Since I've been taking the pill, somehow I'm not myself

This phrase - "as if I'm not myself" - is not a rhetorical exaggeration among people taking hormonal contraceptives. There may be several overlapping biological mechanisms behind it.

Combined hormonal contraceptives (oestrogen + progestin) "flatten" the natural hormonal fluctuations of your own cycle. During the normal cycle, oestrogen and progesterone change dynamically, and these hormones act directly on the brain: they affect the serotonin, dopamine and GABA systems. These neurotransmitters regulate mood, motivation, attachment, thinking and even partner preference.

When the hormonal pattern is set to a stable, artificial level, the brain's reward and emotion regulation networks (in particular the connections between the amygdala and the prefrontal cortex) may respond to emotional stimuli in different ways. Some research has shown that in women taking contraceptives, emotional responses may be blunted, stress responses may be altered, and the dopamine response associated with romantic attachment may be different.

There is another layer: the natural phases of the cycle influence the type of men we are attracted to. Around ovulation, preferences may shift in a different direction than during the luteal phase. If this cyclical dynamic is broken, the 'chemistry' we had previously experienced may change. This does not mean that the relationship was false, but that the neuroendocrine environment has changed. In my 4-week course on contraceptives, we'll go deeper into why it matters whether you met your partner before or during a period of tablets, and how the pill can affect your relationship and intimacy.

The experience of "not being myself" often stems from a shift in one's emotional reactivity, sexuality, motivation or mood nuances. Much of our experience of identity is built from these subtle internal states. When the internal biochemical background changes, the subjective experience of self can also change.

Research results are mixed. Some people report more stable moods, while others report increased anxiety or mood instability. Individual sensitivity, previous mood disorder, life situation and type of medication used all play a role.

The brain is not a static machine, but an adaptive system that is sensitive to hormones. When we interfere with hormonal regulation, it affects not only the ovaries, but the whole nervous system. Therefore, the feeling of "not being myself" is not a hysteria - but a possible subjective formulation of a neurobiological phenomenon.

And this is where the really fascinating question begins: where is the boundary between biologically modulated mood and our identity? How stable is the "self" if the hormonal environment can nuance it to such an extent? Modern contraception is not just a reproductive technology, it is also a neurological intervention - and one that needs to be consciously addressed.

Although there will be a separate lesson on the role of endometriosis, my course is not just for women with endometriosis, but for all women.