60 years after its introduction, a social media movement sees young women discovering that perhaps they are better off without the pill

Illustrations by Lily Dearman

What was once seen as a medicinal miracle has become something to revolt against, the contraceptive pill has a growing community of women ready to abolish its widespread use. Gen Z are rejecting what had been the ultimate symbol of freedom for their parents and are reimagining their concept of freedom in a new era of feminism.

As the mouthpiece of today’s youth, TikTok gives light to all trends from dances to social and political movements. #comingoffthepill has over four million views on the app, captioned on videos of women joining in on the conversation about the detrimental side effects of the contraceptive pill. Other hashtags on the topic include #offthepill with over 300,000 views and #naturalbirthcontrol with almost 13 million views. This wave of solidarity has snowballed since the late millennium and after gaining ground on social media, has reached international waters. Registered Nurse and Faculty Trainer at sexual health charity MSI Choices, Sim Sesane explained that there’s a historical pattern of changing attitudes towards the pill. Sesane recognises the most recent cause for concern to be the COVID-19 pandemic which caused disruptions in contraception for 12 million women, resulting in 1.4 million unwanted pregnancies. For the past 60 years, the pill has been a lifeline for women, allowing them to live as sexually free as men and preventing millions of unwanted pregnancies internationally with fewer than one in 100 women falling pregnant. With perfect use it is 99% effective at preventing pregnancy and has been used over the years to treat heavy/painful periods, migraines, and acne.

Three TikTok users explaining the benefits of coming off the pill

Left: @emilyhackettfitness

Middle: @dose_of_daisy

Right: @sien.nnna

Over the last five years in the UK, the number of women on the pill, currently standing at over three million, has dropped by 5% after experts noticed greater numbers switching methods. The global contraceptive pill industry was valued at USD $16.51 billion in 2020 and is only expected to increase, however estimations may be challenged by the women moving from the pill to long-acting reversible contraceptives including the coil and the implant. The coil, medically known as an IUD (intrauterine device), is a small t-shaped plastic or copper device fitted by a nurse or doctor in your uterus. The implant is a small plastic rod that is fitted under the skin on the upper arm and releases hormones into the bloodstream. In the spotlight are the two most common pills, the mini pill (containing only the synthetic hormone progestogen) and the original combined pill introduced in the UK in 1961 (containing both oestrogen and progestogen).

Recent television adverts promote the progesterone-only contraceptive brand Hana, newly accessible "over the counter". Although thought of as the safest option with lesser side effects - due to the absence of oestrogen - the progesterone pill can cause side effects parallel to the mini pill including depression, anxiety, low libido, weight gain and cystic acne. 19-year-old Kiarra explained on TikTok that her progesterone-only pill Desogestrel caused “constant bleeding, excessive weight gain and hair loss”. The pill is still the most widely used method, with more than three million UK women prescribed the combined or progesterone only pill annually.

The contraceptive pill gave women a new found sense of freedom... as long as the husbands gave their permission 

Video: BBC Archive

The news circulating the media concludes that coming off the pill will improve your livelihood. Claims of women include “a dark cloud” lifted from above their heads, resulting in improved mental stability. Worryingly, the pill has a habit of hiding underlying conditions, including Polycystic Ovary Syndrome (PCOS). This causes women to produce higher than normal amounts of male hormones, with irregular periods being a common side effect. The most dangerous side effect of the combined pill is the small but very real risk of deep vein thrombosis (DVT). The oestrogen found in the combined pill increases the risk of a DVT by causing the blood to become “sticky”. Period tracking app Clue identified that blood clots arise from the pill in four to 16 users out of 10,000 each year. Jane*, 53, suffered an almost fatal case, the blood clot began in her leg and was in danger of “snapping off”, reaching her heart and therefore causing immediate death. Jane took the combined pill on-and-off for 20 years without many other side effects or real knowledge of what the pill could do to her body.

Maisy Radley, a 21-year-old student, told her TikTok followers, “I felt like I’d just woken up from a long dream and didn’t know who I was.” She was taking the combined pill Lucette and came off to “achieve a bit of normality” and regulate her cycle, which in turn led to her to discover that she had PCOS and the pill had been hiding her symptoms for years. Radley began taking the pill again as advised by her doctor to treat the PCOS, but soon came off as she felt herself “falling back into depression”. She decided that she’d rather endure the PCOS-induced heavy bleeding, excess hair growth and weight gain than take the pill. A Danish study of more than one million women aged 15 to 34 with no prior history of depression found that, compared to non-users, adolescent women who took the combined pill were 80% more likely to receive a prescription for anti-depressants later in life.

