How the Pill messes with women's minds

By JILL FOSTER FOR THE DAILY MAIL -20 October 2011

Bizarre as it sounds, it was an almost-empty carton of orange juice that nearly put an end to my relationship.

Arriving home from a hard day at the office, tired and dehydrated, I reached into the fridge for the carton, poured out its contents — and the tiniest, meanest dribble of liquid fell into the glass.

What can only be described as murderous rage surged through my body. I hurled the glass across the kitchen, sending it smashing into tiny pieces against the wall.

At

At breaking point: Taking the Pill can make some women become angry and emotional (posed by model)

My boyfriend came racing into the room to find me wailing that life wasn’t fair and I hated everything... including him.

We had a blazing row and I stormed out of the kitchen. Looking back, I’m astonished the poor boy was still in the house when I sheepishly returned an hour later. Especially when for weeks I’d been irritable and moody, barely wanting to touch him, let alone sleep with him. 

But stay he did. Robin is now my husband and he still refers to that moment as ‘the time you went a bit psychotic’. He also admits it’s the closest he’s ever come to ending our relationship.

That was more than ten years ago and what saved us was the fact we both knew my behaviour wasn’t normal. My mood swings and uncharacteristic tearful outbursts were, we decided, down to the Microgynon contraceptive Pill I’d started taking several months earlier.

Days after I stopped taking it, I returned to my (relatively) sane, easygoing self. 

Since then, I’ve never experienced anything like it, but I’ve often wondered how many other women have had similar episodes. 

The Pill, which celebrated its 50th birthday last year, revolutionised how we think about sexuality and relationships. Not only is it more than 99 per cent effective, if taken correctly, there’s evidence it reduces the risk of cancer, heart disease and stroke. 

'The Pill sent me crazy. One minute I'd feel fine, the next I'd be crying'

Today, three-and-a half million women in Britain — one in three women of reproductive age — use it. And last year a four-decade study of long-term Pill takers, published in the British Medical Journal, found they may live slightly longer than those who don’t take it.

We all know the physical side-effects — nausea, weight gain and an increased risk of deep vein thrombosis — but little is said about the psychological risks. 

Last week, however, scientists at Stirling University claimed the Pill affects women’s choice in men. The study showed women taking it tend to choose reliable, caring and steady men, rather than adventurous, dashing and dangerous types. 

The theory is the hormones in the Pill — oestrogen and progestogen (an artificial hormone like the female hormone progesterone) — guide women away from macho types who might not stay put to help bring up children. 

Final proof, perhaps, of what many of us have long suspected — the Pill affects us mentally, too.

Hormone changes: One in three women of reproductive age in Britain take the Pill, but for some, could it be doing more harm than good?

Yet, despite the findings, doctors remain unsure whether the Pill can change a woman’s behaviour.

‘It’s established that oestrogen and progestogen alter the brain’s nerve circuits, but to what extent that affects mood is hard to tell,’ says endocrinologist Professor Saffron Whitehead at St George’s Hospital, South London. 

‘We know oestrogen acts on the limbic system in the brain, which is linked with moods — but scientists aren’t sure where moods come from. All we know is hormones affect our brains.’

Certainly, more women are asking their GPs for alternative contraception after experiencing dramatic mood changes on the Pill. 

Angeline Brunel, 33, a call handler from Glasgow, has vowed never to go back on the Pill after trying several brands in her early 20s. 

‘When I started seeing my ex-boyfriend I went to my GP and got the combined Pill, a brand called Cilest. Within days, it was affecting me emotionally,’ says Angeline, who now lives with her husband Thomas, 32, and four-year-old daughter Madeleine. 

'I don't like putting hormones into my body, but I use the Pill for birth control, as it's so convenient'

‘It sent me crazy. One minute I’d feel fine, the next I’d be crying. All I can liken it to is the feeling of being pregnant, but more emotional.  

‘I went back to the doctor and he was very dismissive. He said: “You’ve just read about those side-effects on the packet. That’s why you’re feeling like that.”’

After registering with a new doctor, Angeline was prescribed a second brand of Pill, called Yasmin, but found it just as disturbing. 

‘I was studying and found I couldn’t focus on my work. I’m sure I was suffering from depression, as I was so unpredictable to live with and would pick arguments or cry at the drop of a hat. Not long after, my boyfriend and I broke up. I’m convinced the Pill was to blame.’

Angeline says many of her friends now take a non-hormone-based method of contraception. 

‘I’m in my 30s and I don’t know anyone who is still on it. We all tried it in our 20s and a few of us had quite bad reactions. But at that age, you’re not aware of other options.’

Sarah Marshall, 31, an executive assistant from North London, was prescribed Ortho Tri-Cyclen (a U.S. brand, as she was living in the States at the time). 

‘I went on the Pill in my early 20s. Initially, I was delighted that my cycle became so regular. But then every month, three days before my period, I’d get angry and upset. 

‘One time, my sister and I shared a four-hour car journey. Suddenly, I became hysterical and started crying. When she asked me what was wrong, I didn’t know. It was four hours of total madness.’

Sarah, who is married to Ken, 35, a film producer she met six years ago, stuck with the Pill for two years before returning to her GP.

‘My doctor told me it can take a while for some women to find the right Pill and that I might be suffering from side-effects, as it was a high oestrogen Pill, which can make some women emotional. 

Side effects: Experts say any mood changes that occur as the body adjusts to the Pill should wear off within a few months

‘He put me on Yasmin, but that made me vomit every morning. For the past ten years, I’ve been on Synphase, which is the right mix of oestrogen and progestogen for me. I don’t like putting hormones into my body, but I use the Pill for birth control, as it’s so convenient and isn’t permanent; so when we want to start trying for a family we can.’

The anecdotal experiences of women who have struggled with the Pill is, admittedly, convincing, but what of scientific proof? 

One of the few academic studies into the emotional effects of the Pill was conducted in 2005 at an Australian university. Using a medically respected questionnaire, researchers found Pill takers had an average depression rating of 17.6 compared to 9.8 in non-users. 

Professor Jayashri Kulkarni, who led the study, said: ‘Since this study, we have been looking at the varying moods between users of different types of Pills. We found women taking Pills with lower doses of oestrogen had significantly worse moods than those using higher-dose Pills or women not using a Pill at all. In fact, their scores were indicative of mild clinical depression. 

‘Conversely, women using pills with a higher dose of oestrogen had better moods than women not using a contraceptive Pill at all.  

‘This suggests different oestrogen doses in oral contraceptive Pills can have differential effects on mood.’

However, this study is neither completed nor published. 

For years, women have reported suffering from reduced libido while taking the Pill. A study of more than 1,000 women at Germany’s University of Heidelberg found the Pill dramatically reduces levels of desire and arousal during sex.

Yet many GPs remain sceptical. Dr Diana Monsour, consultant in gynaecology and reproductive health in the North-East, says: ‘Emotional effects for most women on the Pill do not happen. Our moods vary and it’s too easy to blame the Pill if we’re feeling low. Any scientific evidence in this area is very woolly, indeed.’

So, what is the official guidance for those in doubt? 

Lynn Hearton, of the Family Planning Association, says: ‘Any mood changes that occur as the body adjusts to changing hormone levels from the Pill should wear off within a few months. 

‘For the majority of women, the benefits of the Pill far outweigh the side-effects.’

That’s as may be. 

But as I — and many other women who have had a bad experience on the Pill — believe, suffering a crippling emotional fall-out once a month is a heavy price to pay.