Contraceptive Roulette: We Need To Stop Gambling With Women’s Reproductive Health
I started taking the pill at 15. My mum hauled me to the Doctor, at a loss of what to do with me. My cramps were so blinding, the bleeding so extreme, that I was missing irrevocable amounts of school. My doctor told me that there was a magic little pill that would help, and I wouldn’t be missing any more school. Blissfully ignorant, I took it every day. Learning my lesson the hard way, my cramps were worse than ever. There’s no such thing as a magic pill.
At 16, I dragged myself into a Doctor’s waiting room again. In a desperate attempt to fight back against another teenage trauma- acne. A battle I was sorely losing. My doctor handed me another ( progesterone only) pill. I hoped rather than believed that it would work. For a brief minute, my skin cleared, and I recovered a shred of self-confidence.The moment was fleeting.I felt like an experiment in a chem lab testing what would happen to an already hormonal teenage body if we pumped her with even more progesterone? I was a Mento in a coke bottle, it was only a matter of time until someone ran away screaming or someone chucked one of my meltdowns on Youtube.
At 18, I started dating my first serious boyfriend .I was besotted and needed a new kind of contraceptive for its original purpose. I turned to the implant hoping the no hassle or worrying about forgetting to take it would suit me. But it turned out that was the most no hassle thing about it. My period reversed, leaving me 5 days of respite a month. I was a hurricane of tears and tantrums. No person or thing could calm the storm. My first few months of university were shrouded in depression and anxiety. I didn’t know where I ended, and the implant began.
And I am not alone. Progesterone dominant hormonal contraceptives are “freely given to teenagers from young ages” according to Dr Ellen Grant. One convenient fix to cover a horde of ills. Yet up until 2018, the NHS had no data on the links between long-acting reversible contraceptives ( LARCs) and mental health. Even now, in 2020, it only lists “temporary mood swings” under potential disadvantages of the pill. Simultaneously, a 2014 NHS Mental Health Survey reported that 26% of young women between 16–24 reported mental health issues, compared to 9.1% of young men of the same age.
Of course, these “mood swings” could be a result of their first “teen heartbreak” as proposed by Columbian University Medical Centre professor, Catherine Monk. Far be it for me to disagree with an expert but the lives of one million young women studied in Denmark, revolve around some relationship.
The University of Copenhagen’s landmark study monitored one million women between the ages of 16–34 during 2000 and 2013. By tracking social security records and comparing with non-contraceptive users, the young women who used hormonal contraceptives were 1.23 times higher (1.8 for teenagers) to be diagnosed with depression. In other words, for the 55% of women in the study that used hormonal contraceptives, 133,000 had at least received their first anti-depressant prescription by the time researchers followed up at the end of 6 years of monitoring. A second connected study even identified a link between hormonal contraceptives, suicide and suicide attempts.
In 2017, I had dragged myself through my first year of university. I had abandoned the implant and was seeking advice from a local sexual health clinic. I remember sitting in a windowless room, littered with far too many graphic STI leaflets, across from a Doctor and a medical student. I remember hearing myself rattling off my sexual history, dispassionately like I had done so many times before.
I braced myself for another textbook reaction; confusion, disbelief, maybe a sympathetic smile just to have another pill pushed at me and the door to hit me on the way out.
It was then that Doctor told me that I wasn’t alone. She told me about the Danish study and the floods of stories of women that followed. Women with experiences, just like mine. She told me that the BBC 4’s Woman Hour had teamed up with The Debrief’s Vicky Spratt with an investigation called: Mad About the Pill.
Researching later, I discovered that the investigation had collected the experiences of 1000 women on hormonal contraceptives. The investigation called out the NHS’s lack of data on the links between hormonal contraceptives and mental health despite it being a well-known concern amongst experts in the medical community. It asserted that more research on the links needed to be carried out so that women could make the safest and well-informed decision as possible.
It’s all a woman, like me, wants to be able to do make a safe and well-informed decision for my body and health. School taught me nothing more than putting a condom on a banana. That and not to trust a man to ever have contraception covered. It doesn’t help that there has been next to no research on male contraceptives over the past 50 years. There have been recent developments in male pills, gels and injections but all are years of research away from being publicly available. In fact, one such injection had a recent setback after one in five participants reported “mood disorders”.
The irony is not lost on me or journalist Holly Grigg-Sprall for that matter. She remarked that we find it: “acceptable to blame women’s depression on the fact that they’re women. Yet, we cannot stomach the claim [that] a powerful medication formulated from synthetic hormones could be at fault.” Unless of course, a man claims it.
The choice to use contraception goes beyond whether or not a woman wants a child. It’s a choice that asks what she can live with and what she is willing to risk to keep her current life and build the future she wants. I had to make that choice. After exhausting every hormone option- and ruling out them all, I settled on the non-hormonal IUD- commonly known as the coil. I will spare you the details, it’s an awkward procedure that definitely isn’t for everyone. One that I’m definitely grateful only comes round every 5 years. I still experience extremely uncomfortable periods from time to time but at least I still feel like myself.
It’s the choice I made with the few facts set out in front of me. No woman should have to make this choice and gamble away our health when we only know some of the facts. We cannot leave the health and wellbeing of 842 million women who use modern contraceptives to chance. I don’t want to play roulette, I’m out.
Rebecca Carey
