How Does Birth Control Impact Overall User Wellness:

A Mixed-Methodology Approach Surveying How Physical, Mental,

and Social Wellness is Impacted by Use of Birth Control

A Capstone Presented for the

Bachelors of Arts

Medical Humanities

The University of Nebraska at Omaha

Ashley Beamon

May 2023
ABSTRACT

The purpose of this study is to understand the ways in which birth control may impact

wellness. By looking at physical activity, social wellness, experienced side effects, and a range

of demographics, the goal is to better understand how the use of birth control may impact its

user’s overall wellness. After gathering data in a two-week survey, I discovered that mood

swings, weight gain, and depression were the top three reported side effects and Latina women

reported irregular bleeding at a higher frequency than white women. Loneliness is impacted by

birth control use; users were 30% more likely to report being lonely multiple times a week than

nonusers. The results of this research can be used to further investigate the relationship between

social wellness and birth control use. Additionally, more research can be done into why Latina

women may experience irregular bleeding more frequently.

INTRODUCTION

According to Greek mythology, Persephone, the Greek goddess of Spring, was kidnapped

to the Underworld, raped, and forced to marry the God of Death, Hades. While in the

underworld, she ate only one thing: pomegranate seeds. As a result of eating the pomegranate

seeds, she was forced to remain in the Underworld for a third of the year, corresponding to

Wintertime on Earth. The purpose of the Greek myth is to explain the first Winter on Earth; a

time where the Goddess of Spring withheld her fertility, contained in the Underworld (Knowles,

2012). Modern scientists now know that pomegranate seeds contain estrone, estriol, and other

phytoestrogens that give it contraceptive qualities (Nelson, 2009). It can be reasonably argued

then, that Persephone ate the pomegranate seeds to prevent herself from becoming pregnant, and

that wintertime is symbolic of her choice to take control of her fertility.

Humans have been controlling fertility since the days of living in caves. From drinking

lead and mercury, to hanging the testicles of a weasel on one’s thigh, to walking in a circle three

times around the spot where a pregnant wolf had urinated, centuries of people have desperately

searched for ways to prevent pregnancy (Knowles, 2012). In the mid-20th century, contraception

as we know it today was created. The pill was dreamed up by Margaret Sanger and Katharine

Dexter McCormick, and created by biologists John Rock and Gregory Pincus (Knowles, 2012;

Our Bodies Ourselves Today, 2023). In the first stages, ‘The Pill’ was tested on poor women in

Puerto Rico. These women were not informed of the experimental stage that the pill was in, and

since the pill had unnecessarily high amounts of estrogen, the women in Puerto Rico began

having blood clots and dying. After learning this information, Rock and Pincus lowered the

amount of estrogen and then sent ‘The Pill’ to market. There was no publication of the risk of

blood clots and associated death until after a million U.S. women were already taking the pill

(History of Birth Control, 2019).

 Sadly, this was not the only time that a contraceptive method was not thoroughly and

ethically tested before being sent to market. The Dalkon shield was a type of IUD that boasted a

1.1% pregnancy rate. Over a year, the creator of the Dalkon shield, Dr. Hugh Davis, inserted his

IUD into over 600 patients. With those patients as the only testing done, he then opened the

Dalkon Shield up to the medical market. Within 3 years, almost 4 million Dalkon Shields were

sold. Over these 3 years, and the years following, the FDA was flooded with reports from

Dalkon Shield users who were suffering from pelvic inflammatory disease and blood poisoning.

Twenty women died as a result of complications from the Dalkon Shield. Women suffered from

spontaneous abortion, had babies with brain damage, and some were left sterile.

It was later publicized that the testing Dr. Davis claimed to prove the safety and

efficiency of his Dalkon shield was faulty. He not only advised his patients to use spermicide in

addition to the Dalkon Shield, but only followed up on each patient an average of five months.

The 1.1% pregnancy rate was completely falsified, and the safety of the Dalkon Shield was

based upon five-month follow ups (The Contraceptive (Dalkon Shield), 2018).

All of this is not to discount the impact that contraception has had on women’s lives.

