Once a blessing, now a burden
Away with the pill
After a long week of lectures, kinesiology student Maud (20) sat down on the couch with her sister and mother on Friday evening. On the television, Sing was playing, an animated movie about animals that organise a singing competition. Suddenly, tears started rolling down her cheeks.
At that time, in the spring of 2023, Maud had been using hormonal contraception for four years, because she suffered from menstrual complaints, such as heavy bleeding and severe cramps. In addition to the hormonal implant in her arm, which needs to be changed every three years, she had also started to take the pill, as the implant – her second – wasn’t working well enough.
‘But then I started having more problems: I suffered from acne and gained weight’, she says. ‘At one point I really wasn’t feeling well. I also noticed that I was very emotionally unstable.’ And now, even a children’s movie made her cry. ‘That’s when I thought: I’m quitting the pill.’
Acne and thrombosis
Just like Maud, an increasing number of young people are abandoning the pill as a contraceptive method. According to the 2023 Sexual Health Monitor, published by expertise centre Rutgers, in the past six years, the number of women aged 18 to 49 who have ever had vaginal sex and use the pill has decreased from 30 to 24 percent.
I was able to enjoy things much more and wasn’t as irritable
One of the main reasons for them to swear off the pill are the hormonal side effects. ‘When I stopped taking the pill, it really felt like a weight had been lifted off my shoulders’, says Maud. ‘I was able to enjoy things much more and wasn’t as irritable.’
Charlotte (21), an economics and business economics student, started taking the pill when she was eighteen. ‘I wanted to prevent unwanted pregnancies, but the pill gave me such bad acne.’ She had another reason to go off it as well, though: the type of pill she took increased the risk of thrombosis. ‘That runs in my family, so I was really worried about that.’
Distrust in science
UMCG gynaecologist Marco Versluis understands the concerns among women. ‘When the pill was first invented, it contributed to female empowerment, but as it conquered the markets, we started noticing more risks and side effects. Back then it had a much higher dose of hormones.’
However, he worries about the dangers of trusting alternative methods of contraception. Because although most of the women who quit the pill switched to an IUD (with or without hormones), according to the Rutgers research, 14 percent of women between 18 and 29 use natural methods to prevent pregnancy, such as keeping track of fertile days in a calendar, measuring their temperature, or looking at the discharge in their underwear.
Versluis believes that women turning away from contraceptives is a part of a larger trend of an increasing distrust in science. ‘The blame is partly on the scientific community that is apparently unable to connect with them’, he observes. ‘It’s the same with people who say vaccines are bad for you, deny climate change, or think the earth is flat.’
TikTok videos
This specific trend has been on social media since the summer of 2022. In short TikTok videos, influencers talk about their negative experiences and urge young women to get off the pill. But Versluis says the information they spread is often incorrect, as they have ‘limited knowledge and understanding of how sex and contraception work’.
Some women may have mood swings, but others might feel better with the pill
‘Some women on the pill may experience dysphoria, lower energy levels, or mood swings, but others might feel better with the pill than without. It’s not that every woman has the same side effects’, Versluis explains. ‘And if influencers say that all contraceptives are bad for all women, they’re spreading information that is simply incorrect.’
He is not dismissing women’s complaints, but stresses the importance of having a nuanced discussion about the topic. ‘It depends on the woman involved. And we would like healthcare workers to have time to talk to patients, so that the patient can make an optimally informed choice.’
Aware of the risks
However, students themselves say that they are quite aware of the risks of other means of contraception. Charlotte saw a few videos on TikTok about alternative methods, she says, but is too afraid of getting pregnant to put her trust in them.
International relations master student Floor (23) also says she is not easily influenced by social media trends. ‘When I hear some woman say something about whether or not to take a pill, I think: Yeah sure, but I’ll think for myself.’
She did decide to quit the pill, but that was because of a break in her sexual life. ‘Why would I take a heavy hormone pill every day when I’m not even sexually active?’ she asked herself.
And nineteen-year-old pharmacy student Laurence doesn’t think herself vulnerable to misinformation on the internet either. She didn’t have any negative experiences, but after three years of being on the pill, she felt she didn’t really need it. ‘I read every website on the first page of Google when you search “quitting the pill” before I made my decision to stop.’
Lived experience
Feminist philosopher Ruby Schofield agrees that the problem is more complex than women being fed misinformation. ‘A lot of women and trans and non-binary people are incredibly well-informed about this topic’, she says. ‘Their lived experience is a form of expertise that we should take seriously as well.’
For a lot of people it feels like we’re stuck between a rock and a hard place
She thinks women are also increasingly dissatisfied with the methods available to them. ‘I think for a lot of people it feels like we’re stuck between a rock and a hard place, like we don’t have any real choices.’
Women who decide to quit the pill want to reduce the burden that contraceptives put on them. ‘They have to take a lot of measures compared to the men they’re having sex with’, says Schofield. They are really concerned about side effects such as mood swings, headaches, or loss of libido. Cisgender men don’t suffer side effects, nor do they have to take responsibility in the same way.’
Informal networks
Laurence saw several videos on TikTok in which women talked about the negative side effects of the pill. ‘I didn’t relate to any of their problems, but I was interested in their experiences.’ Instead of quitting the pill, Laurence says she was propelled to start a conversation on this topic with her friends. ‘One of my friends said quitting the pill was good for her. Another said she’s not going to put hormones in her body when she doesn’t need it.’
Young people turning to informal networks is happening increasingly often, Schofield says. ‘I think there’s something empowering about using networks such as social media, families, or friends to develop counter expertise.’
According to her, women feel neglected by the medical establishment. ‘They’re delegitimised by health professionals who don’t see women as allies in the process.’ Conversely, talking to peers makes them feel more heard and understood.
That means the advice of friends is invaluable to them. Floor says that she follows her friends’ counsel blindly, even recognising that they sometimes know just as much or even less than TikTok influencers who she doesn’t trust at all. ‘Nevertheless, when it comes to advice and wise words, my friends are more useful to me than anything else.’
The name Floor is a pseudonym.