Tell us the truth about the PILL
As a new study reveals it has powerful effects on our bodies AND minds, women who say their lives were blighted are demanding...
TO ThE outside world, Triona McBride’s life looked perfect. In her early 20s, she was in a stable relationship, with close friends and a job she enjoyed. And yet, one summer day, while having lunch at a friend’s house, she found herself sobbing in the bathroom while looking through her hostess’s medication, wondering if there was anything strong enough to end her life.
Thankfully, Triona came to her senses and returned to the meal.
‘That moment had been preceded by three weeks of almost non- stop crying,’ recalls Triona, now 34. ‘I felt desperate. What stopped me hurting myself was the thought that I’d ruin the day for everyone else.’
The incident functioned as a wake-up call: she finally realised how serious her sudden, devastating mood swings had become. ‘It prompted me to go to a counsellor for the first time,’ she says. ‘But although I went on to see several therapists, none of them ever realised the true cause.’
It would be a further nine years before Triona discovered that her depression was caused by the contraceptive pill.
While many millions of women take the Pill without problems, a significant minority are reporting a devastating impact on their emotional well-being.
Depression is listed as a side- effect in the small print warnings leaflet included in every packet, along with symptoms such as blood clotting, weight gain, pain and decreased libido — although experts say doctors are failing to make women aware of the risks. Some believe medics are worried about a spike in unwanted pregnancies if women’s trust in the Pill is shaken.
Triona first took the Pill aged 15 — with her parents’ consent — because she was experiencing severe period pain, and this can be alleviated by going on the Pill.
Within two months, she says she went from being ‘bubbly and sparkly’ to feeling she ‘couldn’t put one foot in front of the other’.
At the time, it was all too easy for her doctors to dismiss this as typical teenage drama. A few years later, when she again sought help, another GP told her it was normal to have ‘dark moods’ from time to time.
Triona had been put on a medication that seriously disrupted the function of her hormones, which play a vital role in the regulation of emotion. Yet little is known about the impact this can have on a young woman — and startlingly little research has been done on it.
This week, one German study found that hormonal contraception can reduce a woman’s ability to identify emotions in other people, which researchers believe could lead to misunderstandings and arguments. The study’s lead author, Alexander Lischke, said: ‘More than 100 million women use oral contraceptives, but remarkably little is known about their effects on cognition, emotion and behaviour.’
For Triona, relief came only when she herself spotted a pattern.
The contraceptive pill contains artificial versions of female hormones that override the monthly reproductive cycle. Traditionally, women have been advised to take it every day for three weeks, followed by a week’s break.
Triona found that she felt ‘ normal’ during that week’s break, but when she started taking the pills again, the darkness would descend.
Without consulting a doctor, she simply stopped taking the Pill and used condoms as contraception instead. Within a couple of weeks her suicidal thoughts had vanished, and she felt happier than she had since she was a young teenager.
‘ No doctor or counsellor ever referred to the Pill causing these horrible feelings,’ she says. ‘I was so frustrated when I realised it was the Pill making me feel this way.
‘I just wish I had been told about the link to depression.’
Psychotherapist Christine Elvin says Triona’s story is sadly familiar. Indeed, each time she sees a new female client with anxiety or depression, her first question is: ‘Are you on the Pill?’
Christine says: ‘These aren’t isolated incidents; it’s happening all the time. I’m starting to see doctors taking more notice of the psychological effects of the Pill, but a lot more needs to be done.’ If Christine suspects a patient’s depression is linked to the Pill, she recommends they ask their GP if they can switch to a different brand.
Alleviating these women’s depression, she says, is often as simple as testing out a few different formulations of the Pill to find one that agrees with them.
‘The majority of my clients’ mental states change once they’re prescribed a new Pill,’ she says.
Although there are dozens of different brands of the Pill, most contain a mix of two synthetic hormones: oestrogen and progestogen. The ‘ combined pill’ gives a dose of both of these; the ‘mini-pill’ has only progestogen.
A 2016 study at the University of Copenhagen of more than a million women found a clear link between hormonal contraception and subsequent diagnoses of depression. Those using the combined pill were 23 per cent more likely to be diagnosed with depression and those on the mini-pill 34 per cent more likely.
Teenagers had an 80 per cent increased risk of depression on the combined pill, and this risk was even higher with the mini-pill. Other forms of hormonal contraception were even worse.
Incredibly, given how many lives were potentially affected, the statistics seemed to slip under the radar.
ANOThEr
study by the same researchers in 2018 found that hormonal contraception use tripled the risk of suicide. The study looked at more than 475,000 women with no pre- existing psychiatric problems over eight years. Again, teenagers were particularly affected.
Unfortunately, there seems to be no one-size-fits-all answer to which pills will cause side-effects in which women. Everyone’s hormonal balance is different, so it often comes down to trial and error.
That’s something I know firsthand. I was on the Microgynon pill when anxiety and low moods took hold. I spent my 19th birthday in tears. I was in my first year of university and having the best time of my life — so why did I feel so low? I was lucky to have a GP who realised what was going on and switched me to a pill called Yasmin, and later another called Cilest. There’s more oestrogen in Cilest, which had a positive impact on me. Back then, the notion that the Pill could trigger depression or anxiety was largely a hunch based on my own experiences. It wasn’t until I started researching the link as a journalist that I realised just how many people suffered similar issues.
