• Idle Chit Chat

The Immaculate Contraception

I have been shocked over the years about how many friends ask me: “what contraception should I use?” This shouldn’t really come as a surprise considering Sex-Ed at my school consisted of struggling to put a condom on a banana amidst a chorus of stifled giggles. I don’t mean to terrify you, but in the UK, if a couple uses condoms for 1 year, then on average the chance of pregnancy is 18%. I know right? They didn’t tell you that whilst you were slithering around with that fruity Durex.

So, this is a quick run-through of some of the popular options, the big hitters, the more failsafe methods. All of the following options are hormonal apart from the copper coil. The two hormones are oestrogen and progesterone.

NB: The statistics on accidental pregnancy are averages in the UK and include the many people taking the contraception incorrectly.

As a disclaimer: this information is part anecdotal, part autobiographical, and a bit scientific. There are plenty more side effects and contraindications in the small print which I have not included. Please use https://www.nhs.uk/conditions/contraception/ for further info.

FUN FACT: Traditionally, women took a 7-day break in between combined pill packets every month. There is little scientific evidence to suggest this is necessary. A gynaecologist (vagina doc) proposed the break because he thought it would be more acceptable to the Catholic church back in the day, as women could hide the fact they were on contraception by having regular periods.

(From Emma Barnett’s book Period)

I have left out the condom and the obscure femidom—if anyone has used please let me know your reviews - I am fascinated. Interestingly, the accidental pregnancy rate per year = 9% for femidoms, halving the condom’s feeble stats, but I think that this might be because users have their shit together. These ‘barrier’ methods are of course the only protection against infections (not ‘the pull-out method’ as assumed by a school friend.) It is estimated that 1 in 20 sexually active women under 24 have chlamydia in the UK—in the words of Lil Wayne, trust nobody.

I have also left out the patch, the vaginal ring, the injection (unsafe long term for your bones), and sterilisation, mainly due to lack of knowledge and experience. The Rhythm method (one that I was taught at my Catholic primary school) uses natural ovulation cycles to time when it is safe to have sex. Users are often called parents. There are now lots of apps which you can use which measure your temperature to check where you are in your cycle. I’m sure the science is there but I have my doubts.

For the past year I have asked many men (aged 20–30):

“If you were a woman, what contraception would you use?”

The most common answer: “Ermm one with no hormones?”

Me: “Oh so condoms then?”

Them: “Errr nooooooo!!!!!! The one that goes inside you, with no hormones, obviously!!!”

I’d love to take these men down to a coil clinic.

Ladies, the issue doesn’t end if we do decide to have children (I stress, IF not WHEN.) I vividly remember sitting in a family planning clinic in hospital with a couple in their late 30s. They explained that they had three children and wanted to discuss sterilisation. They didn’t want any more kids and she didn’t want to be on birth control for another 10 years. At this point the doctor turned to the man and said: “Male sterilisation [vasectomy] is actually a much simpler and safer procedure than female [hysterectomy], and since your wife has been on various forms of contraception her whole life—maybe it’s your turn.” The man reacted as if she had asked him to cut off his own genitals and feed them to a pack of seagulls.

My overall advice would be TRY them: try them all if you need to, for 3—6 months at least, unless you can’t tolerate them at all. What works for you might not work for your twin sister. In particular, mood changes and weight gain can vary between people, with few studies supporting their direct correlation, but anecdotal evidence suggesting otherwise. Don’t be embarrassed to go back to the doctor and ask to change what you’re on because it’s just not working FOR YOU (I realise that this isn’t feasible right now as I write this during a lockdown… I am sure there will be a baby boom in January 2021.)

Finally, don’t be bullied by statistics, anecdotes, or men. You know what makes you feel shit, drives you to eat more cake, or causes your skin to erupt like the pacific ring of fire. Remember: it is not your body that has failed; it is actually Medicine’s fault for not giving us better options. Believe me, if men had to use these things there would be BILLIONS more money spent on finding the immaculate contraception… but that’s another story.

- Dr. Cheden