Sarah Dean, 24, received thousands of comments when her video went viral with 3.5 million views on TikTok. In the video, she charts the positive effects of coming off the pill after seven years: increased libido, eradication of chronic migraines and depression and higher energy levels. The comments ranged from confused women unaware of the changes the pill was making to their bodies, anecdotes of similar experience and messages of encouragement. The TikToker noticed that the state of her mental health had worsened since being on the pill and decided to come off in the hope of it improving, and it did. From her own experience, she advises women to “research supplements and foods with high levels of progesterone to help regulate your hormones”. Millie Arnold, a 22-year-old Biology student, had a similar experience, becoming “less emotional and sensitive”, feeling “calmer and less moody”. Her twin sister Olivia Arnold agreed and remarked that her mood swings “disappeared”. Dean’s lasting message is “speak to other women about what works for them”. All women interviewed about their experience on the pill have turned to new methods of contraception, either condoms or non-hormonal methods including the copper coil.

This move towards an anti-pill life comes at a time when anti-vaccine movements are more popular than ever. These movements evolved after the global pharmaceuticals industry, referred to as Big Pharma, eroded public trust and created a sense of hesitancy about the COVID-19 vaccine. Similar attitudes apply to contraception, as only 2% of drug companies' annual revenue from contraceptives goes back into research and development. These companies do not stand to make much from the pill so will not invest more into its innovation.

Research and education in natural remedies is becoming seemingly popular. Promoted across social media is company Natural Cycles, which is a non-invasive, non-hormonal FDA approved method of fertility tracking with over 1.8 million users worldwide. The user takes their temperature every morning and enters the data into the Natural Cycles app where it is calculated if protection is needed that day. With typical use it is 93% effective, but many factors can skew the result including illness, stress and irregular menstrual cycles.  Women across TikTok are sharing their experience with this method. American user Sophia Panella hails its “natural, non-hormonal” brilliance and explains how it “taught her to be more in-touch and in-tune with her body”. Panella disclaims that without regular use there is still the risk of pregnancy, with many comments of pregnant women confirming this.

Former Love Island contestant Montana Brown advertising the use of Natural Cycles to her 1.2 million followers on Instagram

Image: @naturalcycles

Similar reports on Trustpilot relay this issue, with women questioning why their strict use ended in pregnancy. Gynaecologist Mr Evans Jones of the Oaks Hospital in Essex said he would “never recommend” its use to any of his patients as a form of birth control as it is a preferred method for tracking fertility for when trying to get pregnant. Herbal birth control is promoted as a good alternative to avoiding synthetic hormones but does not have a lot of backing from medically established sources.

Women’s wellness blogs and books educate women about their options and the results found by experimentation. Sarah Pope of the Healthy Home Economist explains that herbs may be helpful with enhancing and “dampening” fertility. Queen Anne’s lace, also known as wild carrot seed, is taken seven days after unprotected sex to help prevent fertilised eggs from implanting the uterus. This method is often used in Rajasthan, India as a preferred method of contraception. Since these methods are not FDA approved or recommended by doctors, it is not known how they will affect women’s bodies for definite. Some general side effects of herbal birth control incurred have been allergic reactions, low blood pressure and kidney irritation. Student nurse Lauren* frivolously recommends the use of the plant to women on TikTok as a way to induce the miscarriage of an unwanted foetus, reassuring that “it worked for her”.

When commenting on her experiences, Sarah Dean said that, at first, she relied heavily on the pill to clear up her acne and help with unbalanced emotions. She emphasised not forcing her ideals on young, impressionable women but encouraging them to do their own research, speak to their GP’s and listen to their bodies. Olivia Arnold also felt that she would never want to “ram information down women’s throats” and let them come to their own conclusions. Coming off the pill can be a turbulent time for women, Dean expressed having to balance the pros and cons of this decision, as many women experience an increase in facial acne and more painful, irregular periods. Not to mention the heightened risk of unwanted pregnancies, either when switching methods or “taking a break” from all forms and relying on methods prone to user failure including condoms. Women begin to ovulate as soon as 48 hours after coming off the pill so extra precautions should always be taken. Not all women on the pill are part of this movement, there are many who are content with their choices and do not experience detrimental side effects including 22-year-old Hannah Wolstenholme who, after 6 years, feels she is “more than happy to continue with the combined pill”.

So, what should young women do for the best? Or better yet, what can men do? Nurse Sim Sesane says “it takes two people to get pregnant”. Social media is a convenient way of obtaining short snippets of information from unprofessional sources, but it seems GPs should be supplying more detailed advice to both young men and women about all available options. We can only hope that the future holds safer and healthier contraceptive options for these young women.

*names have been changed.