Many women who take the Pill are mystified by the conflicting advice, with ardent discussions online about which brands cause what sideeffects. Some feel that GPs don’t care about finding the best option for each patient, preferring to hand out the most common or affordable forms of contraception.
The news last month that the NhS has changed its longstanding guidance about taking a week’s break from the Pill each month only emphasises the lack of transparency in regard to female contraception.
The Faculty of Sexual and reproductive healthcare, which sets NhS standards, said there was no health benefit to the break, which can result in women experiencing cramps, muscle aches and mood swings. (It had apparently been introduced to make the Pill seem more natural — by allowing for monthly bleeding — and to try to convince the roman
Catholic Church that the Pill ll was acceptable.)
In fact, the bleeding that at women experience while taking g the Pill isn’t a real menstrual al period at all, but simply a reaction cic to the drop in synthetic hormones when they stop taking ng their daily dose.
NHS guidelines state that most st mood swings caused by the Pill ill will improve over time or stop op altogether within months; only nly then is switching to a new pill recommended. ecice This is also the advice many GPs offer when patients nts complain about mood swings.
But for Shaveve Sharpe, 31, who ho works in distribution in London, on, the ill-effects were long-lasting.
She used the combined pill before having her son, now aged ed 13, then went back on to it for ra a further three years after he was born, but quickly began to feel out of sorts.
At first, she attributed her experience to the intense emotions of being a new mother.
She says: ‘I was very shorttempered and I used to get in arguments for no reason. I suffered from bad depression, moodiness and anxiety. I found it hard to work out what other people were feeling. I was just not functioning as usual.’
Miserable, she lost interest in sex and felt withdrawn.
Again, Shaveve did not make the link between the Pill and her mental health until unforeseen circumstances intervened.
In 2008, she experienced severe breathlessness and was rushed to hospital, where doctors found a blood clot in her lung. ‘I thought I was going to die. I was terrified,’ she says. ‘I spent a month in hospital while they did tests. Then I was told the clot was caused by the synthetic oestrogen in my contraceptive pill.’
Blood clots are a rare but extremely serious side- effect of the combined pill.
When she had recovered, Shaveve was advised to start taking the mini- pill, which contains no oestrogen.
However, she felt uncomfortable taking any synthetic hormones after her experience, and came off the Pill altogether.
‘Two months later, my depression suddenly lifted,’ she recalls. ‘I didn’t feel low any more. ‘I went out more and had time to look after myself. I enjoyed watching my son growing up. And, suddenly, I was having more fun when it came to my sex life.’
Despite a wealth of anecdotal evidence, not all experts agree that there is a causal relationship between hormonal contraception and mental health problems.
Last year, researchers in the U.S. reviewed 26 studies on depression and progestogen-only methods of hormonal contraception, and concluded that there was insufficient evidence to prove a link.
There is, however, ongoing research into alternative methods of contraception. In 2016, an injected in male contraceptive was found fo in tests to be 100 per cent effective. ef But in a development that th may seem ironic in light of recent re headlines about women and an the Pill, all research was halted ha after men reported sideeffects ef of depression, muscle pain, pa acne and increased libido. In I recent years, the NHS has encouraged en the use of ‘ longacting ac reversible contraceptives’ — forms that don’t require a woman o to remember to take a pill eve every day.
For example, the coil is a device inserted into the womb that comes in two versions — one with progestogen ges and the other with no ho hormonal component; the con contraceptive implant is a matchsticksti sized device placed in the upper arm that works by slowly releasing progestogen; and the contraceptive injection provides three months’ worth of hormonal contraceptive in one treatment.
According to the NHS, in 2017, 39 per cent of women accessing contraception through its sexual health clinics opted for one of these longer-lasting forms.
But again, finding the right method for you seems to be a case of trial and error.
Emmie Harrison, 25, a writer from East London, started taking the Pill aged 14. After suffering severe mood swings and anxiety, she decided to have the implant fitted aged 19.
‘Things got even worse after that,’ she says. ‘My mood swings were horrific — and I was on my period for a solid three months.
‘My sex drive was next to nonexistent because I felt uncomfortable with my body and unhappy with the person I was becoming.
‘I stopped caring about other people’s concerns because I was so confused and upset by what was happening to me.
‘At no contraception appointment I attended was I told of mental health risks by my GP. And what 14-year-old reads the label word for word?
‘Yes, I’d been told that I might get fat or spotty from taking the Pill, but never that I’d cry in the middle of a lesson, feel sad for no reason or go through extreme mood swings.’
Six years ago, Emmie had the implant removed and instead got the Mirena coil fitted — a brand with low doses of progestogen.
She says: ‘It has been a lifesaver. I’ve used it for six years now. I don’t get a period, and while I get bad cramps once a month, it’s much better than anything I tried before.’
Since I began writing about the Pill, hundreds of women have contacted me to share their bad experiences.
I hope that by encouraging this conversation, more women will feel better equipped to ask their GP for help finding a solution that works for them.
In the meantime, far more research is needed into the link between hormonal contraception and mental health — not to mention more support.
Expecting women to find a solution by trial and error simply isn’t good enough.