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Welcome back to the psychology of your 20s the podcast where we talk through some of the big life changes and transitions of our 20s and what they mean for our psychology.
Hello everyone, welcome back to the podcast for a new episode, a new week, new listeners, old listeners.
Great to have you here to discuss a really interesting topic today, one that has been interesting just from my own personal knowledge but for maybe anyone who's listening to do a little bit of a deep dive into this topic and we have just one major question to answer today.
One question I really want to get to the bottom of and it's how does taking hormonal birth control in our 20s influence our psychological experience and well -being and at the end of the day is it worth it?
Should we be given more information when we make that decision and what do we need to know about the interactions between taking hormonal birth control and our general well -being and how we experience the world and our emotional reactions in our 20s?
So a super interesting topic, super interesting to research.
There's so many different thoughts and it was a bit of an effort to discern fact from fiction.
I think anytime we talk about women's reproductive health it gets a little bit messy, there's often a lot of subjective information that we have to overlook so there'll be heaps of really nuanced discussions in this episode that I hope you enjoy and thank you to my wonderful friends Meg and also Meg,
yes, two lovely Megs for suggesting this topic or some version of it.
I have really wanted to discuss this on the pod for some time but like I said it did require a little bit of research and I think it might be slightly controversial in the eyes of some so I really wanted to tread with some care but still do it justice.
I think personally from the rhetoric I see online and even in my daily life birth control can come with a lot of opinions attached to it as do many topics related to female reproduction and female bodies so in planning this episode I really wanted to dispel some myths and discuss it from the perspective
that we always take which is a psychological one.
So let's jump straight in and yeah kind of get to the bottom really I don't know just have a nice discussion about what there is to consider when we start taking hormonal birth control.
I think we need to be honest most of us are having sex in our 20s maybe casually or in a serious or committed relationship but sex and intimacy do form a big element of most of our lives in our 20s as we test relationships we figure out what we want and quite frankly just enjoy ourselves and have fun
but fun and exploration and pleasure aren't the only parts of sex so as is probably clear by now in this episode we're going to talk about birth control for people mainly for people with a vagina but if you are someone who identifies as male and who has sex with women or those with a vagina this episode
is still very much for you.
It is a neutral responsibility both parties responsibility to be concerned with reproductive health and the possibility of not only pregnancy but also STDs when we are engaging in consensual sex and the use of hormonal birth control for those who are having sex who are sexually active is obviously a big
thing to be considered but it should not be a simple consideration and I think too often when women go to their doctors at you know 16 17 18 and whenever they become sexually active and ask about birth control or are asked about whether they consider it by their doctor or what method they are on the first
thing that's often suggested is hormonal birth control normally the pill and one that is estrogen based it's easy it's effective it's cheap and I think that's often all that we want and we might not ask many further questions especially since we accept what our doctors have to say we trust them and considering
that the pill is so socially accepted and prevalent we probably know someone who is already on it especially if you're a young woman in their late teens or early 20s but part of the conversation that is normally not had in that kind of medical context is the physical and psychological emotional mental
side effects that can last even beyond when you do seek alternative methods when you change birth control or stop it all together and that's what we're discussing today how does the use of hormonal birth control in our 20s shape our psychological experiences and our well -being how does it impact our
relationship to our bodies um I know this is said all the time but like the natural cycle for a woman you know follows a lot of cycles in nature is that something that's important to consider interrupting that cycle might remove how in touch we are with the natural cycle of our hormones and the natural
cycle of the planets I know it sounds a little bit wishy -washy but this was some of the stuff that came up when I was researching this and put all the cards on the table I think it's really important to consider so um hopefully we learned something today I definitely did so stick around so before we
discuss the psychology of birth control specifically birth control that uses hormones like progesterone and estrogen mainly the daily pillows kind of the focus of let's do a bit of a history lesson and explain how it is that hormonal birth control methods came to be and how they work so before we had
this simple and easy form of reproductive control the daily pill modern forms of birth control um like latex condoms and iud and of course birth control pills they're all still relatively new in the context of you know general overall human history but there were things that came before it and records
from you know ancient greece and egypt showed that I think control over reproduction has been a concern for you know pretty much as long as humans have been reproducing being able to have control over women's bodies either for women or um I guess for women or by others that are invested in women's reproductive
