About 60% of women in the United States take birth control pills, and yet we barely know anything about their side effects.

We should celebrate the freedom that contraception gives women, but it is shocking that the side effects of a medication that so many women worldwide taking are so poorly understood. In fact, despite women complaining about the pill’s side effects for decades, there is little-to-no research and testing of the short and long term impacts of this medication.

When I started taking the pill, I was given (as many of my friends) a mile-long list of the side effects that I might or might not notice and that could be related to the hormones I was going to be taking. The doctor also said that, even if I noticed side effects, those might disappear with time.

Birth control pills have side effects. We all know that, and we have accepted them as a minor evil for the sake of preventing pregnancy. However, with the appearance of alternative and arguably more effective contraceptive methods, the side effects of the pill should no longer be ignored.

The list is long and the most common side effects are generally tolerable, such as increased breast tenderness, nausea, an increased risk of blot clots. Marra Ackerman, MD, the director of NYU Langone Health’s reproductive psychiatry program, said that the concerns regarding the birth control pill are “real concerns based on evidence.” However, “the evidence isn’t consistent and can’t help guide us in a neatly organized way to make changes.”

In 2004, Stephen Robinson analyzed the data from seven studies conducted in the early 2000s and concluded that women that were taking oral contraceptives suffered increased rates of depression, anxiety, fatigue, neurotic symptoms, divorce, tranquilizer use, sexual dysfunction, compulsion, anger, and negative menstrual conditions. However, the side effects were too varied and the types of birth control pills too different to reach definitive conclusions.

A 2007 Swedish study led by Lindén Hirschberg found that oral contraceptives reduce the general wellbeing of women. They took 340 healthy women aged 18-35 for a double-blind study, in which they gave them placebo pills or contraceptive pills containing ethinylestradiol and levonorgestrel (found in most birth control pills) over a 3-month period. Those women who had been taking birth control pills reported that their quality of life had decreased significantly since they started taking them. They generally complained about a worsening of their moods, self-control, and energy levels.

A more recent study of more than 1 million Danish women found a statistical correlation between the use of oral birth control and depression diagnosis, particularly in teenagers. However, other doctors have pointed out that the actual increase in new diagnoses and new antidepressant prescriptions among women taking birth control was very small.

However, another 2016 review of all studies on hormonal contraception use and mood over the past 30 years, concluded that most women on the pill do not experience mood changes or if any, that the pill actually improves their mood. Nonetheless, the different studies in which the review is based on have very different ways of measuring mood changes and look at different types of birth control pills. For this reason, its conclusions are not definitive.

Moreover, the research connecting oral contraceptive pills to cancer is contradictory. Some studies have linked the long-term use of the pill to a 7% increase in the risk of breast cancer, as well as an increased risk of cervical cancer. However, other research has proven that oral birth control decreases the risk of other different cancers, such as endometrial cancer (by 30%) and ovarian cancer (30-50%).

Other research suggests that birth control pills might decrease women’s sex drive. Alyssa Dweck, an OB/GYN from New York has stressed: “There is some subset of women who have diminished libido and increased pain with sex. We have seen that discontinuing birth control will get rid of the problem. It’s a genuine concern.”

All of this data serves as just more proof of the already well-documented gender gap that exists in research. Many more scientific studies are done on cis men and their reproductive health specifically because it is considered less complex and therefore cheaper to study than women. Several trials of different types of male birth control have been rejected because of their side effects, despite them being very similar to those of the female birth control pill. Women’s hormonal cycles are not only a complication in their daily lives but also a barrier to research that could improve their situation.

Women’s reproductive rights are fundamental, but included in those is the right to knowledge on how birth control affects their bodies, and this can only be obtained through research.

  • Beatriz Valero de Urquia is a historian, writer and journalist. She graduated from the University of Cambridge in 2020 and spends her time between Spain and the UK reading, listening to musicals and writing her first novel.