“Is it doing something to me?”: A qualitative study of the embodied experience of Irish women using the oral contraceptive pill

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The common use of contraception in Ireland is noteworthy given the previous moral influences in Irish society. Research exploring the social and embodied experience of OCP users in this context is lacking. Methods Participants were recruited online and 11 female, Irish participants aged 23 – 29 years old took part in online, semi-structured video interviews to examine their lived experiences. Interviews were analysed using Reflexive Thematic Analysis (TA). Results Participants in this study experienced an undercurrent of tension from several directions and across interpersonal relationships. While they felt the OCP provided control over their bodies and their fertility, they also experienced negative side effects (both physical and mental) and felt that their experiences were not taken seriously by doctors. A perceived lack of support from parents and the education system in making decisions regarding contraception was also evident, resulting in a reliance on social and inter-generational knowledge and misguided concerns regarding potential damage or illness. Conclusions Using the OCP is a complex experience, and Irish women experience much tension and internal debate over their decision to begin using it. Information and misinformation regarding safety and impact is shared informally amongst close social networks. There is a need for more educational resources to ensure women are making informed decisions regarding contraception choice. This lack of accessibility of accurate knowledge is perceived as disinterest into the lived experiences of women by education and medical services. What is already known on this topic The physical health experience of taking the OCP is a universal one, but research into the psychological and embodied experience is lacking, particularly in an Irish context. What this study adds This study is the first to explore the experience of Irish women using the OCP, and highlights how the decision to use the OCP is a complex and stressful one. Participants highlighted how they felt unsupported by parents, doctors and the education system; they experienced a lot of method shopping; that they were reliant on informal networks to gain information; and that they still experienced a lingering effect of the strong influence from the role the Catholic Church played in Irish society. How this study might affect research, practice or policy Educators and medical professionals need to be aware of the importance of their role in providing information regarding discussions of contraceptive choice (including the OCP) and disseminating existing research. Researchers should continue to explore the effect of the OCP on mental health and wellbeing. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://hrbopenresearch.org/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://hrbopenresearch.org/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://hrbopenresearch.org/articles/8-75/v1", "name": "“Is it doing something to me?”: A qualitative study of the embodied..." } } ] } Home Browse “Is it doing something to me?”: A qualitative study of the embodied... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article McGuinness A and Foley S. “Is it doing something to me?”: A qualitative study of the embodied experience of Irish women using the oral contraceptive pill [version 1; peer review: 1 approved with reservations] . HRB Open Res 2025, 8 :75 ( https://doi.org/10.12688/hrbopenres.14017.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article “Is it doing something to me?”: A qualitative study of the embodied experience of Irish women using the oral contraceptive pill [version 1; peer review: 1 approved with reservations] Ailsa McGuinness https://orcid.org/0000-0002-2686-884X 1 , Sarah Foley 1 Ailsa McGuinness https://orcid.org/0000-0002-2686-884X 1 , Sarah Foley 1 PUBLISHED 04 Jul 2025 Author details Author details 1 University College Cork School of Applied Psychology, Cork, County Cork, Ireland Ailsa McGuinness Roles: Conceptualization, Investigation, Methodology, Project Administration, Writing – Original Draft Preparation Sarah Foley Roles: Conceptualization, Investigation, Methodology, Supervision, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background The oral contraceptive pill (OCP) is the most prescribed form of contraception worldwide and in Ireland. The common use of contraception in Ireland is noteworthy given the previous moral influences in Irish society. Research exploring the social and embodied experience of OCP users in this context is lacking. Methods Participants were recruited online and 11 female, Irish participants aged 23 – 29 years old took part in online, semi-structured video interviews to examine their lived experiences. Interviews were analysed using Reflexive Thematic Analysis (TA). Results Participants in this study experienced an undercurrent of tension from several directions and across interpersonal relationships. While they felt the OCP provided control over their bodies and their fertility, they also experienced negative side effects (both physical and mental) and felt that their experiences were not taken seriously by doctors. A perceived lack of support from parents and the education system in making decisions regarding contraception was also evident, resulting in a reliance on social and inter-generational knowledge and misguided concerns regarding potential damage or illness. Conclusions Using the OCP is a complex experience, and Irish women experience much tension and internal debate over their decision to begin using it. Information and misinformation regarding safety and impact is shared informally amongst close social networks. There is a need for more educational resources to ensure women are making informed decisions regarding contraception choice. This lack of accessibility of accurate knowledge is perceived as disinterest into the lived experiences of women by education and medical services. What is already known on this topic The physical health experience of taking the OCP is a universal one, but research into the psychological and embodied experience is lacking, particularly in an Irish context. What this study adds This study is the