Hard to swallow? The future of the contraceptive pill

The alarm beeps, and you grab your phone and silence it. Reaching into your bag, you pull out the brightly coloured sheet of pills, and, glass of water in hand; swallow the correct day’s dosage.

For thousands of women, this is a daily occurrence. Once prescribed purely for contraception, the pill has grown in popularity thanks to its cheap production costs and versatility of usages. And versatile it is: now in its ‘third generation’, the contraceptive pill is sold under many different names and in a few varying dosages. Through rigorous testing, it’s given women all around the world the opportunity to take control over their bodies in a way that science has never allowed before.

However, that’s not to say it doesn’t have its negatives. A recent petition created by 21 year old nurse Laura Ephraums is proof that further adjustments are needed to ensure these women remain not only safe from pregnancy, but also happy and healthy.

Petition

Laura had only been taking Rigevidon, a commonly prescribed version of the combined pill, for eight weeks before she grew ill in a matter of days. “I’m sure all the professionals did what they thought was best and there was no intentional dismissal of what I was experiencing” she says, “I think it’s just down to awareness, they really didn’t expect someone of my age to go through what I went through.”

For the first two months on the pill, Laura carried on with life as normal. Then, one day while strolling down the beach in her hometown in Devon, Laura’s ears popped. “I got a sudden headache and the ground looked like it was spinning.” she tells me.

Laura
Laura Ephraums

Unfortunately, less than four days after the initial symptoms, Laura was rushed to hospital, where doctors found she had suffered a blood clot on her brain, which presented itself as a stroke. After numerous tests, she was told that the pill had most likely been the cause for the clot.

It is estimated that a million women are taking the contraceptive pill. The current prescribed pills are less likely to show the side effects of previous variations and have a lower dosage of Progesterone in them. However, women taking these pills have a doubled chance of suffering from a blood clot, which is four times as likely as a woman not taking the pill. As trials for a male contraceptive pill were ended early due to side effects suffered (including anxiety and depression, which over 44 per cent of women on the pill suffer from already) there is nationwide controversy as to how women’s pills aren’t subject to the same scrutiny.

This is not to say that all women suffer side effects; rather, the bigger problem is the range of side effects that can be experienced.

 

All women’s bodies are different and react differently to combinations of hormones. This is the reason as to why there are varieties of both the contraceptive pill and other forms of birth control, like the coil, patch or non-hormonal methods like condoms.

Laura suffered badly, but in order to see how widespread the problem is, I spoke to other young women who have also been prescribed the contraceptive pill. All were on different pills, and all had differing experiences.

There may still be issues with the pill, but it’s definitely become safer over the years.When it was first prescribed in the 1960s, the contraceptive pill was quickly recalled due to the large amount of women suffering dangerous side effects. Since then, the pill has been developed and reissued. Now, the pill is the safest it ever has been.

 

The focus now seems to be on improving the experience for women taking the pill, and making sure they are also aware of other options.

 

I spoke to Doctor Rebecca Mawson, a Sheffield GP specialising in sexual health and contraception, to get an objective approach on the pros and cons of prescribing the pill.

“I think people Google a lot,” she says, “there are a lot of forums full of very angry, very unhappy people and I think the problem is that if you’re happy with your contraception, you won’t go online.”

She continues, “You only hear about the bad stuff. There’re risks with taking all medication, but there’s millions of women who successfully take the pill. I think it’s about being aware; whenever I prescribe the combined pill I always talk about the risk of blood clots and I always say there’s hundreds of options if you don’t like this one. But you can’t tell everyone everything.”

 

“I think the problem is that if you’re happy with your contraception, you won’t complain about it.”

 

Rebecca explains that although the pill has its dangers, it’s not half as dangerous as pregnancy.”It’s one of the worst things a woman can put her body through,” she tells me. “There are elevated risks that come from taking the contraceptive pill, yes, but they’re very slight compared to the risks associated with pregnancy.”I pointed out I was apprehensive of taking the pill because I’d heard little other than horror stories about women who had experienced horrible side effects. “Trying to judge the number of women who have issues taking it is one of the big problems we have.” Rebecca continues, “Currently, we prescribe the pill but I might never see you again – and so I don’t know if you’ve had problems.”

But it’s not surprising we have reservations about taking hormonal contraceptives, with almost daily headlines pointing out the dangers:

One area we could soon see more research in is the male contraceptive pill. Working under the same umbrella as the female pill, it would severely cut the likelihood of conception through reducing sperm count. “The pill is a mix of Testosterone and Progesterone,” Rebecca tells me, “and it works really well at reducing the sperm count, which then picks straight back up when you stop taking it – it’s really effective.”

The young women I spoke to about their experience on the contraceptive pill were all for the continuation of male pill trials, but is it that simple to start them back up again?

“The problem here is the issue of responsibility” Rebecca sighs, “it’s the ethics of it. There was a real argument around the male contraceptive pill – I think because the phrase was the male ‘hormonal’ contraceptive and my argument was that actually, we just need more research around the male contraceptive, not just hormonal ones.

“You’re asking a man to take a potentially dangerous medication to protect somebody else. It’s really difficult – the ethics mean that any negative side effects will stop the trial because they’re not first hand.

“It’s not that we don’t want to do the research, it’s that the ethics are dodgy because you’re researching on someone who won’t have the direct benefit of the medication.”
Doctor Rebecca Mawson

“There’s other stuff like monkey research where they inject gel into the tube that comes from the testes and this works as a blockage. You can open it back up again; it’s like a reversible vasectomy. There’s some interesting research out there and I think it will be picked up on.”

It’s difficult to pinpoint exactly how the pill will develop over time because it’s not used purely for contraception. More and more women are being prescribed the pill for medical problems like Endometriosis or acne. It can be used to regulate periods, moods, and skin conditions. In order to create a better experience for women who use the pill, we would need to look at exactly why they’re on it in the first place. And with so many variations, there is no single cause and effect for many of the side effects women face.

Aside contraception, what else is the pill used to treat?

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So, what’s the future for the contraceptive pill?

It’s clear that the pill has been revolutionary. From preventing pregnancy to supporting various medical conditions, the contraceptive pill has changed women’s lives all around the world. The rise of technology has seen a shift in women using hormonal birth control towards non hormonal methods – like fertility apps, which follow the traditional calendar method. Similarly, more and more women nowadays are using the contraceptive coil, which releases a much lower level of hormones. Alongside this, research into the male contraceptive pill could see another birth control revolution; but, for the meantime at least, it’s looking like women will still take the front seat when it comes to progress.

   

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