Can we talk about contraception?

[Amethyst24]

Someone mentioned on here the other day that contraception is still an issue for feminists.

I think the comment was that more research needs to be done into the side-effects of hormonal contraception, rather than minimising women's experiences of them (I've experienced this loads - "Oh, yes, you might put on weight but only a few pounds" etc).

It's an issue that's weighing on my mind at the moment, because we've decided it's time for my partner to have a vasectomy, and I am feeling irrationally guilty about it, even though he suggested it in the first place.

I'm not sure what I'm asking really . Is there any recommended reading about contraception from a feminist perspective?

First time poster here, but this is something that I feel very passionate about, so here goes...

There is of course the theory that a patriarchal society pushes all the responsibility of contraception onto women, because women are the ones who will ultimately have to deal with a pregnancy.

Male contraception is a controversial topic of discussion and it throws up some interesting debate on birth control and responsibility, and the difference in experience/effect between men's bodies and women's bodies. I thought it might be useful for you to read about because you're feeling guilty about your husband's vasectomy, so I found two articles that might interest you as a starting point:

There are some excellent birth control facts in this article by the Daily Beast, about the negative effects of long-term hormonal birth control on women's bodies. This article from The Guardian, by Jessica Valenti, contains links to a lot of other articles about the abuse that hormonal birth control can wreak on women's bodies, as well as feminist theory on the difference between the sexes when it comes to birth control and perceived responsibility in our society.

What's ultimately interesting is that I work with a lot of foreign students, including many from Venezuela, and they've told me that clinical trials for the male contraceptive injection also took place in many Venezuelan cities. Ultimately it was rejected as a contraceptive method, not because it didn't work - it was 100% effective - but because it was too good. Medical companies were refusing to buy it because it's a one-off injection (plus another to reverse the effect), rather than supplying weekly/monthly methods of contraception which, of course, provides ongoing income. It sounds from the article like some are changing their minds. I certainly hope so. I hate hormonal contraception and I hate thinking about what it's probably doing to my body, but I suffer from an extreme allergic reaction to condoms, so I don't have much of a choice.

I can't recommend any reading but IMO contraception is a huge feminist issue. It can't be denied that ready access to contraception changed women's lives massively for the better - the ability to reliably control pregnancy meant that women were suddenly freed from the burden of constant childbearing which automatically gave them so much more access to the world at large.

However, I think hormonal contraception has also had negative consequences for women. Firstly, it has given the message that women and women alone are responsible for longterm contraception, particularly in relationships, underlining the idea that women are the "gatekeepers" of sex - they are the ones responsible for ensuring pregnancy doesn't happen. A male poster commented yesterday that "in that it is very hard for guys to stop a long term girlfriend getting pregnant if she wants to." That is clearly just bollocks - if you really don't want a pregnancy, use a condom or do other things rather than PIV sex.
That last point leads me on to another problem I have with hormonal contraception - the fact that its main aim is to make women constantly available for PIV sex with without the threat of pregnancy. Given that a lot of women don't orgasm through PIV sex, it would seem that ensuring PIV sex is always on the cards is a condition that greatly benefits men at the expense of women. Women take artificial hormones, the long term effects of which are not clear, and suffer all the side effects, to have sex that may not satisfy them at all, when there are plenty of other ways to enjoy each other's bodies that don't involve any pregnancy risk and that women tend to get more pleasure from. The idea that "sex" automatically means that at some point the man will put his penis in his partner's vagina, means that other ways of avoiding pregnancy aren't even considered - it's deemed important and necessary for women to take this medication every day for years rather than just think of other ways to get around the problem. It always strikes me a supremely selfish of a man to refuse to use condoms - his pleasure comes ahead of the health (and possibly also pleasure) of his partner - he would rather see her taking hormones every day than to do other things to get sexual pleasure and just use a condom when the mood for PIV strikes.

I am always horrified by the way the obvious health implications of longterm hormone use are constantly downplayed. Hormone replacement therapy, which has proven benefits for menopausal women, is constantly the subject of scrutiny given the health risks it can pose. Yet hormonal contraception is essentially the same thing - long term ingestion of synthetic hormones - but when the risks of that are brought up it's just pooh - poohed. It looks suspiciously like HRT is examined and criticised because women alone benefit from it but because men benefit from contraception there is every effort made to divert attention from its downsides - men would hate to have to actually step up and take responsibility for preventing pregnancy. They would rather women continued to suffer so that their ready access to PIV isn't disturbed.