health has been something that's been on everyone's minds for a while and it is actually a big part of history I think we often tend to think that only in the last 100 years have methods become available for women to have control over when they want to have children if they want to fall pregnant but early
birth control methods from around the world have been around for some time and I had a little look into what some of these included because I thought it would be really interesting but of course um we had condoms um often they were made from animal blooders or linen or silk or plants I don't know if that sounds
particularly pleasant um but yeah I guess they had to do what they had to do another really interesting one was spermicides so spermicides essentially stopped the sperm from reaching an egg um by killing the sperm or by making it unable to swim and there were these really interesting um kind of archaeological
studies and historical studies that found that some ancient cultures used to make spermicides out of vocation and honey and rock salt um and sometimes even like animal feces and yep also doesn't sound sponges like made of moss or bamboo um these and they would often be soaked in oil or vinegar or lemon juice
like substances that were believed to slow down or weaken sperm and there were even early kind of suggestions of there being oral contraceptives often used by nobility including queen ant so she used to take lead yep and other toxic metals mixed with things like pomegranate seeds and papaya and silithium
and blue coercion and things like that and would consume them on a daily or before she was like having sex to prevent herself from falling pregnant so these don't sound like particularly fun methods of birth control and not only were they not very effective they could often be very dangerous and sometimes
it was the choice of men whether they were used so cheap easy accessible birth control that is within the woman's control such as the oral contraceptive has obviously now been championed as a massive step forward for women's rights big move from you know stuffing sponges in lemon juice up there not to
be crude but um that kind of makes sense oral contraceptive has really changed the kind of landscape around reproductive health it's now the personal consistent choice of women over whether they want to have children or fall pregnant and allows them to kind of control the size of their families i think
we hear all these stories about people having 10 -15 children before hormonal birth control was invented um and that sounds also pretty unpleasant and i think before the creation of the daily pill women and people with a vagina were often kind of subject to the whims of their uterus and their cycles
and didn't really have the same level of control over their reproductive systems um it also has to be said that it's a woman's choice often whether she consumes the pill and it's completely within her control when she takes it if she wants to take it in most cases um and that is something that has only
come up recently before it was kind of the men's decision whether they wanted to control the size of their families or prevent someone from falling pregnant so hormonal birth control particularly the daily pill it was pioneered by four people in particular and although they have contributed greatly
to reproductive rights for women their personal beliefs and values um don't really paint them as kind of the feminist icons people serving heroes that the history books often call them there are some details that are definitely overlooked that kind of murky the waters a little bit so firstly there was this activist
and sex educator her name was Margaret Sanger and she is often called the founder or creator of modern day birth control if you look up who is the creator of you know the pill her name will probably often come up and it will say something around the fact that she was this huge advocate she was this feminist
she was pro -sex that all sounds really lovely right sounds like something we really get behind but what is not often known is that is kind of the way that she was able to catalyze or activate science to pursue this new technology and that was by appealing to the eugenics movement to advocate for birth
control yes eugenics for those of you who don't know what eugenics is i'm sure you've seen it in the history books in one form or another it is the study of how to kind of arrange reproduction within a human population to increase the incurrence of heritable characteristics that we see as desirable
okay so if that sounds off and a little bit gross you would be right other supporters of the eugenics include Hitler for example in his extermination of Jewish people and other populations this can kind of be credited with thoughts and ideas that he gathered from the eugenic movement and the idea that we
want to be able to arrange the human population to be desirable some white supremacy groups also still a big proponents of eugenics so it doesn't sound like a particularly kind and moral group to be a part of but it also does make sense that the people who would want to eliminate undesirable characteristics
and genes would be the first ones in support of a form of medicine that allows them to control in some ways who and who cannot have children so that was kind of the group that Margaret was appealing to there is the jury is still out of the weather she just saw it as a means to an end and just wanted
funding to pursue this new technology and she thought it would really put the power back in the hands of women but that's kind of still up for debate and I think it's a very dark history when we think about how common hormonal birth control in the daily pill is now and how kind of unconsciously a lot
