Unintended consequences of birth control

[FeministBadger]

This week I've had another frustrating discussion with a doctor trying to push LARCs on me and I ended up lying about planning on conceiving to get them to drop it.

Dwelling on it over the weekend, I've realised that while birth control has been a fantastic freedom for women it's come with a lot of consequences including an expectation that women should just put up with 30+ years of not so minor side effects to control their fertility.

I feel like there's a feminist explanation in here somewhere - it's almost like a backlash of "You want to be able control your fertility? Fine but you're now the only one responsible for if you get pregnant, you ought to be sexually available at all times, and don't complain about any side effects just consider yourself lucky"

Can someone a bit more feminist-y articulate what I'm saying?

Cross post with Jozyxqk. That's so terrible. I'm sorry.

Public health messages tend to be deliberately 'dumbed down' on the assumption that the general public can't absorb a more complex message. The only thing it results in, however, is otherwise intelligent people having to deal with unreliable and inconsistent information resulting in anxiety and poor choices. I don't know how the government hasn't figured this out at this stage.

Do you think that's a general problem, Spaghetti? My feeling is that it tends to be particularly the case with issues to do with women's health, but maybe that's simply because those are the ones that have affected my life...?

Nodding so much reading this my head may fall off...

Nobody told me the pill might be responsible for losing 5 years to depression. The push for contraceptives post birth pissed me off so much - I ended up telling the smug GP that I didnt was the pill because I feel amazing when i ovulate he told me that lots of women have ovulation pain & are grateful

I also have a major thing about what taking hormonal contraception does to our pheromones therefore to our choice of partners & ultimately our offspring. Pheromones are nature's way of pairing complementary genes (especially immune system iirc).

Jozxyqk

It was a chance conversation that led me to discover my pill was incompatible with my visual aura migraines - at least 4 gps hadnt asked me.

It's a general problem Typeractive, although they did start to get the message a bit with smoking, when they started saying people should cut down if they couldn't quit. Before that it was all about quitting on the assumption that people wouldn't or couldn't cut down, but what they found was that because the message was quit or nothing, people were choosing nothing - ie they would continue on 30 a day rather than trying to cut to 15 a day. Now, the actual health benefit from cutting from 30 to 15 is much smaller than cutting from 30 to 0 but it's not nothing, and actually many people who cut their consumption will go on later to quit, because of the sense of achievement (and relative wealth!) involved in cutting down. It took a long time for that message to filter through to the PH people though. With matters of sexual and reproductive health, ridiculous moralistic attitudes add another layer of complexity.

As a young woman trying to sort birth control I had utter faith in my doctor to be doing the right thing. So when I suffered horrendous side effects and went back to report and told me to wait another 3 months for it to settle down, I trusted they knew what they were talking about.

It is worrying that doctors in a position of trust and authority have so little faith in women's ability to describe side effects of birth control, and that they frequently act in what they believe is right, rather than what we say is in our best interests.

Absolutely! This thread is such a breath of fresh air.

I had an implant fitted and bled heavily for 9 months straight. Despite the severe anaemia, fainting, and fatigue, and 3 appointments to request removal, the GP refused. I removed it myself, and am never having any form of LARC again. Compared to the anaemia, migraines, mental health side effects, condoms are massively underated. We can cope with the minor impact to his sensations during PIV.

Typeractive - thanks. It's not the worst thing that could have happened - it could have been a stroke (which the doctors initially thought) or a brain tumour (which was their next suspicion). I've known people with both conditions & would rather be me than either of them. At least we now know I'm a stroke risk so I can avoid all risk factors, as much as possible. Lots of people don't have that warning. And I can warn my DD or make sure it's on her medical notes that there are major risk factors for stroke & migraine on both sides of her family. She was born healthy, against the odds, & I want to help her stay that way.

I discussed this with my sister, and the scary thing is that like many young women we were on the pill as soon as we were in our first serious relationship on our teens.

We didn't come off again until, in my case, I was nearly 40. That's a lifetime on synthetic hormones, and because we had started so young we didn't realise that the way we were wasn't us. Life is is different now, I am generally mostly happy rather than mostly unhappy, and it's like everything is in colour rather than seen through a grey filter.

