Birth Control and Bad Sex

Responding to Mary Harrington's call for "Rewilding"

Did you know that if you’re on hormonal birth control you’re turning the friggin frogs gay!? I didn’t either until I read about this very real and important problem in Make Sex Wild Again by

Mary Harrington

. While there’s at least some truth to the claim, compounds from hormonal birth control do make it into the water supplies and there is evidence that environmental estrogens negatively affect aquatic life, there are many other sources of estrogen that cause environmental damage and which make their way into the environment. This study found that “Contrary to popular belief, birth control pills account for less than 1 percent of the estrogens found in the nation’s drinking water supplies”. Regardless, even if any ecological problems are mainly caused by birth control, it’s pretty clear that the health of the frogs is not Mary’s main concern.

Her argument that women should forgo birth control rests on a couple of key claims:

1. Women are having casual sex out of politeness, and the lack of ability to use pregnancy risk as an excuse (due to being on the pill) is an important reason why

2. Sex off of birth control is more sexy and fun because it’s more dangerous

3. Birth control prevents women from being in touch with their bodies and natural cycle and may cause depression, weight gain and other side effects

As a woman who’s been continuously using a hormonal IUD for a decade I really can’t comment on 2 or 3 but both sound plausible. I’ve heard from friends with kids that sex when you’re “trying” is super hot, but I’m not sure whether that would extend to sex off of birth control when you’re trying to avoid pregnancy. Mary says that “Studies have shown that women’s sexual libido peaks just before ovulation, a cycle that makes perfect sense from the perspective of what sex is ultimately for – but if the menstrual cycle is disrupted by hormonal birth control, this effect disappears.” And it’s easy for me to believe that sex off of birth control and near a woman’s natural peak in sexual libido (and fertility) is better than sex on birth control. But when you’re not on birth control and want to avoid pregnancy (using something like the “rhythm method”), this is precisely the time where you have to avoid having sex… so it seems like the “better sex” benefit would be significantly curtailed when you’re not actively trying to get pregnant. 

I agree with Mary that it’s worth reflecting on the degree to which use of hormonal birth control may be causing unwelcome side effects that you’re not aware of or that there may be downsides to not experiencing your natural cycle and considering whether these costs are worth it to you. Of course there are also benefits to not being connected to your natural cycle - I haven’t had to deal with the downsides of a period in a long, long time. But personally, I’m excited to go off of birth control once I’m married. The reason I use a hormonal IUD is because it’s the most effective method of birth control available and doesn’t require anything of the user day to day. I care a lot about the effectiveness of my birth control because I strongly prefer to have children only after marriage and don’t want to have an abortion (but think they should be legal in almost all cases), so all-in I feel that the costs of birth control are well worth the benefits to me. That said, I wish I had a deeper understanding of how birth control works and what the potential effects of its long-term use are.

But is there a meaningful link between the use of hormonal birth control and having casual sex? Mary says that the pill is “a crucial precondition for bad sex, because it de-risks casual hook-ups”. Anecdotally, I’ve seen some friends stop using the pill when they became single, reasoning that they’ll use condoms if they have casual sex anyways and since they’ll be having less sex overall the potential side effects of birth control aren’t worth it anymore. And I’ve seen other friends stop using it when they got into a relationship, reasoning that using the rhythm method and waiting a few days is a lot easier when you have reliable sex available, and that they’d be more comfortable handling an unexpected pregnancy with their partner than they would’ve been had they been having casual sex. This study¹ found that “Women in casual relationships, or without a partner, were also less likely to be currently using effective contraceptive methods than those in consistent relationships.” where effective contraceptive methods included the pill, patch, vaginal ring, DMPA, Implant, or IUD, but the population they look at is very young and not at all representative. In line with the ambivalence of my anecdotal observations the authors say: 

Evidence on how relationship type influences contraceptive use is also mixed among adults [7,9–12]. Women in erratic relationships may be less likely than others to plan sexual intimacy, leaving them unprepared to protect against pregnancy [13]. Yet, living in a marriage-like arrangement may reduce the motivation to avoid a pregnancy, and thus reduce effective use of contraception [14,15].

While I didn’t find representative data on the percentage of women using hormonal contraception by relationship status, CDC data² shows that in the US both educated women and white women are more likely to use the pill as well as long-acting reversible contraceptives (like an IUD) and I doubt these groups are more likely to be having casual sex. And most of the women I know who are married or in long-term relationships use hormonal birth control when they’re not trying to get pregnant. So, while I think Mary’s suggestion that women consider the side effects of hormonal birth control is reasonable, it's not clear that there’s a link between its use and engaging in casual sex.

Mary doesn’t just claim that women who use the pill are more likely to have casual sex because they’re less concerned with unwanted pregnancy, but also that because they’re less likely to experience unwanted pregnancy they have less reason to turn down sex and therefore end up consenting to sex they don’t really want. As she says “Pregnancy risk is, after all, a cast-iron reason to reject having sex with anyone out of politeness.” What in the world is going on that women are having all this sex out of politeness.

Louise Perry

seems quite concerned with this as well. To the extent that women really are having sex out of politeness, that’s their problem and to complain about it is pretty pathetic. The message to these women (assuming they exist in meaningful size) should be that they need to be more assertive, or if they can’t do that then they should just lie, not that they shouldn’t use birth control. Birth control is not a worthwhile trade for every woman, but the decision of whether or not to use it shouldn’t be based on your inability to turn down unwanted sex.

Near the end of the piece Mary attempts to connect the use of birth control to BDSM and kink saying that with sex, “Shorn of its connection to the source of life itself, that darkness and danger will find twisted expression in depraved fetishes and sexual violence.” and hypothesizes:  “Add the real, material ‘power exchange’ of fertility back into sexual intimacy, and I’m willing to bet the popularity of ‘kink’ would evaporate overnight. Or, rather, return to its proper place.” I don’t have anything to say about this other than it would be really nice if Mary made some attempt to back up her convoluted theories with evidence. As it is, her “pro-pleasure, pro-love, pro-embodiment case” against hormonal birth control just feels like a cringe attempt to make purity culture seem hot.

1. Upadhyay, Ushma D., Sarah Raifman, and Tina Raine-Bennett. "Effects of relationship context on contraceptive use among young women." Contraception 94.1 (2016): 68-73.

2. Daniels K, Abma JC. Current contraceptive status among women aged 15–49: United States, 2017–2019. NCHS Data Brief, no 388. Hyattsville, MD: National Center for Health Statistics. 2020.