So you’ve come off your contraception, now what?

As studies show that more women are turning their backs on long-acting forms of contraception, Olivia Petter examines the complications this can create with new sexual partners

A 2023 survey found that 77 per cent of women experienced side effects from their contraception, including headaches, depression and lowered mood and sex drive (Shutterstock/KaryB)

In today’s increasingly fraught dating game, there’s no shortage of unpopular players. On one side of the field, you’ll find an array of f*** boys, soft boys, and other emotionally unavailable types. On the other, you’ll stumble upon a catfish, a ghost and maybe, if you’re lucky, a raging narcissist. Among all these, though, is one character whose ubiquitous unpopularity seems to transcend all else. Introducing contraception: the single most-hated player of all.

Women’s attitudes towards it have noticeably changed over the last few years. Out of my single female friends, I can’t name one who’s currently on any form of contraception, hormonal or otherwise. It’s in stark contrast to five years ago when all of us were juggling various pills, coils and implants. We’re quietly rebelling against the previously accepted norm that we must, biologically and socially, play a nasty game of Russian roulette when it comes to our health.

Most of us have been at the sharp end of contraception gone wrong. If it isn’t an implant giving us rage blackouts, it’s a hormonal coil getting trapped in our small intestine. If it isn’t one pill bloating our bellies, it’s another one making us depressed. Copper coils that make us bleed incessantly for months; condoms getting trapped somewhere inside us: it’s a minefield. And a miserable one at that – almost a quarter of women who have taken hormonal contraception say it caused, or played a role in, the end of their relationship, according to one study carried out by Stowe Family Law from 2022.

“I came off the implant three years ago because it was making me depressed,” says Fran*, 31. “I didn’t know why I was alive; it was awful. I’m pretty sure it’s the reason why me and my boyfriend at the time broke up.”

And Fran is not alone in ditching medical contraception methods. Last year, a survey of 4,000 women conducted for the Channel 4 documentary Pill Revolution found that 77 per cent experienced side effects from their contraception, including headaches, depression and lowered mood and sex drive. One-third stopped taking it as a result. A recent report by the United Nations found that 63 per cent of partnered, reproductive-aged women worldwide use some form of contraception – implying that the other 37 per cent don’t. Meanwhile, apps that allow women to naturally track their cycles, signposting whether or not they’re ovulating, have surged in popularity. Natural Cycles, for example, which claims to be 98 per cent effective at preventing pregnancy with perfect use, currently has more than two million users worldwide and is regularly endorsed by influencers.

Anecdotes of nasty side effects aside, it remains unclear why more women are opting out, given that there are plenty of people for whom mainstream contraception methods work well, and that they’re the safest way to prevent pregnancy. “As healthcare providers, I don’t think we really understand well enough why so many women are stopping contraception,” says Dr Janet Barter, president of the Faculty of Sexual and Reproductive Healthcare. “People don’t listen to women well enough. We know loads of research has been done on contraception but very little has been conducted on its side effects and why women stop using it. So I think a lot of women out there are, for all sorts of reasons, taking risks with getting pregnant.”

We know loads of research has been done on contraception but very little has been conducted on its side effects and why women stop using it

Dr Janet Barter, President of the Faculty of Sexual and Reproductive Healthcare

Since coming off the implant, Fran has been reliant on tracking her cycle, condoms and the pull-out method. But this hasn’t always worked as well as she’d hoped. “Last year, I was sleeping with someone who just refused to wear a condom,” she says. “He said they’re uncomfortable and he can’t come while wearing one. So we agreed to try the pull-out method but occasionally, he ‘accidentally’ came inside me and just didn’t say anything. He knew I wasn’t on contraception. I just don’t think he cared.”

This recklessness seems to be a common experience, one that may feel hard to address, particularly in the early stages of a relationship. According to research conducted last year by Durex, two-thirds (62 per cent) of sexually active UK singletons don’t use or rarely use condoms. As for why – well, ask your single male friends. The Durex study revealed that one in five (20 per cent) of sexually active UK men claim their biggest barrier to condom usage is the perception that they reduce sensation. This is despite the fact that 2023 saw a 24 per cent increase in STI rates in England.

It’s a worrying trend; after all, even if you are on some form of contraception, condoms are still necessary to prevent you from catching STIs. But even that doesn’t seem to concern some people. Mo Carrier, founder of condom brand, MyBliss, was on the pill at university when she slept with someone who knew she was using contraception, and so insisted they didn’t need to use a condom. “I felt too embarrassed to push him on it,” she recalls. “A few weeks later I found out I had contracted chlamydia because of that. I think that kind of thing really is just another example of women being made to feel like they have to take full responsibility for contraception; the notion that it’s on women to protect themselves against STIs and pregnancy is so outdated and really needs to change.”

Unfortunately, these attitudes are shaped at an early age. For millennials such as myself and my friends, who weren’t given sex education beyond “This is a condom, use it so you don’t ruin your life”, we’re still battling these outmoded beliefs as adults.

Culturally, contraception has never been presented as a man’s responsibility (Shutterstock/Ground Picture)

“Historically, women and girls have been faced with far more serious ‘consequences’ of sex than boys and men – pregnancy, social stigma, shame. Little ‘consequence’ often then leads to cultural reluctance,” says Emily King, somatic sex and relationships therapist. “Many women and girls don’t even have basic knowledge of their bodies and the contraception options available to them, while men and boys have even less knowledge and awareness. However, if the burden of birth control remains a woman’s responsibility, then men will never have to learn about women’s bodies and basic health.”

Culturally, contraception has never been presented as a man’s responsibility. Have you ever seen a sex scene on screen where the application of a condom is anything more than a blink-and-you’ll-miss-it moment? How about a man initiating an actual conversation with a woman he’s about to have sex with about what contraception she’s on? No, me neither.

It reinforces attitudes that can result in women struggling to build and maintain trust with new and existing partners. “As a somatic sex therapist, I see the consequence of not sharing this responsibility in my female clients, who are becoming increasingly resentful of their male partners,” says King. All this isn’t just holding us back from a health and equality perspective, but from a pleasure one, too. “For sexuality to thrive in a relationship, responsibilities and duties must be divided equally, and this includes contraception,” she adds.

Aside from trust and STIs, the very real potential consequence of unprotected sex is, of course, babies. “There is a tendency to think an unplanned pregnancy will happen to someone else and not you,” says Dr Barter. “We don’t talk about abortions enough but we know that one in three women will have one. That’s not something many men seem to think about, which always surprises me.”

Although it shouldn’t take impregnating someone to make men stop passing the buck, perhaps it’s only if and when this reckless attitude fails that the penny truly drops. “I have a male friend who got a woman he’d slept with once pregnant, and the woman decided to keep the baby,” says Marta*, 32. “He barely knew her and, while he isn’t with her romantically now, he’s involved in that child’s life – but says he’ll never be so cavalier about contraception again.”

It’s in men’s interests to be just as invested in the contraception conversation as women are. As Dr Barter points out: “If a man gets somebody pregnant, he rightly has no say in whether she continues the pregnancy or not. But if she decides to continue, then he’s committed, at least financially.

“You’d think men would take that seriously, wouldn’t you?”

*name has been changed