HER chest tight, Kelly Jacobson Collins ran through her pre-holiday checklist again. Tickets, insurance, taxis… but the harder she tried to concentrate, the more her head spun.

“I was having palpitations and kept telling myself I needed to calm down, but I couldn’t,” the mum of two remembers. “I knew it was normal to have a few pre-holiday jitters, but this was completely different. I’m usually so organised, but instead I was in a horrible state of panic, which was making it even more difficult to get things done.

“As I got myself in more and more of a state, I felt completely out of control. My body reacted too and I suffered diarrhoea. The whole thing was unbearable.”

It was a scenario that had become all too familiar for Kelly, 44, from east London – and although she didn’t know it at the time, the reason behind her panic attack was something around 3.5 million women in the UK pop on a daily basis: the contraceptive pill.

Introduced in the UK in 1961, the drug revolutionised the lives of women around the world. If taken correctly, it’s 99% effective in preventing pregnancy. Plus, it can make periods lighter and less painful, alleviate symptoms of PMT and reduce the risk of ovarian, endometrial and colorectal cancers.

But while it still remains the most used form of contraception in this country, the Pill’s popularity is in decline. With reports linking it to an increased risk of strokes, heart attacks and breast cancer as well as psychological side effects such as mood swings, depression and anxiety, many women are now questioning whether the Pill is still fit for purpose.

“Women are becoming very aware of what they’re putting into their bodies,” explains Dr Anne Henderson, a Doctify-rated consultant gynaecologist.

“Thanks to social media, there’s a huge amount of information available, from the pros and cons of traditional contraception to the growing wellness movement. There’s been a rise in ‘body-friendly’ products such as organic tampons and cycle-tracking apps because people don’t want to put synthetic products into their bodies, and that includes their contraception.”

Holly Grigg-Spall, author of Sweetening The Pill, agrees. “Women today question what they eat, which beauty products they use and what harmful ingredients are in cleaning products, and once you’ve gone through that process, it can seem strange to be taking synthetic hormones every day. You won’t buy hormone-treated steaks, but you might take the Pill. Why?”

Of course, the breadth of options available nowadays – from the implant, injection, vaginal ring, patch and copper intrauterine device (often called the coil) to the hormonal IUS (intrauterine system) – is another factor in the Pill’s declining popularity.

While the number of women relying on user-dependent methods of contraception such as the Pill has dropped by more than 13% in the past 10 years, the figure using long-acting reversible contraception (LARC) such as the coil and implant has almost doubled.

“If it’s not always used according to instructions, then the combined Pill is only around 91% effective,” explains Bekki Burbidge, deputy chief executive of the sexual health charity FPA. “In contrast, LARCs are over 99% effective at preventing pregnancy and also really convenient, as once you’ve had one fitted you don’t need to think about it.”

Kelly fell out of love with the Pill when she began to suffer from anxiety after taking a progestogen-only (POP) brand in February 2017.

“I’d been on the combined Pill, which contains oestrogen and progestogen, since I was 15 due to heavy periods and painful ovulation,” she explains.

“But I took a break when my husband Paul and I decided to start trying for a family in 2007.”

They had their first son Isaac in 2011, and Linus came along two years later, after which Kelly began to suffer from painful ovulation again. At first she tried to live with it, preferring to avoid synthetic hormones, but assuming there was no other way to control the pain, she went back to her GP 18 months ago. This time her doctor persuaded her to go on the POP, saying it would suit her better than the combined Pill.

“I’d never suffered from anxiety before other than the usual teen angst, but within a few months I’d get stressed and tetchy over the tiniest thing, like getting the kids in the car or dressing them,” she remembers. “Usually I’d take it in my stride, but I began to find it overwhelming and couldn’t control my temper.

“I remember one morning feeling as though my blood was actually boiling when Isaac still hadn’t put his shoes on, and I ended up roaring at him. It was so out of character. After a few weeks, Paul began saying to the boys: ‘Be careful of Mummy,’ which irritated me even more, but also made me aware that my behaviour wasn’t normal. I just didn’t know why. We decided it was probably down to me being a busy working mum, so Paul tried to help out more.”

But it wasn’t just at home that Kelly was feeling out of control. In her job as a partnership developer at a virtual reality start-up, she suddenly became unable to focus – despite having done really well since returning after having children.

“I couldn’t keep up with my workload,” she remembers. “My mind would drift or I would be worrying about chores I needed to do at home. It was like a constant to-do list was running through my mind. These were all things I’d never stress about usually, but I felt swamped.”

On top of that, Kelly’s anxiety affected her social life.

“It would hit me in all sorts of situations, from play dates to nights out with my friends,” she admits. “One evening I went to a pub quiz with a group of mums from school, and I felt as though I wasn’t really in the room.

I spent the evening mentally running through all the things I had to do once I got back home.

“By the end of the night I felt like my head was going to explode. Alarm bells should have been ringing, but I just thought that this was what being a working mum had turned me into.”

