I started taking the birth control pill as a sophomore in high school to help with my acne. Most of my friends got prescriptions around then, too.
I never thought twice about birth control — let alone going off it — until the pandemic, when I had more time to consider the pill I popped every morning. I began wondering how taking artificial hormones every day was impacting how I think and feel.
Recently, after six years on it, I decided to stop taking the pill. But it isn’t just me. Many of my friends are independently doing the same, whether it’s driven by concern for their mental health, desire for something more natural — or curiosity about what the world looks like when you’re not in a hormonal fog.
For more and more Gen Z women, there’s an intuitive sense that hormonal birth control might be messing with us, and our brains. And research is backing it up, showing correlations between the pill and a decreased sex drive, as well as higher rates of depression and suicide, and even stress reactions similar to PTSD survivors.
Research psychologist Dr. Sarah Hill thinks so. In 2019, she published the book This is Your Brain on Birth Control: The Surprising Science of Women, Hormones, and the Law of Unintended Consequences after going off of the pill herself.
“It was going off of the pill and seeing how that changed me that inspired me to write the book,” Hill, who is a professor of social psychology at Texas Christian University, told The Post. “I had a lot more energy, and I was exercising and cooking again. Suddenly, I was interested in sex.”
Since then, Dr. Hill said, she’s noticed a “greater awareness of some of the side effects” of the pill that has potentially contributed to a slow but steady decline in prescriptions. Between 2002 and 2017, there was a 9% decrease in oral contraceptive use.
And, although more up to date numbers are yet to come in, doctors are anecdotally noting an increase in young women desiring a change.
“I have noticed that many patients prefer non-hormonal birth control,” Dr. Taraneh Shirazian, a gynecologist at NYU Langone Health and director of the Center for Fibroid Care, told The Post. “Many are keen on limiting their body’s exposure to outside hormones so that they can feel more natural and like themselves.”
This trend may be partly inspired by viral TikTok and YouTube videos discussing the pill’s side effects — and the early days of COVID.
“The pandemic allowed us to focus attention on our health,” Dr. Hill explained. “For women who were not in relationships and weren’t sexually active, it was an opportunity to break up with their birth control …They wanted to find out how they would think and feel and experience the world without it.”
Komi Frey, 30 of Albuquerque, decided to go off of the pill in 2021 after about six years of taking it. “I went off the pill primarily because I didn’t like the idea of ingesting exogenous hormones on a daily basis,” she told The Post. “I just had an instinctive aversion to that idea.”
It’s a sentiment Dr. Hill has noticed more and more.
“We are moving, culturally, toward a place where we’re recognizing that putting a bunch of chemicals in our body isn’t necessarily a great idea,” she said. “People are looking for more natural approaches.”
Dr. Hill’s research is shedding light on just how profoundly the birth control pill can impact women beyond the classic side effects like weight gain, blood clots and even stroke.
One of the most commonly reported psychological side effects of the pill is decreased sex drive. That’s because women on the pill have artificially high levels of progesterone, which Dr. Hill dubs “sexual anti-venom.” Research has revealed that taking oral contraceptives is associated with a decreased enjoyment of sex, on top of an already lowered libido.
But the pill may also impact partner selection, too. Researchers found that women on oral contraceptives prefer less masculine faces in potential partners. Women off the pill, meanwhile, have been found to subconsciously prefer the scent of men with higher testosterone.
It’s an experience Kennedie Khourie had herself. The 24-year-old Austin, Texas, resident decided to go off of the pill last spring after six years, she suspected her mental health was being adversely impacted.
Not only did Khourie feel “less hormonal and manic” after quitting, but she experienced entirely different feelings toward potential partners. “I’m not even attracted to the same people,” she told The Post. “People smell different to me. Men smell different to me.”
Amazingly, research reveals that the change in attraction is so pronounced that women who picked their partners while on the pill are more likely to experience diminished satisfaction with their romantic relationships when they go off of it.
But birth control’s impact on the brain goes beyond just sexual preferences. It’s impacting women’s experience of the world around them. According to Dr. Hill’s research, being on the pill may be associated with lower self-control and less perseverance.
It also affects the way women react to stress. While the body’s typical response to a stressful experience is the release of the hormone cortisol, women on the pill have a dulled — or completely absent — cortisol response.
