Why are so many young people ditching the pill?

Since launching as a consumer drug in the UK in 1961, the pill has earned a reputation among feminist historians as one of the driving forces behind the sexual revolution. For generations now, the circular wheel on the green tinfoil package has been recognised as a rite-of-passage drug for those seeking sexual freedom without the risk of pregnancy. Today, it’s estimated that 151 million people take the contraceptive pill worldwide. 

However, recent studies show the intake of the pill is decreasing. Early this year, the UK government reported that the rate of ‘short-acting combined oral contraceptives’ remains 30 per cent below the pre-pandemic level when prescribed from primary care, and 50 per cent below the pre-pandemic level when prescribed from Sexual and Reproductive Health (SRH) services. Meanwhile, over on TikTok, videos of young women sharing their experiences of ditching hormonal contraception are racking up millions of views. It seems like the pill is no longer liked by young people – but why?

Scepticism about the pill is hardly anything new. Concerns of weight gain, lack of libido, depression, severe mood swings, suicidal thoughts, and even cancer are all well-known side effects that often plague the minds of those considering the drug despite potential risks. Talking about her early impressions of the pill, 23-year-old Bridie tells me: “I remember hearing horror stories about what the pill was as if it was this scary unknown that you were diving into.”

These fears don’t come from nowhere. Maddy, a final-year student at Durham University experienced blood clotting in her leg which landed her in the ICU as a result of taking the combined pill, prescribed by her GP as a form of acne treatment when she was 19 years old. “I don’t think there’s enough research or communication about the varying effects of the pill – why people experience it differently, and what factors lead to that,” she says. “The idea that it’s being handed out to teenagers to treat things like acne is so dangerous. I think people are becoming a bit more sceptical of that.”

Horror stories about the effects of the pill have also made their way onto social media. Just a quick search on Instagram, Twitter or TikTok will expose you to thousands of young people explaining their distressing experiences. As a result, alternative methods of contraception are growing more popular. Nicole Bendayan, a holistic menstrual health influencer, makes TikToks explaining how natural tracking methods can be used as a form of contraception. Although she is not a licensed medical professional, she has racked up a total of 825,000 followers and 7.9 million likes.

But influencers like Bendayan have been criticised for fear-mongering and spreading misinformation, which creates more anxiety about taking the contraceptive pill. “I think people have a more emotional connection to influencers because of their availability and how much they post,” says Rina Raphael, women’s health expert, author of The Gospel of Wellness, and writer of the popular newsletter Well To Do. “The algorithms incentivise shocking and novel information, so a video going on about the safety of birth control will get glossed over. But if you do a video saying birth control will completely wreck your system? Well, that’s interesting, people want to watch that.”

It’s not only influencers who have capitalised on this growing scepticism; the wellness tech industry has also jumped on the bandwagon. Natural Cycles, an app with over three million registered users, is marketed at those who want to plan or prevent pregnancy – claiming a 93 per cent effectiveness rate, the same as the contraceptive pill. The app uses an algorithmic method to predict and supposedly ‘confirm’ your ovulation and fertility status by users logging their period and measuring their daily temperature. Natural Cycles costs £49.99 for a 1-year subscription and has even partnered with another wellness corporation, Oura, which allows you to track your fertility while you sleep for a mere £290. In the past, Natural Cycles has come under increased criticism due to reports of app users experiencing unwanted pregnancies. One TikToker who once vouched for the app as her preferred method of birth control came to describe her experience as a “mistake”. 

Raphael is also wary of fertility tracking apps. “This dichotomy of fake versus natural doesn’t help women. It’s much more nuanced than that,” she says. She adds that she’s sceptical of the effectiveness of apps like Natural Cycles. “Unfortunately, they’re usually far less effective than the pill because it requires strict adherence and most people aren’t that strict,” she explains. “That can have issues, especially as not everyone has the availability to make whatever choices they need to if they do find themselves pregnant and they don't want to be.”

This mass exodus from the contraceptive pill may also be a result of changing attitudes towards sex in general. It is no secret that Gen Z has been dubbed “the sexless generation”, so it makes sense that the contraceptive pill is no longer in such high demand. Many who bemoan the sexual malaise of our time argue that sexual liberation and the subsequent rise of ‘hookup culture’ has made sex worse for straight women. The irony is that the pill – one of the first pharmaceutical technologies designed primarily to serve the interests of desire – arguably may have thwarted the act that it aimed to liberalise.

This way of thinking can be a slippery slope to right-wing sexual conservatism, which inhibits access to safe contraception. But it’s worth considering that the migration towards natural methods may be symptomatic of a generation who are having less sex, inundated with technology, and longing to reconnect with their bodies. “It’s fine for women to have more questions about the pill,” Raphael surmises. “I think that women haven’t been educated about hormonal birth control and shaming them for that is not the answer. I think the answer is to educate them. I believe the body of evidence that says it is generally safe, but it’s okay to ask questions too.”