A study came out last week that should have caused great alarm. For 13 years, researchers at the University of Copenhagen studied more than a million women between the ages of 15 and 34 who were taking a type of drug — one that is popular in all developed countries. Taking this drug, the researchers found, correlated with an increase in the risk of depression. The correlation was particularly strong in adolescent girls, who showed an 80 per cent higher chance of being diagnosed with depression.
Usually when a story about women’s health and depression breaks, a phalanx of activists and campaigners pop up all over the media to ‘raise awareness’ of the issue. Last week, however, barely a peep — the papers carried the story and a few online sites ran delicately objective surveys of women on the pill, but there were few howls of outrage.
Why the muted response? The answer is that the type of drug in question was hormonal contraception, and it is today a sin just to suggest that it may not be the greatest gift ever given to womankind. Almost everybody agrees that female contraceptives — pills, implants, patches or intrauterine devices — have liberated us; set us free to be sexually active human beings. Few dare raise concerns about that, because to do so is to risk being called a prude, and nobody wants that.
There are plenty of questions to be asked, though. Not least because 3.5 million British women are on the combined contraceptive pill — known as the ‘Pill’ — and the study showed that those who take it were 23 per cent more likely to be on antidepressants — possibly taking pills to cope with the Pill.
Many of my friends are on the Pill. We started taking it towards the end of our teenage years, prescribed by the NHS, and lots of us have continued to use it for the past decade. It has certainly done its job; we are now reaching the final years of our twenties, and not one of us has had a baby. I suppose that’s progress, of a sort. We’ve spent a large chunk of the most fertile period in our life taking state funded contraception. Only time will tell how fondly we look back on that fact.
The advent of the Pill, which first came to Britain in the 1960s, is not just regarded as a medical breakthrough. The Pill is the great turning point of the sexual revolution; a Great Leap Forward for equality. It enabled women to take control of their bodies, whatever that means.
Children are now taught about reproduction from a very young age, and sex education is compulsory from the age of 11. Around the age of 16 — the legal age of consent — school nurses start circling, terrified that their sexually aware charges will get knocked up. Doctors’ appointments are booked, prescriptions are issued, and before long teenage girls are popping a little pill every morning as they brush their teeth.
To start with, girls were often put on a cheap one, such as Microgynon. If you reacted badly, you were given the chance to try a more expensive version. There seemed to be little method behind each prescription. It was trial and error, trial and error, until you found a pill that didn’t make you cry for days or turn you into a porker.
Most young women are familiar with the arguments for taking the Pill; we were taught them early on. It prevents unwanted pregnancies and abortions. It can reduce some types of cancer — though it increases the risk of others. But the overriding benefit is that the Pill makes us equal: it lets a woman approach sex as a man does — without the fear of pregnancy.
The substantial negative side effects tend to be ignored or brushed aside. Research such as the Copenhagen study should be noteworthy, but it will probably end up as a part of a warning in the small print. Nobody wants to stop women protecting themselves, or make them fearful of sex — even if it makes them miserable.
The big pharmaceutical companies now manufacture a number of ‘third generation’ pills that promise to reduce the unappealing side effects. Around a million women in Britain are on these new pills, which promise to be good for skin and help to stabilise weight. But in 2014, all British GPs were told to warn anyone taking the third generation pills that they were at risk of developing potentially fatal blood clots. A study had revealed that the annual risk of a woman of childbearing age having a serious blood clot was one in 5,000 if she wasn’t on the Pill. The risk went up to one in 800 for women on third generation pills. But these pills are still very popular, despite a number of women having had strokes while taking them.
When I was younger, sex education classes made you feel that you should be on the Pill, rather than relying on more unfashionable, natural methods of contraception, such as the rhythm method. It was what intelligent, responsible women did. Ten years on, I’ve begun to wonder whether the real rationale was more pernicious. After all, it’s far cheaper for the state to give out contraceptive pills than support mothers and children. No wonder birth rates are dropping dramatically across Europe. And so what if the Pill causes depression, cancer and blood clots? Maybe that’s just a risk worth taking in exchange for sexual emancipation and fewer unwanted babies.
It may be a worthwhile trade off. What’s disturbing, however, is how readily feminists fall into line when it comes to the Pill. Dissent is frowned upon. In 2013, Holly Grigg Spall published a book called Sweetening the Pill: or How We Got Hooked on Hormonal Birth Control. It was met with much disdain, particularly in the US, where 11 million women use the Pill. Her book was called ‘a dishonest anti Pill treatise’ because she dared to point out that hormonal contraceptives are ranked by the World Health Organisation as a class one carcinogen alongside tobacco and asbestos.
Grigg Spall was dismissed as a ‘crank’ elsewhere because she tried to argue that ‘true liberation means being left alone to experience feminine bodily functions like ovulation, childbirth and breast feeding in all their natural glory’. One critic declared loftily that trials had not found ‘modern birth control pills to cause more depression, headaches, or weight gain than a placebo’.
Well, now a trial has shown a strong link between depression and hormonal birth control — and the normally loud feminist lobby is silent. It’s not surprising that hormonal contraception is linked to depression. Hormones affect moods — and here we are, in an era where millions of women dose themselves up daily with powerful synthetic hormones in order to not get pregnant. We are sexually liberated, but emotionally depressed; free, but not all that happy. It’s reasonable to ask: is the Pill worth the pain?