of women tend to take it without really knowing the origin stories of this of this birth control method but there are other pioneers of kind of modern day hormonal birth control and these include the biologist and scientist Gregory Pinkers the suffragist and she was also a millionaire Catherine Macomric
she was an heiress and is kind of credited with giving a lot of the financial backing to some of the first early clinical trials and then we have a catholic physician and a gynecologist also a scientist whose name was John Rock and he helped conduct the first clinical trials so the research was kind
of getting underway in the 40s as scientists realized that by increasing the rates of certain hormones in primates but also in humans they could prevent ovulation and they could prevent people from falling pregnant but in 1954 these two doctors Pinkers and Rock with the backing of our friend Catherine
and the racist Margaret began their first trials in Massachusetts and they were pretty small it was only on about 50 women and like I said they had realized a little bit earlier that if we increase the rates of estrogen and progesterone in our bodies the two main hormones that work on our reproductive
system and within our bodies the following effects that it would have on our internal systems and the reaction would help prevent pregnancy so this is how the pill works when we artificially increase the rates of estrogen and progesterone these hormones suppress the release of a follicle stimulating
hormone and the luteinizing hormone from the pituitary grant in the female body so basically these two hormones trigger the release of estrogen from the ovaries which in turn stimulates the release of a mature egg which is how we fall pregnant but if these two hormones so the follicle stimulating and the luteinizing
hormone are suppressed the chances of ovulation and therefore fertilization by a male sperm cell are significantly reduced basically it interrupts our body's signals within our normal cycle and tells the body that you know no we don't we can't get pregnant we shouldn't release these two main hormones
because we already have enough of this other hormone in the body our body is doing fine we'll be able to fall pregnant normally so it basically blocks our body from responding to natural cues to release an egg meaning that no egg is released and therefore you can't get pregnant so progression only birth
control pills they do something a little bit different if it's just progesterone they kind of make it difficult for sperm to reach the egg in the event that ovulation occurs but it has less of a direct effect on that follicle stimulating and luteinizing hormone so it doesn't stop ovulation it just prevents
kind of the sperm from getting in so these two doctors rock and pink has used an oral contraceptive pill much like the ones we have today containing synthetic progesterone that they got supplied by a pharmaceutical company and they administered it to 50 women under what they called a fertility study
because at the time in the 1950s so not even a hundred years ago not even a hundred years ago contraception was illegal in much of the United States including in Massachusetts so they kind of had to conduct this study on the guise of actually trying to help women fall pregnant rather than giving women
the power to not do so so this pill was taken by women for 21 days followed by a seven -day break and they concluded that no ovulation occurred in any of the women during drug administration based hundred years ago contraception was illegal in much of the United States including in Massachusetts so they
kind of had to conduct this study on the guise of actually trying to help women fall pregnant rather than giving women the power to not do so so this pill was taken by women for 21 days followed by a seven -day break and they concluded that no ovulation occurred in any of the women during drug administration basically
meaning that when these women were taking this artificial steroid they could not fall pregnant so one of these scientists they wrote a scientific research paper and explained how this drug succeeded in inhibiting ovulation but skepticism kind of remained in authorities at the time there was i guess
a lot to head and in order to provide kind of further evidence that this daily pill was effective they moved their studies to Puerto Rico to conduct a larger clinical trial now there is a lot of ethical discussions around conducting medical trials in communities that might maybe less developed or have lower
incomes than say more developed countries like the US so it's believed that the reason they took their study here was because a it was cheaper to get participants in some cases they didn't they only needed to pay them a small amount and there would be less kind of ethical and moral questions and questions
from the government regarding their intent basically they could do things that were a little bit more dangerous knowing that no one would really care other than the communities and their voices weren't loud enough to be heard on an international scale luckily enough the pill was reported to be successful
but and this is a really crucial point for our later discussions there were so many side effects for legal consideration and for medical consideration that the medical director of the clinical trials actually said that this should not be considered that the hormonal birth that hormonal birth control
the pill posed too many side effects and dangers for it to become more popular and prevalent instead they forged ahead and after kind of conducting further clinical trials and lowering the dosage of estrogen and progesterone the female controlled contraceptive method now known as the pill began and for medical
consideration that the medical director of the clinical trials actually said that this should not be considered that the hormonal birth that hormonal birth control the pill posed too many side effects and dangers for it to become more popular and prevalent instead they forged ahead and after kind of conducting
