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What I Wish I Knew Before Taking the Birth Control Pill

And what I want to make sure you know now


Originally published in Medium on March 24th, 2025


A few months after going off of the birth control pill, it occurred to me that I felt — different.


More awake, somehow. More alive.


I also had horrible mood swings, developed awful acne, and thought my husband of 2 wonderful years would change his mind about our marriage after discovering who I was off of the pill.


Looking back now, 7 (married) years later I wish I had known then what I know now.


What I didn’t know then was that despite enabling me to control my reproductive choices, the uniform daily dose of hormones I took for 15 years prior, had far-reaching impacts on my body — both while I was on it as well as when I went off — which science is now starting to uncover.


The purpose of this article is to share these effects so that women are aware and can make informed choices about birth control. And that if they experience these types of side effects, they can understand that the pill may be the cause (and not immediately assume that they are crazy).


First, I want to make it unequivocally clear that I am 100% grateful for the birth control pill and am not by any means suggesting that those who decide to take it should stop.


Research is evolving, and with it, we are learning more about women’s health than ever before.


What we learn is important to understand for optimizing health and understanding what we are putting into our bodies.


For me, it is information I wish I had 25 years ago when I first started taking the birth control pill — as well as when I went off 15 years later — and that I want to make sure all women have access to today.


A quick recap of the role of hormones


To understand the effects of birth control on the body, it is first essential to know the basics of how the two main female sex hormones, estrogen and progesterone function when naturally produced in the body.



In other words, it makes you look and feel great; changing the way you walk, talk, dress, and act to make you as attractive as possible while at the same time gifting the capability to select the best genetic mate possible.


I noticed this effect filming short videos for my public speaking project. The first set of videos I filmed during the second week of my cycle (when estrogen is about to peak) are vibrant. My voice is melodic, and my eyes sparkle. My movements are alive and somewhat alluring (as much as they could be in a professional context).


This is in contrast to the videos I filmed the week following ovulation. In these videos, I appear and sound more — flat.


It’s hard to put a finger on, but the difference is noticeable.


My husband and I both commented on this after previewing all the video footage together. “What was different that time?” he asked me.


“I don’t know. Maybe I was tired?” I said.


This was before I read Sarah E. Hill’s book, “This is Your Brain on Birth Control,” which gave me a much deeper understanding of hormones and how much monthly fluctuations affect pretty much everything about brain and body function.


And that I wasn’t just tired in the second week of filming — my whole body and mind were in a different state.


Back to the hormones


Progesterone takes over during the second half of the menstrual cycle to maximize the body’s ability to nurture conception and pregnancy.


This shifting hormone landscape:


Essentially, the body is now in lock-down mode, hoping an egg is fertilized and optimizing the environment for an embryo to develop.


My second, flat week of filming now makes complete sense. I simply didn’t have the same level of energy or attractiveness that I had the week before.


More specifically, I didn’t have the same level of estrogen that I had the week before — and it was noticeable.


All of this changes when a woman takes birth control.


How hormonal birth control works


Birth control pills are effective because they give the brain a steady level of progestin, a “funky” version of progesterone (in many cases derived from testosterone!), which makes it think the ovary has just released an egg and is waiting for implantation.


Effectively, progestin makes the brain believe day after day that the body has just ovulated, and therefore, pregnancy is prevented as long as the pill is taken regularly.


Brilliant!


A definite win for controlling reproductive availability and giving women control over if and when they conceive a pregnancy.


The unintended consequences


Now for the part science didn’t know until recently and that I just learned about last week.


Remember the incredible effects that naturally produced estrogen has during the first half of the cycle?


The same ones that made my videos “pop” in the first week of filming?


The birth control pill eliminates this phase entirely along with all the benefits of naturally produced estrogen in the body and mind.


