‘STOP USING CONTRACEPTIVES THAT DON’T WORK FOR YOU’
The mini pill has been made available over-the-counter from pharmacies for the first time– amid headlines about side effects and overlooked pain linked with other forms of birth control. Dr C weighs in
We’ve been working on making the progesteroneonly, or mini pill, available without prescription for years. It’s crazy it’s taken this long. We’ve been prescribing it for decades, so we have all the data to prove it’s safe. However, the whole topic of contraception can feel like a bit of a minefield, so read on for some useful advice.
PICK THE RIGHT ONE
Women are given the progesterone-only pill when they’re over 35, if they smoke, if they have migraines or if they’re obese. This is to reduce risks of blood clotting or strokes. That’s not to say the combined pill is bad – it’s extremely safe – but the mini pill is even safer. We’re all different, and some women just don’t get on with the combined pill or can’t take medication with oestrogen. There’s a lot of variation, and no two women are the same. A pill can make one person feel awful while another will feel fine. I wish we could predict it, as I see women struggling with side effects like weight gain, mood wings and bad skin. Do your research and, if you get side effects, change the pill and don’t just stick with it.
AVOID A CHARGE
Be aware that if you get the mini pill from the pharmacy, you have to pay £7.50 a month, whereas if you see your GP, it’s free. For me, that doesn’t make sense, as you don’t need to have your blood pressure checked, unlike with the combined contraceptive pill. Ask the surgery to fax a prescription to the pharmacy to get it for free, as you should – but you’ll still need a consultation with the pharmacist.
GIVE IT TIME
If you’re put on a pill and are struggling, give it three cycles, as side effects often settle down. If things haven’t improved, go back to your GP, because there are lots of other contraceptive pills to try. There are also lots of useful online resources giving information on the different pills, what the most common side effects are, and what to expect. Think about what might be better for you.
RESEARCH DIFFERENT OPTIONS
Pills aside, there are lots of other contraceptive options. You don’t have to take hormones at all. Speaking as a man, I think it’s incredible that women remember to take a pill at the same time every day, take a break, then start again. Longerterm methods like the coil last five years, so are useful if you do forget. It is a small, T-shaped plastic and copper device that releases progesterone, put into your womb by a doctor or nurse. Women sometimes avoid them if they’re planning on having a baby in the not-too-distant future. Most contraception – apart from injections (which last between eight and 13 weeks and are over 99 per cent effective, but can take up to a year for fertility to return to normal) and the implant (a small plastic rod placed under the skin in your upper arm by a doctor or nurse, which releases progesterone and lasts for three years) – is instantly reversible. The coil is also quickly and easily removed, and is usually less painful than putting it in.
DISCUSS YOUR FEARS
There have been recent headlines about the coil – also known as the intrauterine
contraceptive device (IUD) – after BBC presenter Naga Munchetty, 46, discussed how painful it was for her to have hers fitted. For many women, the coil is fine and they don’t experience a lot of pain, but some women do find it very unpleasant.
Doctors can apply local anaesthetic gel or spray and we always advise women to take anti-inflammatories like ibuprofen or aspirin beforehand; these do help but often aren’t enough. If you’re uncomfortable or anxious, say you want to stop. Doctors might seem intimidating and you don’t want to feel like you’re wasting their time, but your health and wellbeing are more important.
GET OTHER OPINIONS
I think the coil is a good, safe form of contraception, so it is a real shame if the recent negative press coverage has vilified it.
For alternatives, look at trusted sources like nhs.uk and also ask close, honest friends and family about their own experiences. Of course, condoms are extraordinarily effective and the only birth control that protects against STIs, but we have to acknowledge they can feel slightly unromantic. Doctors can be very stubborn and tell patients that they are the best option, but the glaring reality is that most people don’t like using them. We doctors have to be better at that, and help patients find the right contraceptive method for them.