NB: As with the post on periods, this is not just one for women. Although most of the contraceptives discussed will be for women to use – because that’s just how it is – these are important things men need to think about too, especially if we are ever to achieve some kind of equality with how much contraceptives affect each gender. Also, I am not a doctor. I mention here the most common advantages and disadvantages to these types of contraceptives, but I’m sure there are many more and you should do your own research.
Today, we are very lucky to have such a wide range of contraceptives on offer. Both men and women can take control of their health and whether or not they’re going to have a baby – to a greater extent, at least, than people used to. But it often feels like most people assume the war has been won, and that contraceptives are no longer something people should worry or complain about. However, there are still issues with most types of contraception, and for some people it is still a major issue.
Condoms are great in that you don’t need to plan anything in advance, apart from getting hold of some; they don’t cause problems for most people (unless you’re allergic to latex in which case it gets more difficult) and they are one of the only contraceptives that protect against both STIs and pregnancy. However. They are expensive, they smell weird, they can be a terrific mood killer (and, for some men, erection killer) and if you’re a person who’s never fully understood how to put them on then they induce The Fear of being asked to be the one to do it. Which way round is it again? How do you pinch the top and roll at the same time? Does this hurt? What if I make a hole in it with a nail? If I do this wrong and it comes off halfway through, it’s going to be my fault that I end up with an STI/a baby/a condom stuck inside me. Plus, if you’re sleeping with someone new, then condoms also bring out The Other Fear: at what point do I pause things to put it on, if you’re the one doing the penetrating, or when do I ask him if he’s got one and when he’s planning to put it on, if you’re the one receiving? And what do you do if he never stops to put one on? If you’re of an awkward disposition, this can be the equivalent of going to the till to buy something and the price being much higher than you thought it was going to be. It’s too awkward to point out this isn’t what you wanted, so you just go along with it. And then get The Raised Eyebrow of Shame from the nurse when you go for an STI test. Plus, although they work most of the time, I personally wouldn’t want to rely on condoms alone to stop me getting pregnant. I’ve seen too many sitcoms where they don’t work.
Has anybody ever used these? How in the name of Moses do you put them in? I don’t think I’ve ever even seen them for sale.
And now the NuvaRing- similar in that they’re both things women put inside their vaginas themselves. Diaphragm just for sex, NuvaRing for three weeks and then out for a week, as it has the same hormones as work in The Pill, but you have a lower dose as it’s localised and not going through your blood stream. Personally I worry about both in case I put them in wrong. Or can’t get them out. Or that the man can feel them during sex. I think I’d be so stressed I wouldn’t want to risk having sex at all, I’d just be conscious of it all the time.
Women also have the option of an implant in the upper arm, which produces progesterone and can last for up to three years before you need a new one. The advantages are that you don’t have to worry about putting it in at the time, or about remembering to take a pill each day, and for some women, they stop your periods completely. However. They are painful to put in, and if you’re squeamish then being able to feel it under the skin might be too much to handle. And, starting a theme that will run for the next couple of options, although it might stop your periods, it also might give you constant bleeding for several months. Try it and see!!
The coil (IUD)
There are two types, the hormonal coil and the copper coil. I have friends on both. (Not one woman with both, obviously, various people who have one or the other.) The advantages of the hormonal coil, as with the implant, are that once it’s in, you don’t have to worry about it for several years, and they’re one of the most effective forms of contraception. They used to cause issues long-term with women’s fertility, but they don’t now. However, they can be extremely painful to insert – to the point that a friend of mine whose parents are doctors said that if I want to get one put in, I should go to a sexual health clinic that puts you under general anaesthetic to do the procedure. Most places only use local anaesthetic, but I swear whatever they call local anaesthetic in those cases is actually just water – am I right, ladies? I had a colposcopy once where they allegedly used a local anaesthetic, and it hurt like hell.
The copper coil is good for women whose bodies don’t cope well with the additional doses of hormones which you get from most contraceptives. It’s a non-hormonal contraceptive that stops the sperm and egg from surviving in the womb or fallopian tubes. However, they can also be uncomfortable to put in, and you may get very heavy periods for the first few months or longer. A friend of mine had one, and it was great in terms of her not getting the side effects from taking hormones, but her periods were so painful that she couldn’t walk a few days a month. Being a woman is so great.
