Oral Contraception’s Negative Effects on A Women’s Physical and Psychological State: The Untold Truth

Emma E. LaVopa

Department of English, The City College of New York

ENGL 21003: Writing for the Sciences Section K

Ms. Katelyn Conroy

October 23, 2020

Abstract

This literature review accesses three scholarly articles on the negative effects that oral contraception has on a female’s physical and psychological state. A main focus of this article is that when woman first start taking birth control pills, they are seldom exposed to every possible side effect, varying from weight gain to complications that could be fatal. The next topic discussed is how oral contraception is measured contains discrepancies that have still not been addressed. This leaves many women confused about certain side effects that influence their mood and even who they chose to be in relationships with. This could lead to psychological morality issues later in life. The final main topic discussed in this article is the number of information gaps and unanswered questions discovered was incomprehensible. For a medication that is widely accessible and used by millions of women daily, such a lack of information is unacceptable. The review concludes with how negative effects have the potential to impact all women due to the finding that the variation in measurements, effects, and unanswered questions are so vast.

Keywords: oral contraception, measurements, birth control pill, negative side effects, age, hormones, physical and psychological effects

Oral Contraception’s Negative Effects on A Women’s Physical and Psychological State: The Untold Truth

            The use of oral contraception (OC), the birth control pill, affects women’s bodies in several ways. In this literature review, we will be discussing the numerous side-effects, unspoken, and known, varying from heart diseases to mood disorders that many women experience. The three articles synthesized throughout this review are ‘Reexamining the Oral Contraceptive Issues’ by Roberta Orne and Joellen Hawkins, ‘Studying the Use of Oral Contraception: A Review of Measurement Approaches’ by Kelli Hall, Katharine White, Nancy Reame, and Carolyn Westhoff, and ‘Psychological, social, and spiritual effects on contraceptive steroid hormones’ by Hanna Klaus and Manuel Cortes. By cross-referencing these three articles an abundance of information was found on the negative effects birth control can have on a woman’s body. Along with that, many women on the pill are unaware of these severe side effects. The use of birth control pills developed not long ago but quickly became one of the most used planned parenthood methods. The article ‘Reexamining the Oral Contraceptive Issues’ by Roberta Orne and Joellen Hawkins states that “Oral contraceptives have been in use since the 1960s.” Knowing that millions of women use this medication daily one could assume that the research on every possible side effect, physical and psychological, would be covered extensively and thoroughly, but is that the case?

The topic of psychological effects is extremely understudied and typically treated wrongly. There is a big demand for studies to be performed about the effect that hormonal contraceptives have on the brain due to a large group of women that have suffered these effects. A major contributor to this is the jumbled numbers used to measure hormone levels in different contraceptive pills. Not only are the measurements of hormones disorganized but as are the way they hold women accountable for keeping up with the daily pill. Although discredited, consistent use of OC is largely measured by methods of “self-reports from a written survey, interview, or diary. […] Self-report remains the most common OC use measurement,” as stated in the article ‘Studying the Use of Oral Contraception: A Review of Measurement Approaches’ by Kelli Hall, Katharine White, Nancy Reame and Carolyn Westhoff. This discrepancy is due to the lack of studies and research done on why women miss pills and how it affects their bodies. The language used throughout these articles is on a doctoral level. Due to this, there are numerous amounts of everyday women being left uninformed on what exactly is entering their body and what it does to them.

Literature Review

Oral Contraception: The Unspoken Effects

            Many people know the more common effects that birth control pills have on women’s bodies such as weight gain, and changes in one’s mood over time. Compared to what research shows these are only the surface of possible effects. The authors Orne and Hawkins state that towards “[…] the late 1960s problems began to surface. Oral contraceptives were not without life-threatening risks as well as annoying, although often transient, side effects.” Knowing that the pill became public in 1960 and these issues arouse not even a decade later is cause for concern. These life-threatening risks that are caused by the pill include, but are not limited to, strokes and heart attacks of which make up about 500 deaths each year (Orne and Hawkins 1985). Already 500 deaths could be prevented with the correct amount of information provided and dosage given. Regarding a lack of information, there is not much emphasis from doctors about how important it is to take the pill at the same time daily. According to Hall, White, Reame, and Westhoff, “As many as 30% of women report missing one or more pills per month, and approximately half of new OC users will discontinue use within the first year. By missing just one pill women are opening themselves up for rough consequences but who is to blame for that? How is a woman supposed to know if she was not told about the importance of a strict schedule? It is a common thread amongst these articles that many women stop taking their oral contraceptives due to its harsh side effects, but this could lead to other unspoken negative results. Hannah Klaus and Manuel Cortes state in ‘Psychological, social, and spiritual effects of contraceptive steroid hormones’ that, “The high rates of discontinuation of contraceptive steroid hormones often led to unplanned pregnancies, sadly about half aborted.” This was shown amongst woman in Britain with 40 percent of women, out of the 66 percent that underwent abortions, using oral contraception inconsistently, according to Klaus and Cortes. This is a factor that is unexamined and avoided when placing a woman on the pill. Many women fail to hear every side effect that could occur while using oral contraception and while part of the blame is on their doctors, the other part falls on the backs of researchers who refuse to dive deeper into these occurrences. The National Institutes of Health recognizes this issue between the stopping of the pill in correlation to unplanned pregnancies and have “[…] issued a request for research for non-hormonal contraceptive. But they need look no further than NFP and will save taxpayer funds in the process,” says Klaus and Cortes. The ‘they’ that the authors are referring to here are the big pharmaceutical companies that put their attention onto other issues that they believe are more important even after hearing constant concerns.

