44. The history and psychology of hormonal birth control

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Speaker 1: Welcome back to the Psychology of Your Twenties, the podcast wherever you talk through some of the big life changes and transitions of our twenties and what they mean for our psychology. Hello everyone, welcome back to the podcast for a new episode, a new week, New listeners, old listeners. Great to have you here to discuss a really interesting topic today, one that has been on my mind for a while, and I thought it would be interesting just for my own personal knowledge, but for maybe anyone who's listening to do a little bit of a deep dive into this topic. And we have just one major question to answer today, one question I really want to get to the bottom of, and it's have does taking hormonal birth control in our twenties influence our psychological experience and wellbeing? And at the end of the day, is it worth it? Should we be given more information when we make that decision? And what do we need to know about the interactions between taking hormonal birth control and our general wellbeing and how we experience the world and our emotional reactions in our twenties. So a super interesting topic, super interesting to research. There's so many different thoughts and it was a bit of an effort to discern fact from fiction. I think anytime we talk about women's reproductive health, it gets a little bit messy. There's often a lot of subjective information that we have to overlook. So yeah, there'll be heaps of really nuanced discussions in this episode that I hope you enjoy. And thank you to my wonderful friends Make and also Make Yes two lovely mans for suggesting this topic or some version of it. I have really wanted to discuss this on the pod for some time, but like I said, it did require a little bit of research, and I think it might be slightly controversial in the eyes of some, so I really wanted to tread with some care but still do it justice. I think personally from the rhetoric I see online and even in my daily life, birth control can come with a lot of opinions attached to it, as do many topics related to female reproduction and female bodies. So implanting this episode, I really wanted to dispel some myths and discuss it from the perspective that we always take, which is a psychological one. So let's jump straight in and yeah, kind of get to the bottom. Really, I don't know, just have a nice discussion about what there is to consider when we start taking hormone or birth control, and I think we need to be honest. Most of us are having sex in our twenties, maybe casually or in a serious or committed relationship, but sex and intimacy do form a big element of most of our lives in our twenties. As we test relationships, we figure out what we want and quite frankly, just enjoy ourselves and have fun. But fun and exploration and pleasure aren't the only parts of sex. So as it's probably clear by now, in this episode, we're going to talk about birth control for people, mainly for people with a vagina, but if you are someone who identifies as male and who has sex with women or those with a vagina, this episode is still very much for you. It is a mutual responsibility both parties responsibility to be concerned with reproductive health and the possibility of not only pregnancy but also STDs when we are engaging in consensual sex. And the use of hormonal birth control for those who are having sex who are sexually active is obviously a big thing to be considered, but it should not be a simple consideration and I think too Often when women go to their doctors at sixteen, seventeen, eighteen, or whenever they become sexually active and ask about birth control or are asked about whether they've considered it by their doctor or what method they are on. The first thing that's often suggested is hormonal birth control, normally the pill and one that is issued in based it's easy, it's effective, it's cheap, and I think that's often all that we want, and we might not ask many further questions, especially since we accept what our doctors have to say, we trust them, and considering that the pill is so socially accepted and prevalent, we probably know someone who is already on it, especially if you're a young woman in their teens or early twenties. But part of the conversation that is normally not had in that kind of medical context is the physical and psychological, emotional, mental side effects that can last even beyond when you do seek alternative methods, when you change birth control or stop it all together. And that's what we're discussing today. How does the use of hormone or birth control in our twenties shape our psychological experiences and our well being? How does it impact our relationship to our bodies. I know this is said all the time, but like the natural cycle for a woman follows a lot of cycles in nature, is that something that's important to consider. Interrupting that cycle might remove how in touch we are with the natural cycle of our hormones and the natural cycle of the planets. I know it sounds a little bit wishy washy, but this was some of the stuff that came up when I was researching this and put all the cards on the table. I think it's really important to consider, so hopefully we learn something today. I definitely did, so stick around. So before we discuss the psychology of birth control, specifically birth control that uses hormones like progression and estrogen, mainly the daily pillars, kind of the focus of this episode, let's do a bit of a history lesson and explain how it is that hormonal birth control methods came to be and how they work. So before we had this simple and easy form of reproductive