The pill is no longer a rite of passage for young women. (Karen Warren/Houston Chronicle via Getty)
Like many women, I’ve tried most contraceptive methods. I soldiered on with Microgynon and Cerazette for years longer than I should have, and spent multiple afternoons in the university surgery with an infected implant. The copper coil was a medieval experience, both in its painful insertion and the fact that it made my hair fall out, as if in punishment for wanting one-night stands. In the end, I decided morning-after pills were worth the expense if they saved me the heartache. When I later found out that I would need fertility treatment to get pregnant, my first thought was that Boots owed teenage me a lot of money.
I don’t regret a thing. We millennials would risk pretty much anything to have carefree sex — even our waistlines. A new generation of women, however, is not so keen. They aren’t wild about the acne, mood swings, weight gain, heavy bleeding and migraines that are associated with hormonal contraceptives. According to Tik Tokers, those side-effects are now thought to extend to anxiety, depression and even suicidal thoughts. So while taking the pill used to be something of a rite of passage, now women are coming off it in droves.
Part of the problem is there just isn’t much reliable scientific research into why different contraceptives cause different reactions. For most women, finding your contraceptive is like embarking on a blind taste test of various pills, injections and contraptions. Information about how contraceptives work is hard to find and often mystifying. We’ve long known the pill wasn’t perfect. It was described by Elizabeth Siegel Watkins in 2001 as the “least unsatisfactory choice in contraception for American women”. And the “father of the pill”, Carl Djerassi, predicted back in 1989 that “new approaches to birth control – for example a male pill, a once-a-month menses inducer, and an antifertility vaccine – cannot be realized before the next century”. In fact, he said, choice is likely to become more limited, pointing to “an informed and highly motivated group of women [who] strongly criticised the pill while emphasising their abhorrence at male domination.” This middle-class feminist politics resented the idea that women would have to endure side effects to prevent pregnancies and questioned the idea that science might enable women’s sexual freedom.
Yet over 70 years since the pill was first synthesised, he has been proved right. In an article echoing Djerassi, Nicola Thorp wrote in 2018 that the “contraceptive industry is institutionally sexist“. She asked why it was that women were expected to “try different methods until they simply give up and are forced to accept the least painful side effects”? And she also makes the case that if women don’t take action, nothing will change. And today, women aren’t pushing for an improved formulation, with fewer side effects or greater efficiency. Quite the opposite, in fact, the idea of scientific “meddling” with our bodies and medicalising health is increasingly eschewed by younger generations and nowhere more so than in the already fraught world of women’s reproductive health.
The change has been drastic. NHS data for women accessing sexual-health services in 2022-2023 shows the number of women using “natural family planning” to prevent pregnancies has doubled in ten years and the number choosing oral contraceptives has plummeted (down from 429,600 to 126,400 in a decade). It’s only a snapshot but the data does align with trends we’re seeing elsewhere. Natural Cycles, the non-hormonal contraceptive method of choice for celebrities and influencers, is now so popular it boasts over two million users and has been cleared by the FDA in America.
“I’m not convinced dressing up age-old methods, like the rhythm method, in snazzy new apps is the reproductive utopia fem-tech companies want us to believe it is,” says Dr Rebecca Steinfeld, an expert in the politics of reproductive justice. “They all romanticise a past when people lacked access to revolutionary, literally life-saving innovations like modern contraception, effective pain relief in labour, safe surgery in birth, and life-sustaining formula milk,” she says. And what many pill-critics don’t like to admit is that “natural” techniques are much less trustworthy. “I felt colossally naïve,” said one user who got accidentally pregnant while on Natural Cycles, “I’d used the app in the way I do most of the technology in my life: not quite knowing how it works, but taking for granted that it does.”
Join the discussion
Join like minded readers that support our journalism by becoming a paid subscriber
To join the discussion in the comments, become a paid subscriber.
Join like minded readers that support our journalism, read unlimited articles and enjoy other subscriber-only benefits.
Subscribe