• Isabelle Osborne

Reviewing Dr. Sarah Hill's 'How the Pill Changes Everything'

I have just finished this incredibly though-provoking book, 'How the Pill Changes Everything', within which Dr. Sarah Hill, an associate professor of psychology and a leading researcher in evolutionary psychology, exposes the unknown truths about the contraceptive pill.


Hill begins the book recognising how, when she decided to come off the pill, she started to notice minute changes in her behaviour over a gradual period of time - she let her hair grow long, she started going to the gym, she purchased a Spotify membership. All of this may seem inconsequential, until Hill realised the changes could be attributed to her coming off the pill.


The book offers an insightful exploration of the biological/social effects taking the pill has on women's bodies, and considers things that women may have been completely unaware of before now. Hill explains how the pill actually functions within the female ovulatory cycle, before going on to discuss how the pill impacts our relationships with our partners, how it affects our stress levels and many more interesting topics.


Here are some of the things that I discovered whilst reading the book that stuck with me:

  • Side effects: there is a belief that the pill has specifically negative side effects, such as weight gain, hair growth etc. This is not strictly the case - the pill may cause a woman to have a larger appetite, which then causes them to eat more and subsequently put on weight, but the pill itself does not cause the weight gain directly.

  • Identity: on the pill, you are a different version of yourself. This seems obvious having now read the book, as the pill changes your brain chemistry and hormonal functions, yet before reading this book I hadn't even considered the affects it could have on your actual personality.

  • Relationships: research has show that being on the pill changes our attraction towards men/women, depending on oestrogen levels and fertility at any given moment, amongst other things. This means that the partner you choose whilst on the pill may not be the partner you would choose whilst off the pill.

  • Social impact: due to the pill, women have more sexual freedom that allows them to have a career as well as the sex life they desire without the fear of unwanted pregnancy. This means the number of women graduates and women in leadership roles has increased. Go women!

  • Animals: Interestingly, humans are not the only party who the pill is available for. Female monkeys in zoos are given the pill to prevent over-breeding in small enclosures.

  • Men: research shows that when the pill didn't exist and women had little control of becoming pregnant, men had to work harder to become their sexual partners, as pregnancy was always an option and women had to choose the kind of man they wouldn't mind having a child with if they wanted a fling. However, now women have more sexual freedom and are less choosey about their partners (as pregnancy whilst on the pill/contraception is very low), men aren't working as hard within the dating field.

  • Sex bias: The majority of scientific research is carried out on men, not women, because dealing with the complexity of the female hormonal system means female candidates are harder and more expensive to work with. This, combined with the fact that researchers have to publish a large amount of papers in order to continue to receive funding, means research has swayed towards what is cheap, what is easy, and what is fast. Scary.


It is the last point that concerns me the most. How can science restrict research to half the population? Sure, researching female biology may present more of a challenge than researching men, but science owes it to women to provide a balanced perspective when publishing valuable scientific information. What is also alarming is that research is conducted under fear of being struck off at any moment, meaning the less nuanced your research, the better (as nuanced results in expensive and complex). Isn't this what research is all about?


Additionally, I was interested to see how the pill has affected men as well as women, as is suggested by the penultimate point above - reading this book is a great way for men to begin to understand the discussion around the pill and how it affects their partner's bodies and lives. What this highlights is that, although women are the ones taking the pill, it has a vast social impact that, without reading this book, I would have been completely unaware of.


If any of the above interests/concerns you, I urge you to pick up this book. Whether or not you are on the pill, this book offers crucial advice, information and support, for those considering taking the pill as well as those who have never been on the pill in their lives.


It is alarming that women can take a pill without knowing the truth about the impact is has upon our bodies. There is so much that is left in the dark when discussing contraception, and there is vital information that is left off the box your pill comes in. Hill has opened the opportunity for women to make more informed decisions on what birth control means for them.


This book is possibly the best way for women to decide a) whether artificial birth control is for them, and b) whether the pill is the best option for them. I hope this sparks a conversation about the pill and how it affects the female body outside the realm of preventing pregnancy, because there is so much more to learn.

Words are all we have.

 - Samuel Beckett

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World of Words 

By Isabelle Osborne