AMA with Kate Muir about her book: Everything You Need To Know About The Pill (But Were Too Afraid To Ask) - Thursday 9th May 6pm

[SophiaCMumsnet]

Hello,

We're excited to announce that Kate Muir, the author of ‘Everything You Need to Know About the Pill (But Were Too Afraid to Ask),’ will be joining us for an Ask Me Anything on Thursday evening to mark the release of her new book.

Kate is a women’s health campaigner, writer and filmmaker. Over the past four years, her campaigning work has created profound change in women’s health in the UK, bringing the menopause conversation to a massive audience. As well as writing the book Everything You Need to Know About the Menopause (2022), she pitched and produced two ground-breaking menopause documentaries for Channel 4.

Last year, Kate produced Davina McCall’s Pill Revolution, and her new book delves deeper into the subject. It's an eye-opening, practical guide to understanding the pill and other contraception, which offers answers to the questions hidden behind bad science and centuries of patriarchy. Kate equips readers with knowledge of the latest science on contraception and advances in reproductive healthcare, amplifies the voices of women who have struggled to get the help they need, and exposes the sloppy science and hysterical headlines that have had a negative impact on women’s health for the last twenty years.

You can join Kate live from 6pm this evening, or post your questions below in advance for her to answer.

Thanks,
MNHQ

Hi Kate, I saw your piece in the Times which mentioned male contraception - do you think it will genuinely ever become a widespread thing? It seems to me that it will be difficult to push back against the years of patriarchy that have made the whole thing the women's responsibility.

I was wondering what you thought about the suggestions last year that counselling should be seen as on a par with HRT?

Im nearly 51 and have been taking the Mini Pill since i was 48. How am i supposed to know whether my periods have stopped due to the Mini Pill or the menopause. Its a desogestrel pill

Hi everyone
Really please to be on here this evening from 6pm on to answer all your questions about my new book Everything You Need to Know About the Pill. Remember, I'm not a doctor, but I am an investigative journalist so I hope I can point you to the latest research and Info. It's quite often hormone hell out there...
Kate

Also happy to talk about the menopause too!

Is it dangerous to stay on combined pill indefinitely? Ie potentially decades

Think the bigger problem will be women trusting them/it!

You're so right. It's the 64th anniversary today, May 9th, of the approval of the contraceptive pill for women, but we still don't have anything but condoms and vasectomies for men. 🙄Patriarchy very much not sharing the burden. But a new generation of entrepreneurs has appeared and I think within two years there may be Plan A - a temporaray gel vasectomy injection, which you can dissolve when you want to be fertile again. Also the testosterone-progestin shoulder gel, and the ultrasound testicle bath - still being researched!

I’m on Cerazette (progesterone only pill). As this shuts down your natural cycle is it possible it can cause similar symptoms to perimenopause from lack of estrogen? Sweats, headaches etc. I have a constant low level headache whilst on it ☹️

GRRRR. Yes, there were those 4 papers in the Lancet saying menopause was over-medicalised and we should try CBT (cognitive behavioural therapy) instead of hormones replacement therapy. CBT is a great addition - but it's not the answer and it's not going to stop hot flushes or brain fog. Most women want their hormones back, and we can now get body-identical ones on the NHS.

Good question - you don't know when you're on the pill, but you could take a "pill holiday" for a couple of months to see what happens if you don't need it for contraception. Experts I've talked to say it's better to change over to HRT around menopause and not stay on the pill, because the natural hormones in body-identical HRT (usually Utrogestan progesterone and Oestrogel or an estrogen patch) are safer than those in the contraceptive pill. Good luck!

Yes, the research shows around half of women no longer ovulate on the progestin-only pill (like Cerazette) and it sounds like you should see your doctor and ask for a change of pill or another form of contraception like a coil. Dr Louise Newson says in my book that sometimes by lowering natural hormones, the pill can cause a "mini-menopause". Around 26% of women get headaches as a side effect of the pill (according to a survey we did for Channel 4) and you shouldn't have to suffer that. I've also interviewed women in my book who got a dry vagina/vulva on the progestin-only pill due to lowered hormones. Hope you sort it out!

The NHS tries to take you off the combined pill (ethinylestradiol and a progestin) as you get older, often in your thirties, mainly due to a higher risk of blood clots and strokes. But the risk is different for different pills depending on the progestin in them and highest for ones like Yasmin (Eloine) (Risk is on the leaflet in the packet). There is a better option with less risk - pills with body-identical estrogen in them available on the NHS (but expensive so they don't offer them upfront) and they are Zoely, Drovelis and Qlaira (they still have synthetic progestins, but it's a newer formula). Or there's no risk of clots with the hormonal coil. Hope that helps. The Lowdown is a sort of Trip Advisor for contraception and worth looking pills up there.