Between 1960 and 2021, the percentage of women in the United States over the age of 25 with at

least a high school degree increased from 42.5% to 91.6% and the percentage of women with a

bachelor's degree increased from 5.8% to 39.1% (“Rates of High School Completion and

Bachelor’s Degree Attainment Among Persons Age 25 and Over, by Race/Ethnicity and Sex:

Selected Years, 1910 Through 2021,” 2021). Women have made immense progress in the

workplace, now earning half of all doctorate, medical, and law degrees (McKay, 2020). Birth

control has changed the way people live, and most of that change has been good. However, it is

important to recognize the ways in which the negative change has impacted women’s lives and

overall wellness. In order to keep making improvements, the negatives need to be not only heard,
but believed and addressed. The purpose of this study is to understand the ways in which birth

control may impact wellness. By looking at physical activity, social wellness, experienced side

effects, and a range of demographics, the goal is to better understand how the use of birth control

may impact its user’s overall wellness.

LITERATURE REVIEW

The scope of this literature review is limited to my ability to gain access to studies

through the institution University of Nebraska at Omaha. One area of struggle I encountered

while looking for research into birth control usage and the symptoms associated, was finding

recent studies in the United States. A majority of the research available relevant to this topic was

done in Europe in the 1990’s. Additionally, most studies available to me examine oral

contraception only. This poses a problem because hormonal birth control extends beyond just

oral contraceptives. In the current political climate of the United States, access to abortion and

reproductive healthcare services have become more limited than in the past. For that reason,

literature about the impact that accessibility to reproductive healthcare has on women’s health is

included within the scope of this literature review. The literature included gives context to the

original research I conducted by highlighting the lack of accessible information regarding

people’s complaints about birth control and the gap between user experience and what the

research has concluded.

The Contraceptive Mandate falls under the ACA (Affordable Care Act), implemented by

President Barack Obama in 2010. It ensures that female contraceptives are covered under the

ACA and plans offered through network providers cannot charge a copayment, coinsurance, or

deductible for preventative measures (Chamber and Jeffries, 2021). This mandate allows for

easier access to birth control for women who come from lower socioeconomic classes, and
therefore will help to support planned pregnancies and the removal of barriers to financial

success (Chamber and Jeffries, 2021). When the Trump Administration took office, they allowed

for exemptions to the Contraception Mandate, which allowed employers to omit contraceptive

services in their insurance plans (Chamber and Jeffries, 2021). This decision disproportionately

impacts women of color and women experiencing poverty, as they are no longer able to afford

effective forms of birth control (Chamber and Jeffries, 2021). Within the scope of my own

research, the rollback of the Contraceptive Mandate and the overturn of Roe v. Wade limits both

women’s choice to be on birth control. In turn, women’s health and wellness may be negatively

impacted.

German women’s perception of side effects of birth control, compared to side effects

actually experienced are at odds (Oddens, 1998). While 59-73% of women reported expecting to

gain weight when starting birth control, only 27% of users, past and present, reported actually

gaining weight (Oddens, 1998). A 2022 study found that 40% of the women that turned down a

method of birth control, turned it down due to its potential side effects (Kingsberg, 2022). When

looked at as a cohort, it was found that depression and oral contraceptives had no association (De

Wit et Al., 2020). Oral contraceptives were not shown to have a significant impact on mood

swings (Natale and Albertazzi, 2006). In fact, oral contraceptive users reported a steadier mood

level than nonusers over an entire menstrual cycle (Natale and Albertazzi, 2006).

A 1997 study in Sweden found that for all age groups studied, oral contraception was the

most frequently used method of birth control (Larsson et. Al, 1997). For 19-year-olds,

contraception use at some point in their life was reported by 73% of respondents. For 24-year-

olds and 29-year-olds, contraception use was reported by 94% and 97% of respondents,

respectively (Larsson et. Al, 1997). The most frequently reported reason for oral contraception

cessation across all age groups was fear of oral contraception (Larsson et. Al, 1997). Weight
gain, menstrual bleeding disorders, and mental side effects accounted equally across all age

groups as reason for cessation (Larsson et. Al, 1997). Throughout the literature, a fear of

potential side effects, or perceived side effects was a common theme. Looking across various

studies (Larsson et. Al, 1997; Kingsberg, 2022), side effects were reported as reasoning for

cessation, however, there is no significant relationship between birth control use and these side

effects (Natale and Albertazzi, 2006; De Wit et Al., 2020). It begs the question, why are so many

people reporting side effects then? Is it a mass placebo or is there something else that hasn’t yet

been studied? There is a gap between the symptoms being experienced by women and what the

research is reporting. My research will hopefully be able to start layering the foundation for

closing that gap.

