Do you take a pill every day despite being completely healthy? If the answer is yes, you may be one of the millions of women who are on hormonal birth control. For many of us, taking hormonal birth control (which tends to get shortened to the ubiquitous ‘the Pill’) starts in our teenage years with an unsuspecting visit to the doctor’s office. Yet according to the World Health Organization, hormonal contraceptives are a class one carcinogen, ranking alongside tobacco and asbestos. And the Pill doesn’t only have long-term effects: Half of all women on hormonal birth control experience negative mood changes. So why do we pop the Pill so easily?
According to Holly Grigg-Spall, author of Sweetening the Pill, there are many forces pushing us away from direct barrier methods (condoms, diaphragms, etc.) toward completely body-transforming hormonal methods. Grigg-Spall makes a compelling case for a cultural gender bias, encouraged by the pharmaceutical industry, keeping us hooked on the Pill. We taked to her about its effects, the underlying forces keeping us on it, and the ways we can change our birth control patterns. You'll want to read on if you're one of the millions popping the Pill.
BUSTLE: What led you to write this book?
HOLLY GRIGG-SPALL: I was on the Pill for 10 years, and on Yasmin for two and a half years. I had a pretty bad experience with Yasmin. I had a lot of dramatic side effects, both physical and psychological. I didn’t realize for some time that it was the Pill that was causing me to feel so unwell. When I did find out it was the Pill, I wanted, as a journalist, to put an article together for a British magazine about the side effects of the Pill. So I wrote this piece called “What You Don’t Know About the Pill” for Easy Living. I then started writing a blog with my own research. Probably three or four weeks into writing the blog I decided to come off the Pill entirely after ten years of taking the Pill. I wrote about that transition and how it made me feel. I was shocked and amazed at how little I knew about what it did to my body, and how much better, after a period of withdrawal, I felt from when I was on the Pill. The blog went on for two or three years on and off, and then I decided I would submit to write a book based on the blog.
What kind of responses did you get when you started writing and critiquing the prevalence of the Pill?
For the most part, it wasn't very welcomed. From my blog, I got a lot of emails from women who had a similar experience as my own, who were really pleased to find someone sharing their story, and wanted to share their own story with me. Then, I wrote a guest blog for Bitch magazine which alerted me to some of the less supportive side of the situation. Bitch is obviously a young feminist magazine, but people were really wary of me criticizing the Pill from a feminist perspective. People were quite defensive about it. So in the beginning it was 50/50 really, I found that lots of women were experiencing the things I was talking about, that there were also people who were invested in women not talking about this. That was obviously partly the medical establishment that wanted to minimize discussion of risks or issues and always wanted to emphasize the safety and effectiveness of the drug. But it was also people within the women’s movement itself who were very dismissive and thought it was scaremongering to be open and honest about negative experiences with hormonal birth control.
Women who speak out against hormonal birth control are often chided as hindering the feminist cause. Is there much of a pro-feminist movement against hormonal birth control and toward other methods?
No, I wouldn’t [say there is]. Quite the opposite. There’s a combination of reasons for that. We have a lot of awareness about these long-acting methods—including Mirena, Skyla IUD, the implant, the patch, the ring, and the shot—and the medical establishment and pharmaceutical industry are pushing those [through] advertising, in doctors’ offices, and through governmental bodies doing awareness campaigns about these methods, which are all hormonal based. That has all been backed by women’s movements and people associated with feminism. I watched, while I was writing my book, what happened with the Affordable Care Act. Making birth control available galvanized a lot of women to support the Pill and hormonal birth control even more enthusiastically, at the expense of discussing safety and side effects.
How much of a role does big pharma play in our choice of birth control?
It certainly helps, because [most of the] information that many women get is through advertising and through pharmaceutical companies on TV and in magazines. But also through surreptitious means: Pharma companies pay for articles in magazines, place news spots on TV, even pay experts and doctors to push certain brands through books or lectures. Lots of women get their information from their doctors, but doctors are massively compromised by pharma companies, through [monetary] gifts, free samples, and biased literature. Pharma companies are not releasing all research and shut down research being published.
[There’s also a] general culture that we have that's supportive of women taking hormonal birth control, backed up by bodies like Planned Parenthood. They see their role as promoting the most effective form of birth control regardless of the side effects, or regardless of whether women want to stay on them or not. [This] goes back to a wider issue: the pharmaceutical industry’s desire to produce profit through population control, which is the undercurrent of the popularity of hormonal birth control. We have a desire on a lot of sides to control population for different reasons. Some believe population control is going to elevate social status and prevent poverty. For others, it’s about controlling certain populations in a way that's based in the Pill’s eugenics origins—preventing poor people and certain races from having children.
You discuss how the Pill been co-opted from a woman’s way to control her body to men’s control of female sexuality. In what ways are men influencing our choice of birth control, and how can women take back control of their bodies?
