There I was, sitting on the toilet staring at a white test strip with tiny ‘LH’ letters on it. The luteinizing hormone test was negative again, for the seventh day in a row. Where the hell was my positive test, indicating ovulation was on the way?
The next month, the same rodeo. I thought my period had come because I had a day of bleeding, but now I was not so sure. My ovulation test strips were still coming up negative and my basal body temperature was not rising. Was this stasis due to wedding stress? Honeymoon travel?
As all women know, getting your menstrual period is anything but enjoyable. However, the only thing more alarming than waking up to blood in your underwear is the absolute lack of it for months on end. After weeks of uncertainty, I broke open a book I had neither the time, nor energy to read before my wedding day: Taking Charge of Your Fertility by Toni Weschler, MPH.
What I found, pouring over the pages concerning “anovulatory cycles,” blew my mind. According to the book, I had not had a period at all for two months, despite the presence of bleeding, because I had, in fact, not ovulated. Why had I not been taught about this phenomenon, or about anything fertility-related for that matter? High school health class was not particularly illuminating, and in college, the week after I had one excruciating period, I was on the birth control pill.
I remember the appointment distinctly. After an unfortunate start to my last year in undergrad, where, for an entire class session, I laid my sweaty forehead on the linoleum of the basement bathroom in Texas A&M’s psychology building, writhing with cramps, I signed myself up for a contraceptive consultation. I heard that the Pill helped with acne and cramps, both things I was more than happy to part ways with. The added benefits of not having a child were also in the back of my mind.
The doctor explained that the pill I was to take, Lo Loestrin Fe, was a combination pill with 10 micrograms of estradiol, a synthetic estrogen, and 1000 micrograms of norethindrone acetate, a synthetic progesterone. She asked me if I had migraines, I said no, and she sent me on my way, only pausing to tell me to come back if I had any undesirable side effects. The entire appointment was ten minutes, in and out. She did not enumerate what “undesirable” effects I should watch out for, and I didn’t bother reading the insert with its mountain of tiny text.
I was back on the tissue paper-covered examination table pretty quick. It turns out that Lo Loestrin Fe gave me severe depression, suicidal thoughts, and brain fog. The doctor cheerfully switched my brand to another pill, Audra EQ. This pill had 100 micrograms of levonorgestrel (colloquially, Plan B) and 20 micrograms of estradiol. And it worked a treat. My skin was flawless, cramps were a light breeze, and the past memory of the linoleum floor and the possible future of an unplanned pregnancy were quickly vanishing from my mind. I was not worried; I was religious about taking that pill, despite being irreligious everywhere else.
I was on the Pill from September 2018 to sometime in 2021. I do not recall when I finally gave it up, but it must have been before November 2021, because that is the month I was confirmed into the Catholic Church. Famously, the Catholic Church believes that the use of contraception is a mortal sin and an affront to God’s natural design for women and the family, and I wanted to be a member in good standing.
The Church did not need to convince me much; by that time, I was slowly realizing that everything I had heard about the Pill was either a lie or, at best, an omission. On the biological front, I eventually built up the curiosity to ask the internet how the Pill even worked. I was not prepared for what I discovered.
For one, those “periods” that I thought I was having while on the Pill were not periods, but withdrawal bleeds. For all my body knew, I was simply in limbo for three years straight, in a state of possible pregnancy. Meanwhile, I was not ovulating nor producing my own hormones for those three years, doing untold damage to my developing body. In addition, I learned that the Pill can cause abortion by not allowing a fertilized egg to implant on the uterine wall. Notably, the Pill has also been associated with cancers and dangerous blood clots, hence the doctor’s question about migraines at that first appointment. She at least did me one solid. Unfortunately, everything else went unmentioned.
Second, and more disturbingly, my psychology classes were revealing uncomfortable facts about the Pill’s effect on memory, trauma processing, and mate selection. One study examined the Pill’s effect on fear extinction learning and memory, key skills to avoid dangers in the future. The researchers discovered that naturally cycling women were better able to recall fear extinction memories. These results were replicated by another study that revealed that higher levels of estrogen enhanced fear learning, i.e. the mice (in this case) were more alert to threat.
While there can be cases where a woman is oversensitive to threat (such as anxiety), fear is an incredibly important emotion tailor-made to keep us alive in a dangerous world. Therefore, blunting learning and memory surrounding traumatic events is not a good thing, and the Pill’s low doses of estradiol do just that. This is especially concerning for women in treatment for PTSD, where recalling traumatic memories and learning to extinguish negative emotions is of utmost importance.
In my social psychology class, we discussed mate selection. One day, Dr. Smallman (attempting to re-test a hypothesis in a study we were reading) asked the class a question: “When selecting a partner for an incidental hookup, are there any aspects of that person’s personality that you are willing to deprioritize for the night, but would demand of a long-term partner?” She polled the men first. Uniformly, they agreed that while they would tolerate an unintelligent woman for one night, they would not tolerate it for longer than that.
Dr. Smallman then turned to us, the women, who were still recovering from our collective disgust at the men’s response. We would seek the same traits for a one-night stand partner and for our husband-to-be, we declared proudly. The difference in responses indicate something about how women and men select their mates, and the risks that women operate under by being the sole sex that can get pregnant. How then does the Pill shift this calculus?
