From mood swings to strokes, the side effects of the pill can be serious. Doctors say the benefits outweigh the risks, but many women are unconvinced.
Recent research has found that women who take hormonal contraception - specifically a progestogen-only "mini-pill" - have an increased risk of developing breast cancer.
This link is nothing new, as all types of hormonal contraceptives are known for having potential side effects, with some more serious than others.
The pill is still widely considered a life-changing invention that gave those with wombs a convenient and reliable method to prevent unwanted pregnancies and has even been prescribed for medical conditions such as endometriosis.
But the latest findings have revived the conversation around birth control methods and their impact on women’s physical and mental health.
"The pill as an overall broad medication is one of the best things that has happened to the world of contraception for millions and millions of people, and it remains an incredibly common form of contraception. But it's not for everybody," Dr Alyssa Dweck, a practicing gynaecologist in New York, told Euronews Next.
From mood swings to sore breasts, headaches, and reduced sex drive: in recent years, many women have been complaining about the side effects of hormonal birth control and even ditching the pill following reports of serious health complications.
A decade ago, public alarm swept France when a 25-year-old woman filed a lawsuit over the debilitating stroke she suffered while using a third-generation contraceptive pill combining the female hormone oestrogen with a synthetic version of progesterone.
That "pill scare" caused a sharp dip in the number of women taking the pill over the following years, though it remains the most widely used method in the country, according to the French Institute for Demographic Studies.
What are the main side effects of the pill?
Common side effects while on the pill include irregular bleeding, nausea, breast tenderness, and potentially some weight change in either direction, Dweck said.
In some small cases, people may experience much more serious complications such as blood clots, which can travel to the lungs and cause a pulmonary embolism, or reach the brain and cause a stroke.
Studies have also associated the birth control pill with an increased risk of certain cancers, specifically of the breast, cervix, and liver.
A recent study published in PLOS Medicine found that women who take hormonal contraception have a 20-30 per cent higher risk of developing breast cancer.
"This risk does not appear to vary by the type of contraceptive last prescribed," said Kirstin Pirie, from Oxford Population Health's Cancer Epidemiology Unit and one of the lead authors of the study.
"However, as the underlying risk of breast cancer is small for women in their 20s and 30s, the excess number of breast cancers associated with use at younger ages is also quite small," she told Euronews Next.
While these findings may seem worrying, Pirie noted that the risk is only prevalent while on the pill and it substantially starts declining when it’s stopped.
Dweck added that the pill can even be beneficial in some cases.
"The birth control pill also is well known to help to prevent risk of ovarian cancer and uterine cancer. And these are not highly publicised, but sure are quite important for those people who worry about these diseases, maybe due to family history," she said.
"So there is an awful lot of good that can be accomplished with the birth control pill for the right person, and there are side effects for others," she added, noting that individuals should be mindful of their health history before taking the pill.
However, some experts such as Pirie are calling for more research on the side effects of the mini pill.
“Much is known about the risks associated with the use of combined oral contraceptives, as these contraceptives have been used for many decades by large numbers of women around the world. However, in recent decades, the use of progestogen-only contraceptives has increased substantially in the UK, and so it’s important to continue to assess the shorter-term and longer-term risks associated with their use,” she said.
What other options are there?
Fortunately, there are alternatives to the birth control pill when it comes to preventing unwanted pregnancies.
Dweck cited apps that can track cycles and predict ovulation, female or male condoms - which come with the added benefit of preventing sexually transmitted infections (STIs) - and non-hormonal intrauterine devices (IUDs) as the most relevant forms of non-hormonal contraception for people who are considering ditching the hormonal pill.
There’s also hope on another front: male contraception. While women have for decades borne most of the responsibility of birth control, recent studies have suggested that men may soon be able to share this burden more fairly or even take it entirely off women's shoulders - whether by taking a "male pill," rubbing a hormonal gel on their shoulders or getting a reversible vasectomy.
Ditching the pill
Many women are not waiting for a revolution in male contraception and are already turning their backs on hormonal birth control.
A year ago, *Sofia (whose name has been changed at her request) was prescribed the contraceptive pill following her diagnosis of polycystic ovarian syndrome (PCOS), a condition that affects reproductive hormones and typically causes irregular periods, acne, excess hair growth, and infertility.
"Sadly, when you go and see a doctor and you have PCOS as a female, the one thing they tell you is to lose weight and to take the hormonal pill if you want to get regular periods, and then when you are trying to conceive, you can come back and discuss fertility treatments," she told Euronews Next.
When she enquired about the potential side effects, she said her doctor "brushed them away," and emphasised that the pill would help reduce her risk of uterine cancer, which is increased by PCOS.
Not totally convinced, but lacking alternatives, she started taking the pill - until the side effects were too much to handle.
"One specific thing that really scared me was the mood swings. I really struggled with those because I could go through different emotional states, and one day just out of the blue, I would be sad and then I would be happy, and then I would be crying," she said.
"I would go through times, like a succession of days, where I just wasn't feeling like myself".
Sofia said she initially believed the pill would help minimise the symptoms of her condition, but that it ended up causing her more harm than good.
Meanwhile, on social media, she was coming across stories of women saying they were able to balance their PCOS naturally, without hormonal contraception.
After just five months on the pill, and fed up with the side effects, she decided to try instead to embrace diet and lifestyle changes to control her medical condition.
“For me, the decision to ditch the pill was medical,” she explained. “I wanted to take my health back and I wanted to go the traditional, natural route to try and solve the problem”.
While her journey to balance her hormones naturally has been bumpy, she has seen some positive results and said she was able to experience a somewhat regular menstrual cycle and a much better mood overall.
Stories on social media extolling the benefits of ditching the pill have been encouraging an increasing number of women to take the leap and live hormone-free.
However, experts warn of the dangers of making big medical decisions by following online trends without consulting a health professional.
"The great thing about social media is that it's bringing a very big awareness to topics of conversation that we all need to have, whether it's with our friends, our family, our doctors, our partners," Dweck said.
"The downside is that there's a lot of misinformation, or misguided information, or information that may pertain to one individual and not everybody. So that has to really be taken into account," she added.
"So, good news is that we're talking about it. Bad news is that we do need to speak with experts who are familiar with our individual circumstances to find the best options".