control, the daily pill modern forms of birth control like latex condoms and uds, and of course birth control pills, they're all still relatively new in the context of general overall human history, but there were things that came before it, and records from ancient Greece and Egypt show that. I think control over reproduction has been a concern for, you know, pretty much as long as humans have been reproducing. Being able to have control over women's bodies, either for women or I guess for women, or by others that are invested in women's reproductive health has been something that's been on everyone's minds for a while, and it is actually a big part of history. I think we often tend to think that only in the last one hundred years have methods become available for women to have control over when they want to have children if they want to fall pregnant. But early birth control methods from around the world have been around for some time, and I had a little look into what some of these included because I thought it would be really interesting. But of course we had condoms. Often they were made from animal bladders or linen, or silk or plants. I don't know if that sounds particularly pleasant, but yeah, I guess they had to do what they had to do. Another really interesting one spermicides. So spermicides essentially stopped the sperm from reaching an egg by killing the sperm or by making it unable to swim. And there were these really interesting kind of archaeological studies and historical studies that found that some ancient cultures used to make spermicides out of vacacia and honey and rock salt and sometimes even like animal faces, and yeah, also doesn't sound particularly pleasant. Some of the other ones that were really interesting were sponges, like made of moss or bamboo these and they would often be soaked in oil or vinegar or lemon juice like substances that were believed to slow down or weakened sperm, and there were even early kind of suggestions of their being oral contraceptives often used by nobility, including Queen Ann. So she used to take lead yep and other toxic metals mixed within like pomegranate seeds and papaya and silopium and blue cohercion and things like that, and would consume them on a daily or before she was like having sex, to prevent herself from falling pregnant. So these don't sound like particularly fun methods of birth control, and not only were they not very effective, they could often be very dangerous, and sometimes it was the choice of men, whether they were used so cheap, easy accessible birth control that is within the women's control, such as the oral contraceptive, has obviously now been championed as a massive step forward for women's rights, big move from stuffing sponges in lemon juice up there. Not to be crude, but that kind of makes sense. Oral contraceptive has really changed the kind of landscape around reproductive health. It's now the personal, consistent choice of women over whether they want to have children or for pregnant, and allows them to kind of control the size of their families. I think we hear all these stories about people having ten fifteen children before hormonal birth control was invented, and that sounds also pretty unpleasant. And I think before the creation of the daily pill, women and people with a vagina were often kind of subject to the whims of their uterus and their cycles and didn't really have the same level of control over their reproductive systems. It also has to be said that it's a woman's choice often whether she consumes the pill, and it's completely within her control when she takes it if she wants to take it in most cases, and that is something that has only come up recently. Before it was kind of the men's decision whether they wanted to control the size of their families or prevent someone from falling pregnant. Hormonal birth control, particularly the daily pill, It was pioneered by four people in particular, and although they have contributed greatly to reproductive rights for women, their personal beliefs and values don't really paint them as kind of the feminist icons people serving heroes that the history books often call them. There are some details that are definitely overlooked that kind of murky the waters a little bit. So Firstly, there was this activist and sex educator. Her name was Margaret Sanger, and she is often called the founder or creator of modern day birth control. If you look up who was the creator of the pill, her name will probably often come up, and it will say something around the fact that she was this huge advocate, she was this feminist, she was pro sex. That all sounds really lovely, right, it sounds like something we really get behind. But what is not often known is that is kind of the way that she was able to catalyze or activate science to pursue this new technology, and that was by appealing to the eugenics movement to advocate for birth control. Yes, eugenics. For those of you who don't know what eugenics is, I'm sure you've seen it in the history books in one form or another. It is the study of how to kind of arrange reproduction within a human population to increase the incurrence of heritable characteristics that we see as desirable. Okay, So if that sounds off and a little bit gross, you would be right. Other supporters of the eugenics movement include Hitler, for example, in his extermination of Jewish people and other populations. This can kind of be credited with thoughts and ideas that he gathered from the eugenic movement, and the idea that we want to be able to arrange the human population to be desirable. Some white surprise. Hermiscy groups also still a big proponents of eugenics, So it doesn't sound like