Pain, Pills and Coils: My Contraception Quest

By Muriel Gévaudan

One year ago, I fell in love with the greatest guy on the planet. But with him came one of the most stubborn medical struggles I’ve dealt with to date: contraception.

I’m going to preface this with a few things. Firstly, I am in the privileged position to live in a country where all types of birth control are given out free of charge and where medical procedures are, for the most part, safe and reliable. I’m young, I’m healthy and I have a strong support system for whenever I’m not feeling quite right.

I’m also conscious that hormonal birth control constituted a huge part of female empowerment by enabling people who can give birth to family plan autonomously, especially with the first wave of a publicly available birth control pill in the 1960s. This revolutionary drug permitted heterosexual couples to stop viewing sex primarily as producing offspring but rather as a shared pleasure that can bring us closer together and strengthen bonds with our partners.

So far, so progressive! I applaud the inventors of hormonal birth control. But I also curse them. When my partner and I looked at birth control other than condoms (which are not a long-term option for us for various reasons), it became evident quite quickly that, while the number of products on the market is high, factually our choices were very limited.

We ruled out a vasectomy first – while they are in many cases reversible, the NHS estimates the reversal success rate to be at 75% if the procedure is done within the first three years. The rate drops down to as low as 55% within the following five years. If you plan to have children in the future, a vasectomy is not a viable option for birth control. And that leaves the number of options for men at – you guessed it – zero.

My first experience with birth control was the pill when I was a teenager, and I only realised how much better I felt when I got off it years later, so this time I wanted to try a non-hormonal method. I wasn’t comfortable with the temperature method, mainly because this factors in being diligent about measuring, which I don’t really trust myself with, but also because this method comes down to the use of condoms again. The only option that remained was copper – in my case, a copper coil.

The insertion left me sore and had me bedridden for two days, but that wasn’t my issue. It is widely known that copper can make your periods really long and painful; that was the case for me (I don’t mean to fearmonger, I know people who are very happy with a copper device). Instead of my usual 4-day period, I was bleeding and in unbearable pain for around 7-9 days per cycle. I lasted less than four months and decided to then go with a hormonal coil instead, the one with the lowest hormonal dosage.

With this, my period should have grown weaker or gone away completely. Great! Turns out, it was false hope. I started having even longer periods, albeit lighter, but lasting for 10-13 days nonetheless. Additionally, a whole bunch of possible side effects kicked in, including headaches, mood swings, fatigue and weight gain. These normally go away within the first six months, and they did. All of them but one: after seven months, I still have these really long periods. My gynaecologist recently prescribed me a gestagen pill to take for a month to counteract this symptom. I’m still taking it at this point; it’s not showing much promise.

My case is one of many. Only after I started having these issues did I find out that up to 10% of users suffer from longer and more painful periods, depression, weight gain, bloating, mood swings… The list goes on. My problem is not that I’ve had issues with a couple of methods, but rather that I am running out of options altogether.

The types of contraception I have tried are clearly not suitable for my body. But what do I do now? Do I try another method, like a different pill or a hormonal implant, and just literally hope for the best? All of these are significant invasions of our bodies, and only because they work – meaning they keep us from getting pregnant – do we seem to have given up looking for alternatives.

It’s not easy for my boyfriend to watch me in pain, either. But he can’t help it, can he? If you exclude rubber, there is really nothing left for him to use.

Research on male contraceptive pills has been called off for good reasons – side effects such as acne, headaches, mood swings, and depressive episodes. Multiple studies in which female contraceptives were tested have been called off in the past as well. The difference: there have been significantly more studies for female contraceptives, and, at the end of the day, functioning products have been put on the market (products that have had users battling with these exact side effects for decades).

Mechanic methods such as RISUG®, which stands for ‘reversible inhibition of sperm under guidance’, a minimally invasive procedure invented in India, have been proven to show promise. They might be an inexpensive, long-lasting, reliable and reversible way of stopping semen from leaving the penis and fertilising an egg, with no known side effects. ‘Might’, I say, because even decades after RISUG® was first designed, there hasn’t been enough research yet to make it into a publicly available product. Pharmaceutical companies are reluctant to invest in an affordable product like this due to the possibility of missing out on money from the female contraceptive market.

Putting the main pressure of birth control on people with uteruses directly contradicts the pursuit of equality. These people should be able to have easy access to these methods if they work for them. But they shouldn’t have to suffer through a method that is clearly wrong for them, just for a lack of options that is created by our own negligence.

Just because contraception is ‘good enough’ doesn’t mean we can roll down our sleeves and stop working on it. And just because it’s an intimate matter doesn’t mean we shouldn’t have an open conversation about it. Giving issues such as this a platform can affect real change. With that change, I hope my future children and grandchildren will have more options to choose from than I do in 2022.