A few weeks later, Kelly burst into tears at work, confiding in her boss that she didn’t feel as though she was coping in her job. “She was lovely, but admitted she’d noticed it, too,” admits Kelly. “It made me realise something was seriously wrong, especially as it was just a month after I’d had the panic attack before going on holiday to Morocco. As I racked my brain trying to work out why, it suddenly hit me that it could be the Pill.

“When I went back to my doctor, she tried to tell me I was suffering from depression, but I insisted I change back to the combined Pill I’d used before in case that was the cause. I’d loved to have given up the Pill completely, but as it’s the only medication that actually stops ovulation, it was the only option for me.”

Kelly’s experience is certainly not unique.

“Women are often being let down by their doctors,” Holly says. “Their side effects are being dismissed or they’re told their experiences are not valid. They are given the Pill for everything from acne to PMS, like it’s a cure-all. It’s not.”

According to Dr Henderson, the financial cost also has an impact.

“A lot of women don’t realise that there are contraceptive pills out there such as Qlaira that have natural oestrogen, so the side effects are minimal,” she explains. “But they cost more, so GPs are less likely to prescribe them.

“It’s a classic case of getting what you pay for – none more so than in the case of a Pill called Yamsin, which was considered the holy grail of contraception for years. It was the first port of call for most GPs, however European data released in 2014 revealed it – along with two other contraceptive pills, Femodene and Marvelon – carried more than double the risk of thrombosis than other Pills. It was headline news all over the world, with women swapping their contraception immediately.”

But Bekki is quick to point out that we need to be measured in our responses to scare stories.

“Media coverage of rare but serious side effects can put women off their method of contraception even if they’ve been happy with it,” she says. “However, that can leave them at risk of unplanned pregnancy. While blood clots can be very serious, the risk when using the Pill or other combined hormonal contraception is very small. In fact, you’re more likely to get a blood clot when you’re pregnant or have just given birth.”

Sadly, when Bridie Kirsopp, 25, a freelance writer and blogger from Leeds, was first prescribed the Pill 10 years ago, she wasn’t told about any potential risks.

“At 15 I was given it to help with heavy periods,” she explains. “My GP never discussed side effects, and being a teenager I didn’t check out the leaflet that came with it. Looking back, I wish I had been far more informed, as I would probably have decided against taking it.”

Bridie had been on the Pill for 18 months when, during Christmas 2010, the 17 year old woke one morning with a severe headache and began vomiting. When her symptoms didn’t alleviate over the next few hours, her worried family called out a GP, who diagnosed a migraine. However, the next morning the left side of Bridie’s body became numb. As the day went on, she became more dizzy and drowsy, so her parents rushed her to A&E. Tests revealed that Bridie had a blood clot in her brain, which had caused her to have a stroke.

“The neurologist was 99.9% sure it was down to the Pill,” she says. “I felt numb with shock. The stroke could have killed me, which was horrifying.”

Bridie was discharged from hospital but was left with a loss of feeling on her left side as well as a neurological condition called central pain syndrome (CPS), which she describes as a “constant, intense burning sensation within my skin.”

She also suffered mental health issues following the traumatic experience.

“In the weeks and months after my stroke I had severe anxiety,” she explains. “I’d have panic attacks and didn’t want to leave the house. Over the years it got better, but I still suffer from anxiety today.”

Eight years on from her stroke, Bridie has continuing health issues. “I still have numbness on my left side and live with CPS,” she explains “I can’t hold down a full-time job. It’s hard to plan things and any exercise – even walking – makes it worse. Every day I wake up in pain, which makes it tough to keep a positive mindset, but I try my best.”

Understandably, Bridie has concerns about birth control now. “I’m unable to ever use oestrogen-based contraception again because of the risk of a stroke or clot, but I’d be very anxious about using any type. I don’t have a partner currently so thankfully it’s not something I need to think about right now. But women really need to consider what they are putting into their bodies and make sure they know all the risks.

“It’s no surprise some are turning their back on the Pill. It’s a shame in a way, as it’s such a lifesaver for so many women, but it nearly cost me mine.”
Kelly, now a freelance business developer, agrees. Within days of going back to the combined Pill, she felt like a huge weight had been lifted.

“I remember getting the kids ready for school with the usual chaos,” she says. “Just a few weeks earlier, I would have been fizzing with rage. But not this time. I’m so glad I got my doctor to prescribe it to me – I just wish I’d done it sooner. I’d never consider the Pill as the enemy, as it’s empowered so many women. I just think we need to be much more confident in telling our doctors if something isn’t feeling right.”

As far as Dr Henderson is concerned, it’s down to GPs to be far more transparent so patients can make informed choices.

“It’s like buying a car – not every one is the same,” she says. “Patients should shop around and work out what they want to get from contraception – is it just to prevent pregnancy, because of heavy periods or clearing up bad skin? Ask questions, and no matter what contraception method you use, you need to feel 100% happy with it. And if you don’t agree with what your GP is suggesting, tell them. It’s your body, after all.”