Is there a disregard for the effects of contraception on women's mental health?

[PinkFluffyJumper]

I've just been wondering about this recently as I'm planning on giving up on hormonal contraception following some awful, awful mood swings and depression.

I've read about women whose experiences of this (as a result of hormonal contraceptives) have been disregarded by some HCP.

Given that this seems to be quite common/widespread, why aren't the effects of these drugs on mental health more widely spoken about?

I feel strongly about this because most men , it would seem , don't like using condoms. Because it dosn't feel as nice. Well no but the pill makes me psychotic. Nowadays if someone dosn't use condoms until I'm sorted they can piss off. The pressure to go on the pill normally strts early; after about 3 dates. Why can't they design a pill for men for example?

So what choices of non-hormonla contraception do we have? Condoms, copper coil....female condom?

Agree totally, super.

I don't entirely know why diaphragms have gone out of fashion - I expect they're just too fiddly. But it does annoy me when blokes say they 'can't' use a condom.

OTOH it's not perfect and if you use them, you have to be prepared to swing into action with the morning-after pill if need be.

I would love to see a MN campaign. Something that bugs me is that I (like lots of people) can't use microgynon because the risks for people who get aura migraines include stroke and death. My first issue with this isn't a mental health one - but I'd say roughly 50% of GPs I've met didn't know this and prescribed it anyway. But the second issue is with mental health. Microgynon makes me feel a huge amount better mentally - it is amazing. So clearly there is something hormonal going on, which isn't - so far as I know - being properly researched.

This is a really interesting thread.

I've just decided to stop taking the pill after ten years, seven of which were on Yasmin and the last three on the mini pill after my migraines started getting much worse. Planning to chart cycles and use condoms. I'm just fed up of putting hormones into my body without even thinking about it. My side effects weren't even bad compared to many people - weight gain, spots and a loss of libido.

I don't intend to tell my GP either because I know I'll get a telling off for stopping the pill and have the implant or coil thrust upon me, which I really don't want.

I also think a campaign would be a great idea. It seems the vast majority of us just take it as read that we'll go on the pill. The risks and side effects were never once discussed with me at appointments.

I agree too super

All contraception carries negatives. For who, though? Mustn't interfere with sexual enjoyment, especially for men. That is such a grimly tenacious meme in society. For the sake of clarity, I feel compelled to add I'm not just a feminist pruderist (or whatever that stupid word was)

It's almost a right of passage to go on the pill in a newish relationship, it's making a statement that it's getting serious.

Weight gain - now that's an interesting one too. For all sorts of reasons.

I wonder would it have anything to do with this obesity epidemic I hear so much about?

Also, I wonder if it's true that all the artificial hormones being excreted is ending up in the water table and affecting the general population? Thereby adding to the obesity problem among the general population - not to mention other environmental effects.
I could well be talking bollox here.

Well, I think women are to blame as well as men. Why do you unquestioningly go on the pill? Why do you choose men that expect it?

Women are capable of reading the health risks inside the packets for themselves and making their own decisions.

We've used condoms for years and I bet lots of other women could, but they haven't. Their body, their choice.

Well, yes, of course everyone can read the inside of the packets. But most people don't, it seems, they just assume it will be fine. Why is that? that's what we are trying to get at. Cultural messages are strong and definitely influence that, imo.

You could have a point, Sal. I certainly don't think you could say it has no impact.

ithaka I don't know if it's a question of women choosing men who expect it, although I'm sure that may be true in some cases. I started taking the pill as a teenager and when I made an appointment to talk about it my GP said 'Okay, I'll put you on the pill.' That was it. I had to bring up the fact I suffered from migraine with aura. At that time I think it wasn't considered a problem to take the combined pill. I think in a lot of cases the decision is made when a woman is very young and after several years, it's just what you do.

Everyone certainly can't read the inside of the packet!

That's a huge issue.

My mum has worked with women who are illiterate, and often there is very little provision for them.

There are also many, many people who do not know they are not understanding what they read.

It is incredibly problematic to assume that all women are nice, well-informed, well-educated types.

There is also the issue of weighing up risks. I am literate, but if my GP prescribes me a pill, and the risks of that pill include death, how do I know how high that risk is, and whether or not that pill is seriously something I shouldn't take? That is not my job.

I think there is also a secondary issue, that we're not really encouraged to try to educate ourselves. I can understand that for medics, it must be very tedious to be constantly faced with 'well I looked on google and ...' or 'well google says my diagnosis is ...'. But many women (and men) feel intimidated by doctors and unable to challenge them, or even to ask for clarification. Many women are simply not told that the side-effects are avoidable. More worrying, some doctors do not realize that some side-effects are avoidable.

