Negative Expectations May Amplify Side Effects from the Pill, Study Suggests
A new study from the University of Sheffield indicates that psychological factors, specifically negative beliefs about medication, may contribute to the side effects experienced by women taking oral contraceptives. researchers found a strong link between negative expectations and the likelihood of experiencing adverse effects,suggesting the “nocebo effect” – where negative expectations lead to negative outcomes – plays a significant role in women’s experiences with the pill.
The research, published in Perspectives on Sexual and Reproductive Health, surveyed 275 women aged 18-45 who had used oral contraception within the previous 18 months. The study revealed four key psychological factors associated with reported side effects, ranked by their influence: a pre-existing expectation that the medication woudl be harmful, low confidence in the medicine progress process, a belief that medicines are generally overused and harmful, and a self-perception of sensitivity to medications.
nearly all participants (97%) reported experiencing at least one side effect. Over the course of the 18-month study, just over half (54.2%) continued using the pill, while 45.8% discontinued, with 42 switching to alternative contraception methods.
“The contraceptive pill gets a lot of negative attention, particularly on social media, and we were interested in how these negative views could be influencing the way women are experiencing oral contraception,” explained Dr. Rebecca Webster,from the University of Sheffield’s School of psychology,who supervised the study.
lead author Lorna Reid emphasized the importance of understanding the nocebo effect in this context. “It is important to acknowledge how some women’s experiences of oral contraception are impacted by the nocebo effect. With this information, women can make more informed decisions about their use of oral contraception. This is particularly so with younger women who may be exposed to more negative messaging around use of the pill through greater use of media platforms.”
Researchers acknowledge the study’s limitations, noting the participant pool was predominantly young, white women. However, they view this exploratory research as a foundation for future investigations into interventions that could improve women’s experiences with oral contraception. The study is titled Exploring the relationship between medicine related beliefs and Side-effect experience among white oral contraceptive users in the UK (Reid, L., & Webster, R.K., 2025, Perspectives on Sexual and Reproductive Health; doi.org/10.1111/psrh.70012).
