Episode 213: Revolutionizing Birth Control

Unraveling the Surprising Science of Desire and Your Brain with Dr. Sarah Hill – How You Can Impact Your Relationships & Hormones for a Healthier Future

Hi everyone. Welcome to the show. My guest today is Sarah Hill. She is a Ph.D. and the author of a groundbreaking book. I loved it. It’s “Your Brain on Birth Control: The Surprising Science of Women Hormones and the Law of Unintended Consequences.” Now, before all my men run away, if you have a daughter, if you have a female partner, or even if you have a mother, because you know, we’re always like, oh, my mom is crazy, let’s bridge the gaps. Let’s get information about birth control. And even though we’ve all benefited from having the opportunity to have birth control because it was sort of this liberation like you can go to work and you didn’t have to pay the consequences of an unwanted pregnancy. But there are a lot of really surprising things about what it does to us in the long run. 

So her extensive expertise in neuroscience and psychology brings this fresh perspective to the conversation surrounding birth control. And she challenges and expands our understanding of its impact on women’s minds and who we choose who we want to have sex with, who we want to marry, and our bodies. And she is a professor and researcher, and she dives deep into the effects of birth control on the female brain. She’s here to share a ton of fascinating findings and shed light on the intimate connection between hormones. I feel like, especially as females, we are in touch with these cycles, mental health, and overall well-being. I thought this was an incredibly important and empowering conversation because you don’t want an unwanted pregnancy, or maybe you choose that. You don’t want to go down that path, or you’re doing other things. But this idea of being equipped with information allows you to make decisions that are best for you now and in the long run, not only for your life but for your mental health and your body.

We talked about many incredible things, like this idea of certain parts of our cycle, when your estrogen’s high, you’re picking a different type of partner versus when you’re in the phase where your progesterone is more dominant. It’s a wait-and-see, a fixed position where you would choose a different partner. Some interesting data suggested, hey, what happens when one person’s either not on birth control or a low dosage hormone, and then they pick partners? Then they get off all these hormones? All these fascinating things that happen to our sex lives and our desire and some interesting biological things.

Having three daughters, I’m interested in empowering people so they can navigate and make the best choices for themselves. So I hope you enjoy this fascinating conversation I had with Sarah Hill.

Welcome to the Gabby Reece Show, where we break down the complex worlds of health, fitness, family, business, and relationships with the world’s leading experts. I’m here to simplify these topics and give you practical takeaways that you can start using today. We all know that living a healthy balanced life isn’t always easy. Let’s try working on managing life a little better and have some fun along the way. After all, life is one big experiment, and we’re all doing our best.

And so what you see is that for some women, when they discontinue hormonal birth control, they will get either an increase in sexual desire or attraction to their partner. Or they’ll get a decrease in sexual desire and attraction to their partner. And of course, in some cases, you get no, you know, you get no effects at all.

It’s so very idiosyncratic and just like all things in life. But certainly, with this, I think that we’re going to hit on some better solutions. I feel confident in that. I think that the more women that we have who are touched by this experience because we all experience this, and for our daughters where it’s like: how do we regulate our fertility and how do we do it in a way that’s going to be minimally negatively impactful on our development and who we are.

And that’s such, such an important question. I think it’s one of the most important questions out there because it’s just how important fertility regulation is for us.


Dr. Sarah Hill, thank you for joining me and for having this most important conversation. 

Thanks for having me. I’m really excited to be here. 

Why did you decide to write this book? What made you feel that it was important to explore this particular topic extensively?

There were two main factors that led me to write this book. Firstly, it was based on my personal experiences with hormonal birth control. When I went off it, I noticed significant differences in how I felt and experienced the world compared to when I was on it.

Additionally, throughout my career, I have studied women’s brains, hormones, and how hormones impact motivation. However, I had never considered the effects of the hormonal birth control I was taking. This realization opened my eyes to the blind spot we all have when it comes to hormonal birth control.

While we acknowledge that hormones affect how we feel, there has been a disconnect regarding understanding that altering someone’s hormones can also impact their brain functioning. After going off the pill and recognizing the stark contrast in how I felt, I felt embarrassed for not having realized the psychological effects of my birth control earlier, especially considering my research on the psychological impacts of hormones. This realization highlighted a significant gap in information that needed to be addressed for those who rely on hormonal birth control.

How long did it take you to put together all the information for the book itself? 

It took approximately a year and a half of extensive research, delving into existing knowledge and exploring unexplored areas to gather the information for “Your Brain on Birth Control.” Before this project, I had already dedicated years of my research career to studying the effects of hormones on women’s psychology. However, making the connection between hormone changes and their broader impact was a new frontier for me. This required going through a significant amount of literature. Thus, the process of compiling all the necessary information for the book took about a year and a half.

Everyone’s experience with hormonal changes can vary, but there are often common patterns we can explore. Could you share when you started noticing a difference after discontinuing the pill and what specific changes you experienced compared to when you were on it?

To provide context, I had consistently taken birth control for around a decade, with brief breaks during pregnancy and breastfeeding. However, during those times, the hormonal dynamics were different due to the natural changes associated with pregnancy and lactation. After being on birth control for most of those 11 or 12 years, except for the two years I was pregnant and breastfeeding each of my children, I had not experienced the regular hormonal fluctuations of a non-pregnant, non-lactating person.

Around three months after stopping the pill, I distinctly remember a moment while driving with a friend when I felt an intense desire to engage in something adventurous or reckless! This sudden surge of energy made me realize that I had undergone a shift in my mindset since discontinuing the pill. It was a version of myself that I hadn’t experienced since my teenage years when I was not using birth control.

