Mary, 36*, took the contraceptive pill throughout her early twenties because it felt like the ‘easiest’ option. When she turned 29, she swapped to a cycle-tracking app. ‘I’d just been promoted and had a wedding planned, so I really didn’t want to get pregnant yet. But I was seriously considering what being on the Pill for so long does to your body. I wanted to check everything was OK with my cycle,’ she says.
But just two months into monitoring her cycle naturally – to predict her fertile period as a mode of contraception – Mary became pregnant. ‘I really struggled getting my head around it, as I wasn’t mentally in the place for a baby,’ she says. Despite this, she’s still adamant she would never go back to hormonal contraception because it stopped her feeling like herself. ‘I’m on the non-hormonal coil now and, although it’s not perfect, it’s the best I’m going to get. That’s the reality of being a woman.’
Like Mary, a growing number of women are choosing to swap hormonal contraception for more ‘natural’ methods, such as cycle tracking, many citing the havoc the Pill wreaks on their hormones. But a new study examining data from the British Pregnancy Advisory Service (BPAS) has found this trend corresponds with a rise in abortion rates. It found a ‘shift’ in contraception use in the last five years, from ‘more reliable’ hormonal contraceptives, such as the Pill, to ‘fertility awareness-based methods’, said the study published in BMJ Sexual And Reproductive Health. Even more alarming is the decline of contraception full stop. As well as the shift to natural methods, 70% of those seeking abortions in the study reported using no contraception at all in 2023, up from 56% in 2018.
The backlash against the contraceptive pill has been growing in recent years. In 2014, 432,600 prescriptions were issued for it in England, but this dropped to 188,500 by 2021. It should be said not everyone has a bad experience on the Pill, but for some women side effects can be debilitating.
‘None of my friends are on hormonal contraception and neither am I. We’re all a bit reluctant to mess with our bodies, and don’t feel there are sufficient options for women. But the consequences of this are that we’re forced to be riskier with our sexual partners, relying on condoms, which means hoping they don’t break and that the men don’t take them off,’ says Olivia Petter, 30. ‘I know a few people who use tracking apps even though they know they aren’t reliable. It’s a matter of picking your poison: would you rather risk side effects from hormonal contraception or pregnancy?’
It’s a far cry from how the Pill was viewed by previous generations. In the early 1960s, the Pill was a feminist triumph, widely credited as a key factor in the supposed ‘sexual revolution’. Finally, women could make choices about their bodies and their careers. But what was once a symbol of sex-ual freedom has become something that women are increasingly turning their backs on. Ironically, it seems ‘freedom’ these days means being free from unnecessary hormones, which can mean using ‘natural’ tracking methods that come with a higher risk of pregnancy.
Daisy*, 28, said the Pill made her moods ‘mental’ and gave her severe migraines. Then, when her GP swapped her on to the progesterone-only pill, she developed ‘thrush-like symptoms’ and was told her oestrogen levels had dropped too low. After a bad experience with the coil, she now relies on cycle tracking as her main form of contraception. ‘My period comes on the day my Apple Health app tells me it will. I’m super-regular now and I’ve learned to recognise my emotions before my period comes,’ she says. ‘I know it’s a risk, but for me it’s one worth taking. I don’t ever want to mess with my emotions again.’
Experts say the trend towards natural tracking is being fuelled by a backlash against hormonal contraception on social media, where women discuss everything from ‘hormone hacking’ (what to eat and how to exercise at certain points in your cycle) to how to ‘balance’ them. This is alongside hundreds of videos of women touting the supposed benefits of coming off the Pill. ‘It was poisoning my body for so long,’ claims one user. Another shares tips on how women can prepare their body for coming off the Pill because it’s ‘ruining your gut microbiome and depleting you of nutrients’.
Consultant gynaecologist Dr Anne Henderson (@gynaeexpert), who runs The Amara Clinic, attributes the shift away from hormonal methods to the ‘backlash against side effects’, adding, ‘Is this medical misinformation or is it accurate? Women need to be very careful where they obtain medical advice from about something that is as important as preventing an unwanted or unplanned pregnancy.’
But some feel their own experience speaks for itself. Lauren Cunningham, 26, was prescribed the Pill for ‘horrendous period pain’ when she was 14 and was later diagnosed with adenomyosis. It worked wonders for her symptoms, but it wasn’t until she came off the Pill at 24 that she realised how much it had been impacting her mood. So much so that she says she didn’t realise she was queer until she came off it, as it had dulled her emotions and sex drive so much.
‘It changed almost everything about my personality,’ she says. ‘I had a sex drive for the first time in my life and started fancying people – women and men. Then I realised I was in love with my best friend – a woman. I really wish I’d been told how the Pill might impact me when I was taking it. But there was also no other alternative.’
It seems there’s no quick fix in a woman’s quest to find the right contraception. As a starting point, Dr Henderson advises women look for the ‘non-negotiables’ when choosing, such as protecting yourself from STIs if you’re single or, if you’re in a long-term relationship, whether it would be a disaster if you got pregnant. ‘You’ve got to be informed, but I’m not sure young women are being told the honest truth about all the options,’ she says.
Dr Patricia Lohr, director of research and innovation at BPAS, says a separate BPAS survey found nearly half of women ‘face barriers to accessing contraception, such as long waits for appointments, which restrict their ability to choose the methods that work best for them’.
So where does that leave us? Over half a century after our supposed sexual revolution, are women still victims of a broken reproductive healthcare system? The future of the Pill is uncertain, but what women do know is that the freedom we were promised decades ago still feels a long way off.