Sex, Drugs and Ethics: My Experience with Hormonal Contraception
“Just relax. Spread your legs further.”
Above me, fluorescent lights flickered, an epileptic nightmare. I felt sick. The smell of disinfectant clouded my thoughts and I could feel a lump forming in the back of my throat. I was lying on my back. Tears made tracks sideways across my temples as I bled into the thin paper lining that covered the examination table.
I felt the speculum twist inside me and the gynaecologist swam in my vision. I shut my eyes and let the darkness hold me.
There are three main types of hormonal contraception widely available to Australian women. These are the combined pill, hormonal implant (Implanon) and inter-uterine device. Each of these utilise synthetic hormones to stop the ovulation cycle of a woman and prevent unwanted pregnancies.
Reactions to hormonal birth control are unique to each of the women who use them. Many will find that these methods of control suit them perfectly. Others, however, won’t be as fortunate.
The pill came first. Like many young Australians, I began taking the pill before I was sexually active. The combination of oestrogen and progesterone hormones is known to help relieve acne symptoms. I suffered an adverse reaction to the oestrogen levels, which gave me migraines and made me vomit. Every day. The acne didn’t give a shit either – like a bad smell, it stuck around.
When a friend experienced similar side effects on the Pill, her doctor later told her that he wouldn’t ever consider another form of hormonal birth control for her again. My doctor wasn’t so thoughtful.
I had an implanon next, more commonly known as the bar. An Implanon contains only the progesterone hormone at a higher dosage rate than the pill, and is usually used as an alternative for migraine sufferers. The bar is a sneaky arsehole though: blink, and your scales might just break. Then you’re depressed and you’re not sure if it’s the progesterone or the extra 14 kilos you’re packing. Then you lose your sex drive. Then you’re just a fat piece of shit.
Or maybe you were a fat piece of shit all along. Who even knows? There comes a point when you lose all sense of reality and your sanity caves to the hormones.
Research suggests that the synthetic oestrogen and progesterone present in hormonal birth control potentially interacts with mood-related neurotransmitters and affects metabolism.
So why are these types of birth control still so popular within our modern society?
Not overlooking their effectiveness and convenience (of course).
The corruption of major pharmaceutical companies is often viewed as being part of a conspiracy theory. And after a little digging, you might find yourself inclined to agree. The ABC carried out an investigation recently which showed that pharmaceutical companies are using marketing campaigns that pay ‘key opinion leaders’ to promote products, long-acting reversible contraceptives (Implanon and Mirena Inter-uterine device) in particular.
These campaigns have both negative and positive outcomes. Pharmaceutical companies offer sponsored educational events and the opportunity for up-to-date knowledge on products, but this comes at the price of a conflict of interest. And bias. The ethics of how drugs are prescribed is an important discussion.
An inter-uterine device was the next stop in my hellish adventure with birth control. An IUD is a tiny plastic device that is placed inside a woman’s uterus. It is safe to use for up to 10 years and is said to be one of the most effective contraceptives. I had the choice of either the Mirena (hormonal) or Copper (nonhormonal) IUD. My doctor recommended the Mirena, suggesting that the side effects I’d been suffering with Implanon would be reduced as the synthetic progesterone would be contained within my uterus.
Not the case. The effects I was suffering from the Implanon increased tenfold.
I completely lost myself in those next six weeks. It was as though I was sucked into a black hole with no return. The depressive thoughts became literal depression. The extra 14 kilos became 20. Sex became torture. I broke up with the boyfriend I had lived with and loved for two years. I said goodbye to any remaining sanity.
Why had no one said anything to me prior to this point?
Not one doctor. Not one person. And I’d given them every opportunity. None of the doctors whom I’d shared my story with in the last four years were deserving of my trust. Each one had looked in my eyes and persuaded me to continue ingesting the plethora of hormones that were so clearly driving me crazy. None suggested the non-hormonal options.
It was at this point that I begged the gynaecologist to remove the IUD and ultimately ended up on my back. After scrubbing what looked like a mascara wand up and down the inside of my cervix for 10 minutes (for those who don’t know what having your cervix touched is like, it’s number one on my personal top three ‘most painful experiences’ list) he finally looked at me and said:
“I can’t catch the string. You’ll have to have surgery to remove it.”
There was a buzzing in my head and blood, wet between my thighs. His statement brought with it the shit-show emotions of a bad acid trip. My life was falling apart, and I was busy tripping balls on fucking progesterone.
My trust lay in pieces on the floor, beside my pants and my mental health. Prescription drugs are powerful. And for me, they’ve proved to be just as harmful as their illegal counterparts. It’s hard to say if the cost of corruption is worth the funding it’s exchanged for. After all, a medical practice is a business. Ethically however, shouldn’t a doctor be doing more than just selling pharmaceutical products?
Cover by Simone Van Der Koelen