On the personal level, day to day, women feel pressured to choose hormonal birth control because men understand it, as many women do, to be the most effective at preventing pregnancy. If you're going to choose something that isn’t the mainstream choice as a woman, living in a culture that is very supportive of the mainstream choice of hormonal birth control, you do need the support of the person you're having sex with to do that. Otherwise, it just makes the choice more difficult. We also have a culture that's very anti-condoms. We can't wait to be in a relationship where we no longer need to use condoms—we only use them because of a feeling of necessity, to avoid STDs and STIs. If you don't have to use condoms, people don't want to, and I think that's partly to do with the male perception of condoms.
More men than women are aware of the side effects of hormonal birth control. They're often the first people to notice the changes in their partner because of hormonal birth control. They can often be quite supportive of alternatives. We like to think that the Pill was created as a good for women, that it came from a place where the medical establishment wanted to liberate women from their reproductive systems and make sure they were able to choose when they want to have children. But women were already choosing that when they used the diaphragm very successfully. [The creation of the Pill was] about making sure the male-driven society could accept women for being women, because they could take a Pill that would [allow them to] avoid the issues of their reproductive organs and what that would cause them to do and feel throughout the month.
To what extent are women physically and emotionally addicted to hormonal birth control?
When I came off the Pill, I struggled to make the decision [because taking it] had become a habit, and I was enjoying the level of control I understood that it gave me. It was a psychological addiction, but there are people who feel that you can become physically dependent on the synthetic estrogen. [Some people] feel that on some level the hormones are physically addictive because your body has to adapt to them in such a way that to come off them is quite difficult on your body. When you come off, you may appear to be less well than you were when you were on [the Pill], for a time at least. But by "hooked" I mean it more as a social situation, where we’ve become dependent on women using hormonal birth control and the idea of women using hormonal birth control for a lot of different reasons.
Do you think Yaz should be taken off the market?
I don't think there’s any need for it to be on the market. Other birth control pills that do the same thing and don't seem to have the particular dangers that Yaz and Yasmin hold. That said, if it were to be taken off the market, I want it to be taken off with a discussion and not just for it to be glossed over. Banning Yaz from the market would be good, because a lot of women—and many more women than we’re hearing about in the media—have had injuries or died or suffered from these pills, and I don't think there’s any justification for that. It’s very negligent that we don't seem to be too worried about it as a society, as people working for women’s rights and women’s issues. But I would want it to be part of a wider conversation about the Pill, hormonal birth control, how we manage to get so many women to take these pills and keep taking them, and why as a society we’re OK with that apparently.
Researchers are exploring a non-hormonal male contraceptive called JQ1. Could this be a viable alternative to hormonal birth control?
I would never be supportive of a male Pill. I have no desire for men to have to change their hormonal state any more than women. All the [non-hormonal methods] I’ve read about still kind tinker and mess around with biological functions in a way that is purely for contraceptive purposes. It would be interesting to see how these things unfold, but considering what's been created so far by the medical establishment and pharmaceutical companies, I’m not entirely sure that I’d be that keen on anyone trying it out until its been on the market for a few years. I’m much more for the idea of us learning about our bodies, about our fertility cycles. Men [should learn] this information too from high school onwards and develop an understanding that we’re only fertile for a certain amount of time per month. It’s in our ability to track our own fertility. I think I’d rather have anything that comes up in the future have a foundation in body literacy on both sides, for men and women, so that they can make the decision as to whether they choose the fertility awareness methods or barrier methods to avoid pregnancy or whether they want something that's more effective for their lifestyle.
What do you think needs to change besides opening up a larger discussion about the use of the Pill in American reproductive culture?
We should be teaching teenage girls and boys about women’s fertility cycles, about how to know [when] you're fertile, and about ovulation. [Such a program would] have an effect not only on pregnancy prevention but also on confidence levels, self-esteem levels for women, relationships, communication within relationships, communication between the sexes, and confidence within making choices about sex. We need to have these programs in schools, we need to have these programs in colleges. The problem at the moment it that if you’re taught fertility awareness methods, we’re basically in a situation where you can teach someone [but] there’s no money to be made out of that. It’s not like selling someone a pill that they’re going to take every day for their fertile life. We also need to innovate barrier methods so they’re more usable and more pleasurable. Then we need to really [decide] whether effectiveness should trump all other concerns. We’re at a watershed moment: We can either go down this path of more hormonal birth control for more women, or we can go in another direction. A good example [of this] is the Women’s Health Clinics of California, which basically provide an alternative to Planned Parenthood where you leave with more information than you went in with. [At these clinics], you can get any method you like, including the cervical cap, the fertility awareness method training, and the diaphragm. You’ll receive information about the pros and cons of every method that you want.