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The New Age of Contraceptives

A recent Danish study brought to light concerns many women have had for a long time regarding the effects of hormonal birth control on mental health, but probably the most surprising issue it revealed was how infrequently large scale research on women’s health topics is performed. Women are gravitating more and more to newer methods of birth control that are amazing in the fact that they are reliable and low maintenance, but while development of better methods has been extremely successful, to find such serious potential side effects after over fifty years of widespread hormonal use raises some concerns.

 “Have you considered an IUD?” my nurse practitioner gynecologist asked me at my annual checkup, two months before I was destined to leave for college. After being on the mini-pill for almost two years, she had been curious about how competent I was at taking it. And I was good at taking it, you had to be. The mini-pill is a progesterone only birth control pill that becomes immensely less effective if you don’t take it at the exact same time every single day. After immediately responding that I took it every single day, I thought for a moment and answered “Well, except for one day.” My high school graduation was so busy I had completely forgotten to take it until seven o’clock that evening, exactly twelve hours after I was supposed to have taken my pill. Luckily that wasn’t a problem, my birth control was mostly to cope with debilitating periods so missing a pill for the first time in two years wasn’t going to drastically change my life. But what if it could have?

 

Alternatives to the pill have become increasingly popular and with good reason. Women are excited about options that don’t require them having to remember to take them every day. One affiliate of Her Campus described her experience having an IUD as, “IUDs are amazing. I never ever ever worry about messing up my birth control because of it (i.e. missing a pill or not applying something correctly etc.). And I don't have to pay ANYTHING monthly; it was free with my insurance. You'll pay a copay with the doctor's office visits to take it in and out, but most insurances cover the cost. I have had mine for four years with absolutely no issue--AND I haven't had my period in four years because of it either (it lightens most women's periods, but mine was super light anyway so now I get nothing). It basically turned me into a worry free magical mermaid with no period. I have convinced two of my best friends to get them as well and they have had also good experiences.” If being turned into a “worry free magical mermaid” doesn’t excite you I honestly don’t know what will.

 

A different girl described her experience with the patch as, “I wear the patch and I love it! You just apply it once a week so I don't have to worry about it until Sundays and then I just switch it. It stays on even when I shower and if the corner starts to peel you just press it and it resticks. It's made my period so much lighter and shorter and I have no cramps anymore (I used to have pretty bad cramps). Also it's free! Would most definitely recommend.” While birth control options like the patch might not be free for everyone, it is an important question to ask your gynecologist because many insurances do cover them. And even if they aren’t covered, another girl revealed it’s worth the investment; “To be honest my birth control keeps me sane. I have nexplanon which is not an IUD but is implanted in your arm and releases a constant flow of hormone for 3 years. I adore it because I don't really get periods ever, which is good because my PMS used to be REALLY bad. I don't get so randomly emotional and it helps level me out in general. It was 300$ but it’s worth it over my constantly-changing-brands-and-prices oral medication dictated by my insurance company.”

 

Some options might be very convenient but do have notable side effects as discussed by a different woman, “I was on the depo shot for a few years because I can't have estrogen. I had awful breakthrough spotting for 4 months, but after that, I've had no periods and it's more or less worry free! Every 3 months, you go for a shot and it's all set. I liked it a lot, but I recently switched to a pill because I was concerned about some of the side effects like bone density loss. I would totally recommend it.” The side effect of bone density loss while using the depo shot has been well documented and is a warning associated with the medicine, but for many the benefits outweigh the risks. What gets tricky is when all of the potential side effects of a medicine are not known.

 

I did end up deciding to get the IUD, a small one called Skyla that will last me three years. Overall I didn’t realize a change in my mood, but I also had been on the pill for two years before switching to an IUD. I also was transitioning into college and it’s pretty hard to differentiate between stress caused by that and potential hormonal side effects. I love my IUD, it’s a worry-free birth control that I rarely actually think about. It’s just chilling in the background, making my life much easier. But after hearing the report of just how correlated hormonal birth control and depression are among women it makes me wonder if I would feel differently if I hadn’t been on some sort of birth control for the past three years.

A study from Denmark got a lot of attention this past week after raising serious questions regarding the correlation between hormonal birth control use and diagnosis of depression. The study looked at every woman in Denmark, making a study cohort of over one million women. Across the board the researchers found that every form of hormonal birth control was correlated to some degree with higher rates of depressant medication use and diagnosis. The findings were especially significant with the youngest age group included in the study, adolescents aged 15-19. But probably the most troubling aspect of the findings is that many women aren’t even surprised. If you sit down with a group of women, all of which are on some form of hormonal birth control, and ask them if they think their medication affected their mood it would not be unlikely to find someone who has had problems. One associate reported her experience with the pill as, “While I had few long lasting physical symptoms of the pill, I found myself feeling depressed and crying often for no apparent reason- these emotional side effects went away immediately after stopping. I have tried 3 different varieties and would be hesitant to try a 4th.” Another associate reported her experience as, “I had been taking birth control (the pill) every day for 2 years. I just recently stopped taking them about a month ago and I feel like a different person. On birth control, my sex drive was very low, I had a hard time remembering to take them every day and I definitely had mood swings. Now, I've noticed my sex drive increase tenfold and my mood has chilled a lot. I personally am looking for something other than the pill now.” To hear personal accounts of women who have known about these side effects but to have not had scientific proof until now to support it makes you wonder, what has taken so long? The first hormonal birth control, Envoid, an oral contraceptive, was approved by the FDA in 1960. Therefore, for the past 56 years women have been ingesting, inserting, or getting shot by hormones, and only now is there evidence that something isn’t quite right? Quite frankly I believe women deserve better.

 

Photo Credit: 1

 

Sources: https://www.ncbi.nlm.nih.gov/pubmed/27680324

http://time.com/3692001/birth-control-history-djerassi/

http://www.cdc.gov/nchs/data/nhsr/nhsr062.pdf#x2013;2010 [PDF - 251 KB]</a>

http://www.cnn.com/2016/10/05/health/birth-control-depression-risk/

Nursing major
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