further clinical trials and lowering the dosage of estrogen and progesterone the female controlled contraceptive method now known as the pill became a rapid nationwide use for protection against pregnancy and nowadays as we know it is prescribed in its millions to people all over the world every year
and is one of the most popular birth control methods for many of the reasons we've already stated regularly taking synthetic hormones and what that does for our mental well -being and the natural processes and cycles of our bodies okay i'm going to make a bit of a disclaimer and i'm going to make it
early before we start talking about some of the side effects and impacts and influences that come with hormonal birth control particularly the pill personally i am not the biggest fan of this method of reproductive health or reproductive control from my experience i have found that the side effects
greatly outweigh the benefits and in some cases some of the more serious side effects that are more common than you would probably think aren't always discussed in a medical environment or in a medical context when you might be first being prescribed the pill often at an early age but i also know it's
a personal choice and there are a number of amazing reasons for being on birth control and family planning is just kind of one of them so i think there is a misconception that people who take the pill take it for one reason they're sexually active they want to not fall pregnant but it's really an amazing
kind of technology and an amazing medicine for controlling things like endometriitis for controlling acne and regulating heavy or irregular periods that can cause things like anemia and iron deficiency and there's also been some interesting studies that have shown that it can reduce the risk of uterine
cancer and some other forms of preventable cancers that often are more prevalent in women so birth control is not the only kind of function family planning is not the only function it can have a lot of other impacts on our physical health and our well -being that often aren't discussed as much and these
are all some of the really amazing benefits of using synthetic hormones not just for birth control but for other elements of physical health and well -being and it might be something that you would consider if you have you know endometriitis or a regular period it's a great way to kind of take control
over your health not just in terms of deciding when you want to have a family but thinking about your health in a more holistic way though we kind of typically present hormonal contraceptives as a really great success for women which they are sometimes we do tend to overlook some of the serious side
effects that have been reported in mainstream scientific literature and I've often found that when you are initially being prescribed the pill and this is obviously anecdotal they're not always brought up either through you know negligence or just because they're not seen as important and women who do
regularly ingest hormonal birth control methods will find that they usually have a few side effects most of the time they're common and they're manageable but they can be more serious and I'm sure we've all had friends who have told us stories about terrible episodes of depression or weight gain or mood
swings um even stories about people who've had strokes or heart attacks because the interaction between because increasing kind of hormonal hormone levels particularly through artificial methods can really fuck with our bodies in some ways and interact with pre -existing conditions in ways that can be
quite dangerous some of the common kind of physical side effects that I think are pretty manageable can be things like nausea and headaches acne decreased libido and weight gain all of these I think are something that can be brought into the equation of costs and benefits or risks and benefits that we
kind of all personally have to do when we are considering birth control and family planning is you know weight gain is a decreased libido is acne something that is worth it for you and that's a completely personal choice but there are can be some more serious side effects that we don't discuss as much
and although they're not as common for those who do experience them it can be pretty dangerous things like blood clots having heart attacks high blood pressure a stroke there are even some cancers that there have been indications that increasing the synthetic level of hormones such as atrogen and progesterone
in your body can contribute to such as liver cancer but these are more likely to be the case with underlying conditions such as a predisposition or a family history of particular cancers and blood conditions like light and factor 5 which aren't often tested for when we prescribe birth control which was the case
for myself so if you do have a pre -disposition to perhaps experiencing some of the more serious side effects it's really important that that is known and that is part of the equation before you make the decision to take oral contraceptives or to take the pill and often it's not something that is factored
in and it's not something that your doctor alerts you to when you're first being prescribed this medication so if you are on hormonal birth control at the moment or considering it i would really suggest that you get your doctor to run a blood test to make sure that you don't have any underlying conditions
that might increase your likelihood of experiencing some of those more serious side effects like blood clots and like stroke and also considering what dosage you're on the more estrogen and progesterone that is in the pill it will increase the effectiveness but it's more likely that you will have some
of those side effects that we've talked about but this is a psychology podcast so let's cover some of the psychological side effects of long -term and even short -term birth control use that's the question we really wanted to answer today birth control and hormonal birth control is so common particularly
