the contraceptive pill

Are we over the pill? Meet the women opting for hormone-free contraception

New research has found that women who took the pill as teenagers are three times more likely to suffer from depression later in life. And there are numerous side effects to taking hormonal contraception – as four women who have ditched the pill for hormone-free alternatives explain to Stylist

It has been hailed as the “greatest scientific invention of the twentieth century” and credited for revolutionising women’s lives.

But is the contraceptive pill really all that it’s cracked up to be?

As one of the most effective methods of contraception, the pill works over 99% of the time to prevent unwanted pregnancy: so it’s no surprise it’s one of the most popular contraceptives in the UK, with an estimated three million users. A male version of the pill is also rumoured to be arriving in the UK soon, and a third of men recently said they would take it.

the pill side effects depression
Taking the pill has been linked to side effects including depression, mood swings, bloating and headaches

What are the side effects of taking the pill?

There has been a rippling of discontent among the pill’s users, with women taking to Twitter to share stories of their hormone-induced bloating, headaches, weight gain, depression and anxiety using the hashtag #MyPillStory. When we asked 1,473 Stylist readers about their experiences of the pill, just over a third gave a positive report, while two thirds said they suffered from side effects including exhaustion and feeling depressed, alongside other health issues.

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While hormonal contraceptives including the pillcontraceptive implant and injections can work brilliantly for some women, they’re clearly not for everyone – something that chimes with a growing trend among women opting for hormone-free contraception.

And with the NHS offering no less than 15 different types of contraception, half of which don’t rely on hormones, there are hormone-free contraceptive options available that you might not think of immediately.

What are the alternatives to the pill?

Here, four women tell Stylist why they ditched the pill for hormone-free alternatives, and sex educator and Brook charity ambassador Alix Fox offers her advice for those who might be thinking of doing the same.

“The pill made me feel crazy”

Hayley*, 27 from London

The hormones in the pill can cause mood swings for some women
The hormones in the pill can cause mood swings for some women

“I started taking the pill at 16, before I was even sexually active, as my doctor recommended it for my teenage acne. I took Microgynon, then Yasmin, on and off for about eight years. I found Yasmin helped with the awful side effect of water retention, but the pill made me feel crazy - although I didn’t realise how crazy until, out of curiosity, I stopped taking it.

“The doctors hadn’t warned me about any of the side effects. After two months of being pill-free, my emotions were much more balanced. I was so much happier and I only had mood swings around the time of my period, rather than all month long. I also lost about 10 pounds.

“The worst thing about coming off the pill was the terrible acne I was faced with again - it took about a year but now my skin has finally settled down. It was tough but 100% worth it.

“I went back on Yasmin for a month recently to avoid getting my period on holiday and it was a big mistake. Yes, my skin looked amazing and I avoided having to wear a tampon in the sea, but I also turned into an insane person who lost my temper with everyone and had to leave work to cry a lot. It’s safe to say I won’t be messing around with my hormones like that again.

“I’m in a long-term relationship now and use latex-free condoms at the moment, but I’m planning to switch to the non-hormonal coil as a pill-free alternative soon. I’ve heard mixed things from friends, but on the whole it seems worth the discomfort of getting it fitted.

“The only thing putting me off is the chance of extra cramping and heavy periods.

“To be completely honest, I wish there was a contraceptive for men so I could just leave my body the hell alone.”

woman sea
Try sponge tampons rather than the pill if you get your period when you're on holiday

Alix says…

“If you’re worried about Aunt Flo rocking up at an inconvenient time – such as during a holiday – consider giving sponge tampons a whirl. They’re little round or heart-shaped pieces of highly absorbent sterile foam that you pinch flat between your thumb and forefinger, then slide inside yourself, where they expand to stay in place. At about £6 for three, they’re pricier than traditional tampons, but they’re worth the investment as a hormone-free way to make periods less of an interruption. I like a brand named Joy Division.

“Hayley mentions that she and her partner need to use latex-free condoms. Manufacturing technology has advanced mightily in the last few years, and you can now buy condoms – like Durex Real Feel - made from a modern material called polyisoprene. It’s entirely synthetic, so A-OK for people with allergies to natural rubber.