first to explore the experience of Irish women using the OCP, and highlights how the decision to use the OCP is a complex and stressful one. Participants highlighted how they felt unsupported by parents, doctors and the education system; they experienced a lot of method shopping; that they were reliant on informal networks to gain information; and that they still experienced a lingering effect of the strong influence from the role the Catholic Church played in Irish society. How this study might affect research, practice or policy Educators and medical professionals need to be aware of the importance of their role in providing information regarding discussions of contraceptive choice (including the OCP) and disseminating existing research. Researchers should continue to explore the effect of the OCP on mental health and wellbeing. READ ALL READ LESS Keywords women’s health, mental health, oral contraceptive pill, embodied experience, qualitative research Corresponding Author(s) Ailsa McGuinness ( [email protected] ) Close Corresponding author: Ailsa McGuinness Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 McGuinness A and Foley S. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: McGuinness A and Foley S. “Is it doing something to me?”: A qualitative study of the embodied experience of Irish women using the oral contraceptive pill [version 1; peer review: 1 approved with reservations] . HRB Open Res 2025, 8 :75 ( https://doi.org/10.12688/hrbopenres.14017.1 ) First published: 04 Jul 2025, 8 :75 ( https://doi.org/10.12688/hrbopenres.14017.1 ) Latest published: 04 Jul 2025, 8 :75 ( https://doi.org/10.12688/hrbopenres.14017.1 ) Introduction The oral contraceptive pill (OCP) is the second most popular method of short acting contraception globally, after the male condom ( United Nations, Department of Economic and Social Affairs, Population Division, 2019 ). The OCP is a safe and effective contraceptive, and is also prescribed for its non-contraceptive benefits, including treatment for heavy menstrual bleeding, anaemia and endometriosis. It has been proven to reduce risk of certain cancers ( Bahamondes et al. , 2015 ). Common physical side-effects reported include breakthrough bleeding, nausea, headaches, abdominal cramping, breast tenderness, and increased vaginal discharge or decreased libido ( Basciani & Porcaro, 2022 ). While these side-effects are well-documented, the relationship between the OCP and mental health is not definite. Research in this area is limited, with conflicting findings. However, a landmark study conducted on over one million women between the ages of 15 – 34 (excluding women with a prior history of depression), found an increased risk of usage of antidepressants and first diagnosis of depression amongst women who used the combined OCP ( Skovlund et al. , 2016 ). This widespread popularity of the OCP is also reflected amongst Irish women ( Dublin Well Woman Centre, 2020 ). While the physical experience of taking the OCP is somewhat universal, the social and cultural Irish context requires further consideration. The landscape of reproductive rights and healthcare in Ireland has been transformed in recent decades. The sale and use of all contraceptives in the Republic of Ireland was illegal until 1979. The powerful medico-religious alliance within the strongly Catholic Irish society ensured the safeguarding of an agreed moral position on important health issues, namely contraception ( Earner-Byrne, 2010 ). Subsequently, there has been rapid access to contraception and reproductive rights. Irish women now have access to abortion care, and recent legislation has made contraception free for females aged 17–35 ( Department of Health, 2022 ). Given this widespread usage, and changes in attitudes and legislation, it is important to ensure women’s experiences are central to the evaluation and redesign of women’s health initiatives in Ireland. Systemic reviews suggest little evidence to date relating to the Irish experience of contraception choice, use and behaviours ( D’Souza et al. , 2022 ; Pratt et al. , 2014 ). The aim of this qualitative study is to examine the psychological and embodied experience of young Irish women who are taking the OCP. Through thematic analysis of semi-structured interviews, this study highlights decision-making and lived experience within the current social, cultural, and biological understanding of the OCP in the Irish context. Methods Participants Inclusion criteria for taking part in this study included being female, Irish, aged 18 years or over, and current or previous experience of taking the OCP (either combined or progesterone-only). Participants were recruited online in March 2021, following circulation of promotional materials on social media sites. The sample included 11 women (see Table 1 ). Table 1. Sample demographics. Pseudonym Age Currently Taking the OCP Duration in Years of Taking the OCP Michelle 29 Yes <2 Ciara 24 No 6 Jenny 25 Yes 8 Ellen 26 Yes <7 Aoife 23 Yes <10 Lisa 25 Yes <4 Róisín 24 Yes <2 Mary 24 Yes 8 Jo 26 Yes 7 Naoise 26 No 9 Siobhán 23 No <2 Ethical approval was sought and received in February 2021 from University College Cork Ethics Committee of the School of Applied Psychology (ref no: MMH 1002202109), as this was conducted as part of an MA programme of study. Participant Information Sheets were provided to all potential participants and written informed consent was obtained from all who participated in this study. Semi-structured interviews took place via the video platform technology Google Meet ( Google, n.d. ), conducted by author AM. An interview schedule was developed focusing on reasons for choosing the OCP over other forms of contraception; any mental health and physical health side effects participants experienced; observed and lived experiences and attitudes towards the OCP amongst family and friends; along with any additional positive and negative side effects users may have experienced from taking the OCP. This was informed by existing studies which have explored medical practitioner and participant experiences of general contraception use ( Cheung & Free, 2005 ; Glasier et al. , 2008 ; Sweeney et al. , 2015 ). The interviews lasted on average 30 minutes and were audio-recorded. These recordings were saved onto an encrypted laptop and transcribed verbatim by the lead researcher. Transcriptions