amongst women in their 20s but what does that mean for how they experience their 20s and what does it mean for their psychological outlook their choices their behaviors and their emotional well -being so i think the long -term impact of the oral contraceptive and birth control methods on human psychology
has been vastly under -researched in the past and even in the current day and has really only recently become a focus for mainstream scholars particularly i think for minority populations they've often not been included in this research as is often the case and in general i think it is a pretty common understanding
that health issues related to women receive less funding receive less research interest and that can have a really big long -term impact on how things like hormonal birth control are treated and the availability of these medications so hormonal contraceptive uses in contrast with non -users have been
found to have higher rates of things like depression and anxiety fatigue sexual disturbances compulsion anger all of which kind of create our outlook on life it makes sense you're putting something artificial into your body and it does have incredible benefits it allows you to have control over your
body over when you want to fall pregnant it allows for you to have control over some of those other conditions we talked about like endometriitis or iron deficiency but there are some other important studies that show that the depths of the psychological impact are often not well known and not shared
as frequently in a medical context as they probably should be so in september 2016 this psychiatry journal published a really interesting kind of groundbreaking danish study that found a correlation between the use of hormonal birth control and being diagnosed with clinical depression so this study
attracted hormonal birth control use and the prescription of antidepressants over six years for over a million women so this was not a small clinical study like some of those studies that initially led to the creation of the pill that was over a million women and they found the women who were on hormonal
birth control such as the pill were significantly more likely to be prescribed antidepressants compared to those who weren't taking or weren't using synthetic synthetic hormonal forms of birth control and it found a particularly strong correlation between teenage birth control users and depression so there
was an 80 increase risk for teens taking birth control and their likelihood of starting antidepressants after going on the pill and this is a really troubling statistic especially because the pill is often prescribed when we are quite young when we become sexually active or sometimes to treat acne or severe
menstrual symptoms and just as a general preventative measure that's something to be considered depression is obviously a pretty serious mental condition and it's interesting that taking this pill is or taking some form of hormonal birth control is increasing your likelihood of suffering through what can be
and what is often a really traumatic and difficult mental health problem i think the other thing that was often brought up and there are kind of four other links that i wanted to make with psychology and taking hormonal birth control and those are things like uncontrollable mood swings we've talked
about depression changes and sleeping patterns loss of libido and your sexual preferences and your sexual choices all of which will have a pretty deep and profound impact on how you experience your 20s how you go about living your daily life your relationships with your partners with your friends with your
family and just with your general overall experiences so of all of the side effects of hormonal birth control mood swings are often the most common so it's pretty common to feel irritable or short -tempered particularly around when your period might take place and hormonal birth control makes those mood
swings much worse to the point of i don't know crying for no reason feeling a lot of guilt feeling bad about yourself having low self -esteem and just a general kind of sadness about the way that you're living your life so up to 10 percent of women aren't actually able to tolerate synthetic progesterone
as an ingredient in birth control because of this impact because they do have uncontrollable mood swings that make it difficult to kind of function in their daily life and decrease their well -being to the point that taking this easy form of birth control just isn't worth it for them anymore like i said
this is a personal choice and that's only the case with 10 percent of women most women might not have this reaction they might find that their side effects or some of the impacts are super minor and the benefits of being able to control when they fall pregnant of being able to control their likelihood
of having a child or family planning that is an amazing benefit and it's a really empowering benefit and it's worth it for them i want to talk about depression a little bit more because that is perhaps one of the most serious side effects and some of one of the most common as well in the days before
your menstrual cycle begins or before your period it's pretty natural to have an emotional shift that's going to cause you to feel less confident about yourself maybe emotionally sensitive a bit moody but when these symptoms change from uncomfortable feelings to depressive symptoms such as an inability
to get out of bed feeling really unhappy about your life significant appetite changes significant changes to your motivation significant changes to your capacity or your ability to reach out to natural to have an emotional shift that's going to cause you to feel less confident about yourself maybe emotionally
