One of the most popular forms of contraception amongst women is the combined oral contraceptive pill, or just 'the pill'. It was seen as a beacon of feminist hope, and of new found liberty for women when it was introduced, but nearly 60 years on there are questions being asked about it.
The pill, which contains artificial versions of oestrogen and progesterone, was introduced in the UK on the NHS in 1961. However, it was only made available to married women. This changed six years later in 1967 when the NHS offered it out to any women in need of a contraceptive. It was a huge breakthrough and changed the way many people viewed sex. It offered a contraceptive to women, which allowed them to be in control of their own bodies and what they do with them.
The main reasons women are being put off this long-standing contraceptive is down to the array of side effects that can come with it. Weight gain, mood swings, depression, anxiety, sickness, and even in some cases blood clots, a stroke, a heart attack as well as a slightly higher risk of getting breast. This can lead to the question of why do women still use it?
Aside from avoiding getting pregnant, some girls and women are put on the pill by medical experts to help treat some problems they have. Jasmine was originally put on the pill to treat her secondary amenorrhea, which is the absence of menstrual bleeding.
Jasmine said: "On my second course (of the pill) I was having terrible mood swings, depressive spells, anxiety attacks etc. nearly every day. Because of this, I stopped taking them after a month. Pretty much immediately after I felt a lot better, I’m a pretty highly-strung person normally, but the pill just sort of pushed it over the edge. I don’t think I’ll try the pill again for a long time."
These side effects are not uncommon. Research has shown that women who are on the pill are 23 per cent more likely to be diagnosed with depression. Doctors even acknowledge that women who have a history of mental health problems should be recommended to try other contraceptives. Unfortunately, teenagers like Jasmine are most at risk, and as she said it is clear that she is part of this statistic.
Doctors often prescribe the pill for other health issues, not just secondary amenorrhea. It helps with symptoms of endometriosis, acne, polycystic ovarian syndrome (PCOS), prevent menstrual migraines, decreased risk of ovarian cancer, and even just help to regulate your period by preventing it, controlling it or making it a lot lighter.
Jane Taylor, a contraception and sexual health specialist nurse at the New Croft Centre, said: “Young people can very much be influenced, positively or negatively, by their friends’ methods, what parents have used previously. The popularity of some methods has declined for fear of parents finding out. Weight gain can also be a concern for young people, and the combined pill is often used as it helps with both contraception and problems with acne.”
When taken correctly both pills are 99 per cent effective. However, there is a lot of room for error when taking an oral contraceptive. The pill is distributed in boxes that are set to last three months. Each strip contains 21 pills, which are generally taken for 21 days in a row and then you take a seven-day break where you generally have a withdrawal bleed. A withdrawal bleed, also known as a fake period, is completely down to the change in hormone levels within the body and is the weakening of the uterus lining. It is generally used by women on the pill as an indicator as to whether or not they are pregnant. However, if you have been on the pill for a while your doctor or nurse may suggest that you can take three strips in a row and then have a withdrawal bleed after the three strips (63 days). You are even protected from getting pregnant during your week off.
The effectiveness of the pill can vary throughout the time you are on it. Some pills need be taken at very similar times each day, so if your timings are very different day to day it can lower how effective it will be. If you throw up or have diarrhoea within the first one-two hours of taking your pill, it will not have had time to be absorbed, therefore rendering it ineffective for that day. When this happens, you will need to take a second one to be fully protected throughout the day.
Over recent years, long acting reversible contraceptives (LARCs) have grown in popularity. Doctors are recommending them more, and women are selecting them more. They include injections, the implant, IUDS and the copper coil. They are very low maintenance compared to the pill, contain less artificial hormones as they are localised, and in some cases can be inserted and you do not have to think about them for years. Going back to what Caroline Allsopp has said, if you choose a LARC, your parents will not be able to find packets in your room.
When choosing what contraceptive to use it is important to find out what family members have previously used. If your mam has had issues with a certain method, it is possible that it will have similar effects to you.
Caroline Allsopp, a health advisor at the New Croft Centre, said: “Patient preference is taken into consideration, age of patient is also a factor. Students tend to choose the combined pill with convenience of method, or even the IUD as a form of emergency contraception* but then use as a regular method. Certain clinics in certain areas see a higher incidence of choosing depo or implant. Fewer people use contraceptive patch and even less diaphragm or caps.”
Despite the side effects women, like Tanya*, continue to use the pill as it is the best contraceptive to suit their body's and lifestyle. Women continue to risk and accept the possibility of side effects.
Tanya* said: "I started with the combined pill when I was 15 to control my periods, but then changed to the implant when I was about 17 because I started getting migraines. I had to go back onto the pill as my periods were all over the place. I don't see why anybody would choose to be on them if they didn't need to be. It's the only realistic way to not get pregnant."
*The IUD is a LARC that is fitted inside the womb and lasts for 3-6years. If inserted within 7 days of unprotected sex they are over 99 per cent effective in preventing pregnancies as they prevent the egg attaching itself to your uterus.
*Names have been changed