During this period, I found myself going to the gym more frequently, feeling motivated to move my body. I started downloading new music, which I hadn’t done in about a decade and rediscovered the joy of listening to music again. I also noticed an increased interest in cooking and engaging in pleasurable activities that required energy.

Additionally, my sexual frequency had returned to levels reminiscent of my pre-pill days. Reflecting on these changes, it became apparent that the conversation I had with my friend that night about wanting to “get into some trouble” was a pivotal moment. It prompted me to pay closer attention to the transformation I had experienced over those three months, embracing a version of myself that I hadn’t fully realized since my younger years.

It’s fascinating how our lives unfold in different phases, each with unique challenges and self-discovery. During our teenage years, even without considering the impact of chemical birth control, we often grapple with self-consciousness and figuring ourselves out. As we reach the ages of 16, 17, and 18, we start to find a better rhythm and gain more confidence in navigating life. We work hard to understand our identity, immersing ourselves in academic pursuits and personal growth. 

In our twenties, we often encounter a period of questioning where we ponder who we truly are and explore different paths. Then approaching our thirties, we begin to recognize a voice within us, an inner calling that urges us to exercise our authenticity. However, the journey of motherhood brings about additional layers of complexity and responsibilities, making it challenging to discern the subtleties of personal transformation amidst the multitude of changes.

So, it is truly remarkable that you were able to discern that something different was happening within yourself during this period. 

I that my knowledge and research on women’s hormones played a significant role in understanding what was happening to me. Studying the effects of hormones on motivation allowed me to recognize that the changes I experienced resulted from my hormones returning to their natural state. It made perfect sense that with the return of my hormones, I felt a surge of energy and a desire to engage in various activities, including sex, listening to music, and moving my body. All these aspects are interconnected and became clear to me.

Fortunately, we have options like the pill to address various pregnancy and teenage hormones concerns. When teenagers, particularly young girls, experience intense hormonal changes during adolescence, it can affect their skin and overall well-being. They may also become interested in exploring their sexuality, which can create a complex set of circumstances. As parents, navigating these sensitive topics and guiding our teenage daughters becomes crucial. While young pregnancy is not something most of us are prepared for, acknowledging and understanding their sexual drive is important. It can be exciting but challenging when they discover themselves and their desires.

Starting with this context, it raises significant questions for parents about approaching these situations and making informed decisions. How do we support our young daughters? How do we ensure they have access to accurate information? Balancing the desire to protect and guide them with their growing independence can be a delicate dance.

Exploring the available options, understanding the implications of chemical hormones, and seeking the right knowledge are vital steps in guiding our daughters through this phase of their lives. It requires open communication, compassion, and an environment encouraging honest discussions to help them make informed choices.

It is absolutely crucial that we recognize the need for more and better options for women. One of the key messages conveyed in the book is the dilemma women often face, where they are forced to choose between the potential repercussions of an unplanned teenage pregnancy, which is a significant predictor of poverty for women, or resorting to synthetic hormones that can interfere with the natural development of their reproductive system. This predicament presents two sets of unfavorable choices. On the one hand, there’s the risk of an unplanned pregnancy. On the other hand, there’s the option of using synthetic hormones that can disrupt the maturation of the brain’s ovarian axis, which is essential for a developing girl. It becomes evident that these choices may not be ideal for teenage girls who require the normal development of sex hormones as part of their growth trajectory.

However, there are alternative options available. For instance, a hormonal IUD exists that can provide pregnancy prevention benefits similar to other methods while suppressing the HPG axis. However, it’s worth noting that it may not be ideal for teenage girls whose brains are still developing. On the other hand, there is a copper IUD that does not contain hormones but offers the same pregnancy prevention benefits.

Unfortunately, these options seem limited when considering long-acting and highly effective methods. Getting an IUD inserted can be uncomfortable and initially worsen cramps for many women, especially those who haven’t had children. However, over time, most women find it more tolerable. Consequently, it often feels like the only viable option, as relying solely on condoms or fertility awareness methods may not be reliable or suitable for teenage girls who may struggle with consistency and responsibility.

I feel that for younger people, it can be challenging. My husband and I decided to rely on that method after our last daughter. We rode it out until the end, but he had to participate too. We can figure out the fertility window and avoid certain days. But at the same time, the male partner needs to have some level of control. And no offense to 15, 16, or 18-year-old males, but I’m not sure if they can be completely trustworthy in that regard. And then there’s the idea of taking my 15-year-old for a mini surgery, which is required for some other options. It’s fascinating that these are the choices we have.

It truly is disheartening to see the lack of investment in research and development for contraception compared to other medical issues like depression, autoimmune disorders, and cancer. Pharmaceutical companies allocate only a small percentage of their profits towards contraceptive research as if it’s a problem already solved with existing options such as the pill. However, the reality is that we are far from having ideal contraceptive solutions, especially for teenagers. Research shows that hormonal birth control use can come with significant risks, particularly in terms of mental health. Teenage girls, in particular, bear a disproportionate burden of these side effects, including severe depression. Also, recent studies suggest that these effects can persist even after discontinuing the use of hormonal contraceptives, potentially leading to the development of major depressive disorder later in life.

Being a sexually active teenage girl puts one in a difficult position with limited options and potential consequences. Clearly, we are facing challenges and need better alternatives that prioritize the well-being of young women in this regard.