Kingsberg (2022) compared women’s perspective of the side effects they experienced

and the perspective of their healthcare professional. They found that 65% of women have turned

down a birth control method in the past and that blood clots were the most concerning side effect

(Kingsberg, 2022). Comparing what healthcare providers believed women were concerned

about, and what women actually reported being concerned about, blood clots had the highest

discrepancy (Kingsberg, 2022). When doctors are unaware of the fact that women are concerned

about potential side effects, are they less likely to explain them to women before prescribing

birth control? The data obtained from my research will be published for the access by the general

public with the hopes of being a resource for women to educate themselves on contraceptives.

METHODS

In order to execute this study, a survey was used as the source of data collection.

Qualtrics software was used, as it is provided for free to University of Nebraska at Omaha

students. Questions were designed with a holistic approach, using various sources (Mayo Clinic,
2022; Oddens, 1998) for background information such as common side effects of birth control

and birth control methods. Question design took place over multiple days, with a first draft sent

to faculty mentor Dr. Heineman. After revision, questions were entered into Qualtrics, and the

survey was tested by a fellow researcher, and then once approved, opened to the public. The

parameters of the study were people over the age of 18 who live in Nebraska.

The link to the survey was sent directly to the members of Panhellenic sorority Alpha Xi

Delta via QR code. A clickable link was sent to the Collegiate Panhellenic Council to distribute

to the three other Panhellenic sororities, Chi Omega, Zeta Tau Alpha, and Sigma Kappa.

Through direct messaging, a clickable link was sent to Multicultural Sororities Lambda Theta Nu

and Sigma Lambda Gamma. A clickable link was sent through email to the Women and Gender

Equity Center for distribution through their social media. A clickable link was sent to Dr.

Morrison, director of the Honor’s Program, for distribution through the weekly Honor’s

newsletter. A clickable link was sent to Dr. Sarah Nelson for distribution to the UNO Medical

Humanities faculty. In addition to these avenues, the link was sent to personal connections

including family members, friends, and secondary acquaintances of those family members and

friends. This was in an attempt to gain a broader age demographic. All people who responded to

the survey were made aware that the requirement was to be above the age of 18 and to be a

resident of Nebraska.

The survey remained open for submission for two weeks, between February 21 and

March 7, 2023. On the morning of March 8, 2023, the survey was closed, and submissions

stopped being accepted. Qualtrics provides baseline analysis of the data, including percentage

conversions of response numbers. Mixed methodology was used in the analysis of the data. For

the text box questions that allowed for free answers, grounded theory was used to code.

Grounded theory is based upon using data collected in order to create theories. Other calculations
were completed in excel, including cross tabulation calculations. Mean, median, and mode were

also calculated and recorded for individual variables as well as multiple variables. In order to

answer the question of how demographics impact side effects experienced, the data was

separated into weight, age, and race categories and compared against reported side effects.

Distribution percentages were calculated for each demographic group as opposed to distribution

percentages across demographic groups since demographic responses were not equally

dispersed.

RESULTS

A total of 214 people responded to the survey. Out of those 214, a total of 178 completed

the entire survey (92% completion rate), and therefore, the results were analyzed using a total

number of 178. Demographic categories that had less than 8 respondents were excluded from

further analysis. Out of the 178, 88 respondents reported currently using a form of birth control

(49.72%). The largest age group who partook in the survey, ages 18-22, made up 62.92% of the

responses to the survey (Fig. 1). The second largest age group was 48-52 and made up 10.11% of

the survey responses (Fig. 1). People who identify as white made up 84.3% of the respondents to

the survey (Fig. 2). Those who identify as Black made up 2.3% of responses, Latinx/Hispanic

made up 8.99%, Asian made up 2.8%, and Native American/Pacific Islander 1.7% (Fig. 2). The

largest weight range, 135-144, made up 16.9% of the respondents, as can be seen in Fig. 3.
 Figure 1. Age distribution of survey participants.

