Welcome to The V, our weeklong series devoted to all things sex and reproductive health. This is a safe space free from "taboos," because there's no reason anyone should feel awkward talking about their bodies. That said, we'll be clearing up any misinformation on the subject, starting with this huge misnomer: The "V" in this case doesn't refer to the vagina, but the vulva, which is the anatomically correct term for external female genitalia (including the opening of the vagina). Stay tuned all week for need-to-know guides on birth control, tips for taking your orgasm to the next level, real-life stories about endometriosis, and everything in between.
The subject of birth control is a convoluted one—the complexities made even more apparent after reaching out to different women for this piece. As someone who's never interacted with hormonal birth control before, I found myself without an understanding of what it's really like to go get it for the first time, to feel those telltale, awful symptoms, and to hang your head in shame during a lecture from a doctor unsympathetic to your needs. For a medication so ubiquitous with growing up, why, I ask you, is the information still so mysterious? And while we're asking questions, how is it possible that almost every single one of the women featured below has had a negative experience either with the drug itself or the adults manipulating their decisions about it?
It's about time we discuss women's sexual health in a real, raw, and constructive way. Starting with our first experiences with birth control and the subsequent embarrassment, shame, and mixed messaging that ensues. Below, find eight women who have chosen to share their own stories. They span the gamut in age, location, and birth control method, but one thing is constant in all of their narratives: not enough information.
"It was my idea to go on birth control because, out of nowhere, I started having horrific PMS. One day I was on a run with my brother and had to stop mid-run to vomit on the side of the road.
"I decided on my doctor through a friend who referred her. Even having been on birth control for over six years, I still feel like the conversation around different options is not where it should be. My ob-gyn is more on the traditional side and, though I've expressed interest in other methods, my doctor just tells me the pill is the 'safest' method in regard to blood clots and other side effects. And sadly, that's the end of the conversation every time.
"My mom has made me feel uncomfortable as well—I think she has a more traditional outlook too and is always trying to convince me to go off the pill for a few months 'to give my body a break'—but it's totally because she just doesn't believe in it. Other than that, the topic of birth control hasn't given me any problems, but I do use a menstrual cup and I get a lot of negative feedback and judgment when I mention that."
"I decided to go on it on my own when I was 15 after I lost my virginity. I remember being a little bit embarrassed and mostly stressed trying to figure out the logistics of how I was going to go to CVS to fill a prescription without my parents knowing. I wasn't going out of my way to hide it, but I wasn't ready to tell them I was sexually active yet and figured this would be kind of a giveaway.
"I had a really wonderful doctor who specialized in adolescent medicine, so her entire practice basically consisted of dealing with awkward teenagers, and she made it amazingly easy for me. She was very straightforward and helpful in explaining how to take the pill and gave a really wonderful and memorable lecture about how the periods you get on the pill were fake periods designed to appease male politicians and religious leaders and I didn't have to bother with those unless I wanted to. She prescribed me three packs at once, so I could take them straight through for three months at a time.
"The first couple times I had sex on the pill, I called my doctor *FREAKING OUT* convinced that I was pregnant. After the third call, she told me kindly but firmly that if I wasn't mature enough to deal with this feeling on my own, I wasn't mature enough to use the pill as my primary birth control and I should keep using condoms until I calmed down. She was very nice about it and eventually, I got over it. A thousand points to Ann Engelland, MD, for being a star.
"I had really good luck with the pill and never experienced any negative side effects, though plenty of my friends did. I'd always taken a relatively high-dose pill for several consecutive months, so when Seasonale came out, it was like someone had finally created a product specifically for my regimen. I took that for a few years until the generic Jolessa came out, which is what I take now.
"I took a break at the beginning of last year when my pill ran out the same time I went through a horrible breakup and I decided I may as well go off it and see what happened—it turned out my periods were really irregular and I ended up being diagnosed with polycystic ovarian syndrome, so I'm back on Jolessa for the foreseeable future. Birth control is the first-line treatment for PCOS symptoms, so I'm honestly very grateful to the universe and my wonderful doctors for my birth control because those 17 years on the pill ended up protecting my body and my health more than I realized."
"I started birth control when I was 14, due to the extreme cramps I was getting. Plus, I wanted to feel prepared and have ownership and control over my body. My general practitioner grew up with my mom, so it was a bit of a difficult experience asking her for it (but my mom and I are pretty open about this stuff).
"Although I generally have had a good experience with birth control, I also had some bad experiences (extreme mood swings, depression, etc.). I saw an interesting story recently that made me wonder if part of the reason I have serious depression might be due to the birth control. I take it continuously now because my period side effects are too severe to lead my most productive, best life (five days a month in bed or hunched over a toilet is pretty bad). I think I may have PCOS, so I talked to my gynecologist about it, and she said that the course I'm on is the best for managing it because it's difficult to diagnose. I've officially been on the pill for half my life, and it's honestly scary to think about what my life would have been or will be without it.
