Nothing has prompted a greater flurry of frantic calls, texts and emails between my friends than when news broke last year that the birth control pill Yaz (or Yasmin) could be life threatening.
Yasmin had been marketed as a wonder drug. Aside from contraception, it was also claimed to minimise PMT symptoms, reduce acne and facial hair, and even cause weight loss and bigger boobs. And with a list of side effects like that, we were gobbling them down.
None of us were aware of the several known cases in Australia — not to mention the 10,000 cases in the US — where Yasmin was linked to blood clots that caused death, blindness or other disabilities. We all immediately switched brands of oral contraception and forgot about Yaz.
But according to health writer Holly Grigg-Spall we might have been jumping out the frying pan straight in to the fire.
Grigg-Spall says that oral contraceptive pills — regardless of the brand — can cause serious physical and mental health side affects.
"The pill is a powerful endocrine disruptor with a whole body impact. It is one of the only drugs given to healthy people to take over a long period of time," says Grigg-Spall.
"It suppresses the endocrine, metabolic, and immune systems in every woman. It causes vitamin deficiency. It suppresses ovulation which research shows has benefits outside of allowing for pregnancy. Consistent ovulation promotes bone, heart, and breast health long term and protects from a number of diseases that kill women at a high rate."
Grigg-Spall speaks from first-hand experience. In her book Sweetening the Pill or How We Got Hooked on Hormonal Birth Control, Grigg-Spall recounts how taking oral contraceptives left her suffering bouts of anxiety and paranoia, spasms of rage and other extreme mood swings, weekly breakdowns marked by hopeless depression, loss of libido, and chronic fatigue.
Grigg-Spall says she isn’t the only one to experience negative side effects of the pill.
"What little research there is suggests half of women on the pill experience negative changes to their mood. Some research suggests many women experience anhedonia, which is not clinical depression, but the inability to enjoy activities that were previously enjoyed," says Grigg-Spall.
"Essentially, you don't feel miserable, but you don't feel great ever either. It's a detached, "blah" feeling. I think that is quite pervasive and can be very destructive over time."
Grigg-Spall says that discussing hormonal contraception is a minefield because the pill has become synonymous with contraception itself. Questioning the appropriateness of prescribing the pill is seen as an attack on women’s hard-won, and continual battle to maintain, reproducing freedoms.
As she writes in Sweetening the Pill, "Dissenting voices that do suggest the pill may still hold health issues are systematically undermined as fear mongering or as sprung from a spurious anti-female agenda."
But Grigg-Spall is not anti-contraception. Instead she says that the risks of hormonal contraceptives should be better communicated so that women consider different and, in her opinion, safer methods of contraception.
The Australian Medical Association’s spokesperson for Obstetrics & Gynaecology Dr Gino Peccoraro says that some of the side-effects and risks of hormonal contraceptives that Grigg-Spall describes are real for some people, but that’s not to say that the pill should be rejected en masse.
"It has single handedly been one of the greatest advances to women’s health," says Dr Peccoraro.
"We know that going on the pill does increase your risk of blood clots. All pills do that. What you need to do is make sure that your method of contraception is right for you at that particular time in your life," he says.
"Some people talk about feeling depressed or a loss of libido while they are on the pill. In those cases what we would do is change the pill or recommend a different method of contraception," says Dr Peccoraro. "But an unwanted pregnancy can also cause you significant depression and kill your libido."
Dr Peccoraro also points out that for some patients, problems such as depression and low mood can actually be improved by taking the pill. And studies have even shown that the pill can reduce the risk of ovarian cancer and cancer of the lining of the uterus.
"There is no one right solution for anyone", says Dr Peccoraro. "You need an expert to sit down with you and determine the right contraception for you and the right one for you now may not be the right one for you in five or 10 years time as your body changes."
For her part, Grigg-Spall says that there are safer, less invasive approaches than hormonal contraceptives. Personally, she uses the fertility awareness method, condoms and naturally-derived spermicide.
"The fertility awareness method does require teaching and learning and may take a few month’s to grasp, but it's no more difficult than what most women tackle all of the time, such as learning how to use Photoshop, build a website, cook complicated recipes, drive a car, make a spreadsheet, sew a dress from scratch and so on."
Grigg-Spall acknowledges that many of the non-hormonal methods of contraception are not as easy and convenient as popping a pill each day. But if you suffer from negative side effects or are worried about the risks of the pill, then charting your cycle or using a diaphragm or a condom may not seem like such a big deal by comparison.
Kasey Edwards is the best-selling author of 4 books 30-Something and Over It, 30-Something and The Clock is Ticking, OMG! That's Not My Husband, and OMG! That's Not My Child. www.kaseyedwards.com