I won’t delve into personal matters, but let’s consider the hypothetical scenario of being 16 again in a relationship and wanting to have an active sex life. If you were in this situation, what steps would you take to ensure your well-being and make informed choices at that age?

It’s interesting to ponder this question because I’ve had similar discussions with my daughter. Knowing what I know now, I would personally opt for a copper IUD, which is hormone-free and requires a minor surgical procedure. If that option didn’t work out, I would consider using the pill, despite the potential risks involved. The importance of preventing pregnancy is paramount in our society, and it’s somewhat alarming to realize the limited options available to us.

Personally, I would also choose the same approach whether I was a teenager, in my twenties, or even older. However, it surprised me to learn about the various health aspects associated with the pill. Not only does it impact our physical health, but it can also affect our emotions and decision-making, as you mentioned. Perhaps we can delve into the risks you highlighted regarding depression and anxiety and explore what the pill actually does. Many people assume it simply tricks the body into thinking it’s pregnant. Still, it would be beneficial to discuss the roles of estrogen and progesterone and how they contribute to its mechanism of action.

For a naturally cycling woman, the menstrual cycle follows a pattern. On the first day of the cycle, when menstruation begins, hormone levels, such as estrogen and progesterone, are low. Since the hormone levels increase, the brain signals the ovaries to mature egg follicles. As this happens, the estrogen levels rise steadily, peak during egg release, and then fall after an egg release, followed by an increase in progesterone levels.

If pregnancy doesn’t occur, progesterone levels decline, leading to menstruation, and the cycle starts anew. However, the birth control pill alters this process. The pill contains synthetic estrogen and progestin, which mimics the high progesterone and low estrogen levels of the luteal phase. This convinces the body that it is in the second half of the cycle, awaiting the potential implantation of a fertilized egg.

It’s important to note that while the synthetic estrogen in the pill closely resembles the body’s natural estrogen, the progestin is different. Most progestins in birth control pills are derived from testosterone and are modified to activate progesterone receptors. However, they can also bind to testosterone receptors, causing side effects like skin breakouts, abnormal hair growth, mood changes, and weight gain. Additionally, progestins can stimulate cortisol receptors, leading to increased stress levels. So, although progestins serve their intended purpose, they can have unintended consequences due to their complex nature.

Why do they have success in developing synthetic estrogens but struggle with other hormones? 

That’s an intriguing question, and there are different perspectives on this matter. One explanation I’ve come across suggests that synthesizing estrogen from estrogen is relatively straightforward because estrogen is a stable hormone that can be easily digested and not easily absorbed.

On the other hand, when it comes to progesterone, it’s been mentioned that it is less biologically stable and has difficulty passing through the gut to be absorbed effectively. To overcome this challenge, scientists have developed alternative forms of progesterone that facilitate its transportation, digestion, and fulfillment of its intended functions.

I’ve encountered the same question about creating birth control using synthetic hormones that are bioidentical to our own hormones. However, obtaining a clear answer on why this approach isn’t utilized is difficult.

Does the situation ever inspire you to explore other areas within this field and strive for improvements? If given the opportunity, do you feel motivated to delve into different aspects and contribute towards finding solutions? It’s true that sometimes when something seems good enough, it can be tempting to move on due to busyness or laziness. However, does this ignite your desire to push for better and actively participate in figuring out ways to enhance the current state of affairs?

I think about these ideas quite frequently. Specifically, when it comes to hormones, I’ve pondered the connection to autoimmune diseases, which women are believed to experience at a significantly higher rate than men. One proposed explanation for this is rooted in our ancestral history, where women spent considerable time pregnant. Progesterone is crucial in modulating the immune system and promoting an anti-inflammatory state during pregnancy. Considering this, I wondered why we don’t explore the possibility of administering progesterone to women who are at risk of developing autoimmune disorders. Unlike estrogen, progesterone is less associated with cancer and thrombotic effects. What if we provided women, during their peak reproductive years and if they are not trying to conceive, with progesterone for extended periods, such as nine months or intermittently? This could potentially help regulate their immune systems and address the prevalence of autoimmunity in women.

It’s an intriguing concept that constantly sparks my thoughts on these matters.

How is this concept received in the field? I’m also curious about the distinction between progesterone in birth control pills and synthetic hormone replacement options. Are there notable differences between the two?

If you opt for body-identical hormones and choose progesterone as part of hormone replacement therapy, they will provide you with actual progesterone in pill form. It’s interesting to consider why we haven’t transitioned from using progestins in birth control pills to progesterone. Perhaps various factors are at play, including potential conspiracy theories or the inability to patent progesterone. It seems that specific progestins used in birth control pills are patented by pharmaceutical companies, allowing them to profit significantly from their products.

When discussing the second phase of the menstrual cycle, it’s commonly understood that a natural decrease in libido and a quieter disposition occurs as the body enters a holding pattern in anticipation of the next phase. However, when using chemical forms of birth control, this state becomes more permanent in a unique manner. What fascinates me is how these contraceptives can impact not only our sex drive but also our relationships and even influence who we are attracted to and the choices we make in partners. I would love to delve deeper into this topic and hear your thoughts on it.

Research over a couple of decades has consistently shown that as estrogen levels rise during the menstrual cycle, women experience increased sexual desire. This period, associated with the possibility of conception, motivates women to be more flirtatious, exude a more appealing scent to men, and carry themselves in a sexier manner.

Essentially, women instinctively enhance their attractiveness and create an environment conducive to sexual activity and potential pregnancy. 

