mood-altering medication.
The doctor who first prescribed the Pill to me was actually a dermatologist; I went to her after struggling with pubescent acne and she suggested hormonal birth control as a way to regulate my skin. She didn’t talk to me about my lifestyle, or even really about my overall health. Desperate for a solution for my problematic skin and too young to understand how to be proactive in my own healthcare, I took the prescription and never looked back. When I started having sex several years later, I just stayed on the Pill and it became my primary contraceptive method. And it stayed that way until September 2016.
I don’t know if the Pill made my depression worse, or adversely affected my health. At the age of fifteen, I didn’t realize the importance of paying attention to side effects, and by the time I did, I’d already been on the Pill for years and couldn’t remember how I’d felt before it. What I do know is that I have lived with mental illness for the entirety of my adolescence and adult life, and that I wish that a medical provider had at least touched on the topic before prescribing me any medication, including hormonal birth control.
When I eventually did start thinking about going off the Pill and brought it up to my gynecologist, she nodded knowingly and said that many of her patients experience depression when starting hormonal birth control. Her evidence was anecdotal, but it resonated with me.
More than anything, though, I just wanted to experience my body and my cycle without the influence of hormonal birth control. My curiosity was the strongest impulse, since I couldn’t be sure one way or the other how the Pill had affected me over the years. And though it may sound anticlimactic, my body and mind didn’t feel radically different when I stopped taking the Pill. The first few weeks were an emotional rollercoaster as my body adjusted to its natural hormone levels, but then I evened out and felt like myself. I suppose I might have been a little bit happier, but that may have just been my own pleasure with feeling the natural rhythm of my body from month to month rather than any actual chemical difference.
Regardless of whether breaking up with the Pill changed my brain chemistry, I’m happier for having spent over a year without it. The reason? It was the first time I truly made my own decisions about my birth control and reproductive health.
The number one question I get when I tell people that I ditched the Pill is what method of birth control I use now. There are a number of non-hormonal options, from the copper IUD to the cervical cap to the fertility awareness method (FAM), and whichever one you ultimately choose depends on your lifestyle and preferences. Since I went off the Pill while I was in a long-term monogamous relationship, I considered using FAM, but the learning curve with charting my cycle proved to be too daunting for me. I therefore ended up using condoms with spermicidal lubricant, and now that I’m single, I use condoms for both birth control and STI prevention.
No method is perfect and each has its advantages and its drawbacks, which is why it’s crucial to have full and complete information about your options in order to make the best choice for you. Stay tuned for a post that breaks down all the non-hormonal birth control options I considered!
Sarah Doyel is a freelance writer, activist, and health justice advocate who writes at the intersection of wellness and social change. Her firsthand experience working in the healthcare field ignited her passion for making health and wellness accessible to all, and she’s been writing about it ever since. When she’s not freelancing, you can find her running, practicing yoga, and blogging as The Feminist Vegan at www.thefeministvegan.com. Find her on Twitter, Instagram and Facebook.