Debates about the ethical dimension of the Pill are like smoke-filled 19th Century battlefields “where ignorant armies clash by night”. Inquiry is enveloped by dense clouds of competing studies, ideology-fuelled rage, commercial interests, and social indoctrination.

It’s rare to find an overview of the issues which frames it as an anthropological problem, rather than as solely a medical, social or ideological issue. Fortunately, a recent article in the journal Frontiers in Medicine by three Spanish authors, a pharmacist, a doctor and a bioethicist, tackles this controversial issue head-on.

Their starting point is that hormone-based contraceptives (HBC) are artificial. This is fundamental to appreciating its effects on women – and all of society. They write that HBCs are associated with adverse consequences for women’s physical and psychological health, as well as “collateral damage” including “negative effects on communication, scientific mistrust, poor physician–patient relationships, increased patient burden, economic drain on the healthcare system, and environmental pollution.” They write:

Overcoming these challenges requires an anthropological integration of sexuality, as the focus on genital bodily union alone fails to encompass the intimate relational expression of individuals, complete sexual satisfaction, and the intertwined feelings of trust, safety, tenderness, and endorsement of women’s femininity.

Even if one brackets possible adverse effects upon women’s health, there is a host of other issues. The widespread use of HBCs across the world has created a new culture of sexual freedom, “which is often detached from the biological and transcendent nature of human sexual behaviour rooted in the anthropological dimension of sexual intercourse”.

The article is too long to summarise here, but the authors conclude that an evaluation of the impact of the Pill upon women has to be holistic. It needs to take into account all dimensions of a woman’s life – not just whether or not the Pill leads to cancer or heart failure.