It's Not Me, It's You

Background for the reader: I originally wrote this post in September 2016, when I ditched hormonal birth control after nine years of taking the pill. I firmly believe in making all forms of contraception, including the contraceptive pill, available to anyone who wants it, and I am lucky that I have been able to access and make choices about my birth control in the way that I have. Every person has the right to make their own choices about their body, and I don’t believe anyone else can or should dictate these decisions. As such, this letter is not at all a condemnation of oral contraception or other hormonal birth control; it is simply my personal exploration of my body, my wellbeing, and my feminism in the context of contraception.

Dear Pill,

There’s no easy way to say this, so I’ll give it to you straight. It’s over. We’re done. I’m breaking up with you. I didn’t give you much of a warning, but I’m sure it’s the right thing to do, because there’s a buoyancy in my chest that I haven’t felt in years. No, there isn’t someone else. No, I’m not getting the Mirena IUD. I’m through with all hormonal birth control – to be honest, it’s not me, it’s you.

We’ve been together for nine long years, through the good and the bad, and I truly thought I was happy with you. First, you helped me with my teenage acne and irregular cycle, and then you worked wonders as my contraception partner-in-crime. I grew up knowing you as liberation, confident that, like most of the adult women I knew, I would find in you a source of power and freedom. When I turned fifteen we got together and it was pure magic, or so I thought. But I’ve been doing a lot of thinking lately, and in retrospect, I’m not so confident that our relationship was all that healthy.

First came the clear skin. Yes, you certainly helped with that. Convenience and reliability? Check. And the clockwork periods? I was thrilled. Until I realized that they weren’t actually my natural periods, just a withdrawal bleed, and that my body isn’t supposed to be perfectly predictable. My body is supposed to vary and change and shift. And even if I don’t want to experience the changes, I need them. My cycle is an important indicator of my health, and you masked that part of me. When I became anorexic, on the verge of hospitalization, you were still there, the red roses you left each month – like clockwork – convincing me that I was okay. It wasn’t until another woman pulled me out of my reverie that I realized you were an enabler, not a support system. And then there was the depression. The anxiety. I’d already had one span of intense depression by the time we met, and yeah, I had unbearable anxiety prior to our relationship. I cried on my fourteenth birthday out of sheer frustration at how I was feeling.

You certainly did not cause my mental illness, but no doctor to this day has ever mentioned that you might have made it worse. That, just maybe, you were messing with my head. No, it’s not all your fault, and I don’t know if you actually made anything worse. Scientists haven’t cared enough to study the way you affect our brains, but it’s a simple fact that the two hormones you circulate throughout my body – estrogen and progestin – change my levels of serotonin, dopamine, and calming neurosteroids. Who’s to say you didn’t mess with my chemistry? I was silent about my anxiety and depression and OCD when I was younger, because I didn’t even know what they were. No fifteen-year-old I know has the vocabulary to articulate those illnesses. It should have been my doctor’s job to ask me about it, to explore the possible side effects of The Pill, even just to do a brief depression screening like we do with all our patients at the health center where I now work. Maybe I would have still chosen you, but it would have been a choice I made with my eyes open. It’s wrong that nobody warned me about the specter of ugliness floating behind your lovely face.

The truth is that dating you has real perils. The gynecologist was so quick to point out your virtues. She reminded me at every annual exam that you reduced my risk of ovarian cancer, but she never drew any attention to your flaws: you increase my risk of breast, cervical, and liver cancer significantly[1]; you have a long list of exes who broke up with you after suffering from depression[2]; and you probably lower my libido, which defeats the purpose of our relationship in the first place.[3]

I ignored the risks, assuming that anyone who criticized you was just afraid of the confidence and freedom you gave me. Women have fought long and hard for access to hormonal contraception, and to reject The Pill almost feels like a betrayal of my feminism. I don’t see any men getting with you, though, even though the technology for a male contraceptive pill exists.[4] That fact alone is worrisome, since doctors tend to take women’s health much less seriously than men’s.[5] Even the doctors you charmed the most advised me to take a break from you after ten to fifteen years together to minimize my chances of heartbreak. I don’t want a partner with an expiration date.

I know there are lots of other women who will want you. You’re probably a perfect fit for many of them. To me, though, you’re my high school sweetheart, the bittersweet, toxic relationship that taught me so much but that I’ll never repeat.

I’ll never find someone else like you? Well, that’s the point.