In her two-hour interview with renowned author and speaker Jordan Peterson (provocatively titled “Would You Love the Same Man On and Off the Pill?”), Dr. Sarah E. Hill shocked and empowered listeners with her comprehensive research on the effects of birth control on women’s brains and society at large. I found this interview months ago while casually scrolling YouTube and was pleased to see a mainstream in-depth discussion on birth control. Notably, The Dr. Hill episode is one of Jordan Peterson’s most watched videos, with over 1 million views!
The comments on the video were even more enlightening. They included husbands concerned for their wives, grandmothers yearning to pass this information on to their grandchildren, and, of course, numerous “me too” stories shared by women of all ages who experienced the effects of birth control firsthand. As one woman commented, “This needs to be told to women BEFORE they go on birth control.” We at Natural Womanhood couldn’t agree more. And although we’ve referenced Dr. Sarah E. Hill’s 2019 book, This is Your Brain on Birth Control: The Surprising Science of Women, Hormones, and the Law of Unintended Consequences, time and time (and time) again over the years, we recently decided we should finally give Dr. Hill’s book the NW Reviews treatment for our readers.
Dr. Hill is an author, professor, and researcher specializing in sexual psychology and women’s health. She has a bachelor’s degree in anthropology and a Ph.D. in evolutionary psychology. She has written multiple scientific publications, op-eds, and articles, and has made numerous TV and podcast appearances. As our understanding of the negative effects of hormonal birth control increases, Dr. Hill is one of the foremost scientific authorities in making sense of these negative effects.
Who is the intended audience?
Dr. Hill writes her book for any woman of reproductive age, especially for those who have taken any kind of birth control pill, who are currently on any kind of birth control pill, or who are considering going on hormonal birth control.
What are the main content areas of This is your Brain on Birth Control?
The book is divided into three main parts. Part I covers the biology of a woman–what the definition of a woman is (hint: it has to do with our sex cells!), how hormones are part of who we are rather than just something that happens to us (more on this later!), and the ins and outs of a woman’s fertility cycle.
Part II is the “meat and potatoes” of the book, with a deep dive into the complex role of hormones in both male and female bodies. This section explains how birth control, with its daily cocktail of synthetic hormones, can wreak havoc on sexual desire and libido, stress response, mood, and even attraction and mate choice (to name a few).
Part III lays out how birth control has effects on other people, not just the women who take it, plus the politics surrounding women’s issues, as well as practical applications of the knowledge gained in this book.
Strengths of This is Your Brain on Birth Control
Clear definitions of what it means to be male and female, biologically speaking
This is very important, because hormones–which initiate and regulate a whole cascade of biological functions and brain activity–are not just things that act upon us from the outside. As Dr. Hill succinctly puts it, “You are your hormones” (7). So, to understand how birth control works in the female body, we need to understand the key role that hormones play (in both men and women). The fundamental differences between men and women can be sifted down to differences in sex cells. According to Dr. Hill, from an evolutionary biology standpoint,
“If you have a limited supply of large, calorically-expensive gametes, you are a female and we call your sex cells ‘eggs.’ If you have an unlimited supply of small, metabolically inexpensive gametes, you are a male and we call your sex cells ‘sperm.’ And although this designation may sound overly simplistic (and potentially even a little crass), it’s at the very heart of almost all reliably occurring sex differences observed in creatures great and small, including human beings (16). “
It takes a good deal of work to menstruate, ovulate, grow a baby, birth a baby, lactate (with all the hormonal changes that happen in between). As a sex, and historically speaking, women do not take sex lightly and have to be choosy about their partners, given the body- and time-intensive process of female reproduction.
In fact, this is what makes the birth control pill so revolutionary, according to Dr. Hill: “Women are now in the position of being able to have sex with whomever they want to, whenever they want to, without having to worry about whether the men in question would make crappy husbands or terrible dads” (203). Because of this, Hill champions the freedom the pill affords women to pursue education, careers, or family life in the way that they want, without worrying about unintended pregnancy. But she also acknowledges that this freedom comes at a cost–which brings us to the next point.
The effects of hormonal birth control on women’s stress response and men’s ambition
The research studies cited by Dr. Hill that I found most fascinating investigated the effects of the birth control pill on women’s stress response and on men’s ambition (one of the “unintended consequences” mentioned in the subtitle of the book).
Women’s stress response
In the average human, cortisol is released from the adrenal glands in response to stress. This allows the brain to grow new cells, helps the brain learn from experiences inducing stress, and redistributes energy in the body to where it is needed. But chronic stress (the signs of which women on hormonal birth control exhibit) is a bad thing, because, as Dr. Hill explains,
It keeps all the body’s resources tied up with the messy business of stress management, which prevents investment in life-sustaining activities like digestive, immune, and cardiovascular function. It also increases the risk of infection, disease, weight gain, and a bunch of other stuff you probably don’t want happening, including diminished neurogenesis (making new brain cells), brain cell damage and cell death, and reductions in brain volume (152).