Furthermore, studies have revealed that when estrogen is at its peak, women tend to emphasize qualities in potential partners that are associated with “good genes” and male immune function, such as masculine facial features, deep voices, broad shoulders, and dominant behavior.

More recently, researchers began investigating the effects of hormonal birth control on these patterns. As women on the pill do not experience the cyclical rise of estrogen, their sexual desire is generally lower than naturally cycling women. They also lack the cyclic changes in attractiveness to men observed during the estrogenic phase. Additionally, women on birth control tend to show a preference for less masculinized male traits and struggle to discern genetically compatible partners based on scent, which naturally cycling women can do during their estrogen-dominant phase.

These findings highlight the impact of hormonal birth control on women’s sexual desire, partner preferences, and the ability to perceive genetic compatibility cues.

As one who studies and intimately understands the intricacies of biology, chemistry, and hormones, it’s fascinating to observe how our society often attempts to disconnect from or ignore these fundamental aspects of human existence. It seems that we are constantly striving to distance ourselves from our biological nature, sometimes to the point of overlooking important insights and targets that could greatly benefit us. When you share this information with others, it’s understandable to feel frustrated sometimes, as the conversation around these topics is often lacking. It’s as if we believe we are intellectually superior and in complete control, yet there are underlying forces at play that we fail to recognize. Do you approach it forcefully in your interactions, like using a sledgehammer, or do you present the facts and hope that others will grasp their significance?

For me, understanding oneself holistically – spiritually, emotionally, and biologically – provides valuable tools for personal growth and reaching desired destinations. These insights serve as guides along the journey. I’m curious about your approach, steeped in this wealth of information, and how you share your knowledge and experiences with others.

In our culture, there seems to be a tendency to distance ourselves from our biology and focus on the limitations of things like biological sex. However, it is critical to recognize that biological processes play a significant role in shaping our feelings, experiences, and motivational states. Understanding these processes can be incredibly empowering, alongside acknowledging the importance of social factors and spirituality.

Often, we find ourselves caught up in polarizing opinions, treating everything as if it were a team sport. However, it’s essential to embrace multiple truths simultaneously. Biology does matter, and it influences who we are, but this understanding doesn’t have to be prescriptive. For instance, studies show that women’s brains are different from men’s brains on average, but that doesn’t mean all women fit neatly into a specific mold.

It’s also essential to respect individual experiences and identities. If someone doesn’t identify as their assigned biological sex, it doesn’t contradict science or become problematic. Nature encompasses many possibilities, and everything within it is natural. We must address these topics because they are integral to who we are, rather than attempting to suppress or ignore them.

For me, it’s important to view these tools as just that – tools. The information is there for you to use in whatever way you see fit. Even as a woman, having a deeper understanding of our biology can be incredibly empowering.

Take, for example, the insights shared by Alisa Vitti. Understanding that there are certain times of the month when we may crave more calories is enlightening. Instead of questioning ourselves and feeling guilty, we can recognize that it’s a natural part of our hormonal cycle.

The same goes for nutrition. Our biology is wired to seek and consume food when it’s available, dating back to our primal instincts. Armed with this knowledge, we can make choices that serve us best. Rather than fighting against our impulses, we can embrace them and make informed decisions about what we truly want and need.

It’s fascinating how often we try to resist or push against these natural inclinations instead of seeking understanding. By acknowledging and navigating our unique paths, we can find greater harmony within ourselves.

You’re absolutely right about the impact of women’s hormones on our sensory experiences. During certain phases, like PMS, our senses can become more heightened due to the influence of progesterone. Suddenly, sounds or smells that wouldn’t typically bother us can become overwhelming. Rather than ignoring or dismissing these changes, it’s important to acknowledge and embrace them. We can recognize that certain things may affect us differently during this time and openly communicate our needs to those around us. Just as we would apologize for snapping at someone when we’re tired or hungry, it’s equally valid to acknowledge the biological shifts happening before our period.

Understanding these biological differences can greatly improve our relationships. For example, in my own experience, my partner tracks my cycle and finds it helpful in understanding my mood fluctuations. Instead of feeling guilty or confused, he recognizes that certain days of the month may require a little extra care and consideration.

I vividly recall a moment when my husband asked me to explain something related to our work, and I unexpectedly responded with an uncharacteristic lack of patience. Normally, I would have been willing to find out the information and help navigate the situation. However, on that particular occasion, my typical calm demeanor seemed to vanish, and I firmly refused to provide any explanation.

Reflecting on this incident reinforces my belief in the importance of understanding our biological influences rather than attempting to suppress or alter them. Trying to bend or force our innate biology into something it’s not can feel futile and ultimately lead to frustration.

Absolutely! Understanding the impact of different phases in a natural cycle on our preferences and behaviors is incredibly valuable. Research has shown that during the estrogenic phase of the cycle, women tend to pay more attention to cues related to testosterone. However, during the progestogen phase, our focus shifts towards factors like provisioning ability and care. This knowledge can be especially helpful for women in relationships with men. There may be moments in the cycle where it feels like our partner is not meeting our needs or the connection feels distant. In those instances, it’s important to take a step back and recognize that it’s likely not a relationship problem. It’s simply a normal fluctuation in our own emotions and desires, and it will pass in a few days.

By understanding these patterns and acknowledging that they are part of who we are, we can avoid unnecessary relationship conflicts and maintain a sense of perspective. We can trust that our feelings and perceptions will change as we move through different phases of our cycle. This understanding brings valuable insights and allows us to approach our relationships with greater awareness and compassion.

