The crippling costs and bountiful benefits of contraception

Men, before skimming past this article because you feel it doesn’t apply to you, it does. Everyone has women in their life. 

Since my early to mid teenage years I’ve found myself in conversations with friends about what new contraception they are trying and why they’ve decided to use it. “The pill I was on made me so depressed I had to come off it so now I’m trying…”. Now, at 21, the conversation is still ongoing. I’ve had people tell me that they broke up their relationship because the contraceptive hormones they were on made them feel so numb and  disconnected from everyone. Although we sometimes know that these feelings can be caused by the medication we are taking, it doesn’t make them any less real, and it doesn’t make them any easier to deal with.

A lot of hormonal birth control works by giving your body pregnancy hormones which stops an egg being released from the ovaries each month. Our bodies have essentially been tricked into thinking we have a baby growing inside of us. We all know that the physical body changes during pregnancy, and can cause vast amounts of emotional fluctuations, so why is it so hard to imagine how tough being on hormonal contraception can be?

Hormonal birth control may not suit women and people with wombs for a number of reasons. It can increase mood swings, contribute to depression, affect libido, cause brain fog and weight gain. Weight gain, for example, may indirectly cause stress, discomfort, and mental health issues in women and people with wombs who have a history of eating disorders and body dysmorphia. If you are more susceptible to these issues, one may opt for a more local acting hormonal contraceptive or a non hormonal contraception such as the various IUDs, rather than the more invasive hormonal treatments, such as the bar or by injection. These more intrusive treatments often enter your bloodstream through your arm or bottom which then have to travel through your entire circulatory system before reaching your womb, which can then lead to more side effects.  

Physical impacts of hormonal birth control often include weight gain, headaches, and enlarged breasts (one could argue that this could be a positive or negative side effect.) On a more serious note, severe and life threatening side effects such as blood clots and strokes can also occur. This being said, I’ve talked to multiple people who didn’t experience any side effects at all. It’s impossible to predict. 

There is a range of non hormonal contraception such as the IUD, female condom, cervical cap, diaphragm and more. But these have their drawbacks too. The IUD may be great 3 weeks of the month, but it can cause periods to be three times heavier and more painful. Whereas, the cervical cap and diaphragm increases your chances of UTIs. In other words there is no way of telling if any contraception, hormonal or not, will affect you with very little side effects or a cascade of them. 

Like many women and people with wombs I had to try many contraceptive methods before finding one that suited me. I began with the pill, which didn’t suit me because it was so difficult for me to take it at the same time every day. This is a purely personal reason. I then went for a contraception that I didn’t need to remember to take; the implanon bar. It didn’t suit me at all; I felt miserable and anxious. I put on a lot of weight and I would bleed at random. Finally, I went for a non hormonal method: the ballerine IUD. The insertion was probably the most painful experience of my life, especially since I’ve never given birth or had a cervical exam before. I have a very high pain tolerance, which led me to underestimate the amount of pain I was going to feel during and after the procedure. It was no laughing matter. My sister came with me and had to help me walk home, and I had to stay in bed for days afterwards. It took a few days for the cramping to settle down, but once it did, and the brain fog that the hormonal contraception had once given me disappeared, I realised that getting the non hormonal coil was the best decision I’ve ever made. 

The free contraception government scheme launched in September 2022, which has been an immensely helpful step in the right direction for allowing women and people with wombs to explore their contraceptive options and switch medications with ease, without the financial burden that comes along with that. For example, the bar cost me 114 euro to buy on prescription, on top of this it cost me 50 euro for the consultation to get the prescription. I stuck with the bar for much longer than I should have purely due to financial reasons: as a student, it was incredibly difficult knowing that the next sum of money I spent on contraception may not have led to a better situation. 

I often wonder why we have the burden of contraception? Why not men? Afterall, they can conceive several children a day and women only can once every nine months. The fact is that male contraception has been in development for decades, but not enough research has been done in this area, and it seems that it’s possible side effects are the main reasons why it is not readily available. The idea of all men having a vasectomy only to reverse it when ready to conceive always toyed on my mind. The reality is that vasectomies are not always reversible, and besides would you really trust a stranger who says that they’re on male contraception? I wonder why the side effects of male contraception inhibits it’s development, but not female contraception. There does need to be a contraceptive option for men, but maybe it would only work in a healthy and stable relationship. If you want to share the burden of contraception, talk to your partner about your options.

I worked in a pharmacy for a year, where the fundamental message I learned was that with every medication you weigh the benefit over the cost. The cost of being on contraception can be disheartening but let’s not forget that the benefit of it is not getting pregnant. Being pregnant may lead to the side effects that hormonal contraception gives us along with other symptoms and a child to take care of on top of that. 

 

I asked a GP what are some myths that commonly crop up during her consultations. She responded to me with the concern of the belief that some contraceptives ceasing your period is dangerous. She said that she would like to reassure us that the womb lining thickens each month in anticipation of ovulation but if your medication suppresses ovulation your womb lining doesn’t thicken: it’s not essential to bleed! Another common myth is that birth control damages your fertility, when in reality, it doesn’t. You should always feel free to express any concerns you may have with your GP, or to seek information from a reliable source. It’s vital that we feel comfortable with what we put in our bodies. 

To those who still haven’t found the contraception that works for you, hang in there. There is nothing wrong with you. Everybody is different. Take your time, allow symptoms to settle before making your mind up. Shop around. There is no predictor on how a certain contraception may affect you, even if you’ve heard reviews from friends and family. Educate those around you. The contraception journey is an emotional rollercoaster, literally. 

Women do not need to act in any certain way. If your contraception is making you miserable, anxious or angry, there is no need to feel guilty about that. Let’s stop apologising for how we feel and just explain why we feel like this. It’s painful and exhausting and I commend each and every one of you who go to school, college and work when your contraception makes you feel like you don’t want to get out of bed all day. Let’s keep this conversation going. We’re all in this together. Be kind to that girl who seems a bit off today and for God’s sake, stop responding to every moody woman “Is it that time of the month?”