For many women, taking the contraceptive pill is something that is empowering. But there’s a fine line between taking charge of your sexual health, and risking the mental occasional physical implications that hormones the contraceptives can cause. In Australia, just over 2.5 million women between the ages of 18 and 49 use some form of contraception. The most popular choice is the pill, but recent studies have shown a link to depression. Although there are many side effects of using the pill, women continue to use this form of contraception. This may be because they think are no other options that are as effective or convenient.
The pill comes in two forms: the combination pill, and the progesterone only ‘mini’ pill, which is often taken by women who have high risks of heart disease, high blood pressure, and those who suffer migraines. However, with recent studies showing the negative effects, many are looking for alternatives to setting an alarm for the same time everyday. IUD’s, implants, the condom (both male and female), the contraceptive injection, the IUS, the patch, the vaginal ring and the diaphragm (as well as alternative family planning) are all there – but what do women think in regards to changing their method of contraception? How does this affect their thoughts about empowering their sexual health, or regulating their period every month?
Personally, I have changed contraceptive pills three times, and it now costs me just under $100 to be on the pill for three months – it’s no small investment. The first pill I was put on gave me every possible side effect, starting with depression, weight gain, acne, mood swings, nausea: the lot, so it really wasn’t an option to keep going with that one. I stayed with the pill because it’s easy – setting an alarm sounds far less painful than getting an IUD or an implant. So far, I feel it isn’t as bad as it used to be – I get the occasional mood swings and cramps (and chocolate cravings, of course). It’s better than my previous pills, but it’s nowhere near perfect. These side effects of the pill are quite common: itcan increase a risk of mood swings, depression, nausea, PMS, acne, impaired partner selection and a decrease in libido – something that most women just ‘deal with’ on the pill.
When I asked Melbourne based obstetrician and gynaecologist, Dr Guy Skinner about why women might take a break from the pill, he said the most common reason was to “give their bodies a break”.
“It’s either that, or they’re getting side effects whilst being on it…but for the most part they feel safer being on the pill as the side effects and risks that can be imposed on them if they are pregnant are much greater,” he says.
Dr Skinner also says the risks of other contraceptives can scare some women.
“Other forms of contraceptives (such as the implant) can have side effects like breakthrough bleeding, which occurs in 50% to 60% of women. Women need to be on something that is right for them and their body.”
Eloise, an eighteen-year-old university student, spoke to me about her experience of changing from the pill to the rod. “I was firstly put on the mini pill by my doctor as I got painful and infrequent periods. Because I got bad migraines, I couldn’t take the standard combined pill, I experienced weight gain, and the periods just weren’t getting any better, despite being on the pill.”
She also struggled with remembering to take the pill at the same time each day.
“The infrequency of timing with taking the hormones every night was just an inconvenience, so I decided to be put on the rod, which has been a better experience so far. It’s so much cheaper ($40 for three years) and there haven’t been horrible cramps every month.”
Claudia had a similar experience to Eloise, changing to the implanon after being on the pill for about nine months. “I currently have the implantation and have had it for a bit over six months,” she explains, “I decided to change because after researching about it, I realised that the bar is more effective, lasts for three years and is more cost effective.”
The rod, or Implanon, is a small plastic rod inserted just under the inner arm, which eliminates the chances of user error. It can have a higher upfront cost, if not covered by health insurance. The implant is 99% effective and doesn’t contain oestrogen. A common side effect of the pill is a loss of periods as well as reducing the effectiveness of selective medications. The rod proves to be more ‘user-friendly’, as you do not need to remember to take it every night or take anything extra into consideration when travelling.
The rod can also be easier to use when travelling. Mary* said that she decided to go on the rod for ease-of-mind across time zones. “I didn’t want to be dealing with scripts for the pill or managing different time zones in a different country.”
She says despite the initial pain when it’s first inserted, she is pretty used to it now.
“I forget it’s there half the time now, because it’s so subtle.”
Pharmaceutical companies are now looking towards developing the male contraceptive. According to a Kaiser Family Foundation study, 66% of men were willing to take an oral contraceptive, 44% would get a birth control shot and 38% would try an implant. These methods may become a reality, with a male contraceptive injection found to be 98% effective. However, the trial was halted due to side effects.
Whether you’re on the pill, the implant, or nothing at all – making your own personal choice, for whatever you feel most comfortable with, is the most important thing.
*In order to protect Mary’s identity, Catalyst has not published her real name.