Cultivating self-awareness and maturity is a vital part of our personal growth as we navigate through life and transition into adulthood. One aspect of this growth that I found particularly valuable was the suggestion made by Alisa Vitt in her book to have both partners use an app to track their menstrual cycles.

In my own experience, I have noticed that male partners, even if they can’t articulate it, start to understand the influence of hormonal fluctuations intuitively. They have a sense of where we are in our cycle and how it may be affecting our emotions and desires. This intuitive understanding contributes greatly to a relationship’s overall harmony and communication.

Another interesting point you raised in your book is the difference between the two groups: one group being on birth control pills and the other not using hormonal contraception. When the group that was not on the pill entered into a long-term commitment, such as marriage or starting a family, it was observed that they tended to have a higher frequency of sexual activity.

One interesting aspect of hormonal influences on attraction that researchers have explored is the impact of choosing a partner while on birth control and then later discontinuing its use. Similarly, what happens if someone chooses a partner when they are not on birth control and then start using it?

Studies have shown that for women who selected their partners while on birth control and subsequently stopped taking it, there can be a shift in sexual attraction, as well as levels of sexual and relationship satisfaction. However, whether this change is positive or negative depends on how physically attractive the partner is perceived to be. In other words, women tend to experience varying degrees of satisfaction and attraction towards their partner based on their partner’s level of physical attractiveness. 

Isn’t it great? We, females, are also shallow!

This finding highlights the complexity of factors influencing the dynamics of attraction and underscores the importance of understanding the potential effects of hormonal influences on relationship dynamics.

It’s fascinating to explore how these factors interplay and how they may impact the overall satisfaction and longevity of a relationship.

Research revealed intriguing insights into the effects of hormonal contraception on attraction and relationship satisfaction. When women who chose their partners while on the pill discontinue its use, there can be a significant change in their perception of their partner’s sexiness. If they select a partner considered to be physically attractive, their sexual attraction and desire increase, along with an overall boost in relationship satisfaction.

Conversely, for women who chose a less physically attractive partner while on the pill, the opposite occurs. They report reduced attraction to their partner, decreased sexual activity, lower sexual satisfaction, and a decline in overall relationship satisfaction. This suggests that natural hormonal cycling, particularly the influence of estrogen, plays a role in heightening our attunement to compatibility and sexiness within relationships.

The hormones in birth control pills, by suppressing estrogen levels, may dampen this attunement to sexiness and instead shift focus towards more tangible factors like financial stability or provisioning ability. 

Consequently, when a woman discontinues hormonal contraception and returns to her natural hormonal cycle of fluctuating estrogen and progesterone, she may experience a trade-off between a partner’s sexiness and their ability to provide.

It is worth noting that the effects of discontinuing hormonal birth control are highly individualized, and not all women experience significant changes in sexual desire or attraction to their partner. The impact varies from person to person, highlighting the nuanced nature of relationships and the multitude of factors that influence attraction and satisfaction.

If I were a male listener, it would be understandable to have thoughts and concerns about the perception of masculinity in today’s society. While there is a cultural narrative that sometimes pits masculinity against sensitivity, it’s important to recognize that these qualities are not mutually exclusive. Our world can sometimes feel divided on these issues.

In my own experience, I have a partner who embodies both masculine traits like being a good provider and father, as well as qualities like sensitivity and good communication. However, there have been moments when I’ve found myself appreciating his physical appearance and jokingly acknowledging the attraction. I even playfully refer to it as “reverse objectification” as a way to have fun with the dynamics between genders. It seems that when you have a strong sense of self and personal power, these truths about attraction don’t unsettle you. You understand that regardless of external factors like hormonal cycles, you still have agency and the ability to make choices for yourself, whether it’s in relationships or personal style.

In our current world, it’s important to challenge the idea of men in positions of power abusing their authority or physical strength. This behavior doesn’t represent true masculinity. It may stem from misogyny or other issues unrelated to genuine masculinity. Real masculinity, on the other hand, can be seen as something valuable because women, once they emerge from certain experiences, often discover that they are attracted to partners who possess masculine traits. Embracing and celebrating genuine masculinity should not be discouraged. It’s about recognizing personal desires and finding satisfaction, both for oneself and for healthy and fulfilling relationships.

I completely agree with you. True masculinity is about leadership, compassion, and the ability to connect socially. It doesn’t have to be violent or hostile towards women. It’s unfortunate that some individuals, like the examples you mentioned, may exhibit misogynistic behavior due to their inability to attract women.

Creating a generation of men who are not desirable to women is a concerning outcome of the negative narrative surrounding masculinity. However, it’s important to note that true masculinity, when embodied in a respectful and compassionate manner, can be attractive to women.

Like you, I also have a masculine partner who is a great communicator, a caring father, and exhibits strong leadership qualities. These attributes are appealing and attractive to me, as well as to many women. The notion that masculinity equals bad is a harmful stereotype that limits our understanding of the complex dynamics within relationships.

Even the idea of protectiveness is often associated with masculinity, but that doesn’t mean you don’t possess masculine traits yourself.

As women, we shouldn’t drop the ball on this issue. We need to do it for our daughters and other young women. It’s about cultivating and encouraging men to embrace the right kind of masculinity. This way, they will attract partners they genuinely want to be with.

Laird always jokes with me, saying that if he had changed in all the ways I wanted him to early on, I probably wouldn’t want to be with him. And there’s some truth to that. These conversations can benefit both women and men, allowing us to find common ground and win together. It’s not an either-or situation. Additionally, women need to be aware that changing everything about themselves may not lead to getting what they truly desire. This is obvious in the context of dating apps, which often prioritize casual encounters rather than meaningful connections.

