Love Lost: My Brain on Birth Control
By Jess Pittendreigh
LIFESTYLE
Edited by Cece Wilson
5/19/20265 min read
©Cleveland Clinic
When I went on the contraceptive pill at 15, I hardly knew what I was taking. I was warned about potential side-effects like ‘mood swings’, weight gain, and persistent migraines that could indicate spiked blood pressure or clots. In extreme cases, such side effects could lead to serious conditions such as heart attacks, liver issues, or strokes. All would be induced by the medication that, at 15 years old, I had no idea was changing my body. More than that — changing who I was entirely.
I stayed on the pill until I was 21, when at a prescription review my doctor casually mentioned that taking it long term had increased my risk of breast cancer. That, the advice to check regularly for new lumps or bumps, and to avoid worrying as “the risk was low”, was all I received. I left the appointment feeling like my world had shifted, and began to research more into other potential side effects. Rapid weight fluctuations, hair loss, chronic fatigue, depression. All side effects of the pill, and all had affected me — after I’d started taking it.
What began as a default fix for irregular periods later became contraception, but the narrative never quite caught up. I was routinely asked if I was “on the pill”, as though that alone settled the question of protection. The assumption was subtle, but persistent — the responsibility was mine to carry, mine to manage, and ultimately, mine to endure.
Following conversations with other friends who had taken the pill, I decided to seriously look into coming off it. It was a difficult decision, faced with the prospect of enduring side effects like appetite change, acne, mood swings — to name a few. When I turned to my doctor for clarity, I was met with vague guidance to “do what felt right”. The standard cautions followed — mood swings, cramping, the usual list recited almost by rote. I left not reassured, but quietly frustrated, as though I’d been handed a decision without being given the tools to truly make it. Over time, I became more aware of how casually the impact of the pill was dismissed. This tiny, three-centimetre tablet — something I had taken daily for years — had the power to shape everything. Yet, these effects were framed as minor inconveniences — discomforts to be expected. It was hard not to feel that my experience had been reduced to a footnote. The choice began to feel like a no-win situation: stay on it and accept the discomfort, or come off it and face the unknown. Either way, there was a sense that change was inevitable. In the end, I chose to go off. Not out of certainty, but curiosity — wanting, for the first time ever, to understand what my body felt like without it.
As someone already prone to anxiety, dipping into online conversations only made things worse. What little I found was often alarmist, and I quickly fell into a cycle of monitoring everything with an almost clinical obsession. Each new story fed the unease. It wasn’t until a quiet moment scanning women's health that I came across a book that would change everything: Your Brain on Birth Control by Dr. Sarah E. Hill.
From the first few pages, it was clear Hill’s approach was thoughtful, grounded, and deeply informed, by both research and lived experience. The book is eye-opening without being overwhelming — accessible without losing its depth. For anyone considering birth control, coming off it, or simply curious, I cannot recommend the book enough. The reading was easy, at times funny, and always a comfort. Not every page mirrored my own experience, but that wasn’t what mattered. Scattered throughout were moments of sharp recognition — feelings and patterns that I’d never quite been able to name before. By the end, it was clear: the pill gives you hormones. And hormones shape who you are.
The thing that struck me most came on page 135. To quote Hill directly:
“Oxytocin causes the reward centers of the brain including the nucleus accumbens, which is the big cheese of the brain’s reward pathway — to get activated in response to their partner.
Unless you’re on the pill.
When pill-taking women are given a dose of intranasal oxytocin, they don’t see their partners any differently from the way they do in the absence of oxytocin. Pill-taking women also don’t experience increased activity in the reward centers of their brain when looking at pictures of their partners. Instead, when pill-taking women view photographs of their partners, they may as well be looking at the face of a stranger.”
They may as well be looking at the face of a stranger.
At 16, I fell for someone who left me smaller than I’d been before. It changed me entirely. I didn’t just become cautious; I became distant. Love, or whatever version of it I knew, was muted. I felt want like I was struck by it. I’d tether it to writing, run from it, dream about it. But there was always a gap: an invisible buffer between me and anything that felt like a real connection. Coupled with bad experiences, social media, and insecurity, I figured the reason lay somewhere in that midst.
Reading Dr. Hill’s book made me realise that this was never the case.
Research suggests that the pill can blunt oxytocin, the hormone responsible for bonding and alighting the brain's reward response. The pill’s synthetic hormones can disrupt both the HPA axis, which governs stress, and the HPG axis, which regulates reproductive hormones. During an interview with Dr. Anna Cabeca, Dr. Hill emphasised that “cortisol is part of how our body is embedding those meaningful events into our memories, and make us feel good” (15:31). As Cabeca continues “the phenomenon could potentially stem from how birth control affects the HPA axis, which is crucial in transforming emotionally charged experiences into long-lasting memories”.
Simply put, cortisol is how your body responds to something meaningful — good or bad. Interfere with that system, and you don’t just change mood, you change how meaning is processed. Connection, experiences, even emotional intensity can feel dulled. It stops that person feeling like your person.
Of course, it’s never that simple. The pill doesn’t erase bad partners, or fix difficult experiences. But understanding it’s effects reframed something I’d carried for years: the feeling that I was missing something everyone else seemed to have. Never feeling closer after intimacy, never falling victim to rose coloured glasses. No matter what, there was an insurmountable gouge between me and my romantic partners that I didn’t know how to cross. After a while, I became too afraid to even try.
That’s what we don’t talk about, and what we absolutely should.
Reading Hill’s book, it’s clear that the pill isn’t just ‘bad’— nor should it be abandoned. It gives women agency, and in many ways has positive impacts. Less interest in sex promotes motivation in work. Acne can be managed, painful cycles aided, and the uncertainty of not knowing where your body will be becomes regulated. But its effects span far wider than just managing cycles. It shapes self-perception, connection, experience — it shapes us.
And we deserve to understand that before we’re told to “do what feels right”. You can’t freely choose something you don’t fully understand: I write this in the hope it pushes someone to question the small things they’ve been taught to dismiss. With a deep gratitude to Dr. Sarah E. Hill — her work not only informed this piece, but helped me make sense of my own story.
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