By Caitlin Maloney, Charlotte Laidlaw and Abbey Mitchell
Being prescribed a contraceptive pill was not something Bonnie Miles had thought would change her life when she was 18 years old.
On top of birth control, Miles thought the pill would be the answer to regulate heavy periods.
However, she was never informed about the range of potential side effects or that it could impact her mental health.
“[The pill] really affected my thinking, my self-esteem, my self-hate,” she told Central News.
“It was so intense, and I already had mental health issues, so it exacerbated it to the point where it’s not worth it for me.”
Over the past 15 years, Miles has taken many forms of oral contraceptive pills, as well as Depo-Provera – a contraceptive injection.
Had I known what I know now, I would not have gone near it. Because it actually caused a lot of harm to my body.
“What I realised with the pill – it actually sends me quite mad,” she said. “It never really worked for me. It actually caused me more harm than good.
“Had I known what I know now, I would not have gone near it. Because it actually caused a lot of harm to my body.”
An investigation by Central News has found over a third of women (37 per cent) felt their experience using the pill had been negative, compared to 45 per cent who had a positive experience.
A survey of 80 Australian women aged 18-49, who were either taking the pill, had previously taken it or had rejected using it, showed birth control was their primary motivator, followed by regulation of periods, managing pain and treating acne. About 80 per cent of respondents were aged 18-25.
Of the key side effects recorded, four of the top seven were negative, including weight gain, depression, mood swings and anxiety.
Miles, now 49, recently had a hysterectomy, following years of health complications related to hormonal contraceptives.
Bonnie Miles, 49, has had a string of bad reactions to the pill. Photo: supplied.
A combined oral contraceptive pill is made up of two hormones, oestrogen and progestogen, which together prevent pregnancy by preventing the ovaries from releasing an egg each month.
Besides birth control, women may take oral contraceptive pills to regulate their menstrual cycle and hormones, to manage period pain, bleeding, and conditions like endometriosis or polycystic ovarian syndrome (PCOS), according to Professor Danielle Mazza, head of the Department of General Practice at Monash University.
“There are other reasons why you might want hormonal contraception… and that might be because you want better bleeding control, or you want to reduce period pain, or you want to manage endometriosis or polycystic ovarian syndrome or acne.
“There are a lot of different reasons why hormonal contraception might be beneficial to you.”
Courtney Trestrail began taking the pill when she was 14 to manage her menstrual cycle, as well as reducing acne, which was disrupting her competing in dance events.
“I remember complaining a lot about how annoying it is to wear dance costumes with your period… I don’t remember actually asking to go on the pill, but I remember just being like, I have these issues, doctor appointment was made. That was the solution given,” she recalled.
Now, almost 15 years on, Trestrail thinks taking the pill for acne was unnecessary.
“It was never super severe, like, it was never needing to go to a dermatologist,” she said.
“It was normal, just a teenager with acne. But I guess when you’re 16, those things are important to you.”
However, Trestrail’s experience on the pill as a teenager wasn’t without side effects.
“I was so anxious, depressed, and just like not myself at all, and had real trouble sleeping,” she said.
Professor Mazza said that side effects, such as mood changes or breast tenderness are common when people first start taking an oral contraceptive.
“Most women who start the pill will notice some changes, but often these changes disappear after about three months of use,” she said.
Dr James Brown, obstetrician and gynecologist at the Women’s Health and Research Institute of Australia, said contraceptive pills can affect women’s mood, by increasing feelings of anxiety or depression.
“Some people worry about bloating, others worry about acne and other sorts of hormonal dysregulation, and then other people suffer from mood-related aspects once they start the medication,” he added.
They will just throw the pill at anyone who comes in with any sort of menstrual-related issue… the endo specialist [told] me when I was about 16 I had two options: get pregnant or go on the pill.
Professor Mazza also noted some of the risks associated with oral contraceptives.
“The main contraindications would be if you had a history of blood clots or a clotting disorder that ran in the family, or if you had migraine with aura (affecting vision), or if you smoke, or you have liver disease, or high blood pressure,” she said.
However, she added this shouldn’t deter women from taking the pill.
“There’s a lot to put on those scales when you’re balancing up what are the risks and what are the benefits,” said Professor Mazza.
“But overall, I believe that hormonal contraception – if you’re a healthy young woman, then hormonal contraception has a lot more benefits to it than it does risks.”
After her negative experience on an oral contraceptive, Trestrail gave another pill a try. When that one also caused negative side effects, her doctor prescribed her Yaz.
“That one worked for me perfectly, and I was completely back to normal, had no side effects on that one,” said Trestrail. “It felt like I wasn’t on the pill when I took that pill.”
Although she was on and off different contraceptive pills for 10 years, Trestrail said she always felt well informed by her doctor, and trusted the process of finding the right pill for her.
However, Miles said she was more skeptical of medical experts. She is particular with the GP she visits, travelling further so she feels her concerns are properly addressed.
