The Pill
March 21, 2018
The University of Copenhagen in Denmark recently conducted a study on one million women over a thirteen-year period. The woman who took part were aged between 15-34, and also screened for pre-existing mental health conditions; the results were scary -
"...They actually have an 80% increased chance of developing depression when they get hormone contraception."
I'll give you a little back ground into the oral contraceptive pill (OCP) and how it works:
There are four mechanisms in which OCP works - monophasic, biphasic, triphasic & minipill.
1. Monophasic:
Combination of oestrogen and progesterone, oestrogen decreases the release of follicle stimulating hormones (FSH) and progesterone alters secretory activity of the uterine cervix and Luteinizing Hormone (LH). Basically, both of these combined results in the thickening of mucus and therefore impairs sperm transport, decreases endometrial production and as well as the decrease of ovulation and reduces the chance of implantation.
2. Biphasic:
Not used very commonly and is the constant use of the oestrogen component, but provide low progesterone in day 7-10 of cycle and higher levels day 11-14.
3.Triphasic
Is the closest to natural cycle, as the oestrogen component levels are consistently low, while the progesterone component progressively increases three times; this prevents the FSH levels increasing, therefore preventing ovulation.
4. Mini pill:
Progesterone only component and avoids oestrogenic side effects, but is less effective as a contraceptive and timing is of the essence – needs to be taken at exactly the same time each day. Mini pill essentially prevents fertilisation and implantation, not ovulation.
My journey with OCP:
When I was nineteen or so, I thought taking the pill was what you did; all my friends were taking it - almost a right of passage. My period at that time was like clock work, same time every month, I had little to no PMS symptoms, I wasn't sexually active. I spoke to my Mum; we discussed it and she encouraged me to make my own decisions after speaking to the GP (not to mention I went to a Catholic high school, so contraception wasn’t apart of the curriculum). So off I went to the Dr. there wasn't really much discussion, I said I was thinking about it, he wrote the prescription, no questions asked, I left and got the script filled.
Fast forward 3 or so years, repetitive "skipping my period" at my convenience (for those who don't know what this is, when you don't take the 7 days of sugar pills when your period is due, you will not get a period for that month) and I decided that I no longer wanted to be on the pill. So I stopped. So did my period. For around 2.5 years! I may have gotten the odd bleed and I would get so excited! I was mortified, at what taking the pill for what I considered a short time, had done to my body. Another 2 years of sporadic periods, but more regular than prior, I decided to go back to the GP as I was getting concerned about my long term fertility. Suggestion? Take the pill for a month and that "will get it going". Ummmmm *Insert blank stare waiting for him to say jokes, jokes and laugh* . That's what caused this problem, that doesn't make sense to me. So I continued to ride it out and hope my body would adjust to doing the work again soon.
I started seeing a naturopath, who discussed absolutely everything about my reproductive health and I began to track my period, symptoms, regularity, cravings, mood; anything you can think of. Thankfully, 8 years after I started taking the pill, I have a regular period and I can identify my ovulation symptoms - how it was supposed to be.
My reason for this blog however, isn't so I can talk about myself (though I know you were all loving it), it's the thoughts that were provoked when I read the results of the study I mentioned at the beginning. Now don't get me wrong, I'm not saying that Drs. should stop prescribing the OCP, every woman has the right to choose whether or not they take the OCP, but I do think that a very serious conversation needs to take place between practitioner and patient.
Some girls and woman (unfortunately) suffer terrible menstruation, dysmenorrhoea and menorrhagia and feel that the pill has improved their quality of life, as their period was so debilitating for it's duration. But, shouldn't a woman considering taking the pill, have the right to be informed about her options as other contraceptive methods may be better suited to them, the types of OCP, the side effects, and have an open dialogue instead of sliding a prescription across the table. In light of recent research, organising follow up phone calls to see how the treatment is going.
I feel so in touch with my body now, more so than ever before. I feel connected to my body as a whole. But isn't that what we've lost? the ability to identify what's going on 'down there', the knowledge that (for example) clear discharge and an increase in internal body temp around 11-14 days is a healthy sign of ovulation. Knowing that the colour, consistency and amount of "blood" shed during menstruation is important.
I think there is a healthy conversation that needs to take place between Drs., girlfriends, sisters - other woman, to empower each other; there is nothing to be embarrassed about, it is a beautiful, natural thing.
I highly recommend you download an app on your phone and start imputing in the data from month to month and you may start to see trends, and get connected again.
Family Planning NSW offers great resources and information regarding contraception, and womens health : https://www.fpnsw.org.au/
If you are taking the OCP and have been feeling depressed, contact Lifeline on 13 11 14 or speak to your Doctor
In (reproductive) health,
Katie-Coo.