If this wasn’t bad enough, science is starting to reveal some additional unintended consequences of using non-bio-identical hormones such as progestin, which do not act in the same way as naturally produced hormones:


In addition to this, behavioural research shows that the birth control pill:

  • can reduce sexual desire and incentive to bond with a primary partner

  • influences how women choose a mate including inhibiting the ability to pick up on genetic match indicators

  • can change how women feel about their partner when they stop taking it (for better or worse)

  • can prompt eating more/higher calorie foods because the brain thinks it is preparing for pregnancy

  • lowers the level of attraction and mate-protecting behaviour men have for a woman taking the pill

  • can increase unhealthy weight control and focus on appearance


I was in a constant state of jaw-dropping shock reading this science-backed information.


Why on Earth do we not talk about this?


Why was none of this brought up during the decade and a half when I took the pill and visited multiple doctors for health concerns related to inflammation, stress, and mental health concerns?


Not one of them mentioned the possibility that these things could be side effects of the birth control pill.


This is what needs to change.


If that wasn’t enough


All of that is what happens when you take the pill. A whole additional set of changes occurs when you stop.


For years, if not decades, the brain is used to uniform doses of hormones daily, and therefore, it has to significantly adapt when the doses stop.


Symptoms resulting from discontinuing the pill can be significant, unpleasant, and disruptive.


Thinking back to the horrible time I had going off the pill, it all starts to make sense.


Not only did I experience emotional turmoil consistent with hormonal upheaval, but I felt like an entirely different person from who I was while I was taking it — because I was.


So, where does this leave us?


As mentioned at the start, I am not advocating that women stop using the birth control pill. Every situation requires consideration of risk and benefit and must be weighted for each person’s situation.


In my case, if it weren’t for the pill, I might not have travelled and lived in multiple countries, completed a Master's degree, and experienced a satisfying and challenging career before deciding to have my kids, for which I am forever grateful.


What I am saying is that armed with information on the effects the birth control pill has on the body and mind, women of all ages need to make informed decisions.


Some considerations based on age and stage include:

Adolescents considering using the pill as birth control:

  • be aware of potential (mostly unknown) impacts on the developing brain and body if you start taking it before the age of 20

  • adolescents using oral contraceptives are at higher risk for depression, suicide, and decreased bone density

  • if you are not sexually active, consider holding off on the pill for as long as you can


Women of any age who choose to use the pill as birth control:

  • be informed about options for birth control including side effects and non-hormonal options such as the copper IUD

  • if you notice symptoms, find a provider who will holistically talk about your options and is aware of these less well-known effects of the pill

  • be aware of potential behavioural changes including changes in sexual desire, motivation, stress response, mood, eating habits, and exercise — and that this is a growing list the more we learn from science


Women who are going off of birth control:

  • be cognizant of the adjustments your brain and body have to make to start naturally cycling again

  • know that going off the pill can have a significant impact on mental health

  • consider getting a bone density scan to see if you need to bolster bone density-building efforts like strength training

  • understand that there are sometimes biological, science-based reasons behind changing levels of sexual attractiveness towards current partner or other people — even changes in sexual orientation


Women who are considering staying on it through perimenopause and menopause:

  • consider going off the pill to see where your cycle is at regarding perimenopause and menopause

  • consider getting the benefits of naturally cycling by using other forms of birth control while your body can still do it

  • find a provider who is informed about HRT and is open to using it to support specific symptoms, such as progesterone during the second half of the cycle to bolster naturally lower levels in perimenopause


Key takeaways:


The birth control pill is undeniably an incredible advancement in women’s health and empowerment.


It is essential that women have access to all forms of birth control, including the pill, if we want to maintain control of our bodies and position in society.


However, due to the lack of research into women’s health and the effects of taking the birth control pill daily over years and even decades, concerns are coming to light about health effects that adolescent girls and women should be aware of.


With over 60 years since its development and now more than 100 million women using oral contraceptives around the world, this lack of research and insight is startling and disturbing.


Critically, providers of women’s health need to be knowledgeable about these effects as well as holistic alternatives for both birth control and symptom mitigation for perimenopause and menopause, including lifestyle and HRT.


Information is power. The more women know about the full effects of their choices, the more in control of health we will be. This will prevent confusion from experiencing unexpected side effects and mitigate the impact of symptoms from going off of the pill.


Be informed — it will change your experience and arm you with the information you need to control and maximize your health in the way you want to.


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