Hearing the phrase ‘birth control,’ most people picture the pill—a cute pastel tablet that magically wards off babies besides other fun tricks like fighting acne.
“I think we’ve moved to a place where people think birth control pills aren’t even drugs, they’re kind of like vitamins,” said Christine Hitchcock, Ph.D. research associate at the Centre for Menstrual Cycle and Ovulation Research (CeMCOR) at the University of British Columbia.
Hitchcock and others are concerned about the harmful effects of some types of hormonal contraceptives.
The synthetic estradiol and progestin added to the body by hormonal birth control increase women’s risk for blood clots and affects their bone density, Hitchcock said—and there could be other unforeseen consequences.
Hitchcock is particularly concerned with the effects of new versions of the pill, such as Lybrel, which is taken continuously and eliminates monthly periods altogether. She feels there has not been enough research done on these methods.
“The hormones of the menstrual cycle act throughout the body, and interfering with the cycle may have effects we don’t understand,” she said.
But women may not be aware of viable non-hormonal alternatives, like spermicidal foams and gels combined with barrier methods such as diaphragms and condoms.
These methods are very effective at preventing pregnancy and sexually transmitted diseases, said Hitchcock.
Friederike Von Aweyden, a nurse practitioner at Klinic Community Health Centre, said non-hormonal options are discussed less because clients often come in asking specifically for the pill.
“My biggest agenda is helping people prevent pregnancy if they don’t want to get pregnant.”
Von Aweyden does not feel that hormonal contraceptives pose serious health risks, even with long-term use. In fact, they have been shown to prevent endometrial, ovarian and colorectal cancers, she said.
But most women wanting birth control, especially for the first time, automatically prefer the pill because of its prominence in popular culture, said K. Thomas, a volunteer birth control and unplanned pregnancy counsellor at the Women’s Health Clinic.
“It’s more prevalent in the media,” Thomas said, while less popular and less lucrative options are ignored.
“It gives the perception that there aren’t as many options [as] there are.”
Laura Wershler, executive director of Sexual Health Access Alberta, feels that those prescribing contraceptives may be adding to this illusion.
“They (birth control methods) are presented in a hierarchical fashion,” with hormonal contraceptives at the top, Wershler said.
Health risks aren’t the only problems some have with hormonal contraceptives.
“Not everyone likes how they feel (emotionally) when they go on the pill,” Hitchcock said.
When on the NuvaRing, a method of hormonal birth control, Thomas experienced several side effects, including altered moods.
“I had sore body, headaches and emotions all over the place,” she said.
But isolating the variety of factors affecting women’s moods can be difficult. Teenagers may find it especially hard to differentiate between normal emotional fluctuations and hormonal contraceptive effects, Hitchcock said.
And Wershler is concerned that doctors and other health practitioners may ignore patients’ concerns regarding hormonal contraceptives.
“There’s a tendency to dismiss women’s real experience,” she said.
Thomas encountered this dismissal when she approached her doctor with birth control related health concerns.
She also could not get any information on the fertility awareness method, which involves charting menstrual cycles so women know to rely on backup protection at their most fertile times.
“They didn’t know how to handle the situation,” she said. “I was more informed than the doctor was.”
Wershler advocates for what she calls a “body literacy positive approach” to sexual health, in which women take initiative to get to know how their bodies work and make birth control decisions based on that knowledge.
“What I’d like to turn the spotlight on is healthy ovulatory menstruation,” she said.
Thomas feels that those writing birth control prescriptions need to be more knowledgeable on the alternatives because it may directly affect the choices women make.
“When I went to get the pill, if the doctor had said ‘do you know about x y and z methods?’ maybe I wouldn’t have made that choice.”
Published in Volume 63, Number 21 of The Uniter (February 26, 2009)