a particularly kind and moral group to be a part of. But it also does make sense that the people who would want to eliminate undesirable characteristics and genes would be the first ones in support of a form of medicine that allows them to control in some ways and who cannot have children, So that was kind of the group that Margaret was appealing to there is the jury is still out over whether she just saw it as a means to an end and just wanted funding to pursue this new technology and she thought it would really put the power back in the hands of women. But that's kind of still up for debate. And I think it's a very dark history when we think about how common hormonal birth control and the daily pill is now and how kind of unconsciously a lot of women tend to take it without really knowing the origin stories of this birth control method. But there are other pioneers of kind of modern day hormone or birth control, and these include the biologist and scientist Gregory Pinkers. This suffragist and she was also a millionaire, Katherine mccomrick. She was an heiress and is kind of credited with giving a lot of the financial backing to some of the first early clinical trials. And then we have a Catholic physician and a gynecologist also a scientist whose name was John Rock and he helped conduct the first clinical trials. So the research was kind of getting underway in the forties as scientists realize that by increasing the rates of certain hormones in primates but also in humans, they could prevent ovulation and they could prevent people from falling pregnant. But in nineteen fifty four, these two doctors, Pincers and Rock, with the backing of our friend Catherine and the racist Margaret, began their first trials in Massachusetts, and they were pretty small. It was only on about fifty women. And like I said, they had realized a little bit earlier that if we increase the rates of estrogen and progresterone in our bodies, the two main hormones that work on our reproductive system and within our bodies, the following effects that it would have on our internal systems and the reaction would help prevent pregnancy. So this is how the pill works. When we artificially increase the rates of estrogen and progresterone, these hormones suppress the release of a follicle stimulating hormone and the lutinizing hormone from the petuity ground in the female body. So basically, these two hormones trigger the release of estrogen from the ovaries, which in turn stimulates the release of a mature egg, which is how we fall pregnant. But if these two hormones, So the follicle stimulating and the lutinizing hormone are suppressed, the chances of ovulation and therefore fertilization by a male sperm cell are significantly reduced. Basically, it interrupts our body signals within our normal cycle and tells the body that you know, no, we can't get pregnant. We shouldn't release these two main hormones because we already have enough of this other hormone in the body. Our body is doing fine, we'll be able to fall pregnant normally. So it basically blocks our body from responding to natural cues to release an egg, meaning that no egg is released and therefore you can't get pregnant. So Progression only birth control pills. They do something a little bit different. If it's just progressterone, They kind of make it difficult for sperm to reach the egg in the event that ovulation occurs, but it has less of a direct effect on that follicle stimulating and lutinizing hormones, so it doesn't stop ovulation. It just prevents kinds of the sperm from getting in. So these two doctors, Rock and pinkis used an oral contraceptive pill much like the ones we have today, containing synthetic progressterone that they got supplied by a pharmaceutical company and they administered it to fifty women under what they called a fertility study because at the time, in the nineteen fifties, so not even a hundred years ago, not even one hundred years ago, contraception was illegal in much of the United States, including in Massachusetts, so they kind of had to conduct this study on the guise of actually trying to help women fall pregnant rather than giving women the power to not do so. So this pill was taken by women for twenty one days, followed by a seven day break, and they concluded that no ovulation occurred in any of the women during drug administration, basically meaning that when these women were taking this artificial steroid, they could not fall pregnant. So one of the scientists they wrote a scientific research paper and explained how this drug succeeded in inhibiting ovulation, but skepticism kind of remained in authorities at the time. There was, I guess a lot of rhetoric around whether women should be able to control whether they wanted to give birth, especially considering that the World War Two had occurred only ten years before, and there was a big push to increase population size and to have more children. So the introduction of something that would allow women to control whether or whether they didn't want to have children kind of stood in the way of that goal of increasing the size of the population of the US, But they pushed ahead, and in order to provide kind of further evidence that this daily pill was effective, they moved their studies to Puerto Rico to conduct a larger clinical trial. Now, there is a lot of ethical discussions around ducting medical trials in communities that might maybe less developed or have lower incomes them say, more developed countries like the US, So it's believed that the reason they took their study here was because a it was cheaper to get participants. In some cases, they didn't even need to they only needed to pay them a small amount, and there