Dosage Effects: The Wide Range of Oral Contraception Measurements  

            The measurements used to determine the amount of progesterone and estrogen, the two major hormones in a females body, that goes into different oral contraceptives is a big contributor to whether or not a woman will stay on the pill due to its various side effects. Pills that contain progestin and estrogen have been found to cause less dramatic side effects than those that only contain progestin. The article ‘Psychological, social, and spiritual effects of contraceptive steroid hormones’ outline a study done on Norwegian women that revealed that, “The women taking progestin-only contraceptive formulations had an increased likelihood of a current mood disorder, compared with the woman taking combined contraceptive formulations, who had a lower likelihood of a current mood disorder.” Combined contraceptive formulations refer to a mix between progestin, a synthetic progesterone, and estrogen meaning that half the pills contain increasing levels of estrogen and the other half contain progesterone. This could be an explanation as to why women’s bodies are constantly going through changes while on oral contraceptives. Another study was performed on major histocompatibility complex (MHC) genes and their connection to women who were currently taking oral contraceptives in comparison to those who were not. In this study, the effects of MHC on scent was considered. Klaus and Cortes found that “[…] women who were using the contraceptive pill were attracted to the odors of the shirts of men with similar, rather than complementary MHCs.” This was described to be extremely abnormal because when it comes to procreation women tend to lean more towards men who have opposite MHCs than them. This means that “[…] woman may discover that the partner she chose or accepted while ingesting contraceptive steroids is not compatible with her when the effect is no longer present,” as stated in Klaus and Cortes’ article. This could leave women with psychological pitfalls due to confusion surrounding their spouse because this widely unknown information is not given to them by their doctors. There needs to be a cohesive and widespread pill that these effects are not apparent in.  There are many different hormone levels that a woman can be put on and this makes pinpointing a general dosage very difficult. Orne and Hawkins state that, “Unless the perfect contraceptive method is discovered tomorrow, practitioners will be working with many women using oral contraceptives for a long time to come.” Notice how that quote is from an article published in 1985 and there is still no ‘perfect contraceptive method’. What does this tell you about modern-day science? There are still big misconceptions and bad communication between doctors and patients when it comes to the effects of birth control due to a lack of much-needed research. The authors of ‘Studying the Use of Oral Contraception’ reviewed various forms of measurements such as the self-report where women would log in a diary-like style the date and time of which they took their pill. They were able to discredit this form of measurement but, as mentioned previously, the use of it was not changed. A study by Gilliam et al used electronic monitoring devices in comparison to the results of self-report. The article ‘Studying the Use of Oral Contraception’ states that, “The investigators found diaries significantly overestimated daily pill use rates when compared with rates obtained from the device.” Even with this finding, the authors were unable to determine “[…] a single superior measure of OC use.” After extensive research, the wide range of oral contraception measurements remains as it was, inefficient and close to useless. This leaves both doctors and patients wanting more information about what exactly is going into females’ bodies and how it affects them.

Answered and Unanswered Questions: What’s Written Between the Lines

            The various articles discussed in this literature review have posed questions as well as answered them. Many of these statistics have been generalizing women into one category while that is not the case. There are specific groups of women that are thought to be more susceptible to negative physical and psychological side effects. There is evidence showing that many deaths are of women who are on oral contraception, avid smokers, and above the age of 35. Orne and Hawkins speak on how, “If no woman over 35 took the pill and no users of any age smoked, the death rate associated with the pill has been estimated to be as low as 70 per year.” This is a very unattainable statistic because women do not begin menopause until about the age of 45, therefore not needing birth control, and you cannot stop women from smoking that easily. There needs to be further research done on ways around this statistic. When it comes to the younger generation of girls on birth control pills there is advocacy for “[…] LARCs (long-acting reversible contraception) particularly for women 15-19 years of age,” as stated in the article by Klaus and Cortes. The term reversible has been a term used throughout these articles and it is a reasonable stressor. Sometimes girls end up losing their menstrual cycles for good due to the pill and become infertile. This could cause negative psychological effects early on that spill over into adulthood when trying to conceive. When it comes to age, younger women especially, many may not know what questions to ask, if they ask any. It is difficult for these women to access the correct guidance and many do not “[…] understand how to use it correctly or may not have continuous access,” says Hall, White, Reame, and Westhoff. This leaves women with misinformation and no more than a strong pill with unknown side effects on their bedside tables. These unanswered questions are extremely alarming and need the correct revision, time, and expertise.

Conclusion

In understanding that many women are on some sort of oral contraception, there should be concrete knowledge in understanding how it affects a women’s physical and psychological state. Orne and Hawkins state the fact that “Oral contraceptives are used by an estimated ten million women in the United States.” This statistic holds true to this day. Many unspoken effects are surrounding oral contraception and there is still a need for further research. The wide range of oral contraceptive measurements has still not been narrowed down to a concrete definition. This leaves women at an extreme disadvantage especially when deciding whether to go on birth control pills. The number of information gaps provided in these articles was substantially alarming and calls for a revision of terms. This research concluded with various untold negative effects that oral contraceptives have on a woman’s physical and psychological state.

References

Hall, K. S., White, K. O., Reame, N., & Westhoff, C. (2010). Studying the use of oral contraception: a review of measurement approaches. Journal of women’s health (2002), 19(12), 2203–2210. https://doi.org/10.1089/jwh.2010.1963

Klaus, H., & Cortés, M. E. (2015). Psychological, social, and spiritual effects of contraceptive steroid hormones. The Linacre quarterly, 82(3), 283–300. https://doi.org/10.1179/2050854915Y.0000000009

Orne, Roberta, & Joellen W. Hawkins, (1985). Reexamining the Oral Contraceptive Issues. JOGNN Principles and Practice, 14(1), 30-36.  https://doi.org/10.1111/j.1552-6909.1985.tb02200.x