Contraception… It’s Not Fair!

Safe Sex with Ffion Nugent.

The subject of contraception is a complex one – it is seen as a taboo subject that is rarely discussed in RSE lessons in schools and colleges. Contraception is often misrepresented through the male gaze in the media. Leading to many young adults becoming misinformed about the reality of contraception and not making informed decisions about their own sexual health. It is time we discuss women’s sexual health in a real, raw, constructive way. Starting with contraception. 

I have shared my own journey navigating the world of contraception. I have also interviewed a friend of mine about their own experiences with the combined pill. There is one overriding theme, a lack of education surrounding contraception. 

For people who identify as female, there are a range of contraceptives to learn about. Starting with the combined or progesterone-only pills, internal condoms (aka femidoms), the implant, the IUD and IUS coils and dental dams. Despite the large market for female contraceptives in the UK, a male pill is yet to be approved by the The Medicines and Healthcare products Regulatory Agency (MHRA), let alone being introduced into RSE lessons in schools and colleges. This brings a hugely unfair onus on people identifying as female to either be on contraception or to provide condoms as barrier protection. Why should it be assumed for women to be on contraception and not for the opposite sex? 

There are many issues surrounding the accessibility, education and the experience of unexpected threatening side effects to female contraception, where the male does not need to be concerned with. Sarah (pseudonym) was happy to discuss her experiences being on rigevidon, also known as the ‘combined pill’. The combined pill is one of the most popular forms of female contraception, which can also be used to control heavy, painful menstruation cycles, not just for birth control. She stated:

“The pill was easily accessible and I was educated on how to take it, but not about the potential side effects, except for the risk of blood clots.” 

The risk of blood clots in both the progesterone only pill and the combined pill is well discussed in the mainstream media. However, there are many other side effects particularly associated with the combined pill that are rarely talked about. Sarah continued: 

“I suffered from mood swings and incredibly bad depression as well as weight gain, which as someone that dealt with an eating disorder pushed my depression further, but these were things I was not made aware of.”

During my time as a student nurse, I have worked with the charity ‘Sexpression’ to deliver RSE lessons to schools in Cardiff. Personally, I think many pupils are relying on external third sector organisations to deliver comprehensive lessons on contraception over the standard school curriculum. Leaving many young adults misinformed about the side effects of oral contraception. Sarah revealed her negative encounters with others whilst being on the pill: 

“When those side effects started to show, I always appeared too moody, or too depressed. If men were better educated on the lesser known side effects, I think this would’ve genuinely improved my experience.”

Several universities across the UK are trialling the male contraceptive pill which aims to reduce sperm production. The pill does have side effects of its own, such as erectile dysfunction. However, a UK government survey (2018) stated that 33% of men would take the contraceptive pill if it was made available. I think introducing a male oral contraceptive is a great idea. I see it as an alternative way to RSE lessons to educate men how it should be a shared responsibility. However, due to a huge reliance on charitable donations and a lack of clinical interest, approving the male pill in the UK is still a long way ahead of us yet. We have a long way to go before a shared onus on contraception between the genders is a reality. 

I am currently on the progesterone only pill and I have fortunately not had any negative side effects and found it easily accessible. However, not all contraceptives are as common as the pill or the external condom. Dental dams are a hugely important source of STI protection for lesbian sex, although more and more retailers are becoming LGBTQIA+ inclusive, finding a dental dam is hugely difficult and costly! 

Overall, there is too much of an onus on people identifying as women to either be on a contraceptive or to supply contraceptives for their partner. As well as feeling anxious about facing the endless list of side effects. More education is needed in schools, colleges, universities and GUM & GP clinics about the side-effects of contraception, particularly for men. The accessibility of contraception varies, but members of the LGBTQIA+ community are still more likely to be disadvantaged.

Image courtesy of Sian Hopkins.

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