Is the Pill all it's cracked up to be? Peta Bee reports on why the contraceptive is still a topic of debate
It was considered among the most significant medical advances of the last century and, more than half a century since its launch in 1961, the contraceptive Pill remains a means of freedom for many women. Yet its reputation is far from glowing. With repeated health scares about everything from breast cancer and blood clots to bowel disorders and depression, the Pill has come to be regarded as much a scourge to women’s health as a passport to hormonal control.
Earlier this month, the hashtag #MyPillStory began trending on Twitter after a UK journalist aimed to raise the profile of her friend Holly Brockwell’s plight. Brockwell, 26, does not want children and, despite requesting sterilization on the NHS, has been repeatedly told to take the Pill instead despite experiencing side effects including weakness in her legs that left her concerned about life-threatening blood clots.
Women took to Twitter in their hordes to support Brockwell and complain about their own side effects of taking the Pill. Nausea, depression, spider veins, and bloating were among the common complaints with others complaining that the Pill, currently used by 28 per cent of women under 50 in Britain, had affected their weight, infertility and mood. Medical experts admit some women do suffer temporary side effects but generally insist that the Pill remains one of the safest and most effective contraceptives available. So what are the options?
Concern has been raised about newer, so-called third generation combination pills, including Yasmin, Femodene and Marvelon, that have been developed in recent years. These contraceptives containing both oestrogen and progestogen have been linked in scientific studies, including a paper in the BMJ last year, to anything up to a six-fold increase in blood clots or deep vein thrombosis. Concerns were heightened after the death of Fallan Kurek, a 21-year-old teaching assistant from Birmingham who suffered a fatal blood clot after starting a new course of the new-wave contraceptive pill Rigevidon. Many doctors have, however, reverted to prescribing older versions of the Pill, such as Microgynon 30, widely used in the UK, which was found in trials from the Netherlands and Denmark to be one of the safest.
Dr Helen Stokes-Lampard, academic head of community based medicine at the University of Birmingham and a spokesperson for the Royal College of GPs says that doctors are aware that the newer Pills do present a slightly higher risk of blood clotting, and anyone with a family history of blood clots should make this clear at their GP appointment. “But this must be kept in perspective as the newer pills have some other advantages over second generation pills in terms of fewer side effects,” she says. “The combined pill is an excellent contraceptive choice for the majority of women.”
Women should be made aware of the risks and ask plenty of questions, experts say. But the Medicines and Healthcare Products Regulatory Agency (MHRA) says, "These are very safe, highly effective medicines for preventing unintended pregnancy and the benefits associated with their use far outweigh their risks” and that “women should continue to take their contraceptive pill”.
Official statistics suggest that the Pill has a failure rate of less than 1 per cent, but it is not fool-proof. That figure doesn’t take into account human error, sickness and diarrhoea, all notoriously likely to increase the risk of getting pregnant even while taking the contraceptive. It’s the forgetfulness factor combined with the potential for health scares that has seen a rise in popularity of contraceptive implants (called Nexplanon), injections (Depo-Provera) or the intrauterine system (Mirena). Containing fewer hormones than the Pill means the dangerous side effects are less likely.
If none of this sounds satisfactory, then the latest high-tech contraceptive choice could come in the form of fertility software, in particular an App called Natural Cycles that costs £6.99 per month. Created by doctors, it has been the subject of an independent study at the renowned Karolinska Institute in Sweden where it was tested among 4,054 Swedish women aged 20-35. Using body temperature, the app alerts users on days of the month when having unprotected sex carries a risk of conceiving.
Results, published in an in the European Journal of Contraception and Reproductive Health Care, showed it to be equally as effective as the pill. For every 1,000 women using the app correctly, only five would experience an accidental pregnancy in a year compared with an average of three for the Pill. However, the FPA charity says that not all fertility software is reliable. In a statement, it says: “There are numerous apps and online charting systems available, with varying approaches to monitoring changes through the menstrual cycle. Their reliability and effectiveness in avoiding pregnancy is unknown.”