When The Debrief launched its Mad About The Pill investigation into the mental health side effects of hormonal contraception the response was overwhelming. Women from across the world got in touch to tell us about their experiences of depression and anxiety which they believed were caused by their contraception. It underlined just how let down and unsupported women everywhere feel when it comes to how their contraceptive choices might be impacting their mental wellbeing.
Now, according to the United Nation’s Department of Economic and Social Affairs, a record number of women around the world now use contraception. 64% of women used a ‘modern or traditional method of contraception’ such as the pill, coil or condom in 2015 compared with 36% in 1970. From America to Africa and Afghanistan, from China to Latin America and the Caribbean, more women than ever are able to access contraceptives and this can only be a good thing. That said, there’s still more to be done. The World Health Organisation estimates that there are around 225 million women worldwide right now who would like to access contraception but are not able to.
Contraception matters because it gives women choice and control. It allows us to be what Charlotte Perkins Gilman called ‘Conscious Makers of People’ and to enjoy sex without fear of unwanted pregnancy. Contraception gives women reproductive autonomy and the fundamental freedom of being able to choose whether or not she will have a child. This is crucial because, as Gloria Steinem once said, most women are ‘one man away from welfare’. The obvious caveat being that in many corners of the world there is no welfare to fall back on.
Brazil
It’s this fact that underlines why it matters if women in countries like Brazilare able to access contraception but experience problems with it and do not feel supported. The Debrief has heard from countless women who felt they were out of options and had no alternative but to stop taking hormonal contraception.
One reader, from Brazil (where there is a national public healthcare system that provides some contraceptive services but those who can afford to pay go private), wrote ‘I started to have panic and anxiety attacks…sometimes I couldn’t recognise myself. I was afraid to go to public places. It started 6 months [after I started taking the pill].’ She then sought the help of a psychologist, being fortunate enough to be able to pay for one herself, who told her ‘to take depression pills’ which she did not want to do. This left her feeling that she had nowhere to turn, being between the contraceptive equivalent of a rock and a hard place.
Peru
Another reader, this time from Lima in Peru (where abortion is also illegal and punishable bya pretty hefty prison sentence and contraception is not always easy to access), wrote to express her concerns and despair. Reading about other women’s experiences of mental health side effects had made her feel ‘less alone’ she said. She explained that after she started to take the pill she felt that she ‘had changed’; ‘I feel sad all day, I cry, I feel that my boyfriend is going to leave me at any moment, I do not know what to do with my life. I have even thought that I no longer want to live’, she wrote. For this young woman, reading about the experiences of others and the science behind how hormones can interact with our mental health was a comfort. However, she said, she still felt that there was no real solution for her. Sadly, at this point in time, she may well be right.
Egypt
In Egypt, on reader said that many of her friends were experiencing side effects related to hormonal contraception but until the study from the University of Copenhagen was released last year demonstrating a correlative (if not causal) link between hormonal contraception and depression, they had not ‘put two and two together’ because nobody had told them about the mental health side effects they might experience.
France
Closer to home in France one reader explained that while in France women see a specialist gynaecologist instead of a GP (which is organised through France’s Carte Vitale system), the situation is slightly better. One French reader explained that women are told ‘from the beginning that one pill might not work with you, not to worry, it can be changed.’ She went on to explain that you have ‘yearly meetings with a gynaecologist’ in which they also do ‘smear tests and blood tests’.
Germany
In Germany, people are required to have health insurance, which is usually part of a public scheme into which individuals and their employers pay. One German reader explained that while ‘doctors [there] are usually very supportive and good at informing patients’ however, she said, ‘I was never warned about [mental health side effects] in particular but it’s something we all hear about from each other’.
Anecdotally, from The Debrief’s contraception survey and from the women who have contacted us about Mad About The Pill, we know that women who have experienced mental health issues which could be related to their contraception feel they are out of choices when it comes to their reproductive choices.
In countries where abortion is illegal and contraceptive information is difficult to access, particularly for those on low incomes, this is a serious problem. Women need access to contraception as a basic human right, but they also need access to information about that contraception and support when it isn’t working for them.
As experts discussed as part of Mad About The Pill, it makes sense, medically and biologically, that hormonal contraception could adversely affect women’s mental health. What we need now is the data and research to back that up, followed by support for those experiencing mental health problems related to contraception and, ultimately, better methods of modern contraception.
Too many of us have played 'pill roulette' with our mental health, but for women in countries where contraception is difficult to come by and abortion is near impossible to access in safe and legal conditions, the outcome can be deadly serious. It's not enough to simply increase access to contraception, we need to ensure that the contraception available is the best it can possibly be.
Share your stories about hormonal contraception and mental health with us here
You might also be interested in:
Debrief Investigation: Is Your Contraceptive Pill Causing You Anxiety, Depression And Panic Attacks?
Ask An Adult: Experts Explain The Link Between Mental Health Problems And The Contraceptive Pill
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This article originally appeared on The Debrief.