Figure 2. Race distribution of survey participants.

Figure 3. Weight distribution of survey participants. Separated into ranges for the purpose of data analysis.

The most frequently used type of birth control is oral contraceptives. As can be seen in

Figure 6, oral contraceptive use was reported by 74.7% of respondents. The second most

common type of birth control is the hormonal IUD, with 17.4% of respondents reporting use

(Fig. 6). For those who reported currently using birth control, oral contraceptives were the most

frequently reported method of birth control (Fig. 7). The most common reason for use of birth

control, past or present, was to prevent pregnancy (63.5%, n=148 respondents) (Fig. 7).
 Figure 4. Birth control method usage, reported as all methods used in each respondent’s life.

Figure 5. Primary reason for birth control use, past or present.

Figure 6. For respondents who reported currently using birth control, the method they are using.

Out of the people who reported having experienced side effects they believed to be due to

their birth control, 72% reported having mood swings. 60% reported weight gain and 52%

reported depression (Fig. 9). These three side effects were the most frequently reported across all

demographics (age, weight, race). By age group, mood swings were most frequently reported for

ages 18-27, 28-37, and 38-47, as can be seen in Table 1. Weight gain and change in sex drive

were reported equally as often as mood swings for ages 28-37 and 38-47. For ages 48-57,
weight gain was the most frequently reported symptom. There was not sufficient data to make

any trend conclusions for ages 58-67 and 68-77. As seen in Table 2, the most frequently reported

symptom by weight for 105-124, 124-144, and 165-184 pounds was mood swings. For 145-164,

185-204, and 205-224 pounds, weight gain was the most frequently reported symptom. For

weights above and below the mentioned ranges, there was not sufficient data to make any trend

conclusions. By race, there was only sufficient data to analyze respondents who identified as

White and who identified as Latina/Hispanic. For those who identify as white, mood swings

were the most frequently reported symptom (47.3%) (Table 3). Weight gain was the second most

reported symptom (39.3%) by White respondents (Table 3). For those who identify as

Latina/Hispanic, the most frequently reported symptom was irregular bleeding (62.5%) (Table

3). Latina/Hispanic respondents made up almost 9% of the survey population, however,

accounted for 21.3% of the respondents who reported irregular bleeding.

For those who reported currently using birth control at the time of the survey, the highest

reported side effect (Fig. 10) was mood swings (56.8%, n=88 respondents). For those who

reported not currently using birth control, mood swings were also the highest reported side effect

(34.8%, n=89 respondents).

Figure 7. Reported symptoms believed to be caused by any form of birth control.

 Figure 8. Reported symptoms believed to be cause by any form of birth control, comparison between those who reported
currently using birth control and those not currently using birth control.

Table 1. Respondents categorized into age groups and percentages of age populations calculated for each symptom.

SYMPTOMS EXPERIENCED BY AGE

Percentage of Respondents by Age
SYMPTOM 18-27, 28-37, 38-47, 48-57,
n=122 n=8 n=14 n=25
WEIGHT GAIN 38.52 62.5 35.71 40
WEIGHT LOSS 5.74 0 0 4
HAIR LOSS 10.66 12.5 7.14 4
ACNE 24.59 25 7.14 0
MOOD SWINGS 54.10 62.5 42.86 16
DEPRESSION 39.34 37.5 28.57 16
ANXIETY 36.89 37.5 35.71 8
MIGRAINES 15.57 12.5 14.29 12
CHANGE IN SEX DRIVE 35.25 62.5 35.71 16
BLOATING 30.33 37.5 21.43 4
IRREGULAR BLEEDING 31.15 50 14.29 8
NAUSEA 16.39 0 14.29 4
INCREASED BLOOD 3.28 25 0 0
PRESSURE
PELVIC PAIN 24.59 37.5 21.43 8
VAGINAL DRYNESS 11.48 12.5 21.43 8
PAIN DURING 14.75 25 21.43 0
INTERCOURSE

Table 2. Respondents categorized into weight groups and percentages of weight populations calculated for each symptom.