That's true of course LRD regarding illiteracy, showing my nice educated privilege there

Back when I was a newly-wed 23 year old I had a few issues with breakthrough bleeding and irregular bleeding on the pill. This happened with 3 types of pill and I told my (old-fashioned male GP) who advised me to get pregnant!

I'd never mentioned the possibility of wanting a baby (I didn't!) and didn't think it was his place to say that. Basically I think he wanted rid of me.

FWIW, fast-forward 10 year or so and my DH is a GP. He has told me that the NHS has a drive to push long-lasting contraception - coils, implants - as they are cheaper.

Agreed LRD completely. I think it is dangerous to blame women when even the medical professionals are minimising or ignoring the symptoms even when a woman is explaining what is happening to her.

I see the issue for maginalised women, but surely most women are reasonably intelligent and can read. It seems a bit insulting to women to suggest otherwise. You don't need to Google - the information is all in the packet.

Perhaps if women who could read took the time look at their medication packet, it would free up GPs time to focus on the marginalised women who can't do that.

I don't want or need extra looking after because I am a woman and therefore, it appears, need a GP to read out the information inside a packet of pills for my benefit.

Plus people equate the leaflet with 'Caution: May Contain Nuts' on the side of a packet of peanuts. Meaningless legelese. That ties into the point about risk asessment mentioned above, it's the doctor's job and if s/he can't be bothered raising the (possible) issues people conclude the risks are, in actuality, negligable

sal, it was ithaka's post I was thinking of. Not having a go.

But I am going to bang on about it, boringly, because it really worries me.

If you think about all the subsections of the population who might no cope with medicine instructions, it is pretty shocking. Of course if you are able to read and understand the instructions, you have a responsibility to read them. But it doesn't take us far enough.

To be honest, it has always been easier for educated middle/upper class women to get decent contraception. It was women like that who got into the Marie Stopes clinic by knowing that it existed and how to flash their wedding rings. It used to be that divorce was only really available to the very rich.

The basic issue of how contraception affects women's mental health won't go away if we focus on how middle-class Western women could chivvy their GPs. We need a change of attitude, such that it's no longer acceptable to suggest that most women should really just put up and consider themselves lucky.

Cross posted.

I have no intention of 'insulting' women. I am merely pointing out that your generalization is way off. Which it is.

A minority of women are educated enough to second-guess medics.

A larger number of women can read and understand the instructions on a pill packet, I agree. But since the issue here is not the simple 'how many do I take per day' but the rather more specialized issue of mental health, I think it matters to acknowledge both that some women literally can't read the info, and that many of us are not equipped to understand it to the level of second-guessing medics.

Agree, LRD. I also think many people, myself included, tend to read leaflets like that with the assumption the side effects won't happen to me.

To them, sorry.

You don't have to second guess medics. The leaflets don't just include instructions, they also list possible side effects. If you experience any of these side effects, stop taking the pills. It is hardly rocket science, is it? The pills are not necessary medication, safe forms of contraception are available.

Oh, I certainly do that, wasa.

But I mean, also - if it says 'risk of stroke', that is very scary. But that is in the small print of a lot of medicines. For me, microgynon has enough of an increased risk of stroke that I mustn't take it. But I am not a medic, so I don't know how to calculate those risks. FWIW they're associated with what's called aura migraine, but if you've never been diagnosed with that, how do you know?

Of course you try to take some responsibility. But I think it's not really sensible to make out that most women can act as GPs. If we could I'm sure we'd all be earning a lot more!

When I was on the pill, reading the packet wouldn't have done anything. I was barely functioning in terms of caring about myself as I was in a black hole of depression, going to bed each night wishing I wouldn't wake up in the morning. I'd been prescribed it to help with PCOS symtoms and I was a teenager so I didn't question it. Nor had I ever heard about pill-related depression. I'd had a big life change around the same time and gone away to university and I never for a moment linked what I was feeling to being on the pill.

BTW, I've been on the pill twice for 9 months at a time in my teens/very early 20s. I've been depressed twice, both during those periods, never at any other time in my life.

I know LRD.

It annoys me tbh when people think a few hours googling is the equivalent to 10 yrs studying medicine. Most people don't think that, and tend to trust their doctors' judgement over their own in medical matters. Fair enough, I think

ithaka, it doesn't really work like that.

Side effects are unpleasant, but I am fairly sure that if I experience the side-effect of stroke and death, I wouldn't be in the ideal position to 'stop taking it'.

I also think it's very dubious when the side-effects are mental health ones - someone with depression or anxiety, let alone psychosis, is already disadvantaged when it comes to assessing the situation. The medic should be much better placed to help, in that case.

sin - my GP this morning told me 'your friends are obviously right' when I told him what MN said.

So obviously it can help. I am not knocking all GPs, not at all.