There are various factors that can contribute to a decline in men’s testosterone levels, such as environmental factors like phthalates, as discussed in Dr. Swan’s book “Countdown.” However, I’d like to know if women being on chemical birth control could also play a role in this. Perhaps the absence of certain signals related to fertility and reproduction may impact men’s testosterone levels, as there might be less incentive for them to compete for a mate. Could these factors be interconnected, or do you see them as separate issues?

Absolutely! I agree with you. Research has shown that men’s testosterone levels can be influenced by factors such as the presence of attractive and ovulating women, as well as the scent of clothing worn by women during high fertility. These stimuli trigger an increase in testosterone levels in men.

Considering that many women are on hormonal birth control, which suppresses the release of these signals of high fertility, it is plausible that the absence of such cues in the environment could contribute to lower testosterone levels in men. Men’s bodies respond dynamically to opportunities for mating and fertility, and when these cues are lacking, it can impact their testosterone production. The suppression of women’s fertility through hormonal birth control could potentially be a significant factor in the observed decrease in testosterone levels among men. The absence of cues related to fertility may disrupt the natural hormonal balance and response in men.

Finding reliable information can be a challenge, but there are several sources where we can seek better information. Reputable medical websites like the Mayo ClinicWebMD, and the American College of Obstetricians and Gynecologists (ACOG) provide accurate and up-to-date information on birth control options.

Regarding the future, ongoing advancements in contraceptive technologies hold promise. One such example is the development of non-hormonal reversible contraceptives, like the male contraceptive pill or alternative methods for women that do not rely on hormones. These innovations aim to provide more options and address the concerns and preferences of individuals who may want to avoid hormonal birth control methods. The best-case scenario would involve:

  • Comprehensive sexual education.
  • Easily accessible and affordable contraceptive options.
  • A societal shift towards supporting individuals in making informed choices about their reproductive health.

It would empower women to pursue their personal and professional goals without compromising their ability to have a fulfilling and intimate sex life. While the IUD is currently considered one of the most effective forms of contraception, ongoing research and development may bring new and interesting options. 

Ongoing research in its early stages shows promise in the field of male contraception. One particular area of interest involves a derivative of vitamin A that seems to be specific to sperm production. In rodent models, scientists have found a way to block the body’s ability to read the message presented by this derivative, effectively preventing sperm production. Unlike previous attempts at male birth control that artificially lower testosterone levels, this approach targets the specific mechanism involved in sperm production. By blocking this process, it eliminates the need for men to rely solely on low testosterone levels, which can have negative side effects. Instead of shifting the responsibility solely to women, this innovative approach aims to give men an active role in contraception. 

The situation with contraceptive responsibilities does seem to place a significant burden on women. While there are conscientious men who take an active role in contraception, the biological realities often mean that women bear the greater risks and consequences. The fear of an unintended pregnancy can create an added weight on women’s shoulders. 

So we’ve got the derivative of vitamin A. Is there anything else showing up for women?

The short answer is no. The potential use of a vitamin A derivative to prevent sperm production raises interesting possibilities for long-term monogamous relationships. If this approach proves effective and safe, it could provide a viable option for couples seeking contraception. However, for women in casual or early-stage sexual relationships, the burden of contraception is likely to remain predominantly on them.

Considering the challenges women face with hormonal fluctuations due to egg production, alternative contraceptive methods that mimic the temporary nature of tubal ligation could be explored. Brainstorming sessions involving experts from various fields may lead to innovative ideas, such as temporarily using a shunt-like device to redirect released eggs. These out-of-the-box solutions could offer women more control over their reproductive choices without interfering with hormonal balance.

Are there discussions or thoughts suggesting long-term contraceptive methods like the pill and IUD may have significant drawbacks?

According to research, one of the most brutal contraceptive methods in the long term appears to be the hormonal shot. This method is still used, particularly in developing countries where there is a need for cost-effective fertility regulation. The recently introduced progestin-only pill, available over the counter, also has significant psychological side effects and a high likelihood of adverse reactions. The absence of estrogen in this pill is the reason it was allowed to be sold without a prescription, as estrogen is associated with health risks like heart attacks. However, estrogen in birth control pills is essential for women to feel more normal.

Interestingly, combination hormonal contraceptive pills tend to have the best side effect profiles among different hormonal birth control options. The hormonal IUD, on the other hand, can initially cause severe side effects, especially in young women who are still in the developmental stage. This is because the low levels of hormones released by the IUD can disrupt the natural hormone balance and make women feel emotionally unstable. However, after using the hormonal IUD for an extended period, some women may start ovulating again, leading to a positive change in their mood and well-being. 

It’s important to note that the process of resuming ovulation can take up to a year and, for some women, may not occur at all. Studies have shown that the majority of women using the hormonal IUD do not ovulate in the first year of use, with approximately 80% experiencing a lack of ovulation. However, by the fifth year of use, around 80% of women using the IUD are ovulating again. This period allows for a significant change in hormone production. Many women who have been using the IUD for an extended period and have started ovulating again often report feeling more like themselves and experiencing fewer side effects. This is because their bodies are once again producing hormones, resulting in improved overall well-being.

However, it’s important to note that for those initially using the IUD and not yet ovulating, the experience can be quite challenging and unpleasant. Additionally, all progestin-only methods of contraception are generally not recommended unless there are no other viable options available. This is particularly true for women at higher risk for heart disease due to factors such as being over 40, smoking, or being overweight. In such cases, contraceptive methods containing estrogen may not be advisable. For most women, it is recommended to opt for a combination hormonal product if choosing hormonal birth control. Combination products tend to provide a better overall experience and can make individuals feel significantly better compared to those containing only progestin.

