A groundbreaking new BBC documentary with Dr Zoe Williams, who took The Pill herself for 20 years, explores the risk of everything from blood clots to cancer, weight gain and suicidal thoughts.
The London-based GP surveyed more than 1,000 women aged 18-45 who take The Pill, as well as speaking to leading researchers about the effects.
The question she asked was simple: “Do the benefits outweigh the risks? And which of the side effects should we really be worried about?”
The findings are detailed in The Contraceptive Pill: How Safe Is It? which airs tonight. Here’s what they found…
Depression and suicide risk
Of the women polled, a huge 52 per cent reported some negative side effects – with a quarter of ladies experiencing mental health issues.
Danielle, 31, revealed: "The impact The Pill had on me was completely debilitating and terrifying.
"I had never had any mental health problems prior to that, and went from being fine to having suicidal thoughts within about six months."
Neelam, 29, added: "I couldn't handle the strain of being on that pill. It was making me crazy."
I went from being fine to having suicidal thoughts within about six months
Journalist Vicky, 30, was first prescribed The Pill when she was 14 to regulate her heavy periods – and was soon suffering from panic attacks and suicidal thoughts.
She said: "I remember having these really dark, really stroppy patches.
"It's really difficult when you're a teenager to know if the emotions you're feeling are your own because of your naturally fluctuating hormones or as a result of the synthetic hormones you're taking.
"At that point of your life, you don't have an emotional frame of reference.
"I felt like my brain had gone off, it felt mouldy, and I remember thinking 'if this is what the rest of my life is going to be like, I don't want to live it, because I don't want to live like this'."
I couldn't handle the strain of being on that pill. It was making me crazy
Vicky was prescribed anti-depressants and beta blockers for her anxiety, but says doctors never considered her issues could be related to The Pill – although she later discovered a possible link on interest forums.
After the NHS told Vicky they couldn't provide data on the link between anti-depressants and The Pill, she travelled to Denmark, where there's a comprehensive database of their 1.8 million Pill users spanning decades.
Professor Ojvind Lidegaard told her: “On average all users from the start had a 70 per cent higher use of antidepressants compared to never users.
“The risk of suicide attempts was increased by 100 per cent.”
I remember thinking 'if this is what the rest of my life is going to be like, I don't want to live it, because I don't want to live like this'
The effects were particularly bad in young women, with those aged 15-19 and on The Pill twice as likely to attempt suicide than non-users.
But Zoe was keen to stress that, although there's a correlation, it's almost impossible to show cause and effect when it comes to taking contraception.
She said: "You’d need to do a randomised controlled trial and some women would have to take a placebo drug which, when it comes to The Pill, would be ethically and morally wrong.
"What we can do is advise women who feel The Pill is negatively impacting their mood that they don’t have to use it. Go see your GP and explore other options."
Some 36 per cent of women polled were concerned about the increased risk of breast cancer, which was widely reported on following a December 2017 study.
The research, by Professor Philip Hannaford, found a 20 per cent increased risk in women taking The Pill.
But, speaking to Zoe and Pill taker Amy, 24, whose mum died of breast cancer, he explained this only means 13 extra cases of breast cancer out of 100,000 women each year.
To put that into context, smoking 15 cigarettes-a-day would lead to an extra 250 cases, while being overweight, drinking heavily and not exercising were also bigger risk factors than The Pill.
Zoe said: “13 is a low number. I think when it’s explained in this way it’s a lot less scary than that 20 per cent.”
Meanwhile, The Pill reduces your risk of ovarian cancer, endometrial cancer and colorectal cancer (a type of bowel cancer).
Dr Hannaford added: “That effect gets stronger the longer you use The Pill for, and persists for 35, 40 years after stopping, and that’s why you find Pill users do not have an increased risk of cancer.”
A huge 48 per cent of women polled were worried about potentially fatal blood clots, making it the biggest concern for women on The Pill.
It comes after misleading reporting of a 1995 study claimed certain pills doubled the risk of blood clots, scaring thousands of women off taking them.
Professor Anne MacGregor said: “There were a lot of unplanned pregnancies and the following year there were an additional 13,600 abortions.”
The 9 per cent rise in abortions and 25 per cent increase in births cost the NHS an estimated £57 million.
It’s much more common for me to see women with blood clotting in pregnancy
Professor Roopen Arya said: “We do see women with clots related to the combined pill, but they’re in the minority of the overall clinical population.
“It’s much more common for me to see women with blood clotting in pregnancy.
“So I think the risks of having a baby far exceed that of taking The Pill.”
Taking The Pill increases your risk of getting a blood clot from 20 in every 100,000 cases to 90-120, whereas pregnancy increases your risk by 290, and this rises to 4,000 in the weeks after giving birth.
As The Pill's main aim is to prevent pregnancy, women are actually lowering their risk of blood clots by taking it.
Lots of women taking The Pill claim it made them put on weight, but is there any truth in this?
Professor Philip McTernan, who's studied this in detail, said taking an oestrogen pill could alter your metabolism and affect the amount of fat you accumulate, but it could also be down to water retention.
He said: "We do know that being on The Pill you’re changing how much water you’re retaining in your tissues.
"So you could put on what is perceived as more weight, maybe as much as 2kgs."
He's also measured the effect of oestrogen on fat cells and found that it does increase the cell number.
But he added: "These cells are immature, they’re not the lipid cells. You need a lot of other hormones involved to get to that fat cell we associate with weight gain."
In my view it’s shocking that there’s been so little research
Some Pill takers also report a loss of sex drive, which could be because it reduces your testosterone levels by up to four times.
However, some of the women in Zoe's study saw an increased sex drive while their testosterone levels decreased, so it's not as simple as you might think.
Dr Cynthia Graham said: "They say the pill is the most researched medication, but there’s this one area of neglect, the effect of the pill on women’s sexual interest and enjoyment.
"In my view it’s shocking that there’s been so little research."
Because of this, we're still pretty much in the dark when it comes to the effect on libido, but what we do know is every Pill is different – so it could be worth asking to switch.
There have been lots of reports on The Pill's negative side effects, but there are benefits too.
It can help relieve the heavy periods, painful periods, polycystic ovaries, endometriosis and acne, as well as preventing pregnancy for women who are not able to have kids.
Zoe concluded: "The Pill still to this day remains the most revolutionary advancement in contraception, and as long as we screen women carefully, and help them understand the potential risks and side effects, for many women it remains a very safe and effective method.
"And if you're one of those women who is suffering from side effects then please don't, go and see your GP and discuss your options."
The Contraceptive Pill: How Safe Is It? airs on BBC2 at 9pm tonight.
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