There are a lot of ways to prevent pregnancy, and hormonal birth control pills — often referred to as “the pill” — are one of the most common. While the pill is widely seen as a safe and reliable contraception method, doctors also prescribe it for other health issues, from acne and headaches to anxiety and depression.
No matter what you use it for, hormonal birth control, like any other medication, can cause unwanted side effects. The pill can cause irregular bleeding, nausea, headaches, and breast tenderness; less commonly, it can create more serious issues, like high blood pressure, per the FDA.
Anecdotally, on social media and in news stories, many people have revealed how the pill has changed their lives, not necessarily for the better. Hormonal birth control uses synthetic hormones, usually estrogen and progestin, to prevent pregnancy. Some people complain the hormones contribute to their weight gain, acne, and even mental illness. For people with certain medical conditions, like migraines with aura, birth control can even lead to major medical risks. Given all these issues, why is the pill still one of the most popular methods of contraception?
“It’s popular because it works,” says Dr. Mary Jane Minkin, an ob-gyn and professor at the Yale School of Medicine. Of course, birth control only works if you take it — but when it’s used correctly, it can be up to 99% effective in preventing pregnancy.
Still, the pill isn’t for everyone — and providers could do a better job explaining potential side effects or introducing other options.
“You have to sometimes balance things out as far as what works and sometimes bring different medications in the picture,” Minkin says. “With my patients, I try to talk about all the different options and find what works best for each individual.”
For some people, birth control side effects are worth the benefits. But for others, taking the pill isn’t a good option — so they swap it out for another form of birth control, like an IUD (which, as of 2017, has become nearly as popular as the pill itself.) While you don’t have to wean off the pill like you may with, say, an antidepressant, Minkin says people can experience unpleasant symptoms. It usually takes a month or two for people’s periods to become regular, and if you had bad cramps or headaches before starting the pill, they may return — or your period might be heavier than it was before birth control.
Here are five stories of women who stopped taking birth control.
Sloane, 45, Missouri
Sloane started taking hormonal birth control in her mid-20s. Besides pausing during two pregnancies, she took it consistently for 20 years. While the pill was effective in preventing unwanted pregnancies, Sloane often suffered from chronic migraines. Just before the pandemic, she began to wonder if the pill had anything to do with it.
She’d tried everything else she could think of — preventative medications, painkillers, medical Botox and acupuncture — to stave off her headaches. As an experiment, she overhauled her diet and decided to quit the pill after checking in with her gynecologist.
At the time, Sloane also felt it was time to pass the contraception baton to her husband. “Because society designated women as responsible for birth control, I put hormones in my body for 20 years,” she says. “It was time for my husband to have a vasectomy.”
She finished her last birth control pack in 2020, and since, Sloane says her headaches have drastically decreased in number and her mood is more stable. She’s not entirely clear whether the positive changes stemmed from the dietary changes, stopping the pills, or a combination of both. And although she says she’s had some irregular periods, she says that might be because she’s approaching perimenopause.
Either way, she’s grateful she doesn’t have to worry about taking the pill every day, and she’s more comfortable knowing she’s not adding extra hormones to her body. As for birth control, Sloane’s husband recently followed through with the vasectomy. “I’ve put in my time, and now it’s his time,” Sloane says.
Gabriella, 32, Tennessee
Gabriella asked her primary care provider for a birth control prescription before she got married in 2013. She and her soon-to-be husband had plans to travel for weeks or months at a time, and she wanted to have her period as little as possible. Her doctor obliged, prescribing her a pill that would suppress her period for three months at a time.
For three years, it worked; Gabriella says she didn’t notice any negative side effects except for a slight decrease in her sex drive. In 2016, after accidentally missing a dose, she took a double dose the next day. That’s when the bleeding started. For an entire month, Gabriella bled so heavily she had to wear a tampon all day, every day. (Breakthrough bleeding after missing a dose is common, Dr. Minkin says.)
She was traveling at the time, so she decided to stop taking the pill after a month without guidance from a gynecologist. The bleeding stopped right away, and six weeks later, Gabriella’s cycle was regular. “To me, the ongoing bleeding was my body’s way of saying it was done with the pill,” Gabriella says.