SYMPTOMS EXPERIENCED BY WEIGHT

Percentage of Respondents by Weight (pounds)
SYMPTOM 105- 125-144, 145-164, 165-184, 185-204,
124, n=58 n=37 n=20 n=19
n=26
 WEIGHT GAIN 15.38 32.75 43.24 55 47.36
WEIGHT LOSS 11.53 3.44 2.70 5 0
HAIR LOSS 11.53 10.34 5.40 5 10.52
ACNE 19.23 24.13 13.51 10 5.26
MOOD SWINGS 34.61 51.72 40.54 60 31.57
DEPRESSION 30.76 32.75 27.02 35 42.10
ANXIETY 26.92 32.75 27.02 40 31.57
MIGRAINES 15.38 12.06 10.81 5 15.78
CHANGE IN SEX DRIVE 26.92 32.75 29.72 45 21.05
BLOATING 23.07 27.58 16.21 30 21.05
IRREGULAR BLEEDING 19.23 24.13 21.62 40 31.57
NAUSEA 19.23 17.24 10.81 5 0
INCREASED BLOOD PRESSURE 0 0 5.40 5 10.52
PELVIC PAIN 15.38 20.68 21.62 30 15.78
VAGINAL DRYNESS 3.84 5.17 18.91 20 10.52
PAIN DURING INTERCOURSE 7.69 17.24 16.21 10 5.26

Table 3. Respondents categorized by race and percentages of race populations calculated for each symptom.

SYMPTOMS EXPERIENCED BY RACE

Percentage of Respondents by Race
SYMPTOM White, Latina/Hispanic,
n=150 n=16
WEIGHT GAIN 39.33 43.75
WEIGHT LOSS 4.67 6.25
HAIR LOSS 6.67 31.25
ACNE 17.33 37.5
MOOD SWINGS 47.33 50
DEPRESSION 32.67 43.75
ANXIETY 30.00 37.5
MIGRAINES 12.67 25
CHANGE IN SEX DRIVE 34.00 37.5
BLOATING 23.33 43.75
IRREGULAR BLEEDING 23.33 62.5
NAUSEA 12.67 25
INCREASED BLOOD PRESSURE 2.67 6.25
PELVIC PAIN 18.67 50
VAGINAL DRYNESS 12.67 6.25
PAIN DURING INTERCOURSE 12.00 25
NOTE: OTHER REPORTED RACES DID NOT HAVE SUFFICIENT DATA TO DRAW ANY CONCLUSIONS AND INCLUDING
RESULTS WOULD RUN THE RISK OF OVERSIMPLIFICATION.
As seen in Figure 11, most respondents (33.71%) reported engaging in purposeful

exercise three to four days a week. Most respondents (42.70%) reported their weekly activity to
be somewhat active. For the weight ranges 105-124, 125-144, and 185-204, most respondents

reported their weekly activity level to be somewhat active (Table 4). For the age ranges 18-27,

and 48-57, somewhat active was the highest reported activity level (Table 5). For White and

Hispanic respondents, somewhat active was the highest reported activity level, 41.3% and

56.25%, respectively (Table 6). 58.1% of respondents who reported being sedentary also

reported experiencing symptoms they believed to be associated with birth control. 59.2% of

respondents who reported being somewhat active, 44.4% of respondents who reported being

moderately active, and 25% of respondents who reported being very active also reported

experiencing symptoms they believed to be associated with birth control.

Figure 9. Reported number of days of purposeful exercise.

Table 4. Respondents self-reported weekly activity level, responses separated by respondent weight and percentage of each
weight population was calculated.

WEEKLY ACTIVITY LEVEL BY WEIGHT

Percentage of Respondents by Weight (pounds)
REPORTED 105-124, 125-144, 145-164, 165-184, 185-204,
WEEKLY n=26 n=58 n=37 n=20 n=19
ACTIVITY
Sedentary 7.69 17.24 18.92 15.00 21.05
Somewhat active 46.15 43.10 35.14 25.00 63.16
Moderately active 34.62 32.76 45.95 55.00 15.79
Very active 11.54 6.90 0.00 5.00 0.00
NOTE: Weights above and below the weights listed did not have sufficient data to perform analysis and were therefore
excluded.
Table 5. Respondents self-reported weekly activity level, responses separated by respondent age and percentage of each age
population was calculated.

