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?

[LRDMaguliYaPomochTebeSRaboti]

bubble - my mate has been training as a doctor (qualified a year ago), and it has been fascinating seeing what he is and isn't taught! He was really shocked at how brief some of their training was, when in other areas it was extremely detailed.

So yes, I can believe some doctors don't really have the side effects at the top of their mind when they prescribe.

[Lovecat]

I suffered horrible mood swings after going on the mini pill (some 25 years ago now) and it wasn't mentioned to me as a side effect. In fact (and I remember discussing this with some friends who were also discovering sex/contraception as we'd all been given the same message and we were all a bit puzzled by it) the Dr told me that 'the risks of NOT taking the pill are far more serious'. We came to the conclusion that they thought of getting pregnant is an absolute catastrophe (and to be fair at the time it wouldn't have been ideal) and no other kind of contraception could be as effective as the pill. I felt sooo much better when I came off it in TTC and have never gone back.

One thing re. the hideous grim clinics - in the late 80's many of my drama group friends were gay and I was rather jealous of the fact that in every bar in Old Compton Street there would be a huge basket of condoms on the bar, free for all, and people would come around promoting safe sex and handing them out to everyone. It seemed slightly unfair that heterosexuals had to go to the grim clinics/pay at the chemists...

[Lovecat]

as an absolute catastrophe, that should read...

[BeCool]

I was just reading an article, maybe via mn ?, on how development of a male contraception was/would be rejected for this very reason.

It bothers me that woman are expected to carry the burden for 2 long. After 2 DC and wanting no more I asked my then P to consider a vasectomy. He was very upset. Bastard

[scallopsrgreat]

I am with LRD here, ithaca. I've found your posts dismissive, insulting and blaming of women. The medical profession don't treat the symptoms seriously. How on earth are untrained women expected to assess the risks for themselves?

And when certain types of contraceptive are pushed and the considerable benefits (in the medical professionals eyes) explained to women, the choices they have are immediately loaded. The information out there isn't unbiased.

[NiceTabard]

There is a thing here which is making me feel uncomfortable.

How many people read and digest the side-effects and warnings on things like aspirin, paracetamol, lemsip, ibuprofen. And read "risk of fits / seizures / death" or something else dire and think "oh well that sounds awful I won't be taking that ever".

Answer is of course very very few people, and the ones who do are arguably a bit neurotic. The contraceptive pill is in the same bracket as these - everyday drugs that are used in a very widespread way by huge amounts of people. And so no of course women don't read "risk of depression" and think Oh shit I won't take that in the same way they don't read "risk of death" on a packet of paracetamol and decide to do without.

Add to that the position in society - which has for decades been that the pill is THE easy, safe, effective way of preventing unwanted pregnancy.

AND that the doc dishes it out without a by your leave even when contra-indicated if this thread is anything to go by.

AND that many start taking the pill very young - 14 onwards - I started at 16 as did most girls I know - not a time of life when you have much awareness of your own mortality as you are still very young and positive.

AND the fact that many boys/men subtly or not so subtly pressure their partners into taking the pill.

And what have you got? You've got everyone on the pill and NOT because women are stupid and reckless and cavalier with their own health or whatever the accusation was.

This thread is about how medical professionals often dismiss women and girls who complain about side effects from the hormonal contraception they are on. About how they are not listened to and the drive towards more and more hormonal contraception seems to be going ahead without any real consideration or studies into all of these experiences that women are having. That is the conversation here, not whether women are thick.

[LRDMaguliYaPomochTebeSRaboti]

Yes, exactly.

I don't know I put it very well, but I certainly wasn't trying to argue that women are thick. I'm saying I don't think anyone should expect women will read and understand that info the way a medic will. I'm not even sure some GPs read it the way a person who specializes in depression might, because GPs are trained in a system that also tends to minimize the importance of women getting 'side effects' of contraception.

[StormyBrid]

I rang my doctor today to make an appointment to have a copper coil fitted. "No problem," the doctor said, "but why don't you want the mirena?" This is bothering me, and I'm having trouble articulating precisely why. I was very clear and specific: "I'd like to make an appointment to have a copper coil fitted." If she'd questioned why the copper coil in particular, I'd have happily explained: microgynon's having a detrimental effect on my mental health; cerazette made me bleed for the entire nine months I was on it, and I was told this was something I simply had to persevere through; depo-provera was the same; my vagina is under the impression that thrush is the appropriate response to condoms. I'm just left with this vague idea that the mirena is the contraceptive I ought to be taking, and I'm deviating from the norm by wanting something non-hormonal.