Since then, she and her husband have been relying on condoms and natural family planning — monitoring her cycle and skipping unprotected sex when she’s ovulating — to prevent pregnancy. She has no plans to take hormonal birth control again. Looking back, she says had she done more research, she thinks she would have asked for a copper IUD, a non-hormonal alternative, instead. “I think I just didn’t know anything about hormones, and I thought you should just take the pill if you don’t want to get pregnant,” she says. “Now I’m kind of like, why did I have to put my health on the line to achieve that?”
Fabiana, 28, New Jersey
Since she got her first period, Fabiana always had an irregular menstrual cycle. She’d sometimes go months without a menstrual cycle, but doctors couldn’t find a medical reason for the irregularity. As excessive exercise can at times interfere with periods, Fabiana, who grew up as a dancer, chalked it up to her lifestyle. By college, she wanted to be able to predict her periods. In 2014, she asked her doctor for birth control. She took the pill until 2020.
Fabiana says after starting treatment, she began to feel moodier; she routinely felt like there was a dark cloud hovering over her. But she didn’t associate her ups and downs with the pill until a friend who took birth control said she experienced the same thing until she stopped taking it. “That opened my eyes to see that other than regularity, the pill wasn’t doing that much for me,” she says.
Rather than stopping cold turkey, Fabiana visited her doctor and shared her complaints. Her gynecologist supported her decision to quit the pill, with the caveat that if Fabiana became irregular again, she’d consider another hormonal birth control method. After finishing the last pill pack, Fabiana says she had “weird abdominal pains” for about a month, but the pain went away once her cycle normalized a month later.
Stopping birth control wasn’t a cure-all. Fabiana gets heavier periods than she used to, and she still struggles mentally during stressful times. But overall, she says she feels better without the pill. “Birth control is so normalized,” she says. “I wish I’d known at a younger age that it’s not the answer to everything.”
Amanda, 29, Philadelphia
Before she ever took birth control to prevent pregnancy, Amanda took the pill to prevent severe cramps she experienced before every period. Her primary care provider first prescribed it in high school, and she continued to take it throughout college. While Amanda suspected the pill was contributing to her anxiety and depression, she didn’t experience any other side effects — at least, she didn’t know about any.
Well before she started taking the pill, Amanda suffered from migraines with an aura, severe headaches with sensory disturbances like vision changes. During a routine checkup in college, she asked for a refill, but her nurse practitioner told her she needed to pick a new type of contraception. “When I told her I had migraines with aura, she told me they put me at a much higher risk of having a stroke, which was totally new information,” Amanda says. She opted for an IUD instead, which the nurse practitioner assured her wouldn’t pose the same risks.
Rather than unknowingly putting her health at risk to fix her cramps, Amanda wishes the doctor who prescribed her birth control would have sent her to a specialist, who may have mentioned the contraindication.
“At that time, it was so common to get birth control for cramps, but I wish the doctor would have admitted my problem was outside of their scope and encouraged me to establish care with a gynecologist,” she says. “I really value a doctor being able to say ‘I don’t know.’”
Brittany, 38, Seattle
Since she was 19, Brittany took birth control to prevent pregnancy. She always experienced bad PMS cramps, so her doctor encouraged her to skip her week of placebo pills, and start her new pack, so she could skip her period when she wanted to.
The pill didn’t cause any glaring side effects, but Brittany says in her late 20s, she realized she felt totally disconnected from her body. She felt the same the whole month and wanted to experience the normal hormonal fluctuations that happen during a menstrual cycle. “All I knew was that I sometimes would get cramps before my period,” she says.
Quitting the pill cold turkey was an easy choice for Brittany. She wanted to have a baby in the not-too-distant future, and felt it was important to establish normal menstrual cycles before she did. It took a few months for her to get a regular period, and Brittany says she couldn’t believe how empowered she felt.
As she tracked her cycles, she became more aware of the cyclical changes in her body, from changes in her cervical mucus and sex drive during ovulation, to a spike in anxiety before her period.
It’s been several years since she stopped the pill, and while she hasn’t gotten pregnant yet, Brittany says being more in touch with her body has improved her mental health. “It’s been really lovely because it doesn’t make me feel like I must be doing something wrong when I feel different,” she says. “If I’m anxious before my period, I can tell myself it’s normal, because I’m experiencing a hormonal shift. I’m not stumbling around in the dark.”