Decrease in men’s ambition
The second area of research I found fascinating related to a decrease in men’s ambition as an unintended, indirect consequence of increased birth control uptake. Dr. Hill points out that while the percentage of women enrolled in college has increased in the years since birth control became widespread (up 35% since 1940), the percentage of enrolled men has declined. Now, it is common for the majority of students on U.S. campuses to be women. She explains it in this way:
So although the pill and the freedom it allows may be responsible for the fact that women are now able to achieve more than ever before in history, it may have the opposite effect on men… Experiments in my lab support this idea. We find that men’s achievement, motivation and self-control march in lockstep with their beliefs about women’s requirements for sex… Men who believed that women’s standards were high outperformed those who believed that women’s standards were low. And it was only men who responded this way (204).
In other words, Dr. Hill theorizes that having sex more freely available to them (because women offer it more freely when they are unafraid of unintended pregnancy), has actually made men, on the whole, less ambitious.
The pill-taking you is not the real you
Dr. Hill frequently returns to the whole “you are your hormones” concept throughout the book. She recalls how she started becoming aware of the effect of birth control on her own brain when she went off it for the first time (other than for pregnancy and breastfeeding). She writes,
“I realized that I felt … different. I didn’t notice it while it was happening, but one day I realized that my life had recently felt brighter and more interesting. Like I had walked out of a two-dimensional, black-and-white movie into a full-color, three-dimensional, meaning-filled reality. I started exercising again and cooking–things that I used to take a lot of pleasure in but had kind of forgotten about (3-4).”
Dr. Hill’s experience is not an anomaly. Other women she talked with shared similar experiences, and she writes about them in the book. Perhaps the most striking of these were the ones where women realized they no longer felt attracted to their partners after going off the pill. This may be because the birth control pill suppresses the production of estrogen, the hormone that leads women to search for certain traits in a mate that are desirable for passing on to offspring.
Dr. Hill writes, “Experiencing increased sensitivity to sensory cues at high fertility”–when estrogen is at its peak–“is the sort of thing that would have offered women a distinct mating advantage, helping them separate the men from the boys” (114). Women on birth control, however, lack this heightened sensitivity because their own estrogen production is suppressed by it. This could cause women on the pill to choose partners for other reasons that are no longer compelling once they come off the pill. And that would be a heartbreaking situation for any woman.
Limitations or blind spots of This is Your Brain on Birth Control
One limitation of this book is that there is absolutely no talk of fertility awareness. While that may be out of the author’s scope, there was enough encouragement to research birth control options that a detailed look into fertility awareness methods seems appropriate. There was one brief mention of “fertility-tracking apps,” which Dr. Hill describes as “an awesome way to learn about you and your cycle” (240), but we know that to be well-versed in fertility awareness and cycle tracking, one needs a trained instructor. Dr. Hill takes the time to mention forty-six different types of birth control in an effort to allow women to make informed choices about their options; I wish she had taken as much care to explain the different methods of cycle tracking and their benefits.
Dr. Hill also seems to have something of a blind spot when it comes to sex. Her underlying assumption seems to be that women need sex (whether in a committed relationship or not), and thus they also need birth control to ensure that their sex is sterile. At the same time, Hill laments the politicization of women’s issues, calling it sexist that “[w]e live in a world in which women’s hormones, sexuality, and fertility are politicized in ways that men’s are not” (229). But could the politicization of women’s hormones, sexuality, and fertility be in part because birth control makes fertility and childbearing seem like a burdensome lifestyle choice, rather than the natural consequence of a healthy female body coming together with a healthy male body? When we separate sex from its childbearing potential, it would seem unavoidable for women’s hormones, sexuality, and fertility to become politicized.
Dr. Hill makes it her goal to empower women to make their own choices about birth control. As a result, her suggestions are extremely practical. Her whole last chapter is titled “A Letter to My Daughter,” and provides not only a summary of the information provided, but also a sort of blueprint for what to do in response. Dr. Hill writes, “You are a different person on the birth control pill than you are when you’re off the pill. And there’s no bigger deal than this. So, know what you’re getting into and make your decision with your eyes wide open” (236).
The verdict: to buy, borrow, or skip This is Your Brain on Birth Control altogether?
This book is a great buy for women who are currently on birth control or have friends and family members who are, especially if you/they are considering going off the pill. Dr. Hill’s wealth of knowledge will equip you to have informed, thoughtful conversations about the risks and benefits of hormonal birth control.
If you’re already aware of the negatives of birth control, perhaps so much so that you recently stopped hormonal birth control altogether, this might be a better ‘borrow’ than ‘buy,’ though arguably you’ll want to retain it as a resource for communicating knowledgeably with friends and family who are still on the pill. In either scenario, this book is necessary reading for our time. I hope many women seek out alternate means of managing their relationships and fertility as a result of Dr. Hill’s research. Her work is too important to ignore.
