Hormone group, Noella calls it. “I didn’t want it in my body anymore,” writes Eline. Louise feels ‘much better’ without the pill. These are some of the responses to a young woman’s question about experiences with stopping the pill, discussed in a Facebook group.
The use of the contraceptive pill has been declining steadily for years, according to figures from Statistics Netherlands again this month. In 2014, 38 percent of women aged 16 to 49 used the pill, in 2020 it was 32 percent.
For perspective: women continue to want to protect themselves well against pregnancy and the pill is still the most commonly used drug, often enough satisfactorily, says Ineke van der Vlugt of Rutgers Knowledge Center for Sexuality. But it is undeniable that there are shifts in the field of contraception, says the foundation. For example, women become ‘pilmoe’ and no longer feel like taking the drug every day. Then you look for alternatives, says Van der Vlugt. “The IUD and rod are on the rise.”
But more importantly, discussing and questioning the effects of pill use has become more common. For example, ‘the pill’ is regularly a topic of discussion in the consultation room of the Oude Turfmarkt student doctors in the city center: what is the cycle like after stopping the pill? How do you feel without those hormones? In general, says the GGD Amsterdam, healthcare providers see more resistance to the use of hormones: when it comes to contraception, women strive for as little as possible.
Less sex drive
Hormones have gotten a bad name somewhere, says Anne Timmermans, gynecologist at Amsterdam UMC. “While you also have hormones in your body if you don’t use anything.” They are necessary for a natural cycle, egg growth and ovulation. “What those women actually mean by ‘I don’t feel like all those hormones’ is: I don’t feel like artificial, factory-made hormones, which are in the pill to prevent ovulation.”
“There are women who do not want to use hormonal contraception (anymore) because they suffer from side effects or are afraid that it will affect their psychosocial well-being – that it flattens emotions,” says Van der Vlugt. “There are women who suffer from mood swings or less sex drive, or are afraid of this. Some of the women want to regain control of their body. ”
For a long time, the main focus was on the physical complaints, safety and reliability of the pill. Now that women are speaking more about psychological side effects, this has also become an issue, says neuroscientist Anne Marieke Doornweerd. She is conducting research at Utrecht University into the effects of the hormones in the pill (progesterone and estradiol) on mood and emotions. “The pill has been prescribed since the 1960s, that mood swings can occur is stated in the package leaflet, and it is likely that there is a relationship, but we do not know exactly how it works.”
It has long remained a blind spot in science, while a huge group of women make use of it. Women are simply less researched and you can see that here too, she says. “It is embarrassing how little is known about what the pill does in our brain and why it makes one woman feel better, while another becomes depressed.”
Certainly at a time when many women are very conscious about what they put in their body, she believes that this could lead to women preferring to stop taking the pill.
Persistent myth
What also does not help: especially the negative side effects of the pill often surface, says Timmermans. The ‘flat feeling’, the risk of thrombosis and breast cancer. And then there is the persistent myth that after stopping it takes a few months for the pill to wear off. “If there is no underlying clinical picture, which is sometimes masked by the pill, you can immediately become pregnant. And that the pill also reduces the risk of ovarian cancer, among other things, you never hear. ”
Perhaps it also belongs to this time, says Timmermans. “There is more attention to: what does something not bring me, but you should also look at what something does bring you. In the case of the pill, for example, a less intense period, but also timing it yourself. ”
Nevertheless, doctors and experts applaud the ‘investigative attitude’. The days when the GP simply prescribed the pill and that was blindly accepted are really over, says Van der Vlugt. It is no longer just the question: what do you want to do to avoid getting pregnant, but also: what other wishes do you have? Timmermans: “This has become a much more conscious process in recent years, with much more attention for the individual.”
Range of experts by experience
Van der Vlugt: “The youngest group is often led by friends in their choice of contraception. When they are a bit older they search the internet more actively. Sometimes there are vloggers who share their negative experiences with the pill. The latter is risky and not entirely responsible. ”
Search YouTube for ‘stop taking the pill’ and you will find a wide range of experts by experience. Mostly young women who asked themselves questions such as: do I still enjoy putting those hormones in my body? ‘
Timmermans also sees that more women come in with a decision about a substance, ‘because I have read or heard something’. “There is so much information available on this topic, but that also makes it difficult to filter. You can learn from the experience of others, but it is her reality. Not yours. ”
Not everyone reacts the same to the hormones, and some women do benefit from the pill, she says. It depends on what you want to achieve with it. “If you use it purely to prevent pregnancy, but there are mood side effects, you might prefer a spiral, which involves less or no artificial hormones. If you have severe abdominal pain during menstruation that is taken away by the pill, then you may well accept the side effects. ”
What helps: the wide choice of contraception. There is the copper spiral, without hormones, and the Mirena and Kyleenas spiral, with a lower dose of hormones than the pill. Then there is the NuvaRing, the stick, the plaster, an injection and the condom. All with pros and cons. So don’t just accept what someone says, but consider it, also with your doctor, says Timmermans. “Take yourself seriously in this.”
A year ago, the revised GP guideline stated that GPs would pay more attention to psychological side effects in discussions about contraception. A bit late, but a good development, says Doornweerd. “Ultimately, however, it is only really easy to have a conversation with the doctor about this if you know exactly what it does and with whom. There is no need to panic, but we now simply know too little to be able to tailor contraception to every woman personally. And we want to go there. ”
Time for the men’s pill?
The men’s pill has been talked about for years, but it has still not been marketed. “In practice, there appear to be quite a few bumps in the road,” says Ineke van der Vlugt of Rutgers. “Men’s bodies work very differently from women’s and there are, for example, concerns about fertility and masculinity if you try to reduce sperm production through a pill.” In addition, she says there is little enthusiasm among pharmaceutical companies. “The market share is too small. Marketing a contraceptive is expensive, because the research takes years. ” And then there is the enthusiasm among men themselves. “There seems to be. If you ask them if they would take such a pill, many of them say yes. ” From a survey by the EenVandaag Opinion panel in February, more than half of the participating men (16-34 years) said they are open to a men’s pill. Van der Vlugt: “But whether they are then also prepared in practice to take it long-term and daily, that is the question. Women don’t always want to relinquish control.
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