Are there any alternative practices or supplements that can offset the negative impacts of chemical birth control? I’ve heard of people considering more holistic approaches to mitigate these effects. Have you come across any such methods or practices?

Hormonal birth control can potentially lead to certain nutritional deficiencies. While I don’t have all the specific details at the moment, there are some deficiencies in B vitamins and vitamin D that can become more problematic when taking the pill. Authors like Lara Briden, who wrote the “Hormone Repair Manual,” and Jolene Brighten, who discusses these issues in her book “Beyond the Pill,” provide valuable insights into these nutritional deficiencies. It may be beneficial to consider taking recommended vitamins suggested by these authors to address these concerns. One highly recommended nutrient for women, regardless of their hormonal status, is magnesium, known for its numerous benefits.

What does it do, like 72 processes in the body or something insane like that?

There is a comprehensive textbook dedicated to exploring the effects of magnesium on the brain due to its multifaceted nature and powerful properties as a vitamin. Personally, incorporating magnesium into my routine has had a significant impact on my life. As someone who struggles with sleep and tends to experience high levels of stress, magnesium has provided a remarkable sense of balance that I hadn’t achieved with any other remedies before. Its transformative effects have been truly life-changing for me.

Do you use a specific type of magnesium? Is there a particular type that you find more effective for sleep, or do you use a different type altogether? I’m curious about the various types of magnesium available. I’m not sure how many different types exist.

I personally take magnesium citrate, as it is known to be better absorbed by the body. I don’t go for anything fancy. I order it from Amazon, as it is readily available and convenient!

If someone maintains a decent exercise routine and follows a reasonable diet but still experiences significant challenges during their menstrual cycle, are there any other supplements besides magnesium that can provide support? I’ve heard that fish oil is often recommended. 

Yes, and Zinc. B vitamins. So that’s also really helpful. And then making sure that you’re getting enough iodine.

As a parent, I understand that navigating healthy eating habits for children can be challenging. Have you established any specific practices or strategies to encourage your kids to eat better? For example, do you ensure they eat the same foods as you at home, or have you discovered any effective ways to encourage healthier eating habits?

Navigating healthy eating habits with teenagers can be quite a challenge. When my kids were younger, we followed a clean eating approach, and I still remember the hilarious moment when my daughter requested a “broccoli treat.” However, as they grew older and were exposed to less healthy food options at school, getting them to eat nutritious meals became increasingly difficult.

To address this, we prioritize family dinners and make it a point to enjoy the same meals together. I’ve never subscribed to the idea of catering to individual preferences so everyone in the family eats the same thing. While they do indulge in unhealthy food outside of the home, they have also developed a taste for nutritious foods like arugula, Brussels sprouts, and beets. Although they still consume junk food, I believe that exposing them to the goodness of healthy food will eventually help them make the connection between their choices and how their bodies feel. I try to emphasize the importance of listening to their bodies and understanding the impact of their food choices on their overall well-being.

 It’s important to give them the freedom to explore and make their own choices as they navigate the world. While you provide a great template and model healthy behaviors, having faith that they will eventually come back to healthy eating habits is crucial. I’ve witnessed this with my older children as they eventually circle back to the healthy lifestyle they were exposed to growing up. It’s fascinating to see how they incorporate cooking and healthy living into their lives. Don’t panic or get overly concerned when they experiment with unusual food choices or indulge in less healthy options. These experiences help them understand why they prefer healthier alternatives in the long run.

I understand your concern, especially when it comes to my 16-year-old, who seems to be indulging in less healthy food choices. However, it’s important to remember that this is a common phase many teenagers go through. The hope lies in knowing that they have been exposed to healthier options and will likely circle back to making better choices in the future. So, stay positive and continue providing them with a solid foundation of healthy eating habits.

You’re absolutely right. Giving our teenagers the tools and knowledge about healthy choices is crucial. It’s a part of their journey in life, and it’s important to understand that their language at 16 may involve experimenting with different foods, even if they’re unconventional or less healthy.

I am interested in how you maintain such a healthy lifestyle while juggling multiple responsibilities. Being in a partnership, raising children, and engaging in demanding work can be pretty challenging. Do you have any specific practices or strategies that help you manage it all? Balancing everything is no easy feat.

It can feel like a lot to juggle multiple roles and expectations as women in today’s society. While we have more opportunities than ever before, this can also create a culture where we feel the pressure to fulfill both masculine and feminine roles simultaneously. It often feels like we need to live two lifetimes to achieve everything we aspire to. I resonate with this sentiment deeply.

As you noted, being health-conscious has made a significant difference in my life. When I was living in Orange County at the age of 30, I visited my general practice doctor. I presented him with a list of my concerns, including stress, anxiety, sleep issues, gut contractions, and migraines. His response struck a chord with me. He likened me to a thoroughbred horse and advised that to improve my well-being, I needed to exercise like an Olympic athlete. He emphasized the importance of engaging in intense workouts. 

Taking his advice to heart, I incorporated weightlifting and cardio exercises into my routine. While I don’t spend hours at the gym every day, I make it a point to be active almost every day, even if it’s just a 20-minute walk. Typically, I visit the gym around four times a week, spending around an hour and 15 minutes there. This combination of weightlifting and cardio has proven to be highly beneficial for me.

In addition to strength training and cardio, I also practice Surrender yoga. 