"That being said, I live in Canada and know my access to healthcare is better than those in the U.S. Lots of my girlfriends and I talk about it openly, and I don't think I've ever actually had to pay for the pill (just dispensing fees from the pharmacy, which most insurance plans give back). It's really easy to get access to the pill here, and women's health in Canada, I would say, is generally a high priority."
"My experience with birth control isn't 'traditional' in the sense that when it felt like all my friends and peers were going on the pill in high school and college, I opted not to—I was always a little wary of putting something with so many potential side effects in my body, especially because up to that point, my period was always light and my PMS symptoms were quite minimal—I barely even cramped. I remember when I left for college, my mom sent me off with a pack of pills from my ob-gyn 'just in case I changed my mind,' but that was definitely more for her own peace of mind. I never used them—in fact, for most of my adult life, I have been perfectly happy to use nonhormonal forms of birth control and haven't run into any issues.
"But a couple years ago, my hormones suddenly started to act up and I was experiencing really heavy, uncomfortable periods, as well as unexplained weight gain. After exhausting all my natural options (including acupuncture, which had helped with other reproductive issues in the past), my doctor told me that I should really consider getting an IUD since the low dose of hormones would help alleviate these crazy symptoms without giving me other side effects. I was really skeptical (and sad to ruin my streak of going hormone-free), but a year and a half later, I know it was one of the best decisions I've ever made. I feel great, my symptoms are practically nonexistent, and it's also nice to have that additional peace of mind."
"When I was 16, I asked my mom if I could go to the doctor and get birth control because I had cramps that were so painful that I'd have to miss school. My mom was 100% supportive and made me an appointment to see her doctor. Getting a prescription was a piece of cake. I had an exam and walked out with a script for Yaz. The problem is that the only reason I got that prescription is because Yaz was giving free samples to the doctor I saw at the time.
"Instead of taking the time to check out my hormonal makeup or ask more background questions about what my symptoms were like, I just got the drug that was being pushed by big pharma. I ended up having a horrible reaction to Yaz. My boobs swelled, My appetite skyrocketed, and the hormone therapy left me so depressed I would cry every day. Being in high school, I did feel not prepared for how much this was changing my body and mind. When I went back to the doctor to ask to try something else, she was happy to prescribe me another medicine, but couldn't offer any reasons I was now getting a prescription for Lo Estrin. At 16, I realized for the first time I was a complete hormonal guinea pig.
"In the years that followed, I tried several different birth controls. The cycle was always the same. Suffer on it for three months. Go to the doctor. Try something else. Every time I probed the doctors for more answers about how these drugs were different, they had zilch to say to me. I've experienced painful cystic acne, depression, anxiety, periods that last for 10 days, periods that never come, weight gain, and appetite change while experimenting with different pills. It wasn't until I did the research and found the pill I'm on now that my cycle finally didn't cause me to be unwell. It wasn't until I was in college and did my own research that I learned about the androgen scale and how different birth controls work for different women based on their hormonal makeup. At 21, I finally walked into the doctor with the name of a drug—Ortho Tri-Cyclen Lo—that was on the opposite end of the spectrum from what the drugs I was prescribed for years.
"It was a big lesson that these doctors are prescribing pills they are getting office samples of. Big pharma is being placed before the patient. Ninety percent of my friends take the pill, but hardly any of them know the scientific differences between their options. They've all been guinea pigs too. I've now been on the pill for 10 years and recently asked my gynecologist about switching to a nonhormonal form of birth control. I've had recent conversations with women whose doctors had them 'take breaks' from the pill to make sure their fertility wasn't compromised. When I look this up online, the studies are contradicting. My doctor seemed bothered that I would start a conversation like that and responded to me, 'If what you're on is working, there's no point in changing.'
"I think the big issue is we're still having to fight for access to information about birth control. And that fight is blocking the much-needed scientific studies and practice updates for how we prescribe women hormonal medications. I'm sick of women being treated like lab rats. There's no way men would put up with trial and error when it comes to their hormones."
"I feel like birth control and the way it is entirely a woman's responsibility is the root of so many issues around body consciousness and living with quiet pain and shame. When I was 18, my abusive boyfriend pressured me into going on birth control. I went to Planned Parenthood by myself and it was sliding scale and pretty easy. I didn't have much of a choice because all I could afford was the cheapest option.
"I think at Planned Parenthood they've seen it all, so it was pretty much like getting processed at the DMV. They were more shocked that it was my first time seeing a gynecologist. I felt shame myself because it wasn't something I wanted to do, and I grew up in a very religious household. I was worried about the side effects but too nervous to ask. As it turns out, they were bonkers. My boobs went up a cup size, and I was weeping all the time. My then-boyfriend broke up with me because I got so emotional (or maybe mostly because he was an asshole), and I spent a lot of time drinking in my backyard. After about two months, I quit birth control after I realized it was causing my intense moodiness and have never used any kind of hormonal birth control since. Though I know it's risky, now my husband and I just pull out because I don't want to put anything potentially harmful in my body when men don’t have to do the same."
"I was 18 years old when I had my first gynecologist appointment, and it was the doctor who suggested and prescribed birth control for me. She's been my gynecologist for almost 10 years now.