“For this second half of my life, I am educating myself enough so that I am informed about these hormones, because they’re actually quite dangerous for me,” she said … “I’d go to her [GP] because the first time I went there, she cared enough to explain the different pills and why I would’ve been going mad from those older ones.”
Miles also said she had learnt to challenge her treatment.
“These days, I don’t let them prescribe me anything without pushback, especially anything to do with hormones and antidepressants and anti-anxieties,” she added.
Studies on oral contraceptives have found they lower the risks of developing ovarian cancer, which 3,066 women were diagnosed with in Australia in 2020.
Professor Deborah Bateson, from the University of Sydney Faculty of Medicine, said: “Physiologically, it makes sense that the pill does actually reduce the risks of endometrial and ovarian cancers. So that’s a good thing, and that’s because it appears to be linked to ovulation.
It’s not necessarily that it’s being overprescribed, but more that it’s such a tidy solution for the majority of problems that we haven’t found a better solution for.
“[There] does appear to be a small increased risk of breast cancer with pill taking. It depends on how long you’re taking the pill, and then it goes down.”
Professor Bateson said the risk was not something most women considering the pill should be concerned about, and that doctors and nurses should be using the Medical Eligibility Criteria for Contraceptive Use to assist in prescribing a pill.
“If you’ve got a family history of breast cancer, then that wouldn’t preclude you from using the pill,” she said. “But if you had a mutation, a BRCA mutation (giving a higher likelihood of developing cancer), for instance, then you’d have to weigh that up carefully … so I think in terms of risk, we need to keep on gathering the data as much as we can to gain new insights into cancer risks. It’s just making sure that people are aware of the risk and make an informed decision about it.”
Dr Brown also said the pill Zoely “has a very tenuous link to brain cancer”, although “the risks of an unplanned pregnancy are probably greater than that, significantly”.
“The general trajectory of prescribing contraceptive pills is doing it safely, but maximising accessibility without unnecessary barriers,” he added.
Survey results reported some participants had been offered a contraceptive pill for symptoms such as migraines and dermatitis. Central News asked experts for their thoughts on this result.
“Those are unusual reasons to offer the pill, because there’s no evidence at all that the pill would have any impact on these symptoms,” Professor Bateson said.
“We shouldn’t be passing everything to the consumer to understand things. But you’d certainly be questioning those choices because there’s no evidence behind those.”
Dr Brown disagreed that the pill is being overprescribed.
“The problem is that the majority of women’s health conditions are hormonal, and the majority of them can be solved by suppressing most of those hormones, and the quickest and easiest way to do that is with the oral contraceptive pill,” he said.
“So, it’s not necessarily that it’s being overprescribed, but more that it’s such a tidy solution for the majority of problems that we haven’t found a better solution for.”
Aimee McIntyre, 25, recently stopped taking oral contraception after 10 years, to manage her menstrual cycle, PCOS and endometriosis.
“I’ve just not heard this spoken about enough [by] my doctors; they will just throw the pill at anyone who comes in with any sort of menstrual-related issue,” she said.
She described her own experience getting a birth control pill.
“I had two forms of birth control, and then that made me feel pretty crappy, and I kept changing to different oral pills, but they all were pretty bad,” she said, later adding: “I remember the endo specialist telling me when I was about 16 that I had two options: that I could either get pregnant or go on the pill.”
Aimee McIntyre. Photo: supplied.
Miles was also diagnosed with endometriosis around five years ago, which she described as a “relief”.
“It was a relief because I was so sick. I was throwing up in the toilet, trying to have a bowel movement every time I had my period, and I didn’t know what was happening,” she said.
“I’d always had heavy periods, but this was next level.
“So when I found out, I guess it was just a relief to know that, okay, now I know what’s wrong. And now I can do something about it.”
Miles ultimately decided to have endometriosis surgery, but afterwards her surgeon suggested she go back on an oral contraceptive pill to help with any remaining pain.
“He was really blasé… I kind of had to fight for my mental health… [I said] ‘No, you don’t know my history with this,’” she said.
McIntyre said she didn’t feel adequately educated about the side effects when she first started taking birth control.
“When I was first put on it, I just wasn’t warned,” she said.
Dr Brown told Central News that it’s “hard to know” if patients are being educated enough about the side effects of the pill.
“This is a really complex balance, because one of the challenges … historically with the pill is access, so people being able to get it and get it prescribed,” he said.
“At the same time, we want to make sure people are adequately counselled about information and not scared out of using it, so there’s never a perfect balance.”
Professor Mazza also claimed misinformation on social media could be the crux of the issue.
“The problem is that a lot of young women are often getting their information from unreliable sources and receive a lot of misinformation, maybe from social media or from their peers,” she said.
Recent reports from the National Library of Medicine supported the rise of contraceptive misinformation on social media, finding platforms like Instagram and TikTok often influenced users to switch to other forms of contraception, such as non-hormonal methods that linked with women’s natural cycles.
“Young women need to spend time actually finding out about their contraceptive method that they’re using. And it may not happen in the first consultation. They may need a couple of consultations to actually discuss it,” Professor Mazza said.