sensitive a bit moody but when these symptoms change from uncomfortable feelings to depressive symptoms such as an inability to get out of bed feeling really unhappy about your life significant appetite changes significant changes to your motivation significant changes to your capacity or your ability
to reach out to family and friends and ask for support that's probably a time and an indicator that you need to be concerned your overall functioning is not where it should be your 20s are meant to be a time of experiencing things and being happy with yourself and exploring things and trying new things
out and getting out there and making friends and being social before you have some of those responsibilities that come along with later life but research measuring the clinical impact of oral contraceptives like i said it found that women taking the pill are more likely to suffer from depression than non -pill
users and women using birth control with particularly large amounts of estrogen had more instances of depression than those who are on a lower dosage so perhaps that's something that needs to be questioned is it worth prescribing women birth control pills and the pill that have large amounts of this synthetic
hormone that we know can really increase their risk of pretty serious side effects studies have also shown that arrived early and really frequently but when we come to think about the psychological impacts that will bleed on to the rest of your life perhaps it is important to consider non -hormonal birth
control methods or those that aren't as reliant on estrogen to kind of control your cycle there are some other things that are really important to consider that link to our psychology in our 20s and that's changes in sleeping patterns and a loss of libido so it's really normal to have an off day here
and there where you feel like you just want to sleep in you can't get to sleep maybe you're experiencing insomnia but if you feel like this every day it could be that your birth control is affecting your sleeping patterns often it's birth control that contains progesterone that can lead you to experiencing
either extreme insomnia or extreme fatigue and one of the other symptoms that i think is talked about a lot but it's important to be considered in the more nuanced that is a loss of libido let's be honest most of us go on hormonal birth control because we want to have sex and we want to enjoy the sex
that we're having maybe you first considered it when you had you know your first long -term partner or you were becoming sexually active with someone who could you know make you feel pregnant and i guess if that's the that's the reason why you go on hormonal birth control you probably want to be able
to have sex after you're on it but birth control has been found to kind of reduce sexual desire in women so most combined birth control pills which are the most common they contain estrogen and progesterone which we have talked about and these hormones tinker with the way your body works many of these
combined pills actually lower your testosterone levels relative to your estrogen levels and testosterone is the hormone that makes you want to have sex we generally think of it as a male hormone but women also have it just not as much and it's really important for controlling sexual desire and controlling
kind of energy levels levels of kind of passion and emotion but if it if the pill kind of interrupts the the kind of production of testosterone which ignites sexual desire you might see might start to see that you do have lower levels of sexual desire that can have an impact on your relationship obviously
choosing to have sex and when you want to have sex is completely up to you and it should always be consensual but in committed relationships sex is often a really important element of the relationship and it's part of the discussions that we have to have with our partner so seeing a dramatic change
in the amount that you might want to be sexually active with your partner or be intimate with them can really impact the state of your relationship and can lead to perhaps some difficult discussions women who use birth control particularly hormonal birth control i would like to say things like condoms
obviously are external they don't really impact on the internal functioning of our body same with the copper iud which isn't hormonally based but hormonal birth control methods have been linked to like i said reduced sexual functioning but also a high interest in short -term sexual relationships compared
to naturally kind of cycling counterparts and some evidence even suggests that birth control use might even alter your mate choice and may negatively affect sexual satisfaction in women who are choosing to have sex with men and that has really important impacts on who you choose to date the kind of sex
you choose to have and i don't think it's perhaps a negative thing but it's just something to be considered and also really interesting when we think that we think about the relationship between increasing the level of these hormones in our body and who we choose as a mate or who we choose as a partner
or who we choose to have sex with yeah something to be considered i don't think that's necessarily a negative thing but it's just a really interesting finding and i think kind of highlights that deeper interaction i'm trying to paint a picture of which is that taking the pill is not a passive decision it
does actually have huge huge impacts on how we go about our lives in our 20s and whenever you're taking hormonal birth control the choices we choose to make our outlook our mental well -being i would like to say just because there have been links between hormonal birth control and mental health issues
and other psychological side effects um that doesn't mean that birth control will have the same impact on everyone using it i think these can be particular cases and often making the decision to lower your dose or to um perhaps try a different method like i said um non -hormonal hormonal birth control
methods like natural family planning