As a result, they tend to have a diminished capacity to process negative emotions. In fact, this muted cortisol response looks a lot like that of someone suffering from PTSD.
According to Dr. Hill, “We should all be alarmed by the fact that the stress hormone profiles of women who are on the birth control pill look more like those belonging to trauma victims than they do like those belonging to otherwise healthy young women.”
Both Dr. Shirazian and Dr. Hill have noticed a generational change in attitudes about birth control, with Gen Z at the forefront of a new movement toward more natural, non-hormonal alternatives.
Dr. Shirazian thinks it is “part of a generational shift.” She said younger patients generally “want more natural products, less hormones and chemicals, and also want to use products that are environmentally friendly.”
“This generation of women is demanding they get information about what’s going into their body,” Dr. Hill said. “A younger generation of women are saying, ‘Hey, wait a minute. You can’t just tell me what to put in my body and expect me to blindly obey.’”
Laura Lear, 24 of Houston, Texas, went on the pill at the age of 20 — later than many of her friends — when her then-boyfriend and peers urged her to do so.
“I just fell into peer pressure,” she told The Post. “My friends were going on it, and I just decided, ‘Okay, if this is what everyone else is doing.’ It was so normal for kids at 13 or 14 to get on it because they had bad acne. It kind of became the cool thing to do, like, ‘Oh, I take my pill every day at 3 o’clock, let’s sync our timers together.’”
But this generation of young women who went on the pill before they were even sexually active may be shouldering unintended consequences. Research has revealed that going through adolescence on the pill is associated with measurable density differences in brain regions involved with memory and emotions.
It’s a discovery that doesn’t surprise Dr. Hill: “To be honest with you, I don’t know how anyone could predict anything other than that, because the puberty transition is when your brain is remodeling itself from its childlike phenotype into its adult version of itself. It’s hard to believe that, by some miracle, it wouldn’t affect brain development.”
Researchers also found birth control use during adolescence is associated with a “small but robust” increase in the risk of major depressive disorder later in life. Girls who start the pill early are disproportionately likely to be prescribed antidepressants and diagnosed with depression. And a study of half a million women in Denmark revealed early hormonal contraceptive use may even be associated with a tripled risk of suicide.
This risk of lifelong mental health issues and even suicide is not only startling, it’s been largely underreported despite how many young women continue to be prescribed hormonal birth control with little to no warnings.
“It seems to me that there is this belief that birth control as an issue facing women has been solved: We have the pills, and so what’s all the whining and fussing about?” Dr. Hill said. “Drug companies and others who could be investing in trying to find something better for us are mistaking the fact that so many women are on it for the fact that we don’t need something better.”
In fact, only 2% of revenue from birth control pill sales goes back into research and development. And more young women are taking notice.
“We as a society are losing trust in knowledge-producing institutions, including the medical field,” Frey observed. “We’ve realized that they’re often prone to political and financial pressures, as well as human limitations. The incentive system is somewhat warped.”
None of this is to say that the birth control pill hasn’t been an enormous net-positive for women.
Providing liberation through family planning has afforded women flexibility and independence: Females now outnumber males in the college-educated labor force. That’s perhaps why there’s some resistance, especially among older generations, to talking about the pill’s shortfalls.
“A lot of women are very protective of the birth control pill just simply because they can remember a time when these types of options weren’t available,” Dr. Hill noted. “They’re trying to make sure that these options continue to be protected for the latest generation of women.”
That protectiveness is more consequential now than ever, in the wake of Roe v. Wade being overturned.
“Going off the pill is especially scary because I cannot get pregnant,” Khourie, who lives in Texas where abortion is now banned, said. “The reversal of Roe just made it scarier, because I would have to jump through more hoops if something were to happen.”
Many women going off the pill are opting for non-hormonal options, like the copper IUD, diaphragms and — sharing the burden with men as well — condoms. Others, like Frey and Lear, who are both married, are tracking their ovulatory cycles and depending on natural family planning.
“I would like to see there be more normalization of women doing whatever is best for their own bodies,” Khourie said.
As Dr. Hill explained: “There’s no one size fits all answer for anything when it comes to something as complex as contraception.”