It started with a twinge in my arm, a dull muscular ache that tugged at the sinews of my shoulder every time I moved.
“I did a really tough weight class,” I explained to my friends, wincing as I swallowed down another Ibuprofen “I’ve probably just pulled something.”
I was 24 years old and two weeks into a stint on a new pill. Having cycled through various incarnations of the US’s most popular contraceptive option since I was 18, adjusting to a new dose of hormones was second-nature. Linking my new prescription to the persistent twinge in my upper-arm never crossed my mind.
“You have to go to the doctor,” my housemate berated me when I grimaced with pain pulling myself up off the sofa after a weeknight binge on trashy television.
When I took her advice I was floored by my diagnosis. I was rushed to the hospital with a suspected blood clot, in part caused by my new pill. Tests and an ultrasound revealed the extent of the damage: an enormous mass of congealed blood that could have dislodged at any moment. Doctors were shocked that it hadn’t moved to my lungs in the ten days that it had lain dormant in my arm. Such a movement would have been highly likely to result in death — I had come close to being killed by my seemingly innocuous choice of contraception.
Writing about my experience two years later, I feel lucky. I was injected with blood thinners and given drugs that would slowly break down the coagulation in my veins. I was subject to months of tests and scans, told never to risk using hormonal contraceptives again, and sent away — and my life went on.
For others that is not the case. Many women die every year as a result of their contraceptives. Many more suffer from blood clots that develop into more serious — and sometimes life-changing — conditions such as, strokes or pulmonary embolisms. Within my close circle of friends, I am one of three women who has experienced a blood clot whilst on the pill. Freakishly unlucky, perhaps, but perhaps also a sign of how significantly the broken system of contraception harms young women.
Even without the fatal risks that accompany protecting yourself from pregnancy, the contraceptive market is fundamentally flawed. Women hoping to lead a fulfilling sex-life without the threat of an unwanted fertilization looming over them can look forward to a catalogue of health-related woes. Most hormonal contraceptives boast, at best, weight-gain, loss of sex drive, and mood disorders as common side-effects. Perhaps you’d like to try the implant for potential ovarian cysts, heavy and painful periods on the coil, or the inevitable mood kill of condoms.
My own experience of seeking alternative methods of contraception since my medical trauma have been met with sympathetic shrugs and vague acknowledgements that there is no perfect solution. Medication has side effects. Contraceptives carry risks. Everyday women like me make a choice: do we want to protect ourselves from pregnancy, or expose ourselves to the dangers and discomforts of introducing potentially harmful hormones to our bodies?
To be clear, I am absolutely not recommending that women abandon contraception en masse. I certainly would not recommend taking to the rhythm method or the recently trending but woefully inadequate fertility tracking apps to regulate your baby making — or lack thereof. I hasten to add that you should always listen to the advice of a medical professional; the serious risks of most of these medications are relatively small, and for most the side-effects of contraception, although troubling, will outweigh the enormous burden of an unwanted pregnancy.
In spite of this, the clear lack of viable contraceptive options available is a failure to women everywhere. The reasons for the medical sector’s inability to keep up with the needs of a world population where 800 million married or in-union women will be using contraception by 2030 are complex and numerous. I have written elsewhere on the male-dominated nature of medical research, the harmful narratives encrypted in the depiction of female sexuality, and the trend of misdiagnosis amongst women. But as important as the statistics and evidence are there is a human face to this story that too often ends in the loss of a life.
Over the last two years, my life has been shaped by the strange gloss of knowing how easily I could have missed them. There have been career successes and work trips around the globe; there have been days in the office that have made me weep with boredom. There have been nights when I’ve drank and danced and cried with laughter with my friends; there have been nights when I’ve cried over boys who’ve broke my heart. There have been long summer days with a good book, or great company, or an enormous gin and tonic; there have been short winter days when I’ve barely moved from bed. All of these moments, tiny and insignificant, bloom with a newfound luster. I am often moved by the thought of the women who will never have those moments again. I am thankful that I am not one of them and unnerved at how easily I could have been. Until drastic improvements are made in the contraceptive options available there will continue to deaths and dangers. Women deserve so much more.
Concerned about your contraception? Here’s When You Should Speak to a Doctor
If you suspect you may have a blood clot
Blood clots are one of the less common — but most serious — potential side effects of hormonal contraceptives, with the combined pill trebling the risk of developing from a clot. Blood clots most commonly start in the deep veins of the legs, and you should look out for pain, swelling, and visibly dilated veins at the surface of your skin as healthy veins work overtime to negate the blockage. Blood clots are most serious if they move to the lungs (a pulmonary embolism), which causes chest pain, shortness of breath, coughing up blood, and, if left untreated, death. If you experience any symptoms seek emergency medical attention immediately.
If your contraception affects your mood
Hormones play an important role in regulating how we feel, so it’s hardly surprising that mood swings are one of the most common reasons why women discontinue using the pill within the first year. If you have a history of depression or anxiety it’s important to raise this with a doctor when first discussing birth control options, and if you’re finding it difficult to control your emotions then seek advice on lower hormone alternatives.
If you find yourself getting headaches
The hormones used in some kinds of birth control can lead to migraines or frequent headaches. The good news is that this is reliant on the types and doses of hormones used, so speak to your doctor to see if a lower dose might be suitable.
If you experience a decreased sex drive
When contraceptives are designed to enable healthy and safe sex lives perhaps the most counterproductive side-effect is the faltering libido experienced by many women using hormonal birth control. If you find yourself losing interest in sex or experiencing vaginal dryness then your contraception could be a contributing factor. It might be worth switching to condoms, an IUD, or a lower dosage oral contraceptive—seek medical advice to find out what would work best.
If your birth control negatively changes your menstrual cycle
For many women the impact of their birth control on their menstrual cycle is a happy surprise. Hormonal contraceptives can cause lighter and less painful periods, with hormonal IUDs and the implant sometimes causing them to cease entirely. Although this is lucky for some, the non-hormonal (copper) IUD can cause longer and heavier periods, and many women experience spotting and breakthrough bleeding on the pill. If you are finding that your periods have become less manageable when using birth control you should consult on alternative options—some oral contraceptives have low breakthrough bleeding rates, whilst switching from a copper to hormonal IUD may be a sensible change to make.
If you’re feeling unsure and want to try something new
If you’re not happy with your prescribed birth control then there’s no need to look for reasons to stop — the way that contraceptives interact with our bodies are complex and numerous and there are a myriad of reasons why you may want to make a switch. Perhaps you’re concerned about the long-term impacts of hormones, are worried that a change in your health might be birth control related, or simply want to try something new. Whatever your reasoning medical professionals are there to listen and help. Book an appointment, ask questions, and explore your options.