would be less kind of ethical and moral questions and questions from the government regarding their intent. Basically, they could do things that were a little bit more dangerous knowing that no one would really care other than the communities, and their voices weren't loud enough to be heard on an international scale. Luckily enough, the pill was reported successful to be successful. But and this is a really crucial point for our later discussions, there were so many side effects for legal consideration and for medical consideration that the medical director of the clinical trials actually said that the should not be considered that the hormonal birth, that hormonal birth control of the pill posed too many side effects and dangers for it to become more popular and prevalent. Instead, they forged ahead, and after kind of conducting further clinical trials and lowering the dosage of estrogen and progresstone, the female controlled contraceptive method now known as the pill became a rapid nationwide use for protection against pregnancy, and nowadays and we know it is prescribed in its millions to people all over the world every year and is one of the most popular birth control methods for many of the reasons we've already stated. It is cheap, it is effective, it is within the women's control. But it's also important to remember those initial side effects that were brought up in those early clinical start in those early clinical trials that initially caused people to be quite wary of the use of synthetic to control our natural cycles. And this is kind of what I want I'm keen to discuss for the rest of this episode, firstly diving into some of the physical side effects, and then of course moving on to the psychological impacts of regularly taking synthetic hormones and what that does for our mental well being and the natural processes and cycles of our bodies. Okay, I'm going to make a bit of a disclaimer, and I'm gonna make it early before we start talking about some of the side effects and impacts and influences that come with hormonal birth control, particularly the pill. Personally, I am not the biggest fan of this method of reproductive health or reproductive control. From my experience, I have found that the side effects greatly outweigh the benefits, and in some cases, some of the more serious side effects that are more common than you would probably think, aren't always discussed in a medical environment or in a medical context when you might be first being prescribed the pill, often at an early age. But I also know it's a personal choice and there are a number of amazing reasons for being on birth control, and family planning is just kind of one of them. So I think there is a misconception that people who take the pill take it for one reason there's actually active they want to not fall pregnant. But it's really an amazing kind of technology and an amazing medicine for controlling things like endometritis, for controlling acne, and regulating heavy or irregular periods that can cause things like anemia and iron deficiency. And there's also been some interesting studies that have shown that it can reduce the risk of uterine cancer and some other forms of preventable cancers that often are more prevalent in women. So birth control is not the only kind of function only planning is not the only function. It can have a lot of other impacts on our physical health and our wellbeing that often not discussed as much. And these are all some of the really amazing benefits of using synthetic hormones, not just for birth control, but for other elements of physical health and wellbeing. And it might be something that you would consider if you have endometritis or at a regular period. It's a great way to kind of take control over your health, not just in terms of deciding when you want to have a family, but thinking about your health in a more holistic way. Though we kind of typically present hormonal contraceptives as a really great success for women, which they are. Sometimes we do tend to overlook some of the serious side effects that have been reported in mainstream scientific literature, and I've often found that when you are initially being prescribed to the pill, and this is obviously anecdotal, they're not always brought up, either through negligence or just because they're not seen as important. And women who do regularly ingest hormonal birth control methods will find that they usually have a few side effects. Most of the time they're common and they're manageable, but they can be more serious. And I'm sure we've all had friends who have told us stories about terrible episodes of depression or weight gain or mood swings, even stories about people who've had strokes or heart attacks, because the interaction between because increasing kind of hormone levels, particularly through artificial methods, can really fuck with our bodies in some ways and interact with pre existing conditions in ways that can be quite dangerous. Some of the common kind of physical side effects that I think are pretty manageable can be things like nausea and headaches, acne, decreased libido, and weight gain, all of these I think are something that can be brought into the equation of costs and benefits or risks and benefits that we kind of all personally have to do when we are considering birth control and family planning. Is weight gain, is a decreased libido, is acne something that is worth it for you, and that's a completely personal choice. But there can be some more serious side effects that we don't discuss as much, and although they're not as common for those who do experience them, it can be pretty dangerous things like blood clots, having heart attacks, high