"It felt like the normal thing to do, to be honest. My older sister was on birth control, so I was already familiar with it. I also expected the doctor to prescribe it to me because I suffered from menstrual issues for years and read that the pill helps with that. She made me feel like it was not a big deal. I did have to do a blood test first, however. I was more anxious to do the blood exam (it was my first blood test) than to be on the pill.
"The symptoms for the first year were horrible. I was first prescribed Yasmin, and that pill caused me so much grief. I experience a lot of anxiety, weight gain, and horrible mood swings. A year later I was prescribed Yaz, and I've been on it for almost nine years. My periods are fine and regular and I lost the weight almost immediately, but my anxiety has gotten a lot worse. I'm not sure if the birth control has anything to do with it, but it's something worth pointing out. I will say, though, now, for the first time in my life, I'm having a lot of hormonal imbalances, adult acne, weight gain, and digestive issues. My family doctor (not my gynecologist) and endocrinologist suggested that I go off the pill because they think the pill is causing these."
"When I was 18, I was dating a 'super-hot' football player, and I was like 'hm, I should probably get on birth control.' My mom was terrified that I was going to be a garden-variety 'slut', was worried about my reputation, gave me the cow-buying farmer/free milk idiom (is my Midwest showing?), etc., but she ultimately decided to let me get it, which I was grateful for (although I would've gotten it anyway). I ultimately wanted it because pregnancy and parenthood were both big no-no's for me, and I wanted the freedom to make my own decisions. I also really, genuinely hated my period (I was a competitive swimmer, which made the whole thing embarrassing and a total nightmare), so I also wanted it because it promised a lighter flow and manageable cramps. I was lucky because the first one I tried was the perfect fit, and I'm still on it to this day. I remember my skin was total garbage for the first three months I was on it, but it cleared up and didn't cause any other problems. I vaguely remember gaining five pounds, but that went away too, so I was into that."
"I was in a monogamous relationship, so it felt like [going on birth control] made sense. The experience was awful. I wanted to talk about options with my doctor, but she said the pill was the best option for me. I wanted to talk about NuvaRing, the patch, Depo-Provera, and IUDs to make the best decision for myself. She said low-dose would be the best.
"I felt totally sex-shamed. I wanted to get an STD test, as well as talk about birth control. She asked why I wanted an STD test. And then when I told her I wanted to talk about birth control options, she only gave me one. When I asked her what I should do if I miss a pill or threw up, she asked me why I would be throwing up. I said food poisoning or maybe after a long night of drinking, who knows—just want to cover my bases. She said we needed to talk about my alcohol intake the next time I saw her.
"I had a perfect period before I went on birth control, so when I had unexpected spotting and random periods, it was awful. Lots of bleeding, mood swings, and spotting. I felt so out of control of my body and emotions. I tried five pills before I went for an IUD (which, in the end, I didn't get it because it hurt so much). I now use condoms! It's not the best, but it means no chemicals or gadgets. It doesn't 'ruin the mood,' it takes very little time, and my boyfriend is happy that I've decided to go with a method that makes me feel happy in my mind and body. It does remove a bit the spontaneity element, but a condom is usually always nearby."
"I grew up in a very small town in Idaho with a high population of Mormons, so there is a lot of stigma around birth control. I kept it quiet for a long time because I knew people were going to judge me and say that I was 'unclean' or that I was taking the pill so I could have unprotected sex. Our high school health class talked about contraceptives for literally two minutes. They spent way more time showing us photos of STIs and trying to scare us away from having sex at all. It was definitely an abstinence-focused class, which I believe doesn't work and just causes more teen pregnancies (there were three in my class).
"I started birth control when I was 10—I would get month-long periods with five to six day breaks between, and I'd be extremely sick for the first two weeks (cramps so bad I couldn't stand, puking, migraines). My mom took me to our pediatrician because I was missing so much school, and he suggested the pill. I started taking it and immediately my periods were four days and extremely consistent. All the other symptoms went away except on the first day of my period. I didn't have any other side effects. All the health professionals I dealt with were extremely helpful. I think my mom had a lot to do with [my positive experience] as well. She wasn't going to take any bullshit from them (she experienced similar issues during puberty but didn't have the help she needed).
"Right now, I have the Mirena IUD and I love it. I don't even have a period anymore, and none of the regular day-one period symptoms either. But I haven't ever been off birth control since I started taking it 16 years ago, so I'm not sure what might happen if I do."
"I started when I was 13 because of PCOS, and I've been taking the same 28-day pill for 12 years now. The ER doctor suggested it once I had my first ruptured cyst. I've had a lot of weird experiences getting it. I went to a Catholic college and the nurses on campus couldn't prescribe it. I had to find an off-campus doctor or go to CVS Minute Clinics. I ended up playing up the PCOS, so they would give it to me, but it was always a dance of 'severity' so they would believe me and give me a prescription. My mom was questioned a lot about why her teen was on birth control, especially at the pharmacy counter. I haven't had any side effects, but one time I went off of it for a month and had the worst acne of my entire life, so I'm assuming it's helping that at least."