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Why some women went off the pill

Concerns about adverse side-effects and claims of naturalness as reasons for rejecting hormonal contraception in Western countries

Although the contraceptive pill remains a widely used method, its use has declined in recent years in many Western countries, such as Australia, Belgium, France, Germany and Switzerland. This has not been in favour of the new contraceptive methods marketed in the 2000s (implant, patch and ring) but in favour of condoms and IUDs. Although most health professionals attributed these changes to a latent ‘hormonophobia’, i.e. an irrational fear of hormones, there may be other reasons that lead women to adopt new contraceptive behaviours, as recent testimonials on social networks seem to suggest.

Mireille Le Guen (Ined and UCLouvain), Clémence Schantz (IRD-Ceped), Arnaud Regnier Loilier (Ined) and Elise de La Rochebrochard (Ined, Inserm-Cesp) conducted a systematic review of the scientific literature (original research published since the 2010s using data collected in Western countries) in order to build a typology of arguments given by female users and their male partners against hormonal contraceptive methods. Their research, which involved the analysis of 42 articles, enabled them to identify major arguments for rejecting hormonal contraception.

Women and men interviewed in the selected articles mentioned they have experienced adverse side-effects attributed to the use of hormonal contraception. They cite a large range of physical side-effects with two of the most recurrent being weight gain and headaches. Women also reported side effects affecting their mental health like irritability and mood swings as well as sadness and depression. Women and men also mentioned an impact on their sexuality due to a reduced or a lacking libido among women and some discomforts during sex due to vaginal dryness or breast pain. Women also reported that hormonal contraception negatively impacted their menstrual flow: abnormal blood loss or no blood loss at all, which made them anxious because they utilised regular periods to ensure they were not pregnant. More generally, the authors found a deep anxiety associated with the use of hormonal contraception due to a distrust and a fear of experiencing short- and long-term side effects. Particularly, women and men wonder about the impact of hormonal contraception on women’s future fertility, leading some of them to not want to use it.

These experiences and fears about the adverse side-effects of hormonal contraception were often perceived by users as being ignored by health care providers who did not take their concerns about hormonal contraception seriously. Women also described how they managed the adverse side-effects of hormonal contraception on their bodies by themselves. As a consequence, women and men appealed for more ‘natural’ contraception arguing that hormones are unnatural or chemical and that they damage women’s bodies. Some of them were already using a hormone-free methods like sterilisation, condoms or withdrawal.

The findings suggest that the recent changes in contraceptive use in Western countries do not seem to be exclusively due to excessive fear of hormones, but they testify to the diversity of reasons that can lead individuals to not want to use hormonal contraception (anymore).

Source

Le Guen M., Schantz C., Régnier-Loilier A., de La Rochebrochard E. (2021). Reasons for rejecting hormonal contraception in Western countries: A systematic review. Social Science & Medicine, 284. https://doi.org/10.1016/j.socscimed.2021.114247

Author(s) of the original publication
Writers
Mireille Le Guen, Clémence Schantz, Arnaud Régnier-Loilier and Elise de La Rochebrochard