I am angry that this medication had such a negative impact on my life, and that there was no way I could realise this as I had no period of adult life when I wasn't taking it so that I could compare.

@redannie118 just as an aside to the main thread, my DP had a testicular tortion surgery about a decade ago and was still able to have a regular vasectomy (just last year). It may be that your DPs surgery was somehow different to my DPs one, but if you can get a 2nd opinion on the vasectomy it might be worth trying?

I hear you, I was not believed when I told doctors that LARCS we're responsible for my horrendous IBS symptoms. I had to fight to get the implant removed that they insisted was not the cause - I felt better within 5 days. I can track my cycle based on my IBS symptoms- elevated hormones create havoc in me.
I've been putting up with horrendous periods for 6 years with a copper coil because I will not take hormones. I sat DH down and we talked and result is he just had his 'vasectomy effective confirmation letter'

It's like we don't matter enough to work out different solutions

I spent some time working with doctors (I have a fair bit of medical knowledge myself from my work background though I'm not a HCP) and it really surprised me how dogmatic they could be about different medical issues - they seemed to think about various bodily systems as completely separate entities and many just refused to see any connection between them. It's a well known fact for example that in elderly people a UTI can cause temporary cognitive changes. One doctor friend would just not even consider the idea that it was a thing - as far as they were concerned the kidneys and the mind were in no way connected. When I pointed out that they were part of the same closed system they still wouldn't accept that there could be any link. I got the impression that it was just too hard for doctors to try to see the bigger picture - in order to maintain sanity they had to break everything down into neat systems otherwise nothing would ever be solved. I did get that but it has such a detrimental effect on people and it so often leads to conditions not being recognised for a long time because connections aren't made.

Oh and also IME the default position to go for the 'simplest' explanation for things, with the added proviso that if you're no actively going downhill then a wait and see approach is best. For example a friend of mine had terrible digestive problems for years. He was told he had IBS -which is essentially code for 'Your guts are funny and we don't know why.' As long as he wasn't in agony or showing any serious organ damage they basically weren't interested - they gave him meds to control his symptoms and that was it. A couple of years ago he suddenly was in agony, total agony and so went to the A and E where he was ignored for a long time due to his 'IBS' diagnosis. They eventually saw him and it turned out he had a congenital defect in his colon that had gone septic and was about to rupture. They operated, fixed the defect and his 'IBS' symptoms have entirely disappeared.

Now, IMO he should not have been left to deal with such horrendous symtoms for so long without very thorough investigation. In their view they were managing his 'condition' and so nothing further was warranted. But consider the expense of multiple GP visits, years of medication, lost working time etc etc. If they had checked him thoroughly to begin with so much time, money and suffering could have been saved.

OP I'm not sure if this is part of what you were saying you felt you couldn't explain - but I'm really bugged by the pushing of LARC when I am very happy with my contraceptive pill.

Is it cost related? I have other stuff to see the doctor about so I try and do the pill check at the same time. On rare occasions I have to just do a pill check with a nurse and I get handed a leaflet about LARC and asked if I know all about it, which I do, and would like to stick with what suits me.

Interesting to hear a pp comment about why trials of male pills were stopped.

I always say the attitude about cervical smear tests horrifies me as well.

I spent 3 years on the pill to help with my heavy, irregular periods. It gave me depression and mood swings. I didn't understand what had happened to me or that it was a result of the pill. Honestly thought I had had some kind of major personality change and couldn't control it. I was lucky that my partner noticed a change after a temporary break from taking it, then we did some googling and I read so many stories of women who had suffered the same way I had because of the pill. It was a complete revelation. It was amazing to get myself back and I would never take any type of hormonal birth control ever again. Condoms or withdrawal suit me just fine, although right now I'm celibate.

I do think of all the women and girls out there who might be suffering because of the pill, or other forms of hormonal birth control, and have no idea. Especially if they started taking it at quite a young age, they might not know that how they feel isn't really them. I think it's really sad. Also I think it's kind of crazy that we are regularly ingesting large amounts of hormones. Until I realised it was the cause of my moods, I had never given it much thought. Once I started thinking about it I realised just how strange it is.

