Does hormonal contraception do more harm than good?

The contraceptive choices available for women can be life-changing and even culture-altering, empowering women to take control of their family planning, and own their sexuality. However, what's less talked about is the negative effects of contraception: the way they themselves can take control of our health and emotions. This personal account of choosing a contraceptive in our public healthcare system explores the importance of finding the right thing, that suits not only your sex life, but also your mental and physical needs. 

I recently read an article in Vogue Magazine that caught my attention, not because of the lavish clothes, but because it was talking about the decreasing number of women using the contraceptive pill. The pages caught my eye not for the lack of supermodels, but because it is a topic extremely relevant for myself at the moment. I have just had the contraceptive implant inserted. A simple procedure: it took around 15 relatively painless minutes, it lasts three years, and is over 99% effective. See, simple…not quite. This is now the third form of contraception I am trying within the year. As a 21 year old female student this is something that, without a steady relationship, I dismissed as a priority in my student life. Then, after a drunken hook-up almost turned into a Sinners lovechild, I thought it time to reconsider…

First trip to the doctors, I was looking mainly for advice having never used a consistent form of contraception. However, knowing the basics of the combined pill - take it every day for three weeks, off for one - it sounded like the ideal choice, with the bonus of regulating periods. The doctor agreed and as she began to write my prescription, she said as an afterthought, “Oh you don’t suffer from migraines, do you?”. Well, actually, I do. There is evidence that says having migraines while taking this particular pill puts you at risk of a stroke. No combined pill for me.

Not a problem, the doctor went on to tell me, the progestogen-only pill will be suitable. This pill contains none of the oestrogen that causes the stroke risk for migraine-sufferers. It differs from the combined pill in that it is taken every day with no breaks, meaning there is no control over your periods. Some women may have lighter, less frequent periods, some may have their periods stopped altogether, or some unlucky ones may find they come more frequently. Unfortunately, I was the latter, and after have my third consecutive week of a period, I came off the pill.

Yet more research and investigation into other methods followed, but once again I was at a loss of what to do or try next. Most of my friends were on the combined pill. One in particular, who also suffers migraines, was also on the combined pill, and suggested the doctor was maybe being overly-cautious. With the regulation of periods, the combined pill does shine through as the most practical option, and after a month of periods I wasn’t willing to risk anything else ‘progestogen-based’. Back to square one. This time I went to my doctors at home, rather than St Andrews in the hope they would have different advice. They did, and my friend’s suggestion of the other doctor being overly-cautious was confirmed. I came away on the combined pill (given, it was a particular variety with lower oestrogen content).

I took this pill for around three months, having no problems or complaints about it, and was returning to St Andrews as the pack was running out. Another trip to the doctors to gain a repeat prescription, and finally I was on the home-straight of finding suitable contraception…or not. As I produced my current pack of pills to show the doctor which kind I had been taking, she seemed shocked after seeing my medical history. I repeated what the previous doctor had said to me about the lower oestrogen content and it being only a small risk of stroke. She disagreed and refused to prescribe me any more.

Square one. Again. This time, I came away more frustrated than ever. This was another different answer to a question that clearly should have one medical solution, yet three different doctors had told me three different things. Additionally, I didn’t know which was right so not having any specific person to plant my blame on was even more frustrating.

Yet more reading… yet more research… Finally, I decided to go with the implant. Back to a progestogen-only type of contraception as the safest for a migraine-sufferer, but the risk of more frequent, heavier periods. And here I am, having had the implant, and having made a deal with myself to stick it out longer than I did the progestogen pill. So far, so good!

However, the whole process made me really think about what women put their bodies through to prevent pregnancy. Just from reading about contraception, there is a sense of the unnatural, and frankly quite scary, effects that these drugs have. For such a necessary item, we seem to ignore the fact of what these pills or insertions are doing to our body beyond being contraceptive. What about the weight gain, the breast tenderness, the increased blood pressure? Not really mentioned without a thorough investigation through websites or leaflets. And more concerning, there’s the mental side effects of these contraceptive methods.

This is where I return to the Vogue article, in which the discussion surrounds the decreasing numbers of women using the combined pill due to its mental side effects. ‘Mood swings’ are common words seen on the likes of contraceptive leaflets or the NHS website, but the word ‘depression’ is never used, despite this being the complaints of the numerous women. There seems to be lack of discussion surrounding the fact that these drugs are hormones, and hormones that we are releasing into our bodies to override our own natural hormones, altering emotions and feelings also. There is nothing natural about them, and by letting them infiltrate our own natural cycles, whether it be through taking a pill each day, or having them inserted in our arm for three years, there is something that strikes fear in me. Yet, there is one implanted in my own arm because they are a necessity of our generation, so shouldn’t it be easier and simpler for women? In my opinion, yes, but in the meantime my advice to women like myself who are struggling to find the right option is to persist and not to settle, but to make sure you find a method that is right for you and your body. And if doubt, put a condom on him and tell him to stop whining.