blood pressure, a stroke. There are even some cancers that there have been indications that increasing the synthetic level of hormones such as estrogen and progress drawine in your body can contribute to, such as liver cancer. But these are all more likely to be the case with underlying conditions such as a predisposition or a family history of particular cancers and blood conditions like light and factor five, which aren't often tested for when we are prescribed birth control, which was the case for myself. So if you do have a predisposition to perhaps experiencing some of the more serious side effects, it's really important that is known, and that is part of the equation before you make the decision to take oral contraceptives or to take the pill. And often it's not something that is factored in and it's not something that your doctor alerts you to when you're first being prescribed this medication. So if you are on hormonal birth control at the moment or considering it, it would really suggest that you get your doctor to run a blood test, make sure that you don't have any underlying conditions that might increase your likelihood of experiencing some of those more serious side effects light blood clots and light stroke, and also considering what dosage you're on. The more estrogen and progressed roone that is in the pill, it will increase the effectiveness, but it's more likely that you will have some of those side effects that we've talked about. But this is a psychology podcast, so let's cover some of the psychological side effects of long term and even short term birth control use. That's the question we really wanted to answer today. Birth control and hormonal birth control is so common, particularly amongst women in their twenties, but what does that mean for how they experience their twenties and what does it mean for their psychological outlook, their choices, their behaviors, and their emotional well being. So I think the long term impact of the oral contraceptive and birth control methods on human psychology has been vastly under researched in the past and even in the current day, and has really only recently become a focus for mainstream scholars. Particularly, I think for minority populations, they've often not been included in this research, as is often the case, and in general, I think it is a pretty common understanding that health issues related to women receive less funding, receive less research interest, and that can have a really big long term impact on how things like hormonal birth control are treated and the availability of these medications. So, hormonal contraceptive uses, in contrast with non users, have been found to have higher rates of things like depression and anxiety, fatigue, sexual disturbances, compulsion, and anger, all of which kind of create our outlook on life. It makes sense you're putting something artificial into your body, and it does have incredible benefits. That allows you to have control over your body, over when you want to fall pregnant. It allows for you to have control over some of those other conditions we talked about, like and geometritis or eye and deficiency, But there are some other important studies that show the depths of the psychological impact are often not well known and not shared as frequently in a medical context as they probably should be. So in September twenty sixteen, this Psychiatry journal published a really interesting kind of ground bakering Danish study that found a correlation between the use of hormonal birth control and being diagnosed with clinical depression. So this study attract hormonal birth control use and the prescription of antidepressants over six years for over a million women, so this was not a small clinical study like some of those studies that initially led to the creation of the pill that was over a million women, and they found the women who were on hormonal birth control such as the pill, were significantly more likely to be prescribed antidepressants compared to those who weren't taking or weren't using synthetic hormonal forms of birth control. And it found a particularly strong correlation between teenage birth control users and depression. So there was an eighty percent increase risk for teens taking birth control and their likelihood of starting antidepressants after going on the pill, and this is a really troubling statistic, especially because the pill is often prescribed when we are quite young, when we become sexually active, or sometimes to treat acne or severe menstrual symptoms, and just as a general preventative measure. That's something to be considered. Depression is obviously a pretty serious mental condition, and it's interesting that taking this pill is, or taking some form of hormonal birth control, is increasing your likelihood of suffering through what can be and what is often a really traumatic and difficult mental health problem. I think the other thing that was often brought up and there are kind of four other links that I wanted to make with psychology and taking hormonal birth control, and those are things like uncontrollable mood swings. We've talked about, depression, changes in sleeping patterns, loss of libido, and your sexual preferences and your sexual choices, all of which will have a pretty deep and profound impact on how you experience your twenties, how you go about living your daily life, your relationships with your partners, with your friends, with your family, and just with your general overall experiences. So of all of the side effects of hormonal birth control, mood swings are often the most common, so it's pretty common to feel irritable or short tempered, particularly around when your period might