were made of the recordings (excluding any identifiable data), before the recordings were deleted. Analysis Reflexive thematic analysis (TA) was used to analyse the transcripts. A realist, inductive, semantic approach was taken when analysing the data as this is an under-researched area with no pre-existing coding frames or analytic preconceptions. Analysis followed the six steps laid out by Braun and Clarke (2019) . Transcribing the interviews allowed for familiarisation with the data. Initial themes were developed from codes generated from the data before being reviewed (see Table 2 ). Master themes were finalised, and patterns of shared meaning were conceptualised, underpinned by a central organising concept ( Braun et al. , 2014 ), to answer this research question. Table 2. Example Quotations. Theme Example Excerpt Control, Power and Pressure The OCP gives women back control over their body, their pain, their fertility and their lives: “I used to love being able to take two or three months in a row for like if I was going on holiday so like, in a sense yes but also the convenience of it? I loved that, like I loved knowing when it was coming and knowing like if I could skip it or you know I did like that”. Women reported experiencing emotional and physical side effects from the OCP: “It just it wasn’t suiting me at all. The mood swings were just chronic like I would just be going from sadness to anger just over nothing, like there was as much a personality change and I knew that it wasn’t like me, I just did not feel good in myself at all. Just feeling kind of down and things like that”. Participants felt dependent on the OCP, and worried about coming off it: “I mean I don’t think this is a negative side effect but just the reliance on it. I don’t like the feeling of, if I come off it what’s going to happen. I don’t know is that necessarily an ingrained side effect though…But I don’t know when that switch is going to happen and where it’s going to be too and I’m kind of dreading it, low-key”. Each participant’s experience was objectively different in terms of the range and intensity of side effects they experienced: There are so many different types but then I have friends as well and it’s weird…what suited me didn’t suit them. I know everyone is different, everyone reacts different to different pills and things like that, so like I could discuss with friends but we’re never going to have the same experience”. Many experienced initial social and peer pressure to go on the OCP: “I really remember being in college and it was almost like a thing being made of being on the pill, it was kind of seen as like oh I’m on the pill, you wouldn’t understand…it’s more of like…seen as like I’m more mature, I’m more you know advanced because I’m on the pill. It’s almost like this tradeoff or something, it’s like something is attributed to being on the pill that like this popularity”. Unsupported and Unaware Participants expressed worries of interfering with a natural reproductive cycle: “But for me the main concern was just…in my personal experience, never knowing, I had nothing really to compare myself to, like I couldn’t say oh but when you were 18 you didn’t take it and then you started to take it, so I suppose for me it was more like a natural kind of hormonal aspect”. There were also concerns about long-term effects on fertility and about artificiality of the OCP: “I suppose the long-term effects of it. Maybe there is longitudinal research on it, I’m not sure, but just how it might affect long term like taking it on physical health, on fertility, on all those kinds of things”. Finding the right version without side effects involves a lot of trial and error and this is expected: “I think I’ve been on maybe five or six different pills just until I found one that doesn’t affect my mental health or you know, my cramps or my period or anything like that so I’m on, I’ve been on one now for maybe the last three years and think it’s maybe the best one so far”. The OCP was generally considered the best option available out there: “Obviously I would rather take the pill than like have an unplanned pregnancy but I’m also like there surely should be some kind of like middle ground or alternative. But yeah and I think doctors just take that as standard, well that’s just the way it is. Like they kind of don’t really point you towards alternatives or suggest other things”. Difficult Dynamics and Taboo Topics Participants relayed frustration that there was no education provided by schools, have to seek out information: “People aren’t learning anything until they go to college and they’re only learning it in college because their friend told them about it or told them where to go or the students union said you know check out this website or learn about this. Yeah I don’t think the education around it is good in Ireland”. They conveyed a difference in attitudes and understanding between younger and older generations: “I remember my Mam didn’t even explain it to me, it was just kind of one of these things where I went to the doctor and it was like don’t tell anyone you’re on it”. Stark differences in different countries were felt by participants who moved abroad: “Since I’ve come over [to the UK] like two years ago and I see the education that they have here on contraception like it’s just so much better here like how the people, how they disseminate the information, how they teach people about contraception and about what young people are like aware of like different websites”. Participants did not feel supported by doctors in relation to concerns over side effects: “A lot of concerns women have about it are played down a lot by the medical profession. It’s just that’s what I meant when I said oh I think the pill is really affecting my mood, I felt like that wasn’t taken seriously by the doctor. It wasn’t like oh you should go off the pill or something, it was just like oh I’ll just put you on another one and maybe this will work. So I feel like those type of effects aren’t taken seriously”. There was a lack of parental support in decision making reported: “There was a couple of times I’d have a problem with a pill, you know it would affect me maybe my emotions and I didn’t realise that that’s what was happening. Because I wasn’t able to speak to my Mum about it you know? I’d have a year, a really bad year