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  • Writer's pictureStella Tersteeg

Side-effects of hormonal birth control on women

Updated: Jun 14, 2022

Is Dr Sarah E. Hill the woman women have been waiting for?

“We are willing to turn a blind eye (...) because we simply can’t entertain going back to living in a world where women don’t have control over their fertility.”

The moment I started reading This is Your Brain on Birth Control from Dr Sarah E. Hill, I knew for sure I wanted to share this with as many women as possible. Because I’m positive there’s at least one truth in the book for every woman, just like I found many truths in it about myself.

Dr Hill tells us just how it is: you deserve to fully understand how your hormones work and how hormonal contraceptives impact our entire functioning. She goes beyond what there’s to know about the possible side effects of the pill. There’s a lot more to it than what happens from the neck down only.

If you’re new to the topic, you might want to read this blog post first to gain some basic knowledge about the contraceptive pill.

This is not an anti-pill campaign

In the first chapter, Dr Hill starts with a couple of disclaimers for her readers before they get the impression that the pill is the most terrible thing to have ever happened to women.

She is pioneering the field of the effect of the pill on the female body and inform women about her findings. Her goal is to make you more attentive to what influence the pill could have on you. She hopes to raise awareness that empowers women to make a confident choice about their preferred contraceptive.

The author assures even the biggest feminist that she understands that the pill has given women the freedom to discover and practice their sexuality without the risk of becoming pregnant. However, truly and fully understand your body’s response to hormonal contraceptives allows women to claim their freedom even more.

The uprising of available knowledge and scientific research

“Until recently, women’s health has been all but completely ignored by science. And the result of this is that, more often than not women are completely in the dark about their health and how their bodies work.”

Until recently, women have been underrepresented in scientific research. The cyclical changes in a woman’s hormonal balance make it more time-consuming and expensive than their male counterparts.

For this reason alone, science has limited itself to examine only the more life-threatening side-effects of the contraceptive pill. It means that everything else women are experiencing because of the contraceptive pill remains a grey area.

Luckily, Dr Hill sees an uprising of the importance of female health among scientists, general practitioners and medical specialists. Finally, women can start to ...

  • Better understand their bodies response to hormonal changes.

  • Better recognize hormone-related physiological and mental discomforts or disease.

  • Gain more confidence to think critically about the contraceptive they’re using and turning to their doctor for serious medical advice.

  • Tell the critical voice in their heads that there’s nothing wrong with them, but that the contraceptive they’re affecting them negatively.

The above and beyond effects

“The hormones in the birth control pill are picked up by all the cells in the body that have sex hormone receptors. (...) they influence the activities of billions of cells in your body at once echoing throughout the body from head to toe.”

The human body has hormone receptors all over it. And the pill is a type of hormonal therapy that conveys its own hormonal message, that isn’t directed to the ovaries only. It influences many aspects of a woman’s life and her health:

  1. Sex

  2. Attraction

  3. Stress

  4. Hunger and eating patterns

  5. Emotion regulation

  6. Immune system

  7. Gut health

  8. In the brain: emotional processing, social interaction, attention, learning, memory, facial recognition, self-control and language processing.

All the pills out there

“Each woman is different and will respond differently to adding artificial estrogens and progestins into the mix.”

There are four generations of contraceptive pills that all have their own possible (side-)effects on the female body.

Use this information to your advantage when you are looking to change pills:

  1. Shift to a pill with a different type of progestin (1st, 2nd, 3rd or 4th generation) to tackle any major physiological and mental effects on you.

  2. Try out different dosages of both estrogen and progestin to strike out any of the remaining minor discomforts.

  3. Give it a couple of cycles before making up your mind, because your body needs to reestablish itself.

  4. Track your mood, energy, appetite, sleep and libido to be fully attentive to how your body is changing.

Attraction to men

“The ability to discriminate between partners is one of the most valuable functions your brain will ever perform, especially when conception is possible.”

Women normally - so without the intervention of any hormonal contraceptive - experience a certain cyclicity in their taste and preference of men.

Please bear in mind that this is not a bad thing!

But it could be worth it to try and see the differences in how you behave towards men/your partner with and without the pill. It could be a significant indicator of what type of long-term partner fits you best.


“And having a diminished desire for actual sex may be a canary in the coal mine of much more pervasive changes in women’s motivational states.”

According to research, women on the pill may be less captivated by sex-related things.


“Our ability to respond to stress allows us to adapt to whatever type of situation we get ourselves thrown into. Lacking this capacity (...) means that when we’re stressed out, we’re less able to cope. It predicts problems with emotional regulation, learning, memory and social functioning.”

Our body’s stress response is controlled and regulated by the Hypothalamus-Pituitary-Adrenal (HPA) axis. The pill might make the HPA axis go into overdrive. As a consequence, cortisol levels (the stress hormone) don’t go down. The stress response puts other bodily processes on hold:

1. Our digestion

Increasing the risk to gain weight

2. Our immune system

Increasing the risk of infection or disease

3. Cardiovascular function

4. Our ability to properly deal with dynamic cortisol changes

  • We need it to run away from a hungry tiger or smashing your to-do list

  • But we need it too for the positive peaks in life: a steamy session in bed, an extreme HIT workout, or an evening well spent with friends.

The fact that the pill could blunt out the stress response entirely might lead to:

  • Positive experiences seem rather flat or meaningless

  • Feeling sad, low in energy, or even depressed

  • Feeling numb and not enough in touch with your happy emotions

Make your mental and physical well-being your priority

  1. How do you feel your emotions?

  2. How do you deal with stress?

  3. How is your sex life?

  4. How does your skin look?

  5. How is your energy level?

  6. How is your appetite?

These are all questions you can ask yourself when you are in doubt about the contraceptive your currently using. Dr Hill highly recommends learning more about your body and its emotional and physical reaction to being on and off the pill.

“This way you can start to understand what version of yourself you most want to be.” (Sarah E. Hill, This is Your Brain on Birth Control)

Still curious to know more? Buy your own copy here.

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