“If cost is an issue, you can get free condoms from all family planning clinics and a lot of GP surgeries. Most stock at least one latex-free variety if you ask for it. Depending on where you’re located, you may also be able to sign up to a scheme like Come Correct: you’ll be issued with a card that you can take into any pharmacy or outlet displaying the Come Correct logo and get free condoms of your choice. Alternatively, try the Freedoms Shop: it’s an online store that purchases huge numbers of condoms to supply to NHS Trusts and GPs, so they’re able to negotiate big discounts with manufacturers – and now they sell condoms and lubricants direct to the public, too, at really low prices, delivered discreetly to your door.”

“My doctor pushed the coil as a preferred option to the pill”

Beth, 25 from Guernsey

The non-hormonal coil is a popular alternative to the pill
The non-hormonal coil is a popular alternative to the pill

“When I was 16 my doctor recommended going on the pill to help calm my period pains, which were always really bad. I was mainly on Yasmin until I stopped taking the pill when I was 23.

“I only realised after I stopped taking it how bat shit mental I had become: I would cry at the drop of a hat (literally) and became paranoid. I’ve always been an anxious character but about two months after I stopped taking it I realised I was much calmer and more centred.

“I had been off the pill for about a year when I decided I should probably sort myself out and get back on the contraception wagon.  I decided to switch to the coil after hearing it mentioned on TV show 16 & Pregnant (yes, seriously).  

“It was hormone-free and you could keep it in there for up to 10 years - what else could you want? I went to my doctor and she also agreed it would be a good alternative to hormonal forms of contraception, even noting that they were now pushing the coil as a preferred option to the pill.

“My experience of the insertion wasn’t great and my periods have also gone back to being pretty painful. However, I would still recommend the coil. As with anything of this nature it is completely up to the individual, as one thing that works for me may not work for someone else.

“Overall, I can rest easy knowing that I’m protected every day and don’t have to remember to take a pill – I was habitually terrible at realising I needed more pills so this option has taken out the usual mid-week panic of trying to book a doctor’s appointment. Plus, I feel a lot calmer now and can experience actual emotions, rather than when I was on the pill and everything felt heightened.”  

Alix says…

“There are several different types and sizes of non-hormonal coil, or Intra-Uterine Devices (IUDs) (as opposed to Intra-Uterine Systems - IUSs - which do contain hormones). They’re designed to work for between five and ten years depending on the style, which is very convenient.

“They consist of a tiny T-shaped piece of soft, flexible plastic with copper wrapped or coiled around it, hence the nickname. The most modern versions contain more copper, which is toxic to sperm, so this makes them better at preventing pregnancy: they’re over 99% effective. Studies show that over five years, only one in every 100 women using intrauterine contraception will conceive, versus eight in every 100 women on the pill over just one year.

“I’d advise going to a specialist sexual health clinic to get a coil fitted, where staff carry out the procedure on a daily basis and have got it down to a smooth art. Your whole appointment will take around 30 minutes, with the coil insertion itself only lasting about five to ten minutes. If you’re worried about experiencing any discomfort, ask the doctor or nurse who carries out the procedure about pain relief, as they can give you tablets or a local anaesthetic that is usually administered as a gel.

“Periods do become temporarily heavier with the non-hormonal coil, although this usually settles after three to six months. The opposite is true of the hormonal coil, so you’ll have to weigh up hormones vs. period problems and decide what’s best for you as an individual.

“After removal of an IUD, your fertility should instantly return to the levels that are normal for you.”

“If it works by killing off your sex drive, then I found it very effective”

Ella, 26 from London

the pill loss of sex drive
Loss of libido is one of the most common side effects of taking the pill

“I started taking the pill when I was 16 in anticipation of becoming sexually active. I was on the combined pill until I was 19 and then the progesterone-only pill for another three years, but the side effects for me were horrible. With both pills I noticed a huge drop in libido - if contraception works by not making you want to actually have sex then I found it very effective. 

“With the progesterone-only pill I started having irregular bleeding, so I decided to try the implant instead. However, after a while the bleeding became irregular again.

“My implant was removed last week, three years after I had it put in. As I am unable to use either the combined or progesterone-only pill, and the coil isn’t suitable for me, I am left with condoms.

“I am hoping that now my implant is out, my libido will shoot back up. The information I have received throughout the last 10 years has been patchy at best.”