and I’d look back and I’d say do you know what, that was definitely because of that pill I was on didn’t work for me. And I wish I had been able to chat about it a bit more to kind of figure that out, but obviously a lot more important now, but at the time I didn’t really remember being given much information about it”. As coding is an inherently subjective process, the lead author’s experience, skills, training and research values undeniably impacted on the development of codes, and they could be considered an “insider researcher” ( Barrett et al. , 2020 ), being female and of similar age and background to all participants. Viewing the researcher as an instrument, particular researcher characteristics may be more effective in eliciting detailed narratives particularly when discussing sensitive topics ( Pezalla et al. , 2012 ). Being an insider allows for the researcher to be viewed on a more equal footing and minimises the power differential between the researcher and participants. This can encourage rapport between participant and researcher ( O’Connor, 2004 ), which can result in richer data ( Dwyer & Buckle, 2009 ). However, this can also result in presumption on the part of the participant and researcher, who may provide or seek out insufficient detail when collecting data, consequently hampering efforts to achieving a greater depth of data ( Blythe et al. , 2013 ). This researcher engaged in some self-disclosure before the interviews to try and establish rapport with participants, in an act of reciprocity for the degree of openness and honesty that participants engaged in; and after, to bring the interview experience to a natural end. This researcher kept a reflexive research diary, and before beginning the study, made notes of any preconceptions in relation to participants’ experiences as well as engaging in reflexive discussion with the researcher supervisor. Reflexivity can be considered a continual process ( Barrett et al. , 2020 ), and was engaged in throughout the research project. Findings It should be noted that all names used in this section are pseudonyms and are not the real names of the participants. There’s so many different types but then I have friends as well and it’s weird...what suited me didn’t suit them. I know everyone is different, everyone reacts different to different pills and things like that, so like I could discuss with friends but we’re never going to have the same experience - Ellen The OCP is the second most commonly used type of contraception in Ireland, after the male condom ( Dublin Well Woman Centre, 2020 ). While there were clear common themes and similar narratives which developed from all the data provided by participants, what was clear was the variety of experiences that participants experienced, specifically in terms of specific side effects experienced, circumstances regarding first use (i.e. age, primary reason, joint decision with another party, whether the first type used was suitable or whether several types were trialled until a suitable type was found), and whether the OCP had been discontinued or not. While no two participants seemed to share the same journey, thematic saturation was achieved early in the analysis as there were clear similarities across all accounts. It is clear that using hormonal contraception, in particular the OCP, is a unique and personal journey for every Irish woman. Perhaps the individuality of each participant’s experience is one of the most significant learnings to be taken from this research project. However, three main themes were identified and are outlined below. Control, power and pressure At the time of interview, less than half of participants stated that they had begun using the OCP primarily for contraceptive reasons, but were using it primarily for the management of dysmenorrhea, heavy bleeding, and/or acne. The pill format was accessible and appealing, and gave control back to women, as Michelle outlined: It’s just like I can do this, or even the idea that if I didn’t want to take it, it’s up to me like no one is going to actually force it down my throat, so there’s almost like this kind of contentment with the fact that you have the controls in your hands. Naoise explained that although she recently discontinued the Pill and has switched to LARC which has resulted in a return of a monthly withdrawal bleed, she was relieved to experience this. She stated that: Even since I’ve come off it now like, I’ve only just started getting periods again and there is kind of a sense of like yeah this is what my body is supposed to do? Even though I’m on the coil at the moment, and I’m still getting them, you kind of feel like you’re stopping something, or something like that. I don’t know, I don’t really like that. While there was an overarching sense from the data that the OCP (in tablet format and taken daily) allowed participants to feel in control of their hormonal contraception, there was also a clear sense that the usage of and reliance on the OCP to provide this control, was one they were reluctant to celebrate. Participants experienced a lot of trial and error at finding a suitable version that did not cause too many negative symptoms, i.e. increased fatigue, decreased libido, continuous bleeding, increased anxiety, low mood and mood swings. Róisín highlighted her concerns and explained that: But you do always hear these things like “oh it makes you infertile” and all this, and I don’t know how much that is true but...I don’t like the idea of having to take something every day. I don’t know if that’s a silly reservation but yeah I don’t love that idea. I would fear of long-term damage, is it doing something to me. Unsupported and unaware Participants did not feel they were taken seriously by their doctors when they discussed these negative experiences, particularly in relation to effects on their mental health. Participants tended to view their doctor’s expertise as extending as far as physical symptoms, but they did not feel reassured about potential impact on future fertility from taking hormonal contraception and also any potential changes to emotional wellbeing and personality if they were to ever discontinue using the OCP. Lisa highlighted her experience when she raised her concerns about the impact of the OCP on her mood, saying: I felt like that wasn’t taken seriously by the doctor. It wasn’t