Doctors Are Not Being Honest About The Pill
Autumn Mackenzie (24) escaped the contracepted life, and thinks you should too
This is an edited version of an essay that first appeared at Autumn’s own Substack. She is Reactionary Feminist’s first guest author - please give her a warm welcome!
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Doctors Are Lying To Women About The Pill
I remember the appointment distinctly. After an entire class session in my final undergrad year spent with my sweaty forehead on the linoleum of the basement bathroom in Texas A&M’s psychology building, writhing with cramps, I signed myself up for a contraceptive consultation. I heard that the Pill helped with acne and cramps. The added benefits of not having a child were also in the back of my mind.
The doctor explained that the pill I was to take, Lo Loestrin Fe, was a combination pill with 10 micrograms of estradiol, a synthetic estrogen, and 1000 micrograms of norethindrone acetate, a synthetic progesterone. She asked me if I had migraines. I said no, and she sent me on my way, only pausing to tell me to come back if I had any undesirable side effects.
The entire appointment was ten minutes, in and out. She did not enumerate what “undesirable” effects I should watch out for. I didn’t bother reading the insert with its mountain of tiny text.
I was back on the tissue paper-covered examination table pretty quick. It turns out that Lo Loestrin Fe gave me severe depression, suicidal thoughts, and brain fog. The doctor cheerfully switched my brand to another pill, Audra EQ, which worked a treat. My skin was flawless, cramps were a breeze, and both that linoleum floor and the risk of unplanned pregnancy were distant memories.
I was on the Pill from September 2018 to sometime in 2021. I must have come off it by then, because in November that year I converted to Roman Catholicism. But though the Church sees contraception as a mortal sin, I didn’t need much persuading. I was already realizing that everything I had heard about the Pill was either a lie or, at best, an omission.
Those “periods” I thought I was having while on the Pill were not periods, but withdrawal bleeds. For all my body knew, I’d spent three years in a state of possible pregnancy. Meanwhile, I for those three years I wasn’t ovulating nor producing my own hormones. What did that do to my developing body? And I learned that the Pill can cause abortion, by not allowing a fertilized egg to implant on the uterine wall. It has also been associated with cancers and dangerous blood clots: hence the doctor’s question about migraines at that first appointment. Not that she mentioned any of the other risks.
Meanwhile, my psychology classes were revealing uncomfortable facts about the Pill’s effect on memory, trauma processing, and mate selection. One study examined the Pill’s effect on fear extinction learning and memory – that is, both the process of acquiring new fears and also the ability to get over them. Scientists are not sure why, but it appears that hormones have powerful effects both on fear, and on our ability to forget about threats.
Fear is a survival emotion. Blunting learning and memory surrounding traumatic events is not a good thing. But the Pill’s low doses of estradiol do just that. This is especially concerning for women in treatment for PTSD, where recalling traumatic memories and learning to extinguish negative emotions is of utmost importance.
Still more troubling, I learned, is the distorting effect on mate selection of altering women’s hormones. As Dr. Sarah Hill has recently shown, women in the estrogen-heavy phase of their cycle prefer men who have a higher prevalence of what Dr. Hill calls “testosterone cues” in their face, voice, and behavior. For women who are never in an estrogen-heavy phase, such as Pill users, research indicates that they prefer less-masculine features.
And this carries over into long-term relationships. Women who met and married their partner while on the Pill, before discontinuing its use, experienced decreased marital satisfaction if their husband was relatively unattractive. In contrast, if their husband was attractive, discontinuing the Pill led to increased marital satisfaction and sexual desire. As Dr. Hill put it, “all of a sudden the blinders are off.” How many women have fallen in love while on the Pill, only to fall out of love again when they come off the Pill to have kids?
Still more troubling is what the Pill does to a woman’s stress response. Past research had has shown that Pill users have higher levels of proteins that are markers of systemic inflammation. However, these studies did not test their subjects for their levels of cytokines, proteins that increase inflammation in response to stress, before and after stress testing. That is just what Hill and her fellow researchers measured in a December 2023 paper. What they found is that Pill users had higher levels of TNF-alpha, a cytokine, before and after a stress test was administered experimentally.
Dr. Summer Mengelkoch, the paper’s lead researcher, said TNF-alpha may be associated with a more “male-typical” response to stress. Pill users also exuded more cortisol and reported higher levels of stress overall. Meanwhile, naturally cycling women had a more “female-typical” response to stress, with higher levels of Interleukin-6, a cytokine, accompanying their increases in cortisol. However, overall, elevated levels of cortisol under the pressure of the stress test were more uncommon in this group, and the naturally cycling women reported feeling less negative emotion after it was over.
According to Dr. Mengelkoch, this is bad news for Pill users. In an interview, she stated that the Pill could be preventing the female body and mind from returning to homeostasis following a traumatic event. Cortisol, she says, is adaptive and helps us to deal with stressors in the environment. This was not the case with Pill users, whose moods got worse post-stress tests. Dr Hill explains that, under this regime of artificial stimulation, eventually your body helps you cope by shutting the stress response down entirely. This sequence of events lines up with women I knew in college, who would often tell me not to worry about early side effects of the Pill, saying that after about three months of suffering, they eventually “regulated.” To sum up, women on the Pill are chronically inflamed and stressed; they just don’t know it.
One ray of hope is that if you first begin use of the Pill after age 19, the effects seem to be more or less reversible. This is welcome news for me. But what about those girls put on the Pill at 14 or 15? There are not many long-term studies on the Pill’s effects over time. There are still fewer looking at what the Pill does to female brain development. To put it bluntly: for decades, we have been conducting a medical experiment on young women and we are barely even measuring the results. And for what?
It’s about time we took our bodies back.
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Oooo. This hits home. I was put on the pill at 15 to control my periods, which were beginning to last two or three weeks instead of just one. I was essentially bleeding out. Shocker: nobody tried to figure out why. I was just a kid, so I didn’t know any better. It stopped the excessive bleeding and improved my horrific cramps as a bonus. By the time I stopped taking the pill 15 years later (also due to joining the church, funny enough) I was lucky my condition hadn’t left me completely infertile. The only Catholic gynecologist in town solved my period problems literally overnight via dietary changes and I’ve never looked back. The whole thing was a scam, due to doctors too lazy and uncaring to actually figure out what was going on, and who knows what health problems I’ve had or will have because of it. I’ll never know.
Your experience with the Pill very closely resembles my own. I remember going to the gynecologist to complain about the side effects to be told I was probably just making it up, but if I was insistent, I could also be prescribed an antidepressant. I said no thanks, never saw her again, ended up doing a lot of research and stumbled onto fertility awareness methods, and then got really mad that this information about how the female body works is considered fringe and weird, and so the mainstream approach is still control, control, control. In my experience even most providers who are open to natural childbirth and other "crunchy" practices still tend to assume every woman will be using contraception for the entirety of her fertile years except for the carefully managed time when she's trying to conceive (or opts for sterilization after a respectable number of children.)
Once you step out of that frame of reference, it's wild to see just how much it permeates medicine, our understanding of human relationships, everything. And contraception as a normative way of life is still not even a century old.