The fabled Pill. This is still the type of contraceptive most GPs will give you when you go to them and say you want to start taking contraception. It’s highly effective as long as you take them properly – and therein lies the rub for many woman who find it difficult to remember to take them every day, same time every day. The panic when you realise you’ve missed one is dreadful, and on some occasions will mean a trip to the chemist for the morning after pill – which should not be underestimated, it’s powerful stuff and can make you feel pretty unwell.
I think it’s still a commonly held view in life that women should quit complaining since they got the pill and can control their own fertility (and even more so now we have a range of options). However, it’s not that simple. The hormones in the pill can be very strong and do not agree with a lot of women. Among my close friends, say a group of ten, I am only one of two who can take the pill and not get terrible adverse effects to my mood. And that is after a lot of trial and error. If you go to a GP in the UK, they will almost certainly put you on Microgynon. It’s one of the safest pills as it has a high level of hormones. However, many people will get side effects on it. Many women experience severe depression on Microgynon, and it gave me very painful periods. When I went to the doctor about it, she prescribed strong painkillers which commonly caused liver or kidney damage instead of moving me on to a different pill. I was on it for years before realising I could ask the doctor to give me something else. I went onto Cilest, which commonly gives women sore or tender breasts – as it did for me, so I went back to the doctor. I went onto Yasmin, which gave me a strange kind of depression. I realised it was down to the pills because it was cyclical, but it also came and went in bizarre ways. I would get in these dreadful, numb yet irritable moods where I didn’t want to do anything. But not just, oh I want to sit and do nothing. I didn’t want to sit down but I didn’t want to stand up. I didn’t want to go out but I didn’t want to stay in. I didn’t want to talk but I didn’t want to be quiet. It was unbelievably frustrating and exhausting. But I never had to try to pull myself out of it, it would lift on its own – it literally felt like a corner of negativity would lift, and a few positive thoughts would steal in. After a little while, the whole blanket would lift off and I’d be perfectly fine and happy, leaving the people around me thinking: what the hell just happened?! So, I came off Yasmin too and onto Mercilon. This has a lower dose of hormones and it suits me just fine. I’ve been on it a while but came off it for a few months when I was single and noticed no difference in my mood or behaviour whether I was on or off. It’s an important test to do if you’re experiencing anxiety or depression and you’re on the pill – keep a note of when you’re feeling low and if you notice a pattern, try a different type. I don’t know why doctors aren’t so willing to switch you when there is such a range, but it does seem to have to be something you go in and ask for rather than it being offered as a regular solution. And, for most people I know, even if they go in to the doctor saying the pill can give them emotional problems, they’ll still get stuck on Microgynon.
So there you have it, and I’m sure there are lots more that I don’t have so much experience of, either through education or talking to friends. Even with so many options, none of these are perfect, and for many women it can still be an alarming choice between having terrible mood swings or low moods, having something inserted into you that can be very painful and make you bleed for months before your body gets used to it, spending a fortune on condoms that most men don’t like using, or just winging it, which is still more common than you might think. Scientists are aware that there is still a problem, and I hear they’re getting closer with discovering a long-term male contraceptive. At least then it wouldn’t be mainly for women to worry about and go through alone (with the help and support of close friends and (hopefully) their partners, of course). Apparently the big issue with male contraceptives is the sheer amount of sperm men produce. Aren’t vasectomies reversible now? But I’m sure a lot of people and couples wouldn’t want to risk that. And they wouldn’t solve one problem that a few friends of mine have talked about, in that men will still ejaculate, but just shoot blanks. I know men find the idea of nothing coming out deeply disconcerting, and I sympathise, but man, it would save a lot of mess.
I hope they come up with something soon, as this is still a big problem for a lot of people, and one that isn’t spoken about very often. It’s supposed to be so easy now. How dumb do you have to be to still get pregnant? Well, not dumb at all, just sensitive to waves of hormones in your blood stream, or you have a partner with a serious aversion to condoms, or periods that are heavy enough without inserting a foreign object into your body. And still we know so little about how each type of contraceptive will affect each person that doctors can only say, try it. If you’re still bleeding in six months or you can’t get out of bed because you’re so low, come back. Good luck.