take place, and hormonal birth control makes those mood swings much worse to the point of, I don't know, crying for no reason, feeling a lot of guilt, feeling bad about your self, having low self esteem, and just a general kind of sadness about the way that you're living your life. So up to ten percent of women aren't actually able to tolerate synthetic progressterone as an ingredient in birth control because of this impact, because they do have uncontrollable mood swings that make it difficult to kind of function in their daily life and decrease their well being to the point that taking this easy form of birth control just isn't worth it for them anymore. Like I said, this is a personal choice, and that's only the case with ten percent of women. Most women might not have this reaction. They might find that their side effects or some of the impacts are super minor, and the benefits of being able to control when they're fall pregnant, of being able to control their likelihood of having a child or family planning. That is an amazing benefit, and it's a really empowering benefit, and it's worth it for them. I want to talk about depression a little bit more because that is perhaps one of the most serious side effects and one of the most common as well. In the days before your mentoral cycle begins or before your period, it's pretty natural to have an emotional shift that's going to cause you to feel less confident about yourself, maybe emotionally sensitive, a bit moody. But when these symptoms change from uncomfortable feelings to depressive symptoms such as an inability to get out of bed, feeling really unhappy about your life, significant appetite changes, significant changes to your motivation, significant changes to your capacity or your ability to reach out to family and friends and ask for support, that's probably a time and an indicator that you need to be concerned your overall functioning is not where it should be. Your twenties are meant to be a time of experiencing things and being happy with your self and exploring things and trying new things out and getting out there and making friends and being social before you have some of those responsibilities that come along with later life. But research measuring the clinical impact of oral conscienceptives. Like I said, it found that women taking the pill are more likely to suffer from depression than non pill users, and women using birth control with particularly large amounts of estrogen had more instances of depression than those who are on a lower dosage. So perhaps that's something that needs to be questioned. Is it worth prescribing women birth control pills and the pill that have large amounts of this synthetic hormone that we can really increase their risk of pretty serious side effects. Studies have also shown that women with a history of depressive symptoms it can be made worse when they're on birth control. So I think if you have a history of depression, feel a significant change in your emotions leading up to your period, to the point of severe impacts on your functioning, maybe even thoughts of self harm, really low confidence, it's important to speak to your doctor about alternative birth control methods. The pill is really easy, like I said, it's often prescribed early and really frequently. But when we come to think about these psychological impacts that will bleed on to the rest of your life, perhaps it is important to consider non hormonal birth control methods or those that aren't as reliant on estrogen to kind of control your cycle. There are some other things that are really important to consider that linked to our psychology in our twenties, and that's changes in sleeping patterns and a loss of lobido. So it's really normal to have an off day here and there where you feel like you just want to sleep in you can't get to sleep. Maybe you're experiencing insomnia. But if you feel like this every day, it could be that your birth control is affecting or sleeping patterns. Often it's birth control that contains progresterone that can lead you to experiencing either extreme insomnia or extreme fatigue. And one of the other symptoms that I think is talked about a lot, but it's important to be considered in a more nuanced lie is a loss of libido. Let's be honest, most of us go on hormonal birth control because we want to have sex and we want to enjoy the sex that we're having. Maybe you first considered it when you had your first long term partner, or you're becoming sexually active with someone who could make you feel pregnant, and I guess if that's the reason why you go on hormonal birth control, you probably want to be able to have sex after you're on it, But birth control has been found to kind of reduce sexual desire in women. So most combined birth control pills, which are the most common, they contain estrogen and progresterone, which we have talked about, and these hormones tinker with the way your body works. Many of these combined pills actually lower your testosterone levels relative to your estrogen levels, and testosterone is the hormone that makes you want to have sex. We generally think of it as a male hormone, but women also have it, just not as much, and it's really important for controlling sexual desire and controlling kind of energy levels, levels of kind of passion and emotion. But if the pill kind of interrupts the kind of production of testosterone which ignites sexual desire, you might see might start to see that you do have lower levels of sexual desire. That can have an impact on your relationship. Obviously, choosing to have sex and when you want to have sex is completely up to you and should always be consensual, but in committed relationships, sex