like “oh you should go off the pill”, it was just like “oh I’ll just put you on another one and maybe this will work. I feel like those type of effects aren’t taken seriously.” Participants felt that they were not made aware of all potential side-effects, and that it was their responsibility to conduct “research” regarding the OCP and contraception in general. I don’t think like the doctors want the responsibility of doing any educating and I don’t think the schools are ready to do the educating - Jenny. All except one participant highlighted how they did not feel they received adequate sex education in school particularly in relation to all aspects of contraception choice. Along with the non-invasive nature, the main reason stated for choosing the OCP was a lack of awareness of other types of contraception. Ellen vocalised her experience and fears in relation to this: To be honest I didn’t plan to take it for as long as I had. I’m kind of a bit wary about taking it long-term. I don’t know if there’s research out there on the effects on long-term use of it so I am a bit wary but I just feel like right now there’s no other choice. Participants felt dependent on an informal education network and relied heavily on the experiences of peers to increase their awareness of all available forms of contraception and sexual education. There was a clear sense of frustration that users of the OCP themselves had to separate “fact” from “fiction” to get accurate scientific information. Participants viewed the OCP as a relatively modern invention and felt there was no data available to conclude on the effects of long-term use. Maybe there is longitudinal research on it, I’m not sure, but just [I’m concerned about] how it might affect long term - like taking it - on physical health, on fertility, on all those kinds of things - Ellen. Difficult dynamics and taboo topics The lack of education and awareness was attributed to parents, namely from participants’ mothers. But while participants felt that they themselves did not have adequate information, they felt more informed than their parents’ generation. Several discussed how their mothers were hyper-aware about the risk of blood clots, impact on future fertility, and would advise against taking the OCP at all, and additionally regarded it as something to be taken discreetly. I remember my Mam didn’t even explain it to me, it was just kind of one of these things where I went to the doctor and it was like don’t tell anyone you’re on it - Aoife. In some households, sexual education, menstruation and contraception in general were taboo topics and never discussed openly’. Many participants cited how their families were “traditional” and “Catholic” and this would have strongly influenced their inability to discuss contraception. From the perspective of the participants, it was clear that for previous generations, the usage of the OCP for non-contraceptive reasons was never considered as it was associated with promiscuity. For Siobhán, she acknowledged that her strict upbringing played a part in her own opinion on using contraception, and it was only through her own experience in third-level that she became comfortable enough to consider its use: My family would have been very religious and very traditional. So I feel like it kind of took a couple of years for me in college to actually realise that all that stuff was okay? In the way that, I think it definitely influenced my decision to not go on contraception earlier. So there was definitely a stigma in my head around that. For those who had some maternal input, after the initial decision to begin taking the OCP it appeared there was no further discussion or support offered, and none in the wider family environment. This appeared to have affected participants negatively, particularly as several felt they were unable to speak about the side effects they experienced and how taking the OCP was impacting them. Discussion The findings from this study add to the limited literature on the social, psychological and embodied experience of Irish women taking the OCP. Analysis of these experiences reveals that using the OCP is a complex experience, and the Irish women interviewed experienced tension and internal debate over decisions to use the OCP. This tension exists primarily across the following dimensions: embodied knowledge and experience, interpersonal relationships and taboo topics, and cultural and social cues. By deciding to use the OCP, participants felt they were sacrificing other areas of their health, physical and mental. This was amplified through the concerns expressed by all participants, that an additional daily dose of artificial hormones would impact on future fertility or result in changes to natural personality development. Previous research has shown the OCP has not been linked to decreased fertility following discontinuation ( Barnhart & Schreiber, 2009 ; Girum & Wasie, 2018 ) yet this was an oft-cited concern for participants. This concern regarding fertility is in line with previous studies which found that users of contraception do not view doctors as “experts” in this area, and depend instead on other women in their social networks for information or validation of their contraceptive choices ( Lowe, 2005 ). Unintended side effects were cited for many participants as their main apprehension before taking the OCP, or their main reason for discontinuation, similar to previous findings ( Rosenberg et al. , 1995 ; Shakerinejad et al. , 2013 ). Given the historic treatment of women’s health in Ireland, it is perhaps unsurprising that there still exists a lingering undercurrent of unease and mistrust from women towards the medical industries. In our analysis, this tension appears to manifest itself in the “battle” for control that Irish women appear to be facing. As illustrated above, the women interviewed experienced a dynamic and complex sense of agency over their contraceptive choices. While the OCP does provide women with control over their bodies and fertility, for many they also felt as if it has a degree of control over them. Another interesting feature of the embodied experience of participants was the tension that existed in their interrelationships about this “taboo” topic. The discussions, or lack of, between participants and their parents speaks to the taboos that still exist in our