No drug is as sacrosanct in today’s sexually “liberated” culture as oral contraceptives. But the proliferation of the birth control pill since the 1960s has fostered a number of grave consequences for our society: hook-up culture, delayed marriage, and the destruction of the nuclear family.

None of this would surprise Margaret Sanger, the founder of Planned Parenthood. In the early 20th century, she promoted contraception as the mechanism for female emancipation. “Birth control is the first important step a woman must take toward the goal of her freedom,” she wrote. “It is the first step she must take to be man’s equal. It is the first step they must both take toward human emancipation.”

Feminist author Betty Friedan agreed, asserting that the pill gave women “the legal and constitutional right to decide whether or not or when to bear children,” and established the basis for true equality with men.

Because oral contraception has been touted as a cornerstone of women’s equality and freedom, its health repercussions are rarely called into question. Even HHS Secretary Robert F. Kennedy Jr., who regularly wades into controversy by calling for investigations into seed oils and food dyes, remains relatively silent on oral contraceptives.

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This is to the detriment of women across the country. As Dr. Sarah Hill demonstrates in her book, This Is Your Brain on Birth Control: How the Pill Changes Everything, birth control has had numerous repercussions on women, relationships, and society. She shows that women at the peak of their cycle feel sexier, more outgoing, and more confident with the natural increase in estrogen. And men find them more attractive at that time, too.

As Hill points out, birth control pills do more than just prevent pregnancy: they affect a woman’s hormones more generally—hormones that affect everything from her brain to her fingertips and her overall emotional, mental, and physical health. Many of the women Hill interviewed described feeling emotionally blunted, or as if they were moving through life in a fog, while on the pill.

A woman’s menstrual cycle is often known as the fifth vital sign, and a disruption signals a concern to be addressed, not to be masked. Birth control is, in fact, “medicated menopause.” While it can be a difficult reality for many to face, studies show that women who no longer menstruate are not as attractive to men, which is why trying to find a mate in the latter years of life can be challenging. The drive to partner up and reproduce is diminished, making marriage less of a necessity and mere companionship more of the goal.

Studies comparing women who use contraception with those who do not reveal that the pill lowers libido, can lead to mood swings or depression, disrupts natural cycles, can cause infertility after discontinuation, interferes with the endocrine system, and can lead to bloating and a gain of nearly five pounds on average. Other studies have found that estrogen-containing pills raise the risk of venous thromboembolism and, to a smaller extent, strokes and heart attacks.

European countries have conducted many tests that demonstrate such effects. A nationwide Danish cohort study of over one million women found higher rates of first antidepressant use and first depression diagnosis among users of contraceptives than non-users. Another large Danish study found that women who were currently or recently on hormonal contraception were more likely to attempt suicide or die by suicide than women who had never used it.

A Finnish study produced similar results, as did a Swedish one. A British database shows that the first couple of years of being on the pill brought an increased risk of depression, and that women who began using the pill in their teens sometimes had a lasting higher risk.

Few, if any, comprehensive American studies have been conducted, even though about 15% of American women between 15-49 use oral contraceptives.

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Potential problems are not limited to those who ingest the hormones. Synthetic estrogen, an endocrine-disrupting compound used in oral contraceptives, makes its way from America’s toilets to the water supply. Wastewater treatments can reduce, but never fully remove, such psychoactive drugs from drinking water.

U.S. regulators and scientists treat these as “contaminants of emerging concern.” The Environmental Protection Agency and the United States Geological Survey publish methods for measuring the prevalence of such hormones in wastewater and waters used for our drinking supply.

Male fish begin growing female genitals, and fish populations collapse in water containing the synthetic estrogen from birth control, according to some studies. As RFK has mentioned, boys are “swimming through a soup of toxic chemicals today, and many of those are endocrine disruptors.” Though some studies show that typical concentrations of synthetic estrogen in drinking water pose negligible risks to women, perhaps the cumulative exposure to endocrine disruptors affects the sexual development of young males.

RFK promised to “follow the law regarding access to birth control” during his confirmation process. That could include commissioning the National Institutes of Health to conduct “gold standard science” on oral contraception, as he has sworn to do for other food additives and pharmaceuticals, studies that many European countries have already done.

While calling for restrictions on birth control pills would likely cause a frenzy among many, informed consent is a paramount health priority. Though the perceived benefits of birth control pills are loudly and publicly celebrated (women, you too can have sex like a man!), their costs need to be fully exposed if we are going to restore human health and flourishing among both sexes.