Birth Control Pills Make Some Women Miserable. But Are They Stopping?

The woman in the video looks resolute, and a little sad, as she cuts up a pack of birth control pills. “These silly little pills have literally ruined me as a person,” reads the caption. The clip, which is on TikTok, has 1.1 million likes. It’s one of thousands that have proliferated on social media in recent years with virtually the same message: The pill causes terrible, sometimes irreversible side effects, and women should free themselves from it.

Anecdotal reports from news outlets have suggested that women are quitting the pill in large numbers because of this type of online post. “We’ve known for a long time that people really rely on their social circles to help them with medical decision making as it relates to contraception,” said Dr. Deborah Bartz, an obstetrician-gynecologist at Brigham and Women’s Hospital. Against a backdrop of increasingly restrictive abortion access, the idea that women might be giving up a reliable form of contraception because of social media hype has concerned researchers and doctors.

But, according to initial data, prescriptions for the birth control pill are not actually declining at all. An analysis by Trilliant Health, an analytics firm that provides health care companies with industry insights, found that usage has been steadily trending upward in the United States; 10 percent of women had prescriptions in 2023, up from 7.1 percent in 2018. The analysis looked at prescriptions for the pill that were written and picked up. Even among those aged 15 to 34, who would be most likely to see negative social media posts, Trilliant found prescriptions had increased.

The analysis was done at the request of The New York Times, and drew on Trilliant’s database of medical and pharmacy claims. It looked at a nationally representative sample of roughly 40 million women, aged 15 to 44, who used either Medicaid or commercial insurance. It doesn’t account for people who might get their birth control from telehealth providers that don’t take insurance, but that group most likely represents a small slice of the American population, said Sanjula Jain, chief research officer at Trilliant. Several of those telehealth companies also reported double-digit increases in birth control pill purchases in the past two years. The data also doesn’t include sales of the over-the-counter birth control pill, Opill, which has been available in stores in the U.S. since March.

Ten percent of women had prescriptions for the pill in 2023, up from 7.1 percent in 2018.

Source: Trilliant Health

The pill has a reputation as a reliable, if flawed, form of birth control. Its known side effects — including blood clots, weight gain, a loss of libido and mood disruptions — have in fact been the main reason that some women do eventually quit the pill, Dr. Bartz said. When patients raise those concerns with physicians, they are often dismissed, she added, which can erode people’s trust in their doctors, and in health care institutions.