society. It highlights stark differences in attitudes between generations towards sex, along with the reluctance of parents to admit that their child is at the age where they require contraception. As discussed in the previous section, the majority of participants had no familial support or input in their initial decision to begin using the OCP. For those who had maternal involvement, this input and open discussion was not sustained. Particularly revealing was the experience that some participants had of being warned not to tell anyone they were using it, even if it was to manage menstrual symptoms. It is worth considering the contrast in religious influence between generations and the lasting impact of this. Participants who grew up in self-described “traditional” and “Catholic” households expressed worry about their initial decision to begin using the OCP for contraceptive reasons. This point supports previous calls for more comprehensive sexual education, and given the lasting impact of the Catholic Church in education settings, there is further need to integrate evidence-based, inclusive sexual health education in education settings ( O’Donoghue & Harford, 2022 ; Parker et al. , 2009 ; Sherlock, 2012 ). One other important aspect of the embodied experience of taking the OCP is the clear impact for a large proportion of women, on their mental health. Though the physical effects of the OCP have been well-studied ( Dragoman, 2014 ), the understanding into the relationship between the OCP and mental health to date is mixed, and reliant on quantitative data ( Anderl et al. , 2020 ; Doornweerd et al. , 2022 ; McKetta & Keyes, 2019 ). As highlighted by participants, many felt unaware of existing empirical findings and research. Irish GPs and educators should be made aware of the perceived responsibility that rests with them to relay this knowledge more transparently to participants. This lack of transparency and accessibility is subsequently perceived as a lack of interest or importance into the lived experiences of women. Limitations and modifications While this sample did appear to have a varying range of contraceptive experiences, all participants had shared characteristics (white Irish, university-educated, childless women, under the age of 30). Further research should consider the experience of women from varied socio-economic backgrounds, as well as marginalised groups, including non-Irish women, and women with menstrual health conditions. Patient and public involvement Users of the OCP were not directly involved in the design of this study, but had an influence on the topics explored in the semi-structured interviews as these were explored when mentioned. Data availability Underlying data The ethical approval that was issued by University College Cork Ethics Committee of the School of Applied Psychology (ref no: MMH 1002202109) and the informed consent forms completed by participants did not include permission for participant data (i.e. interview transcripts) to be stored in an open access repository. The lead author can be contacted ( [email protected] ) to discuss any additional requests to the data. Extended data Open Science Framework: Supplementary Materials. https://osf.io/bd96g/ ( Foley & McGuinness, 2025 ). This project contains the following extended data: - Participant information sheet and consent form - Interview schedule Faculty Opinions recommended References Anderl C, Li G, Chen FS: Oral contraceptive use in adolescence predicts lasting vulnerability to depression in adulthood. J Child Psychol Psychiatry. 2020; 61 (2): 148–156. 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PubMed Abstract | Publisher Full Text | Free Full Text United Nations, Department of Economic and Social Affairs, Population Division: Contraceptive use by method 2019: data booklet. United Nations, 2019. Reference Source Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 04 Jul 2025 ADD YOUR COMMENT Comment Author details Author details 1 University College Cork School of Applied Psychology, Cork, County Cork, Ireland Ailsa McGuinness Roles: Conceptualization, Investigation, Methodology, Project Administration, Writing – Original Draft Preparation Sarah Foley Roles: Conceptualization, Investigation, Methodology, Supervision, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 04 Jul 2025, 8:75 https://doi.org/10.12688/hrbopenres.14017.1 Copyright © 2025 McGuinness A and Foley S. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics VIEWS $counts.viewCount downloads Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article McGuinness A and Foley S. “Is it doing something to me?”: A qualitative study of the embodied experience of Irish women using the oral contraceptive pill [version 1; peer review: 1 approved with reservations] . HRB Open Res 2025, 8 :75 ( https://doi.org/10.12688/hrbopenres.14017.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 04 Jul 2025 Views 0 Cite How to cite this report: Mengelkoch S. Reviewer Report For: “Is it doing something to me?”: A qualitative study of the embodied experience of Irish women using the oral contraceptive pill [version 1; peer review: 1 approved with reservations] . HRB Open Res 2025, 8 :75 ( https://doi.org/10.21956/hrbopenres.15386.r49427 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-75/v1#referee-response-49427 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 25 Sep 2025 Summer Mengelkoch , University of California Los Angeles, Los Angeles, California, USA Approved with Reservations VIEWS 0 https://doi.org/10.21956/hrbopenres.15386.r49427 The authors conducted a series of semi-structured interviews to qualitatively investigate the experience of Irish women ( n = 11) using the oral contraceptive pill (OCP). The authors used a reflexive thematic analysis approach, and identified three themes: 1. Control, power, ... Continue reading READ ALL The authors conducted a series of semi-structured interviews to qualitatively investigate the experience of Irish women ( n = 11) using the oral contraceptive pill (OCP). The authors used a reflexive thematic analysis approach, and identified three themes: 1. Control, power, and pressure; 2. Unsupported and unaware; and 3. Difficult dynamics and taboo topics. Generally, they found women to feel unsupported, uneducated, and often conflicted about their use of OCPs. I found the research question