WEEKLY ACTIVITY LEVEL BY AGE

Percentage of Respondents by Age
REPORTED 18-27, 28-37, 38-47, 48-57,
WEEKLY n=122 n=8 n=14 n=25
ACTIVITY
Sedentary 9.02 62.5 50.00 24.00
Somewhat active 45.90 12.5 28.57 44.00
Moderately 39.34 25.0 21.43 28.00
active
Very active 5.74 0.0 0.00 4.00
Note: ages above the ages listed did not have sufficient data to perform analysis and were therefore excluded.

Table 6. Respondents self-reported weekly activity level, responses were separated by respondent race and percentage was
calculated.

WEEKLY ACTIVITY LEVEL BY RACE

Percentage of Respondents by Race
REPORTED WEEKLY White, Latina/Hispanic,
ACTIVITY n=150 n=16
Sedentary 16.67 12.5
Somewhat active 41.33 56.25
Moderately active 37.33 25
Very active 4.00 6.25
Note: respondents who identified as other races than the ones listed above did not have sufficient data to perform analysis and were therefore
excluded.
 Visible in Figure 4, when asked how often they feel a sense of loneliness, most people

(37.85%) reported feeling lonely less than once a month. Out of the respondents who reported

being lonely less than once a month, 59.7% of those people were not currently taking birth

control (Fig. 5). Out of the respondents who reported feeling lonely multiple times a week,

63.6% were currently using birth control (Fig. 5). By age group, 18-27 and 28-37 reported

feeling lonely multiple times a month most frequently (Table 7). For ages 38-47, 48-57, and 58-

67, feeling lonely less than once a month was most frequently reported (Table 7).

Figure 10. Reported loneliness of all survey respondents.

Figure 11. Reported loneliness comparison of those who reported currently using birth control and those who reported not
currently using birth control.

Table 7. Respondents reported their average level of loneliness. Responses were separated by age groups and percentages were
calculated.

Reported level of Percentage of Age Group Respondents

loneliness
18-27, 28-37, 38-47, 48-57,
n=122 n=8 n=14 n=25
Every day 9.02 0 14.29 0
Multiple times a week 21.31 25 14.29 12
 Multiple times a month 39.34 62.5 21.43 16
Less than once a month 29.51 12.5 50 72
Note: Ages above the ones listed did not have sufficient data for analysis and therefore were excluded.

Respondents were prompted to respond to the question, “How does taking birth control

make you feel?” Out of the 130 responses to this prompt, 36 respondents mentioned a harder

time controlling their emotions. 12 reported an increase in depression, and 3 reported

experiencing suicidal ideation. 9 respondents reported feeling unbalanced in some way, whether

that was saying their brain feels, “foggy” or that it, “makes me feel fake, almost like I’m

someone else.” 30 respondents reported that taking birth control makes them feel empowered,

responsible, and safe. 2 people reported feeling angry that they were the ones responsible for

controlling fertility and reproduction. 17 people reported some type of physical pain or symptom,

such as weight gain, stomach pain, or migraines. People also reported feeling greater mood

stability, experiencing less acne, and 3 people described their experience as “great”.

94% of respondents reported having insurance. 84% of respondents reported that their

insurance covers birth control, and 18.9% reported that they are limited to certain methods of

birth control due to their insurance. 55.4% were unsure if they were limited to certain methods of

birth control due to their insurance, and 25.7% reported that they were not limited to certain

methods due to their insurance. 37.8% reported that they have a copay for their birth control,

34.5% reported not having a copay, and 27.7% were unsure. Reported copays ranged from 5$ to

220$. The mean reported copay was $31.32 and the mode reported copay was $30. The median

copay was $18.50. Most people (69.2%) were unsure of their copay or had a changing monthly.

DISCUSSION AND CONCLUSION

Oral contraceptives were the most commonly used birth control. Mood swings, followed

by weight gain and depression, were the top three reported side effects believed to be caused by
birth control. Birth control made people feel safe and responsible, however it also made

controlling emotions much harder. Most respondents reported engaging in purposeful exercise

three to four times a week and reported a weekly activity level of somewhat active. For those

who reported being somewhat active, 59.2% reported experiencing symptoms they believed to be

caused by birth control. Out of the people who reported being lonely multiple times a week,

63.6% were currently using birth control. Respondents currently on birth control reported feeling

lonely multiple times a month most frequently, while respondents not currently on birth control

reported feeling lonely less than once a month most frequently.