Hormonal contraception is a only a truly good thing in a world where it is assumed that women are there for men to put penises in. If that assumption wasn't there then the logical thought process would be: PIV sex isn't great for women - a lot of women don't orgasm from it, it can lead to STDs and pregnancy - therefore why not explore other options.

Of course, plenty of women do enjoy and orgasm from PIV (myself included) but I expect my DH to wear a condom - PIV isn't so important to me that I'll risk my health for it, and seeing as there are no health implications to wearing condoms, on balance it makes more sense for my DH to take care of contraception.

Which was the male contraceptive trialled in Venezuala?

Was it RISUG (vasalgel)?

Because if so, it's not lack of investment that is the proble, because it's receiving funding from the Indian government (amongst others) who really do want a cheap, reliable contraceptive, because of the policy importance of population control and the need for long-acting contraceptives because of weaknesses in the health infrastructure.

The toxicological tests had to be redone (first lot, which looked good) did not meet WHO standards, so it's more a case of ensuring safety rather than expecting a problem. Also, I thought they needed further work on reversibility, plus protocols for ensuring sterility after procedure. It is the most promising one in development.

It wasn't Vasalgel, it was based on that one and as far as I'm aware, developed in Venezuela by a pharmaceutical company, but ultimately rejected because of forecasted drop in contraceptive profits.

I always find it rather ironic also that one of the side effects of contraception reported by many women is lack of libido. WTAF is the fucking point of having contraception that leads to you not wanting sex? Why even fucking bother?

The fact that condoms are "uncomfortable" or "reduce pleasure" is often bandied about as a legitimate reason for men to refuse to wear them. Eh, I think a bit of discomfort is probably not that much of a hardship in comparison to weight gain, loss of libido, spotty skin, mood swings and all the other side effects many women experience from hormonal contraception. The underlying idea, as far as I can see, is that it is very very important for men to enjoy sex, as that's the whole point, but if women don't enjoy it (because they feel fat, moody, spotty, or have no libido) well, who cares?

Whatever happened to cervical caps and other barrier methods for women?

They're still there clara. But cervical caps are supreme faff and are quite unreliable, so they're rarely recommended by HCPs.

Thanks so much everyone, some really interesting things to think about.

I haven't used hormonal contraception for more than ten years, apart from a brief experiment with the Mirena, which I think is a fantastic contraceptive - I put on about half a stone in a month, was permanently cross and wouldn't let DP near me

So why am I feeling so bad about him going for the snip? He offered a few years ago and I said no, in case we split up and he ended up with someone who really wanted children (I don't and nor does he), but now we're both over 40 and it looks like we've stuck with each other .

WRT male contraception, I read somewhere recently that dunking your scrotum in very hot water once a week or so is a pretty effective contraceptive en.wikipedia.org/wiki/Heat-based_contraception

The PIV sex aspect is really interesting too. I'm another who enjoys it and can easily orgasm from it, but if you think about it for more than a nanosecond it doesn't actually make sense why it is such a big deal for men.

Just dropping this in here:

www.mumsnet.com/Talk/feminist_book_club/2133914-Book-chat-For-Summer-ish-Non-Fiction-Book-by-Holly-Grigg-Spall-Sweetening-the-Pill

I really like the combined pill - not only does it give me control over my own reproduction but it is also linked to lower death overall (ever-users are less likely to die of all causes than never-uses). It specifically reduced hugely the risk of Ovarian Cancer, reduces the risk of Bowel cancer and also reduces the risk of Osteoporosis. It doesn't work for everyone, but I'm a huge fan.

I do agree that doctors' attitudes are still a huge issue though - for example, I was recently recommended to go on Cerazette, but my concerns about this weren't' well addressed by my GP. There is also a much smaller evidence base on POPs in comparison to Combined pills.

I've been on the pill for decades, two different types. Minimal or no periods, no side effects. Obviously I've had ones that suited my particular body chemistry and it isn't the same for everyone.

been on cerazette for 3 years, marvellous.

the pill doesn't make you fat. It can increase appetite in some women, which is not the same thing.

risks of the pill are the same or less than of pregnancy.

it suits ME. It doesn't suit everyone. Those it doesn't suit - don't take it. Simple.

But, specialsubject something that increases appetite is either going to make you fat or make you feel hungry all the time, isn't it?

I know it's about increased appetite, the Pill doesn't just magic extra calories into your food, but increased appetite does naturally lead to weight gain.