Alix says…

“As an alternative to traditional forms of contraception such as the pill, Ella might be interested in a gadget called Daysy. It’s a digital fertility monitor that syncs up with an app on your phone. It’s designed to help you get to know the natural rhythms of your body and know when you’re most fertile, so you can choose to use condoms only when you’re likely to conceive. That might sound nerve-wracking and dangerous, but the manufacturers claim it has an accuracy of 99.3% when used correctly.

“The gadget is intended to make fertility monitoring simple: every morning, you pop the device under your tongue to take your temperature, and also log the days you menstruate using the app. It will then let you know your fertility status for the next 24 hours, using a colour-coded system to tell you whether you’re OK to go condom-free.

“I must stress that this option is only suitable for couples who are in a committed relationship who have carefully considered what they’d do in the event of an unplanned pregnancy; Daysy performs as impressively as the pill at preventing conception in clinical trials, but I’d feel irresponsible if I didn’t state that there is always a chance of conceiving if you’re not using contraception.” 

“When I was taking the pill, the smallest things would make me angry”

Nina, 25 from London

the pill side effects anger
Unexplained anger can be an unsettling side effect of the pill

“I was diagnosed with polycystic ovary syndrome in 2012 and my GP recommended taking the contraceptive pill so that my hormone levels would balance out again and my periods would become more regular.

“I took Marvelon on and off from between then and May 2014. I would be on it for three months at a time but have to stop as the side effects weren’t worth having regular periods for.

“I suddenly became very depressive, and I got panic attacks, something that has never happened to me before. The smallest things would make me angry and people around me would tell me to stop taking it as I was grumpy all the time.

“I decided that I didn’t want to take hormonal contraceptives anymore and my local sexual health clinic recommended the copper coil. For the first six months after it was implanted I had horrible pain during my period, but apart from that there were no further side effects.

“There was definitely enough information available to me to help me make the right decision about my contraception, and I was well advised at the clinic.”

Alix says…

“A lot of the women in these case studies describe experiencing various emotional side effects as a result of taking hormones, from mood swings to changes in libido and depression. It’s almost impossible to predict how hormonal contraception will affect an individual, and the impact can be very idiosyncratic; a pill that makes one lass feel happy and healthy can leave another blue and bloated.

“It’s worth noting that different brands and varieties of both combined and progesterone-only contraceptives contain different amounts of active ingredients and can have different chemical formulations, so it can be worthwhile trying two or three for a couple of months at a time until you find the best ‘fit’ for you. However, if you experience any other extreme psychological reactions, tell your GP straight away so they can change your contraception and give you any support you might need.

“It’s fantastic to hear that Nina felt so well informed and advised by her local services. Anyone with a question about contraception, STIs or sex in general can get a fast answer from an expert at Brook, the no-bullshit sexual advisory charity. Text your query to 07537 402 024 or use the webchat service here. The Family Planning Association are bang on about all things related to banging, too: visit their website here.”

Which method of contraception is right for you?

There are 15 contraceptive options available on the NHS
There are 15 contraceptive options available on the NHS

Are you unsure whether you want to take the pill or try a hormone-free alternative?

The NHS has created a list of the pros and cons of taking the combined contraceptive pill, listed below:

Pros of taking the pill

  • it does not interrupt sex
  • it usually makes your bleeds regular, lighter and less painful
  • it reduces your risk of cancer of the ovaries, womb and colon
  • it can reduce symptoms of PMS
  • it can sometimes reduce acne
  • it may protect against pelvic inflammatory disease
  • it may reduce the risk of fibroids, ovarian cysts and non-cancerous breast disease

Cons of taking the pill

  • it can cause temporary side effects at first, such as headaches, nausea, breast tenderness and mood swings – if these do not go after a few months, it may help to change to a different pill
  • it can increase your blood pressure
  • it does not protect you against sexually transmitted infections
  • breakthrough bleeding and spotting is common in the first few months of using the pill
  • it has been linked to an increased risk of some serious health conditions, such as thrombosis (blood clots) and breast cancer

If you’re still unsure, the NHS also has a comprehensive online guide to contraception, which you can find here, including a rundown of the 15 types of contraception it offers. This includes hormonal methods, such as the pill and the implant, as well as hormone-free methods, such as condoms and caps.

Choosing a contraceptive method can be a challenging task, and you may need to try a few options out before finding the right one for you.

Images: Getty, Unsplash, iStock

This article was originally published in June 2016

For further information on contraceptives, visit Brook’s advisory clinic here and the Family Planning Association here.

*Names have been changed


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