I have never reacted well to contraception. During my marriage a vasectomy prevented pregnancy.

I have spent 11 years celebrate, I can conceive very easily. Hopefully now I am near the point where nature will prevent further pregnancy. Had I met a decent man I could have relied upon, I would have liked more children.

Male contraception is badly needed.

I remember a horrific AIBU thread once about LARCs, with some women saying they'd got so desperate at HCP's refusals to remove them they'd resorted to DIY with a scalpel and butterfly sutures.

And yes to the "doctors thinking all the cogs whirl round completely separately." In my time I've been told that the pill couldn't possibly cause cognitive effects (brain fog in my case) - then finding peer reviewed research into the effects of oestrogen on IQ test performance, and also being told by an endocrinologist that my thyroid issues couldn't possibly be affecting my periods (crippling period pains that had me bent double unable to do anything) - and again, finding that this connection was a known and documented issue.

Is it cost related?

Yeah, and also the side effects are lower in some ways. The doses of hormones are lower and so there are fewer vascular etc issues. Pill is alsonlinked to various increases and decreases in cancer types. I think the view is that larc is more stable and has fewer of those side effects

... BUT Of course that doesn’t mean it’s effect free and many women will suffer side effects even with those small doses, as well as physical side effects. Some women also get on great with it - contraception is really individual and what works for one doesn’t work for another or can cause serious issues.

More methods are needed, and those methods should be as low impact as possible. Withdrawal and fertility tracking (rhythm method) work fine for some but it only takes a small perturbation in cycle to mess up. It’s not something I’d rely on personally as my cycle isn’t so regular.

I suppose the holy grail is a hormone free, low impact, long acting, pain free, fully reversible method or two for BOTH sexes. There just isn’t enough research going on into it.

If men got pregnant, and suffered the effects (I’m currently suffering with HG and SPD) then there’d be more dollars poured into his than you could skate a stick at.

I also have a major thing about what taking hormonal contraception does to our pheromones therefore to our choice of partners & ultimately our offspring.

Absolutely. I have idly wondered if that's part of the reason many women "go off" their husbands when they have babies/stop taking the pill

Absolutely. I have idly wondered if that's part of the reason many women "go off" their husbands when they have babies/stop taking the pill

Not pheromone mediated but yes there is research in female mate choice and attraction in different hormonal states. Women seem to prefer more masculine faces at certain points of the cycle for example. I can well believe on/off pill would have a similar effect.

Also some research in a type of shrew whose name escapes me that males become less aggressive after young are born, possibly due to a testosterone drop.

Brilliant post @DairyisClosed

This is a excellent thread, so many posters articulating what I think better than I can.

I agree with virtually all of this thread.

It's so depressing how all of this is just accepted when effectively women are pumping themselves full of hormones and suffering such horrible side effects. I think there is an underlying belief in society at large that women should still be so grateful that there is a way for us to control our fertility that complaining about the god awful side effects is throughly ungrateful. Would we rather contraception didn't exist at all? Well no, but similarly to all medical provision and treatment, we would like optimum effectiveness with minimal side effects.

I also think that for as long as the vast majority of women continue to agree to shoulder the burden of contraception in a manner that doesn't affect men at all then there is very little incentive for further advancements in this field to be made. I think women en masses need to start boycotting these hormonal contraceptives and going back to condoms. This will be the kick up the bum that the pharmaceutical companies need to start investing properly in some serious R&D not only into alternative contraception that men could take, but also improving the current offerings and reducing their side effects to a more acceptable level.

Quentin I seem to remember some research to that effect. When not pregnant women apparently rate men with a genotype very different from their own as attractive, whereas when pregnant that preference vanishes. The posited evolutionary explanation (disclaimer: I'm always a bit wary of evo-psych arguments as they feel like after-the-fact just so stories) was that this maximised the genetic variability in the offspring (a good thing in terms of evolutionary fitness) while ensuring that women hung out with their kinship group while actually pregnant (thus reducing the risk of infanticide).

When discussing it with Dr's, I don't think one has just accepted that I use cycle tracking and condoms without trying to persuade me onto hormonal contraception which really doesn't work for me.

It feels infantalising. It's worked for 15 years, I think I've got the hang of it by now.