Yes I think you need to have a rock-solid partner, so to speak, to trust him with male contraception. It's not an option on Tinder - but you should be using a condom there anyway. BTW, condom use massively down among young people. Don't know why

@KateMuir Thanks for answering. Unfortunately i am having to use it for contraception. im child free by choice and was refused sterilisation If i hadnt been i wouldnt be worrying . Thanks

I'm interested in finding out more about women who have used the combined pill to help with the symptoms of PCOS (polycystic ovarian syndrome). Has anyone had a good experience with this?

Do you think we need to be providing better education in schools, especially for girls, around their options on contraception and how it all works? It feels to me that everything is focussed on making sure you’re on some kind of contraception without actually talking about the different options and how they work. Thinking of the conversations on here you see sometimes when mums say they’ve found out their daughters are sexually active and they’re rushing them to the GP to get the pill…

You are so right @selseywilhemina I think we need a whole module in biology (instead of cutting up frogs) on menstrual cycles and contraception and hormone health - for girls and boys. It would be very useful, as 64% of pill users go on it at school. So schoolgirls are taking a decision that may affect them for decades without full knowledge of simple stuff like the difference between a combined or a progestin-only pill. It's also that hormonal contraception is seen as being all about sex - when it might be about helping with heavy bleeding, endometriosis, PCOS or acne. I think it's also great to show girls how a period tracker like Flo or Clue works so they understand their moods and cycles.

What do you think are the pros/cons of the coil versus the pill?

Everyone's different. In terms of mental health, the pill and the hormonal coil can affect mood in some people, but new research is showing that the smaller hormonal coils like the Kyleena and Jaydess are less likely to cause mood swings and depression than the bigger Mirena, as they have lower levels of hormones in them. Also, the Kyleena and Jaydess are 28mm wide rather than 32mm for the Mirena, so easier to fit. The hormonal coil sometimes helps if you have heavy bleeding or fibroids. Always feel confident about asking for an anaesthetic gel or injection - we do it at the dentist so why not when we get a coil fitted?
@CherryReds Of course some people love the pill, and the newer body-identical combined pills with natural estrogen - Zoely, Qlaira and Drovelis - are worth looking our for on the NHS as a new option.

I've been on the combined pill for years, almost consistently from the ages of 16-36.

Over the last 10 years my libido has dwindled to zero and I'm convinced it's the pill. I've come off it now about 6 months and maybe starting to feel some return but very early days. It's very upsetting and worrisome. Have you interviewed anybody with a similar experience? Is it possible for the pill to cause long term irreversible damage through suppression of your natural hormones? TIA!

I feel like there’s been a bit of a move recently towards ‘natural’ methods of contraception with influencers etc talking about it on instagram. Do you think they should be doing more to make it clear that it’s not 100% reliable?

Yes! Have a chapter on this in the book - 21% of women get lowered libido on the pill so you're not alone @Lorelei22. Basically the pill increases your Sex Hormone Binding Globulin (SHBG) which lowers the amount of free testosterone in your body (and yes, testosterone's a female hormone too) so your sex drive falls a bit. Again, some pills are better than others and the body-identical estrogen ones may help, as I've mentioned before. Also some women find their libido is better on the hormonal or copper coil. (Incidentally, women on the Depo contraceptive injection reported the most lowered sex drive). I don't think the low libido lasts long term from the pill, though studies show it may take at least a few months to recover. Hope it goes well!

Yes adverts for the Natural Cycles fertility awareness app are big on Instagram and particularly with influencers on Tiktok, and @SarahHasaBlackCat you're right that some women give the impression it's infallible. In fact the failure rate cited by Natural Cycles "with normal use" is 7% - with "perfect use" it's 2%. That's still a few babies...
But younger women are uneasy about the synthetic hormones on the pill and many feel they have been gaslighted about side effects so there's a move to "Green Sex" - it's just that you've got to take your temperature at the same time every day and it all goes belly up if you're hungover, stoned or have the flu...

I used the combined pill for PCOS and suspected endometriosis. It was the third one I tried that was OK. I came off it to TTC and realised how much better it was to the extent I said I'd never go on it again. It took a year to start ovulating again, the last thing you want when TTC. I had a child and stayed off it. Like many women with PCOS I have regular hormonal migraines and was only allowed the mini pill.

I'm using Myo Inositol now and prepping for my second round of IVF. I felt fantastic on IVF meds when my estrogen was sky high, no more headaches, better concentration, less anxiety. After taking Prostap to shut everything down I felt terrible again, joint pain, inflammation, sleep issues etc. I'm late 30s but get no support from the NHS despite feeling so unwell from low estrogen.