Yonic, I'll have a look for that book, thanks.

I've neither experienced weight gain nor increased appetite.

In fact I lost weight after starting the pill (probably because I'd heard it could make you gain weight). There is no evidence to suggest women who take the pill gain weight. There's lots of evidence to show that they are less likely die, less likely to get all types of cancer (except perhaps breast cancer; but the jury's still out on this one). Some women will have bad side effects on it, but it works incredibly well for a large proportion of women. I reject the idea that it's been imposed on me by the patriarchy!

In fact, my mother told me that she was very keen to go on it during the 70s as she felt it was a feminist act - taking back control of her fertility and sexuality from the vicissitudes of nature.

One of the many reasons I love my DH is that, since our first encounter, he was always happy to use condoms and agreed that I should not have to fill my body with artificial hormones, or undergo invasive procedures, to prevent conception.

He assumed it was as much his responsibility as mine and we both happily relied on condoms before TTC, and now rely on DS1 and dS2 (ha! though possibly might be pg right now with DC 3 fingers crossed).

Considering women are fertile 4 days a month tops between age 11 and 50 and men 20 times a day for ever from age 11 seems it really should be down to men!

cervical caps are supreme faff and are quite unreliable

Whenever I read about contraception, I wonder what happened to barrier methods as well! The cap isn't much of a faff - I used to just bung it in most nights and, if I hadn't got it in or it'd been in too long already, popped off to the bathroom for a minute before getting down to things. Used with spermicide, it's as effective as the pill. It offers some protection against STDs, particularly with the spermicide gel, and can also be used as a mooncup in emergencies ()

I used the 'big' cap - the sort you have to fold to insert. I think the tiny cap is a little less efficient, but not all that much less. And you can use condoms with either, of course.

I'm not taking away from very important points about hormonal contraception, both female and male varieties, but have been suffering an eyeroll build-up over the assumption that women's contraception means using synthetic hormones.

I reject the idea that it's been imposed on me by the patriarchy!

Efficient contraception has to be one of the most liberating things ever to happen to women. You can't wish away the fact that, women being the ones who get pregnant, women are the main beneficiaries of being able to control their fertility. And a lot of research has gone into making it as safe as possible.

The patriarchy leverages it, just as the patriarchy leveraged women's fertility. But having control is a massive game-changer.

Would you trust a male partner who told you he'd recently had his contraception topped up?

Exactly, Garlic! Women being able to control their fertility scared certain sectors of society shitless in the 60s and 70s - you only have to read contemporary articles to understand how transgressive the idea of giving women control was at the time.

I would trust a long term partner; a short term partner I might still use condoms - the option that's always open to men who don't want UK be dads, of course!

:) For the cap-curious, I've now established that mine was an arcing spring diaphragm. It was really no faff! Apparently it's 92% - 96% effective, where the pill is, I think, 98%? I was allergic to the spermicidal cream, but gel was fine and free from the clinic.

Mind you, I have crap hormones and liked being on the pill. I changed to the cap because, at the time, it was thought to be risky after ten years. Now I'm on HRT, the same warnings are issued but I'm staying on it! If you ever look at menopause threads, you'll see a fair amount of annoyance with GPs who dismiss the need for HRT - widely supposed to be following a patriarchal assumption that infertile women are just a nuisance anyway.

It can't be accurate to say that pill users are less likely to die of all causes than non-pill users. Everyone dies, they have to die of something.

In this country I am unconvinced by the additional payments made to GPs for prescribing some forms of contraception. It concerns me that it may create a bias in discussing options with GPs, whether a conscious or incongruous bias.

Think of it like this; a 40 yo has a lower risk than a 70 yo of dying in any given year.

An 40 yo ever pill user has a lower risk of dying in any given year than a 40 yo never pill user.

Wow, really, Alyosha? I didn't know that!

Back to your question, Amethyst: "So why am I feeling so bad about him going for the snip?"

Subliminal patriarchal programming? The spunk in a man's balls is his essence? It's reversible, anyway, unless he's unlucky.

The sadness may well be nothing whatsoever to do with the actual choice of vasectomy.

It is the end of the reproductive years for you as well (assuming you stay together) and that can be emotional in itself. It is quite different to decide not to have more children and to decide to have surgery to remove the possibility.

So you are saying farewell to a chapter of your life. Even when you know it is absolutely what you want to do, it's a transition.