The purpose of this study was to discover the ways in which birth control may impact

wellness. In terms of physical wellness, there did not seem to be a trend in level of physical

fitness and experience of side effects. Most respondents from all demographics reported being

either somewhat or moderately active. This could be due to the large majority of the sample was

college-aged people, which one could assume would generally be more active. Whereas the older

populations are more likely to have jobs that require them to be more stationary, college students

are walking on campus for most of the day. If the sample population was more evenly distributed

among ages, this result could have been different. Moderately active respondents reported

experiencing symptoms they believed to be associated with birth control 14.8% less frequently

than somewhat active respondents. Social wellness was measured by reported level of loneliness.

There was a difference in reported loneliness between those who were currently on birth control

and those who were not. For those currently using birth control at the time of the survey, 23.9%

reported feeling lonely multiple times a week, compared to 13.5% of those not using birth

control. 30.7% of those using birth control reported feeling lonely less than once a month,

compared to 44.9% of those not using birth control. Loneliness seems to be impacted by use of

birth control.
 The second goal of this survey was to understand how age, race, and weight impacts the

experience of taking birth control. By age, mood swings was in the top two reported symptoms

across participants of all ages. For those between the ages of 18 and 27, the top three reported

symptoms were mood swings, depression, and weight gain. For those between the ages of 28 and

47, mood swings, weight gain, and a change in sex drive were the top three reported symptoms.

For those aged 48 to 57, weight gain was the top reported side effect, followed by a three-way tie

between mood swings, depression, and change in sex drive. From these results, it can be inferred

that symptoms do not drastically change as a person ages. Across all ages, the results stayed

consistent, maintaining mood swings and weight gain in the top three. By weight, mood swings

was the top reported symptom for respondents 105-144 pounds. For respondents 145-164 and

185-204, weight gain was the top reported symptom. For respondents 165-184, weight gain

(55%) and mood swings (60%) differed by only one response. These results suggest that as

weight increases, likelihood of weight gain due to birth control use also increases. Potentially

this could be due to genetic pre-disposition to weight gain, however, it could also just be chance

in the sample population. More research specifically looking at weight and its relation to the

impact birth control has on users could shed more light on if this was chance, or if there is

significance.

Analyzing by race was not as effective as originally planned. The range of responses

leaned incredibly in one direction, with a huge majority of respondents being white. With so few

respondents identifying as Black, Asian, and Native American/Pacific Islander, the data from

these respondents was unable to be analyzed. However, the data from White respondents and

Latina/Hispanic respondents was sufficient to be analyzed. For White respondents, the top three

reported symptoms were mood swings, weight gain, and change in sex drive, respectively. For

Latina/Hispanic respondents, the top reported symptoms were irregular bleeding, bloating,
depression, and weight gain. Latina/Hispanic respondents represented a disproportionately high

number of respondents who experienced irregular bleeding. While making up only 9% of the

survey population, they accounted for 21.3% of respondents who reported irregular bleeding.

Bloating, depression, and weight gain were reported equally by Latina/Hispanic respondents.

Overall, symptoms did not differ by age or weight. However, race did seem to impact the

most frequently experienced symptoms. This could be worth looking into further because it is

unclear if it is the small sample size of Latina/Hispanic respondents contributed to the results.

Within the context of the existing literature, this study serves as a branchpoint for more

specified surveys on the impact that birth control has on wellness. There is little research done on

the relationship between wellness and birth control. The results of this study indicate that there is

value in further investigating the emotional impact that birth control has on users. Gaining a

deeper knowledge of the ways in which users are negatively impacted by birth control provides

areas for improvement in our birth control methods. Without research providing this, birth

control manufacturers have no way of knowing how to improve. This study provides a broad

overview of potential research questions that could be examined more intimately. Some example

areas of further exploration include the relationship between weight and birth control side

effects, how birth control impacts social wellness (in terms of loneliness and isolating

behaviors), and how much of a role does birth control play in users’ emotional wellness (such as

depression and anxiety).

