After 7 Years I Went Back On Hormonal Contraception — & It Was Awful

As I sat perched at the edge of my bed, the tension that had been gripping the back of my head, neck and left shoulder felt like it was intensifying. Defeated at the thought of having to endure another month of persistent headaches, I reached for my back and ripped off the sticky patch that I was certain was the cause of my discomfort.

I had been using a contraceptive patch — which is similar to a square sticking plaster that works in the same way as the combined pill — for roughly 90 days. I had begun my fourth month with a new patch the day prior, before deciding to end the cycle prematurely. It was the first time in seven years that I’d used any form of hormonal contraception and it was quite literally a shock to my system. 

Hormonal contraceptives can contain both progestogen and oestrogen (combined pill, contraceptive patch and vaginal ring) or just progestogen (progestogen-only pill, IUS (hormonal coil), contraceptive implant, contraceptive injection). Progestogen prevents ovulation while oestrogen controls menstrual bleeding. 

I’ve joined a growing number of women who’ve chosen to forgo these hormones in favour of what’s known as natural family planning, fertility awareness or menstrual cycle tracking. The theory is that by monitoring your periods and ovulation dates you can learn when and when not to have sex in order to prevent pregnancy. If followed strictly, this method can be between 91% and 99% effective, but if not adhered to exactly, this figure drops to 76%.

According to recent data, use of natural contraceptive methods increased from 0.4% in 2018 to 2.5% in 2023. During this period, fewer women opted for hormonal methods of contraception which fell from 19% to 11%.

Medical practitioners haven’t identified the cause of this change, but some have hypothesised that widespread use of fertility tracking apps, difficulty accessing sexual health services during the COVID-19 pandemic and long waits for GPs and sexual health clinics could all be causes.

I opted for a contraceptive patch at the end of 2024 because I’d used it for years in my 20s, and although I’d experienced some side effects — nausea and sore breasts come to mind — they were fairly mild and manageable. But the second go-round, now in my 30s, was different. Along with the previously mentioned side effects, I’d often find that I was so fatigued I could barely sit up straight, my mood swings were uncontrollable and for the first few weeks I felt like I was battling full blown depression.

Hormonal contraceptives have acquired an increasingly questionable reputation over the last decade or so, with studies finding that women are fearful of hormones, worried about concerning side effects or generally dissatisfied with the options that are available. Even with this in mind, I was reluctant to point the finger at my patch straight away. Instead, I paid attention to how I felt when I was wearing a patch versus when I wasn’t. In order for it to fulfil its 99% efficacy claims, you need to wear the patch for seven consecutive days, change to a new patch on the eighth day, repeat this for three weeks and then have a patch-free seven days. 

Was it a reverse placebo effect that had me feeling more settled, both physically and emotionally, during my off week, or was I genuinely experiencing fewer side effects? While I’m confident it’s the latter, Dr Frances Yarlett, Medical Director at The Lowdown and co-author of Contraception: Your essential guide to separating the myths from the medicine, warns against placing blame on contraceptives when there could be other factors at play.

“There are certainly some women who will start a form of hormonal contraceptive and notice that their mood has changed almost overnight, or that their sex drive is gone,” she says. “But mood and sex drive are so complex, and there’s so many other factors that you have to tease apart. For example, what's happening in your life that could be affecting you? Is there something really stressful going on? This is especially true for women who have been on hormonal contraceptives for years and then suddenly say, ‘My mood has dipped, it must be my pill’. That, for me, means it’s probably not your pill, it's probably life, because you've been stable on [the pill] for a long time.” 

Hormonal contraceptives have been linked to a myriad of unpleasant side effects, including migraines, dizziness, acne, and unpredictable bleeding, but according to the NHS there is ‘not enough evidence to show if these side effects are caused by hormonal contraception’. Some of the most serious risks associated with hormonal contraceptives are blood clots and breast cancer. 

Scepticism towards hormonal contraception is certainly on the rise, stoked by social media users sharing not only their horror stories, but in some instances blatant misinformation. It’s a phenomenon that Yarlett has coined ‘hormonaphobia’. “There's a lot of it at the moment, and I understand why. Hormonal contraceptives do have side effects, and we shouldn't pretend that they don't. But for most women who are really struggling with the side effects, I find that they've just not found the right one for them yet, and they've not had the expertise to guide them into finding the best method for them,” she says. 

Sapphire Coggins, also known as The Sexual Health Nurse, urges women struggling with contraceptive side effects to seek advice from a healthcare professional in the first instance. 

She explains: “Sometimes it can take between three to six months for contraception to settle down within the body, or it can take up to six months with things like the hormonal coil.

“If you’re taking the pill, for example, your healthcare provider can [adjust] the oestrogen or progestogen components by choosing an alternative pill. They will think about what side effects you are experiencing, and what they can titrate [meaning limit potential side effects by assessing how your body will react]. Can they decrease the oestrogen? Can they decrease the progestogen? With contraception, it can be a little bit of trial and error unfortunately.”

Trial and error requires time, patience and a desire to find the right contraception which I frankly ran out of years ago. Having tried the patch, the pill, the implant, the copper coil and the injection over the course of more than a decade, I’m simply fed up (admittedly with a little ‘hormonaphobia’ sprinkled in) so I’ll be sticking to the natural method for the foreseeable. 

If you’re considering doing the same, know that it’s a decision not to be taken lightly. Without progestogen and oestrogen acting as internal barriers to conception, the risk of having an unplanned pregnancy increases. Therefore it’s unsurprising that a rising number of women have sought abortions while using the natural method. “If [fertility awareness] is not done well, it fails,” says Fertility Awareness Practitioner, Sarah Panzetta. “But the idea that it's inherently bad is wrong.

“I think that big tech has got something to answer for in terms of, a period tracker is not a form of contraception. It will give you all of these very slick and confident messages saying ‘you're ovulating today’, and it's based on nothing but whatever cycle day you're on. That's not good enough as contraception. Women will get the idea that they only need to use condoms for three or four days a month when it’s actually a minimum of 11 days per cycle, and that's without your period. It's a big chunk of time.” 

The thought of mastering app-free fertility awareness may seem daunting, but Panzetta wants to reassure women that it doesn’t have to be. “There's this myth that you have to be a perfectly organised human being to use this method. No you don't. You just need to take your waking temperature most days, know what to do with the data, and have a supportive partner who’s prepared to use condoms [when needed].”

Panzetta finds that most women come to her after having exhausted the hormonal contraception options that are available. “The biggest one is they’re fed up of the pill. So a lot of them have done their time on the pill and they've been doing a whole host of different [hormonal] methods.” 

While there are a variety of contraceptive methods available to women, birth control for men remains limited to condoms or sterilisation, despite clinical trials for hormonal male contraceptives dating back to the 70s. In the 50 years since, multiple male contraceptive pills and injections have been developed, yet none have been approved for use. Ironically, unpleasant side effects like acne, mood swings and weight gain — the same things women deal with daily — are cited as one of the key reasons that male contraceptives are repeatedly written off. Even non-hormonal contraceptive options for men have been shelved, and additional barriers like a lack of funding along with men’s feelings of emasculation continue to blight progress.

It’s clear that women will continue to bear the majority of the contraception burden for many years to come. And though current research shows that our reliance on hormonal contraceptives has waned, this doesn’t guarantee that the trend will continue gathering momentum. Settling on your chosen method doesn’t require you to consider societal attitudes, outside influences or whatever is popular on social media. It requires you to figure out what works best for you and your body, which is something only you can decide. And something I’ve hopefully found, too.