is often a really important element of the relationship and it's part of the discussions that we have to have with our partner. So seeing a dramatic change in the amount that might want to be sexually active with your partner or be intimate with them can really impact the state of your relationship and can lead to perhaps some difficult discussions women who use birth control, particularly hormonal birth control. I would like to say things like condoms obviously are external, they don't really impact on the internal functioning of our body. Same with the copper IUD, which isn't hormonally based. But hormonal birth control methods have been linked to, like I said, reduced sexual functioning, but also a high interest in short term sexual relationships compared to naturally kind of cycling counterparts. And some evidence even suggests that birth control might even alter your mate choice and may negatively affect sexual satisfaction in women who are choosing to have sex with men, and that has really important impacts on who you choose to date, the kind of sex you choose to have. And I don't think it's perhaps a negative thing, but it's just something to be considered and also really interesting when we think that we think about the relationship between increasing the level of these hormones in our body and who we choose as a mate, or who we choose as a partner, or who we choose to have sex with. Yeah, something to be considered. I don't think that's necessarily a negative thing, but it's just a really interesting finding and I think kind of highlights that deeper interaction I'm trying to paint a picture of, which is that taking the pillars not a passive decision. It does actually have huge, huge impacts on how we go about our lives in our twenties, and whenever you're taking hormonal birth control, the choices we choose to make our outlook, our mental well being. I would like to say, just because there have been links between hormonal birth control and mental health issues and other psychological side effects, that doesn't mean that birth control will have the same impact on everyone using it. I think these can be particular cases and often making the decision to lower your dose or to perhaps try a different method, like I said, non hormonal birth control methods like natural family planning or the copper IUD or condoms, that just might be a personal and conscious choice that you have to make. If that equation and if that kind of calculation of the cost versus the benefits of hormonal birth control. Maybe is leaning more towards the cost and more towards the risks. Thank you for tuning into this episode. This was a really interesting discussion for me, and hopefully it has been nuanced and I've been able to kind of represent all perspectives. But I think at the end of the day, the conclusion that I kind of made when I was researching this and then I was discussing this, is that hormonal birth control, although it might be common and prevalent, is not always the simplest and easiest way of kind of controlling our reproductive system. And it's not the simplest, easiest way of birth control. There are heaps of considerations that we need to account for, especially around our psychological wellbeing and the interactions that increasing the level of hormones like progressed tone and estrogen has on our mental wellbeing and our emotional wellbeing, how we process emotions, how we see the world, even our experience of pretty intense and severe and significant mental health conditions like depression. So if this has been something that's been on your mind, I would really advocate for you going to your doctor to discuss it with them and doing your research, having the facts and keeping kind of a logo of what the impact has been on you and why you think it might be important for you to perhaps consider an alternative method, or maybe your birth control is going fine, and you know what, congratulations, that is amazing. You should be able to be empowered and I'll be able to make the decision over when you want to fall pregnant, if you want to fall pregnant, if you want to start a family, when you want to start a family. And I think that is just one of the amazing benefits of this technology that, like I said, has only really become available in the last sixty years, and it really has changed the landscape for women's rights and the rights of those with a vagina around how they want to use their bodies and how they want their bodies to be treated. So, yeah, a really really interesting historically based topic on the podcast this week. I really hope you enjoyed it. There will be some resources in the description of this episode if you want to do some further research and have a look at some of the sort that I looked at. I tried to get a nice balance so that there were different perspectives being represented, but yeah, really interesting, and thank you again for listening. If you feel called to do so, please feel free to leave a five star review on Spotify or Apple Podcasts or wherever you are listening to this episode right now and if you feel cool to do so. We do also have a new subscriber network, so you can subscribe on Spotify and receive access to bonus content like let's get friendly episodes and guest episodes. So I'm just kind of trialing it at the moment, but it has been really amazing seeing how many people have gotten behind it, and it really allows me to do some of that content that's a bit more casual and a bit more personal, but makes or make it available to people to listen to it if they are interested. So thank you again and hopefully I will see you back next week when we're going to be discussing the idea of soulmates and twin Flames.