One has to look no further for the answer than Dr. Jordan Peterson’s recent podcast episode with Dr. Sarah Hill, an evolutionary biologist at Texas Christian University with an expertise on how hormones affect women. At around an hour and twenty seven minutes into their discussion, Dr. Peterson raises this study (and other studies like it) for consideration. The thumbnail report is that women who are in the estrogen-heavy phase of their cycle leading up to ovulation prefer men who have a higher prevalence of what Dr. Hill calls “testosterone cues” in their face, voice, and behavior. For women who are never in an estrogen-heavy phase, such as Pill users, research indicates that they prefer less-masculine features.
Women in long-term relationships are not immune from this effect either. For married women, discontinuing the use of the pill led to decreased marital satisfaction if their husband was relatively unattractive. In contrast, if their husband was attractive, discontinuing the Pill led to increased marital satisfaction and sexual desire. As Dr. Hill put it, “all of a sudden the blinders are off.”
While waking up to discover that your husband suddenly looks like a thumb is disturbing, still more troubling is what the Pill does to a woman’s stress response. Past research had shown that Pill users have higher levels of proteins that are markers of systemic inflammation. However, these studies did not test their subjects for their levels of cytokines, proteins that increase inflammation in response to stress, before and after stress testing. That is just what Hill and her fellow researchers measured in a December 2023 research paper.
What they found is that Pill users had higher levels of TNF-alpha, a cytokine, before and after a stress test was administered experimentally. Dr. Summer Mengelkoch, the paper’s lead researcher, said TNF-alpha may be associated with a more “male-typical” response to stress. Pill users also exuded more cortisol and reported higher levels of stress overall.
Meanwhile, naturally cycling women had a more “female-typical” response to stress, with higher levels of Interleukin-6, a cytokine, accompanying their increases in cortisol. However, overall, elevated levels of cortisol under the pressure of the stress test were more uncommon in this group, and the naturally cycling women reported feeling less negative emotion after it was over.
According to Dr. Mengelkoch, this is bad news for Pill users. In an interview, she stated that the Pill could be preventing the female body and mind from returning to homeostasis following a traumatic event. Cortisol, she says, is an adaptive emotion and helps us to deal with stressors in the environment. This was not the case with Pill users, whose moods got worse post-stress tests.
Dr. Hill illuminates why this could be. Apparently, synthetic progesterones (progestins) are synthesized from testosterone. Unlike estradiol, progestins do not have great binding specificity, meaning they like to mess with other neurotransmitters and receptors besides the ones specifically designed for progesterone. The unfortunate results are twofold: 1) you have to take a higher dose of progestin to ensure its efficacy in preventing pregnancy and 2) they stimulate glucocorticoid receptors constantly. After a few months of your body receiving signals that you are in constant stress, it tries to help you cope by shutting the stress response down entirely.1
This sequence of events lines up with women I knew in college, who would often tell me not to worry about early side effects of the Pill, saying that after about three months of suffering, they eventually “regulated.” To sum up, women on the Pill are chronically inflamed and stressed; they just don’t know it.
Is there any hope for girls who got on the Pill at the tender ages of 14 or 15? Frankly, there are not many long term studies on the Pill’s effects over time, still fewer any concerning what the Pill does to female brain development. One ray of hope is that if you first begin use of the Pill after age 19, the effects seem to be more or less reversible, which is welcome news for me. Either way, Dr. Peterson is quite right; the Pill may turn out to be “the biggest biological transformation in our species’ history.”
And it’s time to get off it.
The Pill stresses us out, inflames us, makes us prefer second-rate men, harms our memory and emotional processing, and may even damage our fertility, who knows? While at 19, I was not considering getting married nor having children until I was at least 30, here I stand, 24 and newly married, wondering what damage has been done to my body. And all because I never read that insert of tiny text…
Tune in next time for why the Pill is bad morally, spiritually, and may make women obsolete.
See this 2012 study for more damning information concerning how suppression of natural estrogen and progesterone gives women a more blunted stress response, even when compared to men, and inhibits their emotional memory. By the way, a blunted cortisol response is exactly what a doctor would notice in her patients with PTSD and depression. Not good.
This is disturbing and saddening, but not surprising to me. Much like smartphones and social media, "the Pill" seems like an experiment, "successful" by certain measurements, but with little concern given to the participants -- who are largely unaware that they are being experimented on.
As a man, my concerns in this area are obviously a bit different than those of a woman; but my concern for the women in my life, and the wife I hope to have, is being heightened all the time as I learn more about this subject. It also seems a shame to me that one result of not informing women properly of the science behind these treatments is that most men, the other half of this human species, are unlikely ever to even hear about it, or be able to step up and fight with their partners for better holistic health. All told, we seem as an entire population to be worse off for the Pill's influence, on our bodies, and our culture.
Thank you for sharing of your story, and for caring not just about your life and body, but others' also.
Many have noted the steady decline in male fertility/testosterone over the last 50+ years. This correlates -to my understanding- with the widespread use of the Pill. Do you know of any scientific attempt to examine this correlation?