“It’s not a trip to Disneyland.” That’s what a cheesy, late ’90s movie taught me about periods in my fifth-grade sexual education class. From the outset, it was made very clear that fertility is a nuisance.

“You all know more about how boys’ bodies work than your own.” This was the lecture from my seventh-grade health teacher. It was true. I knew about male reproductive physiology, but when it came to my own, I believed it was just too complicated.

“You should just go on birth control.” That’s been the message from doctors my whole life. For acne, for migraines, for PMS, I was told that my hormones were a problem and the pill was the answer. Never mind that the doctors were unsure about what the underlying problem was. They just knew the pill could fix it.

I was never encouraged to learn about the natural ebb and flow of my body. I was told to suppress it. As a result of this attitude, I know little more about my own biology than I did walking into that sex ed class when I was 11.

According to results of the Centers for Disease Control and Prevention’s most recent National Survey of Family Growth (2015-2017), 80.5% of women ages 15-49 who have ever been sexually active have used the birth control pill, and at the time of survey, 26% were using some form of hormonal contraceptive. Additionally, a 2011 study reported that only 42% of women use the pill solely as a contraceptive. Alternative reasons for using hormonal birth control include managing acne, alleviating cramps, preventing hormonal migraines and regulating the menstrual cycle. The use of birth control for secondary indications exploded in the 1990s, when pharmaceutical companies began marketing the pill as a “lifestyle drug” to attract new customers. This included taking birth control to eliminate monthly menstruation altogether.

In parallel, teens are using oral birth control more frequently. According to Virtua, 16 is the most common age at which girls start using oral contraception. As Kate Clancy points out in Scientific American, teen girls are often prescribed the pill just to manage cycle regularity, but minor fluctuations in the menstrual cycle are actually normal in adolescents. In effect, birth control is preventing young women from learning the natural rhythm of their bodies before they have a chance.

There is also research showing that teens who use hormonal birth control are more susceptible to depression, both in the short and long term. These side effects are not unique to teens, however. The CDC reports that 34% of women ages 15-49 have discontinued use of oral contraception, with 64.4% of them citing side effects as the deciding factor. While Planned Parenthood reports that symptoms such as spotting, headaches and nausea go away after 2–3 months of using the pill, studies have shown that some women experience continued weight gain, severe acne, mood disturbances and decreased libido. And while long-term oral birth control use reduces the risk of ovarian and endometrial cancer, there is a consensus that it also increases the risk for cervical and breast cancer in the long run.

So what? Every medication has side effects, right? Of course. But I think it’s worth noting that a 2016 clinical trial for a male hormonal birth control was suspended after the review board concluded that the men were experiencing too many symptoms, specifically acne and mood swings. In other words, the same things women have been experiencing on the pill for decades.

Why are women expected to endure side effects that men are not? Why are women so liberally prescribed a medication that widely alters their physiology instead of given answers about what is actually going on in their bodies? Why are women taught from the earliest age that their menstrual cycle has to be fought? I believe the answer to all of these questions is that we perceive women’s bodies are dramatic and unpredictable, as something to tame rather than be intimately understood. Rather than addressing the root cause of women’s issues, we too often dismiss them with a prescription for the pill. To me, it seems like the medical equivalent of being told that what you are feeling as a woman is “just hormones.”

So it’s no surprise to me that I see Natural Family Planning (NFP) gaining more popularity among women. NFP, where women record changes in their body throughout the menstrual cycle to predict ovulation and menstruation, was once only for traditional Catholic couples who rejected contraception on moral grounds. Now, I see influencers on Instagram, the same women who post healthy recipes and workout tips, extolling its benefits. Their message is that NFP has helped them to understand their own bodies for the first time. NFP encourages women to learn more about what happens to their physiology throughout the menstrual cycle and listen to what their body is telling them rather than shutting it up. And that, to me, is way more empowering than the pill ever could be.


Related content

Want to read more from the Johns Hopkins School of Medicine? Subscribe to the Biomedical Odyssey blog and receive new posts directly in your inbox.

Share This Post