She added: “Women should turn to health professionals for advice, not turn away from them. Health professionals are highly trained.”
I think if I was a man [with] endometriosis, that they would have a cure by now.
McIntyre felt doctors didn’t know enough about endometriosis.
“They have no knowledge when it comes to endometriosis and severe menstrual pain,” she said. “I just feel like … it’s literally the pill or a referral.”
She also believes there may be a gap between how men and women are medically assessed, and treatment for endometriosis may take longer because it’s a women’s health issue.
“I think if I was a man, [if] endometriosis [affected men], that they would have a cure by now, to be honest,” said McIntyre.
Professor Bateson said using the contraceptive pill to manage endometriosis can be helpful, as it allows women to skip their periods and manage pain.
However, she warned: “If people are still having breakthrough symptoms (getting their period) while on the pill, they certainly need to see their doctor and get further support.
“They may need further ultrasound and investigations to work out what’s going on. But certainly we don’t want to delay diagnosis of endometriosis.”
According to the Australian Institute of Health and Welfare (AIHW), one in seven women born between 1973-78 were estimated to have been diagnosed with endometriosis by age 44-49.
However the AIHW, acknowledged the lack of data, especially for younger people on their website, which states: “There is a lack of comparable Australian prevalence estimates in recent decades.”
When contacted about statistics on oral contraceptive use in Australia, a spokesperson from the Department of Health and Aged Care said: “The Department of Health and Aged Care does not collect comprehensive data on contraception use in Australia, as Pharmaceutical Benefits Scheme (PBS) data does not capture prescriptions outside the PBS such as private prescriptions (non-PBS) or public hospital inpatient prescriptions.”
An examination of data from the PBS shows 1,597,695 prescriptions of contraceptive pills on the PBS were supplied between March 2024 and February 2025.
Central News also contacted the NSW Department of Health to ask if they collect any statistics about oral contraceptive use. They declined to respond.
Many women have reported experiencing negative side effects when coming off the pill, which is due to the pills’ suppression of hormones, according to Professor Bateson.
Side-effects have given rise to so-called “pill detoxing”.
Miles said: “So you actually detox. And, I was so sick in my recovery… I wouldn’t have gone on the pill or any of that hormone medication, had I known what I know now, and how it affected me coming off it.”
However, Professor Bateson argued there was “no science behind it”, but recommended people coming off the pill continue to practice safe sex if they do not wish to fall pregnant.
After coming off the pill, the possibility of having to take it again brings McIntyre “a lot of anxiety”.
“If I had a choice, I don’t want to, just because this whole journey with my acne and all these infections and my health and my moods, I would love to not put my body through this again,” she said.
“I just think about the experience that I’ve had coming off of it and how difficult it’s been, and I might have to do that to my body all over again.
“Unfortunately I might have to, and that is… that’s so sad.”
Courtney Trestrail. Photo: supplied.
Based on her own experience working in the healthcare industry, Trestrail feels people are often not informed on the risks of taking a contraceptive pill.
“If I had a theory on why the pill is overprescribed, it’s because the lack of health literacy in Australia means that it is safer for more people to be on the pill, because it’s just a quicker solution than to actually educate people on what to do,” she said.
“I think that’s probably why some people, [are] just like, yep, just take the pill, because then they don’t have to learn how their body works; they don’t have to learn how fertility actually works.”
Professor Bateson said education around contraceptives “still lack[s] a bit” and warned that some websites promising to inform people about contraceptives are sponsored by pill companies.
“Family Planning New South Wales, Sexual Health Victoria, for instance, [are] really great websites which do explain all the different choices. So I think the key thing is, it’s about raising awareness about where to seek that information,” she said.
The oral contraceptive pills Yaz, Yasmin and Slinda were added to the PBS earlier this year. Slinda provided an alternative contraceptive options for women who cannot take a pill with oestrogen.
One in three Australian women aged 18-39 who use a combined oral contraceptive pill were paying for a non-PBS listed pill, according to the Department of Health and Aged Care.
Yaz and Yasmin were the first oral contraceptives to be added to the PBS in over 30 years. According to the department, pills not on the PBS system were costing women from $70 to $90 for the three-month supply, and will now save 50,000 women hundreds of dollars a year.
According to a statement from Health Minister Mark Butler, over 100,000 Australian women are expected to benefit from this listing each year.
But Trestrail was unsure if taking Yasmin in her teens was worth it.
“Was it really worth me spending $75 a month? Probably not, but I was 14 and wanted to not have my period when I was wearing a leotard and not have pimples,” she said.
Professor Bateson added it was important for women’s contraceptive healthcare to continue to make such improvements in accessibility.
“We really want to encourage the pharmaceutical companies and governments to keep on funding research to increase the options that people can use, because sometimes there’s not as much investment in contraception as perhaps in other areas of health,” she said.
“We just need to make sure that we do continue to really access the science and get new products that women want to use and have that sort of user-centre design. So really making sure that those products that are being developed, they are the products that women want to use.”
Main image of Estelle birth control pill by Jessica O’Bryan.