This study was weakened by the lack of diversity in race. It was also limited by the

design of some of the survey questions. By utilizing open answer responses in place of multiple-

choice categories, it hindered the ability to cross-analyze the data. However, it allowed

respondents to provide unique responses without the influence of prepared answers. From these

open-ended questions, responses could be coded, and trends could be identified. By looking at
such a wide range of factors, I was unable to draw any specific conclusions about the data. In the

future, diversifying the respondents of the survey, and narrowing down the range of questions

would increase the specificity of the conclusions that could be drawn.

This study had to goal of gaining a deeper understanding of the ways in which birth

control impacts wellness. There was not evidence to make any conclusions, however, there is a

whole new set of data available for future research projects. Trends indicated that birth control

increases loneliness and that mood swings were the most frequently experienced symptom.

Future research projects could focus on mood stabilization and healthcare providers could

emphasize the importance of social support when prescribing birth control.

RESOURCES

A Brief History of Birth Control in the U.S. - Our Bodies Ourselves Today. (2023, March

24). Our Bodies Ourselves Today. https://www.ourbodiesourselves.org/health-info/a-brief-

history-of-birth-control/

De Wit, A. E., Booij, S. H., Giltay, E. J., Joffe, H., Schoevers, R. A., & Oldehinkel, A. J.

(2020). Association of Use of Oral Contraceptives With Depressive Symptoms Among

Adolescents and Young Women. JAMA Psychiatry, 77(1), 52.

https://doi.org/10.1001/jamapsychiatry.2019.2838

History of Birth Control (J. Conti & E. Cahill, Interviewers). (2019, March 11). Retrieved

April 6, 2023, from https://vwordpod.com/episode/history-of-birth-control/

Kingsberg, S. A., Loving, J., Alex, H., Bernick, B., & Graham, S. (2022). Women and

Healthcare Professionals’ Understanding of their Concerns of Birth Control Side Effects. The

Journal of Sexual Medicine, 19(Supplement_3), S9. https://doi.org/10.1016/j.jsxm.2022.05.023

 Knowles, J. (2012). A History of Birth Control Methods. In Planned Parenthood.

Katharine Dexter McCormick Library and the Education Division of Planned Parenthood

Federation of America. Retrieved April 6, 2023, from

https://www.plannedparenthood.org/files/2613/9611/6275/History_of_BC_Methods.pdf

McKay, C. (2020, March 16). How Birth Control Has Helped People Thrive. Power to

Decide. Retrieved April 6, 2023, from https://powertodecide.org/news/how-birth-control-has-

helped-people-

thrive#:~:text=Women%20now%20earn%20half%20of,women%20head%20Fortune%20500%2

0companies.

Natale, V., & Albertazzi, P. (2006). Mood swings across the menstrual cycle: a

comparison between oral contraceptive users and non-users. Biological Rhythm Research.

https://doi.org/10.1080/09291010600772451

Noble, H., & Mitchell, G. F. (2016). What is grounded theory? Evidence-Based Nursing,

19(2), 34–35. https://doi.org/10.1136/eb-2016-102306

Obese women need higher or continuous dose for oral contraceptive success. (2015,

January 14). https://www.nichd.nih.gov/. https://www.nichd.nih.gov/newsroom/releases/011415-

podcast-obesity-contraception

Rates of high school completion and bachelor’s degree attainment among persons age 25

and over, by race/ethnicity and sex: Selected years, 1910 through 2021. (2021). In Digest of

Education Statistics. National Center for Education Statistics. Retrieved April 6, 2023, from

https://nces.ed.gov/programs/digest/d21/tables/dt21_104.10.asp

The Contraceptive (Dalkon Shield) (episode 6). (2018, February). Retrieved April 6,

2023, from
https://open.spotify.com/episode/7Bb9spgh1gu1W5q9uUJPvA?si=_Q2yWicnRQmkRzpSq1RR8

Q&nd=1

United States Census Bureau QuickFacts. (n.d.). U.S. Census Bureau QuickFacts:

Nebraska. Census Bureau QuickFacts. https://www.census.gov/quickfacts/NE