to be interesting, and the results worthy of publication. Although the analysis appears appropriate, I am not an expert in qualitative methodology, and defer to other reviewers for this aspect of the review process. Although generally well-written, most of my comments relate to the organization and presentation of the information in the discussion. The overall contributions of the current results to the broader literature are meaningful. I hope that my feedback improves the overall quality of the current manuscript. I suggest a minor revision, in which the following points are addressed: Abstract – In the “what is known” section, the authors state, “the physical health experience of taking the OCP is a universal one, …” However, I think that is an over statement (here and when mentioned in the main text). There is almost nothing universal about women’s experience with the pill. I think the authors are trying to say that while the physical side effects of OCP use are well-documented, less is known about the psychological side effects and embodied experience of women using the OCP, especially in Irish women, but this line feels inappropriate as worded currently. Minor – no need to abbreviate TA in the abstract unless you use the term again in the abstract. Introduction – I advise the use of oxford commas throughout, to improve clarity. Paragraph 1: When stating that there are conflicting findings on mental health side effects of OCP use, please cite a few of these. Paragraph 2: I would cut the second sentence entirely, and move the first to the last line of the paragraph (with some re-wording) to improve clarity and flow. I would also include a time reference to the “recent legislation” line, so that this paper doesn’t become confusing as time passes. Methods & Analysis – The use of the term “the OCP” gives the reader the idea that this is one type of pill (or two counting progesterone only options). I’m not sure how many different formulations are available in Ireland, but in the US, there are more than 150 different pills available. Giving a brief mention that there is a lot of different pharmaceuticals under this umbrella at the outset would be helpful. In the analysis section, there is more attention on the dynamics of being an inside researcher than on the coding methodology, with references out to other publications to see how this type of coding was done. I think that more space here should be devoted to summarizing the methodology used, so that someone else could replicate this work for example, as opposed to justifying interviewing tactics. (At the least, these tactics should be justified in the methods, not analysis section.) Please summarize the six steps taken, and define reflexive in this context, as opposed to sending readers elsewhere to understand the basics of the methodology used here. Did a second researcher review the coding or conduct any independent coding? (I am used to seeing another coder in cases where the same person generates the research question, selects the participants, conducts the interviews, creates the coding scheme, does all coding, and analyzes results.) Findings – nice job summarizing these points into a compelling narrative. Discussion The focus on Irish women’s experiences with OCP use is interesting, but I was hoping to see it compared and contrasted with another group of women in a different sociocultural context. This comparison doesn’t need to be the focus of the paper by any means, but it would ground these results in the broader literature. I find it unlikely that no one else has interviewed women in a similar manor about their contraceptive use experiences, but did not see these results compared to any others. The implications and conclusions noted in the abstract should be expanded upon at the end of the discussion. What are the policy recommendations the authors would make following their study? What are the next research steps? Clinical implications? The discussion highlights three dimensions of tension, which cover different categories than the themes highlighted in the findings. I didn’t really understand where these came from or what they meant here. How are “interpersonal relationships and taboo topics” different from “cultural and social cues”? (generally, things are only “taboo” because of cultural cues; interpersonal relationships and social cues overlap a great deal) What do you mean that there was tension across “embodied knowledge and experience”? I’m not sure that these new categorizations presented in the discussion are an accurate portrayal of the findings, at least the way they are currently presented. With better explanations as to the definitions of these categories, or how they were generated, perhaps they would make more sense to me, however, as they stand, I found them confusing here. Minor – when discussing GPs responsibility to educate, it is patients, not participants, GPs should be aware that they should be educating. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? I cannot comment. A qualified statistician is required. Are all the source data underlying the results available to ensure full reproducibility? No source data required Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Experimental social psychology, with a focus on how hormones and hormonal contraceptive use impact women's stress reactivity I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Mengelkoch S. Reviewer Report For: “Is it doing something to me?”: A qualitative study of the embodied experience of Irish women using the oral contraceptive pill [version 1; peer review: 1 approved with reservations] . HRB Open Res 2025, 8 :75 ( https://doi.org/10.21956/hrbopenres.15386.r49427 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-75/v1#referee-response-49427 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 04 Jul 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 Version 1 04 Jul 25 read Summer Mengelkoch , University of California Los Angeles, Los Angeles, USA Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Mengelkoch S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 25 Sep 2025 | for Version 1 Summer Mengelkoch , University of California Los Angeles, Los Angeles, California, USA 0 Views copyright © 2025 Mengelkoch S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The authors conducted a series of semi-structured