[SauceForTheGander]

Good posts LRD & NiceTabard.

I think there's been some deliberate misunderstandings / gaslighting going on

[NiceTabard]

No I knew what you were saying.

Plenty of people are illiterate.
Plenty of people will accept a prescription from the GP and take the tablets and not read the insert, they will believe that the doc is acting in their best interests and trust them to tell them if there are any likely risks.
Plenty of people will have a look but not get far along with the tiny writing and the medical lingo. "Contra-indications" being a good example.

[NiceTabard]

And there is nothing wrong with trusting your doctor, and not researching everything to the nth degree. That is actually normal behaviour.

The problem comes when the medical profession let people down as seems to be happening with this hormonal contraception issue.

[LRDMaguliYaPomochTebeSRaboti]

Yeah, that's absolutely true.

I think there's the perception that we're terribly lucky to have contraception at all and should really feel grateful. And I do. But I don't usually have to spend 10 minutes in awed gratitude every time I pop a paracetamol for a headache, and I'd be expected to make a fuss if it didn't do the job for me, if only so that eventually the complaints would get back to the pharma companies who develop these things.

[happybubblebrain]

I experimented with a variety of rubbish contraception in my 20s and early 30s, then decided the only thing for me was celibacy. It's the least hassle and most effective of all. Obviously it's not for women that really love sex or need to hang onto their man, but is is an option for some. I don't miss sex at all. As a single mum the worst thing I could possibly do (in the eyes of many) is get pregnant again. Sex would never be worth the risks for me.

[fuzzpig]

I had no idea the pill had these side effects! I have never taken any hormonal contraception, only ever used condoms as the idea of playing with my hormones, cycle etc feels wrong (this is absolutely NOT a judgement on anyone else BTW, purely a manifestation of my huge anxiety issues which often focus on health)

[scallopsrgreat]

Great posts NiceTabard.

[MadBusLady]

Further to NiceTabard's point, I remember reading the side effects list for Microgynon most attentively when I started taking it. It seemed to me to be like every other side effects list I'd ever read (including those for common painkillers), running the gamut from "Tired" to "Stroke/Death". I have an idea leaflets now rank side effects by likelihood, but I'm not sure they did then. The only one that really sticks in my mind was that my breasts might become tender and "might ooze a little milk" which to a 19yo student was just horrific

Anyway, I kept an eye out for the various symptoms. I wasn't aware of any particular changes (apart from weight gain, I think), but part of the nature of mental health problems is that they don't present like a broken leg. It may not be obvious until you look back on, say, several years of some periodically very odd moods, that you realize something may have been up.

And even so, I can't be sure. We can't run the counterfactual scenario in which I never go on the pill. It's only the coinciding of an improvement in my health with coming off the pill that made me think of it at all.

[cochonette]

Like many on here, I first went on the pill at Uni, aged 18 - Ovranette - and suddenly became an emotional, blubbery, not quite complete wreck, but certainly seemed to have lost my fearless love for life. I went to the doc and she suggested I try a 'Tri-phasic' pill instead, which has now in fact been discontinued. I stayed on that one for a few years with no real problems, I seemed to have hit on a secret wonder pill, as I never met anyone else who was also on a tri-phasic, that varies the level of oestrogen you get thru the month to follow your own natural cycle.

i have wondered why weren't / aren't more people put on tri-phasic? It could be that there are other, awful side effects associated with it, or simply that it was untrendy.

I am utterly convinced that the pill is responsible for massively reducing my sex drive - it has never ever gone back to what it was before I started taking the pill. For this i would happily contribute to any articles on this topic!

I think this is a huge adverse effect on many women's lives that frankly the pharmaceutical industry / government have so far got away with.

I have now been completely clear of hormonal contraception for about 10 years, and I never intend to use any form of it again. When after the birth of DS the doc asked me the obligatory contraception question - me and DH just laughed!

Am appalled to read the stories of women having hormonal contraceptions all but forced on them.

We use condoms when we're not trying to conceive.

[Mamamamoose]

I think a Mumsnet Campaign on this would be a great idea. Much needed.

[LRDMaguliYaPomochTebeSRaboti]

mad, I think that is so true. ANd so important.

coch - me too with sex drive. Annoying. On cerazette I had absolutely no libido, not at all.