It sounds like something I would absolutely hate. It sounds like my biggest nightmare!

You know, it’s interesting how sometimes we have these mixed thoughts and feelings about certain things! And in this case, it’s about the practice of holding poses and being active. Instead of being constantly on the move, there’s a different approach where you transition into a more relaxed state.

It’s like going from an active yang state to a yin state, where you fall into a pose and stay there for a few minutes, allowing yourself to stretch and contemplate. I do this practice once a week, and after three years of doing it, I can truly feel the difference when I haven’t been consistent with it. It helps me unwind and release tension that builds up over time.

Engaging in a yin practice can be a wise choice, especially for individuals who may not naturally possess flexibility or tend to be intense, high-strung, or overachievers. There’s a lot to be said about the benefits of yin yoga, which invites the body to ease into positions rather than forcefully pushing it into them. It’s pretty clever when you think about it.

And let’s not forget the intriguing juxtaposition of the names “Surrender” and “yoga” coexisting side by side. It certainly adds an interesting layer to the practice.

For me, it involves incorporating regular exercise, maintaining a nutritious diet, and prioritizing other essential factors like quality sleep and exposure to sunlight. These elements play a significant role in supporting our mental health.

I take this approach seriously. I often ask myself what our ancestors would have done in similar situations. Our evolutionary history makes it apparent that humans thrived under conditions that involved going outside, engaging with nature, soaking up sunlight, connecting with loved ones, and prioritizing family time. With these insights in mind, I consciously try to incorporate these practices into my life. It’s not just about the physical aspects but also about nurturing our mental well-being. 

When you talk about how the pill can potentially contribute to anxiety, depression, and other related issues, it raises important questions about finding alternative options. With that in mind, do you believe we might eventually discover or develop a more suitable and improved form of birth control specifically designed for women?

Absolutely! With advancements in technology, it’s hard not to have faith in finding better solutions. Interestingly, it may not come from the traditional avenues of big pharmaceutical companies or medical research. Instead, many women-led businesses are taking the initiative, recognizing the need for improvement and advocating for better options. The growing number of women invested in this cause gives me confidence that we will stumble upon more effective alternatives. As more women experience the challenges related to fertility regulation, the urgency to find solutions intensifies. This isn’t just for ourselves but also for our daughters and future generations.

The quest for a method that balances minimal negative impact with effective fertility regulation is undeniably crucial. In fact, it ranks among the most significant questions we face. Given the importance of this issue, my optimism remains steadfast.

I completely understand your concern regarding the challenges younger women face regarding fertility and their overall well-being. It’s a critical issue that deserves attention. If you were to invite someone, such as a partner or a father, who wants to learn more or gain a better understanding of the topic, or even women themselves, is there a particular invitation you would like to extend to them?

Absolutely! If you want to learn more about birth control and related topics, I highly recommend reading my book. It’s written in a way that is accessible and engaging for both men and women. While it contains scientific information, it avoids being overly dry or technical.

In addition to reading, educating yourself on the subject is crucial. One great suggestion is for your partner to download a cycle-tracking app. This allows them to learn more about and understand their partner’s menstrual cycle. It can be incredibly empowering for men within the relationship and helps share the responsibility of fertility management. This kind of shared burden is important for fostering a deeper understanding and support between partners.

I completely agree with you. It’s incredibly sexy to have a partner who is fully invested and supportive in every possible way. While certain aspects of fertility and pregnancy may be exclusive to the woman’s experience, there are plenty of other ways for your partner to be involved and help you.

For instance, your partner can provide support and assistance in various ways that don’t involve breastfeeding, like taking care of other responsibilities or being understanding of your needs and desires. This kind of support can create a deeper connection between partners and contribute to a more receptive and fulfilling relationship.

Regarding resources, I recommend checking out the “In the Flow” app by Alisa Vitti. It’s an excellent tool for understanding and tracking menstrual cycles. 

Can you share all the places people can find you? 

Certainly! You can find me on various social media platforms with the handle @SarahEHillPhD. Additionally, my website is www.SarahEHill.com.

I’m thrilled to announce that my book, “This is Your Brain on Birth Control,” has recently been released in paperback. It’s available for purchase at all major book retailers.

Sarah, I want to express my sincere appreciation for your book and the work that you’re doing. One thing that really stands out to me is how you tackle complex topics without resorting to a sense of hopelessness. You provide us with the science and information we need while also inspiring us to stay motivated and driven toward finding solutions. As one of the messengers, you do a remarkable job of encapsulating the challenges we face while still fostering a sense of hope and determination. It’s not easy to strike that balance, but you manage to do it beautifully. Thank you for your incredible efforts.

 I genuinely mean it. Your work is truly impactful, and I appreciate how you approach these difficult subjects with honesty and optimism. It makes a significant difference. Thank you once again.

Thank you so much. That means a lot to me. 

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About Sarah Hill

Born and raised in southeastern Wisconsin, I went on to earn my undergraduate degree in Anthropology from the University of Wisconsin at Milwaukee (pronounced Mwah-kee, in case you want to sound like a local). It was at UWM that I was first exposed to research in human behavioral ecology and evolutionary psychology. To make a long story short, it was love at first sight and off to graduate school I went. I earned my Ph.D. at the University of Texas at Austin working with Dr. David Buss. I have an almost endless number of research interests, but tend to gravitate toward questions about relationships and health. You can learn more about what we are working on now on my Research Page.

In my free time, I love to read, write, drink wine, watch football, cook, drink wine, and spend time with my family.