interviews to qualitatively investigate the experience of Irish women ( n = 11) using the oral contraceptive pill (OCP). The authors used a reflexive thematic analysis approach, and identified three themes: 1. Control, power, and pressure; 2. Unsupported and unaware; and 3. Difficult dynamics and taboo topics. Generally, they found women to feel unsupported, uneducated, and often conflicted about their use of OCPs. I found the research question to be interesting, and the results worthy of publication. Although the analysis appears appropriate, I am not an expert in qualitative methodology, and defer to other reviewers for this aspect of the review process. Although generally well-written, most of my comments relate to the organization and presentation of the information in the discussion. The overall contributions of the current results to the broader literature are meaningful. I hope that my feedback improves the overall quality of the current manuscript. I suggest a minor revision, in which the following points are addressed: Abstract – In the “what is known” section, the authors state, “the physical health experience of taking the OCP is a universal one, …” However, I think that is an over statement (here and when mentioned in the main text). There is almost nothing universal about women’s experience with the pill. I think the authors are trying to say that while the physical side effects of OCP use are well-documented, less is known about the psychological side effects and embodied experience of women using the OCP, especially in Irish women, but this line feels inappropriate as worded currently. Minor – no need to abbreviate TA in the abstract unless you use the term again in the abstract. Introduction – I advise the use of oxford commas throughout, to improve clarity. Paragraph 1: When stating that there are conflicting findings on mental health side effects of OCP use, please cite a few of these. Paragraph 2: I would cut the second sentence entirely, and move the first to the last line of the paragraph (with some re-wording) to improve clarity and flow. I would also include a time reference to the “recent legislation” line, so that this paper doesn’t become confusing as time passes. Methods & Analysis – The use of the term “the OCP” gives the reader the idea that this is one type of pill (or two counting progesterone only options). I’m not sure how many different formulations are available in Ireland, but in the US, there are more than 150 different pills available. Giving a brief mention that there is a lot of different pharmaceuticals under this umbrella at the outset would be helpful. In the analysis section, there is more attention on the dynamics of being an inside researcher than on the coding methodology, with references out to other publications to see how this type of coding was done. I think that more space here should be devoted to summarizing the methodology used, so that someone else could replicate this work for example, as opposed to justifying interviewing tactics. (At the least, these tactics should be justified in the methods, not analysis section.) Please summarize the six steps taken, and define reflexive in this context, as opposed to sending readers elsewhere to understand the basics of the methodology used here. Did a second researcher review the coding or conduct any independent coding? (I am used to seeing another coder in cases where the same person generates the research question, selects the participants, conducts the interviews, creates the coding scheme, does all coding, and analyzes results.) Findings – nice job summarizing these points into a compelling narrative. Discussion The focus on Irish women’s experiences with OCP use is interesting, but I was hoping to see it compared and contrasted with another group of women in a different sociocultural context. This comparison doesn’t need to be the focus of the paper by any means, but it would ground these results in the broader literature. I find it unlikely that no one else has interviewed women in a similar manor about their contraceptive use experiences, but did not see these results compared to any others. The implications and conclusions noted in the abstract should be expanded upon at the end of the discussion. What are the policy recommendations the authors would make following their study? What are the next research steps? Clinical implications? The discussion highlights three dimensions of tension, which cover different categories than the themes highlighted in the findings. I didn’t really understand where these came from or what they meant here. How are “interpersonal relationships and taboo topics” different from “cultural and social cues”? (generally, things are only “taboo” because of cultural cues; interpersonal relationships and social cues overlap a great deal) What do you mean that there was tension across “embodied knowledge and experience”? I’m not sure that these new categorizations presented in the discussion are an accurate portrayal of the findings, at least the way they are currently presented. With better explanations as to the definitions of these categories, or how they were generated, perhaps they would make more sense to me, however, as they stand, I found them confusing here. Minor – when discussing GPs responsibility to educate, it is patients, not participants, GPs should be aware that they should be educating. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? I cannot comment. A qualified statistician is required. Are all the source data underlying the results available to ensure full reproducibility? No source data required Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Experimental social psychology, with a focus on how hormones and hormonal contraceptive use impact women's stress reactivity I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Mengelkoch S. Peer Review Report For: “Is it doing something to me?”: A qualitative study of the embodied experience of Irish women using the oral contraceptive pill [version 1; peer review: 1 approved with reservations] . HRB Open Res 2025, 8 :75 ( https://doi.org/10.21956/hrbopenres.15386.r49427) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://hrbopenresearch.org/articles/8-75/v1#referee-response-49427 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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