How do we support the OP if she does do a MN campaign (if that's even how it works)? I would really like to. It sounds very important.

[girliefriend]

Just found this thread and finding it a really interesting read.

I have been on the pill a couple of times and found it made me feel very anxious and as a plus lost loads of weight.

I had the injection once and it was horrendous, I bled constantly for about 3 months and got zero sympathy for any health professional. Felt generally awful and don't think my periods have ever really been the same.

As i'm now single its fine not to have to use any contraception but if I was to meet someone I would be really struggling to work out which contraception to use apart from condoms (which I like but have yet to find a man who doesn't object to them!)

[Angeletta]

My mother died of breast cancer in her late forties. She had taken the pill early in her marriage and was concerned that it might have been linked to her cancer. She thought I would be better off with non-hormonal contraception and consultants at various breast clinics agreed that was the wiser choice.

I had problems with very heavy painful periods from my early teens, later diagnosed as endometriosis. This means I have been under massive pressure from doctors and gynaecologists to go on the Pill/take some sort of hormonal treatment for my entire adult life. When I explained my family medical history, it was basically ignored and my preference for non-hormonal treatments was treated as a bizarre whim. (I was also told repeatedly that I should get pregnant despite being single - unsurprisingly as I was in too much pain for sex). I finally agreed to try a progesterone-based treatment as I was told that, unlike oestrogen, it wasn't linked to any increased risk to breast and ovarian cancers. In fact, I discovered from a breast clinic later that it was - my gynaecologist just didn't know about it. I was promised the moon on a stick if I would take it - it would cure the endometriosis, no more bleeding, pain free etc. None of which happened. What did happen was horrible side effects - basically having a bad case of PMT for over a year. When I complained I was told to increase the dose. I finally stopped taking it of my own accord because the consultant refused to accept that it wasn't working, although he admitted the scans showed the endo was coming back just as fast as ever.

Since then I have flatly refused any kind of hormonal treatment. I'm glad to say that I'm in much better health today but it's certainly not thanks to the Pill or Mirena, which were sold to me as the magic bullet.

I see two main problems here:

1. The medical profession take anything but a holistic approach. My impression is that they couldn't care less what the side effects of hormonal treatments are if the results will not be something they personally have to deal with. This ties in with the attitude to MH problems caused by the pill.
   
2. Gynaecologists really don't know much about contraception - perhaps because they spend their careers helping people get pregnant (or attempting to bully them into it in the case of my former consultant). I asked my present gynae about options for non-hormonal contraception - she could only suggest condoms. I would use condoms in a new relationship anyway but I wanted a backup too.
   

My conclusion is that the Pill is like the typewriter. In the 19th century clerical staff were male. Then women learned to type and made their living that way - only for future generations to be confined to admin roles because typing was seen as a female activity. In other words, it started out liberating and ended up confining.

Sorry for the long rant, this is an issue which has been on my mind for a long time.

[LRDMaguliYaPomochTebeSRaboti]

angeletta that is so sad.

Your poor mum - and you would think, after that, they could have addressed your concerns properly! How horrible.

[Angeletta]

Thank you LRD. It's the insensitivity that astounds me - so many people seemed not to understand that the early death of a parent might be a traumatic event. I really just wanted someone to hear me and agree that I had a legitimate concern, but that never happened.

[fuzzpig]

That is awful angeletta :(

I would definitely support an MN campaign on this.

I did actually consider having something like the implanon after DC2 and while we discussed the effect on breastmilk and weight gain nothing was mentioned about effects on mental health. This is despite my extensive history of depression including a four month stay in a psychiatric hospital 7 years before.

I feel like a freak for refusing it sometimes, it is so ingrained as 'what women are supposed to do'. I have only spoken to one other woman IRL who has the same stance as me.

[Angeletta]

I feel like a freak for refusing it sometimes, it is so ingrained as 'what women are supposed to do.'

Exactly. It's presented as an obligation not a choice.

In my quest for appropriate contraception I discovered a type of copper coil called the Gynefix which is supposed not to cause the heavy bleeding that traditional copper coils do (which is a problem for me because of the endo). Only it's pretty hard to get as almost no one in the UK is trained to fit it - one London hospital did but stopped because they didn't get enough funding. Why is there seemingly limitless funding and training for hormonal options and so little for the alternatives?